This institution has a long and somewhat confusing history, starting way back to its founding in 1797. The original hospital held many roles during its infancy, including caring for the insane, paupers, sick and disabled seamen, as well as providing general health care. It was privately owned until the state took control of the institution in 1834, where the main building was found in disrepair and subsequently rebuilt. The hospital began only treating the insane around this time, however by 1839 overcrowding was an issue. Partly influenced by mental health reformer Dorthea Dix, the hospital was relocated out of the city and onto a rural tract of land in 1852 to accommodate larger buildings and a farm - and where it still operates to this day.
Construction began on a large Italianate-style main building in 1853 following the Kirkbride plan, suited to hold 250 patients. Problems began even before the building was completed though - funds to build the new asylum ran dry, and the onset of the Civil War halted construction for a few years. It finally opened in 1872, but without sufficient equipment, furniture, staffing and funds for standard operating costs. With money borrowed from private lenders and some reorganization, the hospital started to pull itself together. Mechanical restraints were discontinued in 1878, and the institution expanded to include more farm buildings, laundry, upholstery, tin, shoe and metal shops. The acreage of land increased fourfold from the original parcel. More treatment buildings were constructed in the 1920s to care for mentally ill veterans of the first World War, although they were used for chronic patients within a few years once a nearby veterans hospital was completed. Other structures including a forensic (criminal) building, theater, and athletic field were built in the 1930s through the 1940s.
The construction of new treatment buildings continued well into the 1960s; they replaced the antiquated structures on the campus. Some, including the historic Kirkbride building, were razed, while others were left abandoned or used for storage. The hospital still operates to this day, providing acute, sub-acute, and long-term psychiatric care to adult and geriatric patients.