Pilgrim State
Origins
Structure and Treatments
Decline
Opened in 1941, Pilgrim Psychiatric Center was the largest hospital in the world – no facility of any kind has ever exceeded its size. The sprawling complex in Brentwood, NY had its own police force, fire service, courts, post office and cemetery and accommodated over 15,000 patients and staff at its peak, giving rise to its nickname – Pilgrim State.
From the beginning of the last century, the growing need for psychiatric care placed an increasing burden on the state of New York. By the 1920s, the state had six mental hospitals operating at more than capacity, with demand for residential treatment continuing to grow.
Searching for a long-term solution to the problem, the state decided to put the mentally ill to agricultural work in a relaxing setting on what was then rural Long Island. The new state hospitals were dubbed ‘Farm Colonies’ because of their residential treatment programs, agricultural focus and patient facilities. However, the first two farm colonies, the Kings Park State Hospital (later known as the Kings Park Psychiatric Center) and the Central Islip State Hospital (later known as the Central Islip Psychiatric Center), quickly became just as overcrowded as the institutions they were supposed to replace.
The response from the state was to commission a third Farm Colony, named in honour of the former New York State Commissioner of Mental Health, Dr. Charles W. Pilgrim. The new hospital would house 12,500 patients on 1,900 acres of land the state purchased in Brentwood. Construction began in 1930, and would last eleven years.
The hospital opened on October 1, 1941 as a close knit community with its own police and fire departments, courts, post office, power plant, potter's field, swinery, cemetery, water tower and housing for doctors, psychiatrists, and asylum administrators. A series of underground tunnels were used for routing steam pipes and other vital utilities.
Within months of the opening of Pilgrim State, plans were already underway to increase the size of the hospital. The Federal Works Progress Administration quickly began construction on three vast new ward buildings – buildings 81, 82 and 83 – that would increase the capacity of the centre to over 15,000 patients. The state also built the Edgewood State Hospital, a short-lived independent facility that operated under the Pilgrim State umbrella. The land required to accommodate this increase meant that the complex was now so large that it reached into four townships of Suffolk County – Huntington, Babylon, Smithtown and Islip – and had two major state roads passing through its grounds.
During World War II, the War Department took over control of the entire Edgewood facility along with Pilgrim buildings 81, 82, and 83. Numerous temporary structures were erected and Edgewood and buildings 81-83 were operated as Mason General Hospital, a psychiatric centre devoted to treating battle-traumatized soldiers. Filmmaker John Huston, who received a special commission to the U.S. Army Signal Corps during World War II, made a documentary at Mason called ‘Let There Be Light’ that showed the effects of war on mental health. The film sparked a firestorm of controversy and was not seen by the public until 1981.
The original Pilgrim State layout featured four large treatment groups, each containing five or six separate buildings – two groups for men and two for women. The additions of the late 1940s included a large medical building for the diagnosis of acute disease, that also housed laboratories, consultation rooms, a nursery, morgue and autopsy room. Two large reception buildings were constructed that housed patients during the first months of their residence, along with a hospital unit for the chronically ill and employee housing blocks.
After the war, as Pilgrim State experienced the surge in patient numbers that made it the world's largest hospital, the traditional ‘rest and relaxation’ philosophy gave way to more aggressive treatments. 1946 saw the introduction of Insulin shock therapy, quickly followed by Metrazol shock therapy and, from 1950 onwards, Electric shock therapy for the treatment of schizophrenia and mood disorders.
Prefrontal lobotomies, whereby the prefrontal cortex of the brain is either disabled or removed, also began to be performed at Pilgrim from 1946, as a means of treating schizophrenia, depression, and most forms of anxiety disorder. By 1956, when the antipsychotic drug Thorazine emerged as an effective treatment of the same disorders and lobotomies fell out of favour, more than 1,000 had been performed at Pilgrim State.
As medicine and community care started to emerge as viable alternatives, large mental institutions began to decline.
Edgewood, the last Long Island asylum, closed its doors in December 1971 following decentralization. Kings Park and Central Islip continued operation, but were downsized significantly. Pilgrim State was not exempt from this downsizing, and parts of the complex began to close throughout the 1970s and into the 1980s.
Buildings 81-83 were briefly used as a correctional facility in the 1980s, but after much community protest they reverted back to psychiatric use. In the early 1990s, with declining patient populations in the three remaining hospitals, the New York State Office of Mental Health (formerly the Department of Mental Hygiene) began making plans to re-organize the Long Island hospitals.
The plans were implemented in the fall of 1996, when Kings Park and Central Islip were formally closed, and the remaining patients from both those facilities were transferred to Pilgrim State. The Central Islip site partly became a campus for the New York Institute of Technology, but was also used for residential and commercial development or left abandoned. At Kings Park, three buildings housing community residences administered by Pilgrim State remain open. Large sections of the grounds have become a state park, while the rest sits in abandonment.
Today, Pilgrim State is the last of the state asylums still operating on Long Island. However, it bares little resemblance to the sprawling community of 20,000 patients and staff it once was. The farming section of the hospital was sold off, renovated, and became the Western Campus of the Suffolk Community College in 1974. In recent years, a large part of the Pilgrim State complex was sold to a developer, and numerous abandoned structures on those lands were demolished in recent years. No new construction has begun.
Other abandoned structures, like the former administration building, medical and surgical building, doctor's residences and utilities section remain standing for the time being. Only about a third of the original Pilgrim State site is still in operation, and its future is uncertain.
Pilgrim State also hosts a museum on site, which displays items from Kings Park, Central Islip, Pilgrim State, and Edgewood such as pictures, old newsletters, relics from abandoned or demolished buildings, and other historical information that hint back to a largely forgotten era.