Historical Overview:
Development of public responsibility for persons with disabilities in Massachusetts

1800     Boston Female Asylum for Orphans

1801     Boston Dispensary

1811     Massachusetts General Hospital opens with MacLean as its psychiatric subdivision

1821     First report on behalf of further state involvement in charity to the General Court by Josian Quincy: suggested that
             pauperism should be under annual supervision by the legislature. (Only thirty-one years later, with the establishment
             of three state almshouses in 1852, was his advice followed)

1829     New England Asylum for the Blind

             Horace Mann brings forth the issue of humane treatment and accommodations for the insane; he was then appointed
             chairman of a committee to investigate the practicability and expediency of erecting or procuring at the expense of
             the Commonwealth an asylum for the safe-keeping of lunatics and persons furiously mad (Sanborn 1876: 39).
             Towns were asked to send statistics on their insane to the Secretary of the Commonwealth (Hurd 1916: 586).
             The Legislature was convinced of the need for care: three commissioners were appointed to select a site and
             build a hospital for 120 persons.

1832     Worcester Insane Asylum
             Soon thereafter, state law required separation of insane from criminals in local jailhouses.

1836     Three counties establish facilities for "idiots and lunatics not furiously mad": Suffolk, Essex, and Middlesex

1839     Boston Lunatic Asylum at South Boston, County of Suffolk (taken over by the state in 1908)

1843     Dorothea Dix delivers her Memorial to the state legislature in which she argued that the 120-bed facility
             at Worcester was not sufficient for the large number of insane people she found in poorhouses and jails
             throughout Massachusetts. Worcester State Hospital was expanded accommodate 320 beds.

1846     Two additional committees, headed by Samuel Gridley Howe, are appointed to investigate the need for facilities for
             "idiots" and juvenile offenders

1848     Massachusetts School for Idiotic and Feeble-Minded Youth, South Boston (moved to Waltham in 1887)
             Massachusetts State Reform School, Westbrorough (later "Lyman School for Boys")

1851     Taunton State Hospital for the Insane

1852     State Almshouse at Bridgewater (now correctional institution)
             State Almshouse at Monson
             State Almshouse at Tewksbury

1854     Industrial School for Girls, Lancaster

1856     Lunatic Hospital at Northampton

1859     Nautical Reform School, Marion

1860     over 200 almshouses are surviving in Massachusetts

1863     "Massachusetts Board of State Charities" established by legislature, Chapter 240, developed from the 1854
             "Commission on Lunacy", to gather data, define issues, and to establish public policy. It was the first of its type and
             one of the most influential in the nation (Grob 1983:40,50,79). The Board was chaired by Samuel Gridley Howe from
             1865-74. Two additional insane hospitals were built under the Board's sixteen-year tenure, at Worcester and Danvers.

1869     "State Board of Health" established

1870     Worcester Lunatic Hospital

1873     State Lunatic Hospital at Danvers

1879     "Board of Health, Lunacy, and Charity" established out of the merging of the "Massachusetts Board of
             State Charities" and the "State Board of Health"; it included the boards of trustees at the state reform schools,
             the boards of inspectors of the State Primary School, the State Almshouses amd the State Workhouse.

1884     Westborough Insane Hospital

1884     Massachusetts is noted as pioneer in the development of a centralized legislation for the insane by a national study
             of "Legislation on Insanity"

1886     "Board of Health" re-established by Chapter 101

1887     Walter E. Fernald State School

1889     Hospital for Dipsomaniacs amd Inebriates at Foxborough (first public hospital for alcoholics in the nation)

1892     Medfield Insane Asylum (state's first hospital for chronic cases of insanity)

1895     Monson State Almshouse converted to "Massachusetts Hospital for Epileptics" (third in the country, after
             Ohio, 1892, and New York, 1894)
             Rutland State Sanatorium (first public hospital for tubercular patients in the nation)
             Boston State Hospital

1898     "Board of Insanity and Charity" separated by Chapter 433

1899     Templeton Colony of Fernald School (state's first hospital for chronic cases of retardation)

1900     State responsibility for patients mandated with funding provided in 1904, Chapter 451, Acts of 1900

             State Colony for the Insane at Gardner (Chapter 451)

1901     Grafton State Hospital (Chapter 434)

1902     Colony for Insane at Gardner
             Boy's Reform School at Shirley

1904     Norfolk State Hospital, for the chronic insane
             The state abandoned its methods of assessing a per capita fee on the town for its indigent patients and assumed
             full and direct responsibility.

