The Philadelphia State Hospital at Byberry

By Anne Sparks

In 1946, a nationally recognized reporter and lecturer named Albert Maisel wrote in LIFE magazine: “In Philadelphia, the sovereign Commonwealth of Pennsylvania maintains a dilapidated, overcrowded, undermanned mental "hospital" known as Byberry” [1]. Known for his works on medical negligence and hospital reform work, Maisel was referring to the Philadelphia State Hospital at Byberry, known more commonly as “Byberry”. The hospital first opened in 1912 by the mayor of Philadelphia, and it quickly filled to capacity. The hospital was opened in part as a reform designed to house and treat patients with psychiatric disabilities who would otherwise be sent to prisons and jails. The original goal for the hospital was to provide an example for other states to emulate in the mission to provide better care for individuals with mental disabilities. In the end, the opposite was achieved [2]. 

After opening, Byberry was quickly overfull and understaffed. The staff the hospital did have were generally underpaid, and even underqualified. This resulted in a lack of satisfactory care, and eventually abuse and neglect. The city ran the hospital for two decades until the rumors of negligence resulted in a state investigation in 1936. The findings resulted in the state government taking control of the city-run institution. However, the new management did little to alleviate conditions. One report stated that there was a shocking one attendant for every 400 patients. Underfunding further complicated matters, as costs were cut, Byberry was unable to retain staff and patients just kept coming. The result was an undermanned hospital at 75% overcapacity [2]. 

Things continued down this path for another decade until Maisel wrote his scathing critique on publicly funded psychiatric hospitals. The conditions at Byberry were publicized in the 1940s by conscientious objectors who had been sent to work there during WWII. The objectors were sent by the Selective Service Act to work at the hospitals as an alternative to active duty overseas. Often men adhering to pacifistic religions, such as Quakers or Mennonites, the attendants reacted to the shocking conditions of their assignments by writing detailed reports of what they saw. These reports were sometimes meant as examples of unacceptable treatments, but others were used by writers like Maisel as a rallying cry to the public for reform[1]. One of these men, Leonard Edelstein, remarked: “Advance in psychiatry, medicine, and hospital administration has not reached the greater number of our state institutions” [3]. He reported attendants verbally contributing to the patients' phobias, “they’ll jump out of dark corners and slap them”, “They’ll agree with a sufferer that there are snakes in his stomach” [3]. Edelstein also reported graphic physical abuses to a reporter, detailing how one patient was “subdued” by being choked into subconsciousness [3]. 

While the news coverage led to some reforms, Byberry remained an institutional nightmare. In the 1960s, the hospital held almost 7,000 patients and had increased its staff to 800 members. While this was a marked improvement from one attendant to every 400, it was much more expensive to maintain, so the hospital found other ways to cut costs. Hospital staff were still undertrained, and patients were given few meals and little clothing. In 1970, there were dozens of reported patient deaths due to neglect [4]. Finally, after an extensive investigation into the complaints and tragedies at Byberry, the Hospital was forced to close its doors on December 7th, 1987 [2]. Seventy-five years after its grand opening, the institution would not be taking any more patients. The last residents were officially released three years later, and the hospital was condemned in 1991. Demolition was canceled, however, when profuse amounts of asbestos was found in the walls. It was deemed too expensive to remove the asbestos safely and tear it down, so Byberry was left abandoned. The buildings stayed standing until 2006 when they were finally demolished completely [2]. 

What started out as a well-intentioned attempt to make progress in mental healthcare became one of the most infamous institutional symbols of psychiatric mistreatment. Instead of being a model of emulation, the Philadelphia State Hospital became a stark example of what not to imitate in healthcare. Byberry was not necessarily the worst of these institutions, nor even the most well-known, but it will always merit mention. It is important to remember the history of hospitals like these, both as an example of how far healthcare has come and as a cautionary tale for what to avoid. The patients at Byberry were real people with real lives, and they were subjected to treatment that should never have occurred at the hands of a state-run institution. Their story is a reminder that there must be strong advocacy for groups with disability and regulations that can catch negligence before it becomes a systemic issue. 

Works Cited

[1] Albert Maisel. “Most U.S. Mental Hospitals Are a Shame and a Disgrace”, 1946, mn.gov/mnddc/parallels2/prologue/6a-bedlam/bedlam-life1946.pdf. 

[2] Dolores D. Zollo. “With the Best of Intentions: Byberry Asylum.” Pennsylvania Center for the Book, 2009, pabook.libraries.psu.edu/literary-cultural-heritage-map-pa/feature-articles/best-intentions-byberry-asylum

[3] Edmund Watkins. “Convicts Fare Better than the Insane”, Broadway Gazette, May 9th, 1946. https://civilianpublicservice.org/sites/default/files/sites/civilianpublicservice.org/files/documents/convicts-fare-better.pdf

[4] Erin Kelly. “Inside Byberry Hospital, the Nightmare Mental Asylum Too Dangerous to Stay Open.” All That’s Interesting, All That’s Interesting, 22 Oct. 2021, allthatsinteresting.com/byberry-mental-hospital.