Thomas Story Kirkbride

Thomas Story Kirkbride (born July 31, 1809, Bucks county, Pennsylvania, U.S.—died December 16, 1883, Philadelphia, Pennsylvania) was an American psychiatrist and administrator best known for his influential ideas about the design and construction of hospitals for the mentally ill.

Kirkbride was born to a Quaker family. He graduated from the University of Pennsylvania Medical School in 1832. For a year after medical school, he was a resident at a Quaker mental institution near Philadelphia, where he was exposed to “moral treatment,” a method of treating mental illness that emphasized the value of well-organized daily routines for patients. Kirkbride then performed a two-year residency at the Pennsylvania Hospital before entering private practice in 1836.

In 1841 Kirkbride became the superintendent of the Pennsylvania Hospital for the Insane, a newly founded hospital affiliated with the Pennsylvania Hospital. Kirkbride enjoyed a great deal of administrative autonomy at the new hospital. The treatments he designed reflected the more-humane standards of the moral treatment approach. Restraints were used less frequently than was typical at the time, and a wide variety of recreational and educational activities were offered to patients.

It was at Kirkbride’s invitation that 12 of his fellow mental hospital superintendents gathered in Philadelphia in 1844 and, with him, founded the Association of Medical Superintendents of American Institutions for the Insane, now known as the American Psychiatric Association.

Kirkbride described his theories of hospital design and construction in his influential book On the Construction, Organization and General Arrangements of Hospitals for the Insane (1854). Those theories, which came to be known collectively as the Kirkbride Plan, called for a main central building with wings, arranged in a linear manner, projecting from it. The plan also called for size limitations of no more than 250 residents (a principle later largely disregarded), with an ample, open campus surrounded by a large wall. Dozens of hospitals throughout the United States were built according to the Kirkbride Plan, and many of them operated well into the 20th century.