1904/5  Board of Insanity conducts systemwide review to establish uniform standards of capacity to avoid
             overcrowding at any one of the campuses
             School and Home for Crippled and Deformed Children, Canton (Mass. Hospital School)
             Research Laboratory at Jamaica Plain

1906     State School at Wrentham

1907     Tuberculosis sanatoriums at Lakeville, North Reading, and Westfield

1908     Responsibility for the care and support of indigent feeble-minded children is transferred by the legislature
             to the state, Epileptics are also remanded to state care
             Industrial School for Boys (MCI Shirley)

1912     Boston Psychopathic Hospital, for acute cases

1914     "State Board of Health" is renamed "State Department of Health" (Chapter 792)

1916     "State Board of Insanity" becomes the "Massachusetts Commission on Mental Diseases" (Chapter 285)

1919     Commission on Mental Diseases then becomes the "Massachusetts Department of Mental Diseases" (Chapter 350)
             "State Department of Health" becomes the "Department of Public Health" (Chapter 350)
             "State Board of Charities" becomes "Department of Public Welfare"
             "Division of Juvenile Training" formed within the Dep. of Public Welfare to oversee state reform schools

1922     Belchertown State School

1929     Dep. of Mental Diseases facilities are valued at $27 million, absorb one-sixth of the state budget, and
             maintain;cost $8.5 million to $2.25 million are expended for new construction

1930     Metropolitan State Hospital, Waltham

1937     A special commission was authorized to study all aspects of mental health care in the Commonwealth and to report
             to the General Court. The commission recommended a complete administrative overhaul of the Department of Mental
             Diseases; this was accomplished with passage of St 1938, chapter 486, which renamed the agency as the Dept. of
             Mental Health

1966     The Comprehensive Mental Health and Retardation Services Act called for the department to establish a
             comprehensive community-based program of mental health and mental retardation services including state hospitals,
             state schools, clinics, comprehensive centers, and other facilities. This legislation mandated programmatic movement
             toward deinstitutionalization and the development of community mental health centers, following closely the federal
             Community Mental Health and Retardation Centers Act of 1963. The department was decentralized by dividing the
             Commonwealth into seven administrative regions each consisting of five to eight "catchment" or service areas with
             area directors and citizens advisory boards. Emphasis was thus shifted away from the large state mental hospitals.

             In addition to area boards, a thirty-member State Advisory Council on Mental Health and Retardation
             (more commonly known as the Advisory Council on Mental Health and Mental Retardation) was established to
             advise the commissioner of mental health on policy, program development, and departmental priorities.

1969     Chapter 638, mandate for closure of state reform schools

1970     The Mental Health Reform Act, chapter 888, imposed limits on new admissions to state mental hospitals,
             encouraging the transition to a community-based system.

1986     Chapter 599 removed the responsibility for mental retardation from the Department of Mental Health and
             assigned it to a new Department of Mental Retardation

Currently the Department of Mental Health carries out its function at three levels: central office; regional offices, and area offices. The central office level focuses on hospital management, developing policy and regulatory standards, planning, prioritizing needs, and advocating for resources. The regional office level ensures that standardized services exist in all areas through planning, monitoring, licensing, and quality assurance activities. The area office level is the principal focus of service delivery.

Massachusetts Department of Mental Health, Agency History Record
The Architecture of the Unwanted, Christopher Pilkington, 1985
Massachusetts Department of Mental Health, Architectural Records
Commonwealth of Massachusetts, Annual Reports of State Hospitals and Schools
Massachusetts State Archives, Architectural Records

This website is part of an ongoing effort by Anna Schuleit/ to document the historic state hospitals and state schools of Massachusetts. Unless otherwise stated all historical data was researched at the Massachusetts State Archives, and all photographs were taken on-site. For further questions, comments, or contributions please contact us by email.

Copyright 2000-2008 by Anna Schuleit /