Now known as the Pilgrim Psychiatric Center, the asylum opened in 1931 as the Pilgrim State Hospital, and was the largest hospital in the world. At its height, the hospital held over 13,000 patients and the size and complexity of the building has never been paralleled. Renowned for their experiments with shock treatments such as insulin shock therapy and the electro-convulsive therapy, the asylum became a place of great despair and misery for thousands of patients.
Pilgrim State Hospital
The early 20th Century saw a dramatic rise in the amount of people suffering from mental illness. New York’s asylums has become drastically overcrowded, and ‘farm colonies’ were created to counter act this. The Kings Park State Hospital and the Central Islip State Hospital both consisted of live-and-work treatments, allowing patients to work on the hospital grounds, whilst selling produce and earning additional money. However, both hospitals quickly became overcrowded also, and the need for a third hospital became prominent.
The third hospital was to be called Pilgrim State Hospital, a homage to the New York Commissioner of Mental Health, Dr Charles W Pilgrim. The state purchased the 825 acre plot of land in Brentwood, and construction began in 1929. Just two years later, the building was complete, consisting of its own fire department, police station, post office, sewage system, courts, power plant, pig farm, church and cemetery, a water tower and staff accommodation. The self-sufficient hospital was built with a network of underground tunnels, which connected the buildings together.
Pilgrim State Hospital was designed to be a self-sufficient community that could support itself and sell the excess produce to the local community. In the early 20th century, it was commonly believed by psychiatrists that work was therapeutic for mentally ill patients, along with fresh air and open space. The first 100 patients were transferred from Central Islip State hospital at the beginning of October, 1931, and numbers rose to 9,000 patients by 1935.
The hospital continued to grow alongside its population, and eventually the state were forced to buy additional land to the south west of the facility. Edgewood State Hospital was built on this land in 1940, but was soon taken over by the War Department when the US entered World War II. It was then used as a psychiatric hospital for traumatized soldiers, becoming a part of the Mason General Hospital.
After World War II, the population rose dramatically once again, pushing Pilgrim’s population to 13,875 with over 4,000 employees. At this point, it became the largest hospital of any kind in the world, and shock treatments became a common practice in the busy asylum.
Like many other asylums of its time, Pilgrim State Hospital used shock therapies to treat their patients, including lobotomies, electro-convulsive therapy without aesthetic and insulin shock therapy. The most notorious example of treatment lies within the case of Beulah Jones, a mother of three, who was a patient in 1952. After the pregnancy with her third child, Jones began to have psychotic episodes which resulted in her placement in Pilgrim state Hospital.
Over the period of 10 weeks, Jones had been given 15 rounds of electro-convulsive shock therapy, to no avail. Her delusions continued, and her doctors recommended that she be given a lobotomy. Two holes were drilled into her head, and the leucotome was plunged into the tissue of her frontal lobe. After the surgery, Jones’ delusions were still prominent, and her emotional response had grown dull. Jones’ daughter claimed that after the operation, “there was no change in her behaviour, other than she lost her higher intellect. She could not sit down and read any more. She could barely write, and had no long-term memory.”
The Decline of the Asylum
Pharmaceuticals began rising in popularity in the 1950s, and the emphasis of care was placed on community based care, as opposed to asylums. Edgewood State Hospital was closed down in 1971, and Pilgrim was forced to downsize. Sections of the Pilgrim Hospital were closing down throughout the 1970s and 80s. The farm was sold in 1974, and eventually became the Western Campus of the Suffolk County Community College.
The early 90’s saw a further decline of patients in both The Kings Park State Hospital and the Central Islip State Hospital. They were closed down in 1996, and the remaining patients were sent to the much smaller Pilgrim Psychiatric Center. In 2002, Gerald Wolkoff bought 462 acres of land from the Pilgrim site for $21 million and declared his plan to build a $4 billion residential and office complex. Several additional buildings have been demolished since then, including the former housing facilities for the hospital staff, the old medical/surgical building, male and female admissions buildings and the old administration building.
Pilgrim Psychiatric Center
(According to the New York State Office of Mental Health)
Pilgrim Psychiatric Center provides a continuum of inpatient and outpatient psychiatric, residential, and related services with approximately 380 inpatient beds and 4 outpatient treatment centres, plus one ACT Team throughout Suffolk County . The campus includes several residential agencies on the grounds such as Central Nassau Guidance Center and Transitional Services, Charles K. Post, a residential treatment centre operated by the New York State Office of Alcohol and Substance Abuse, and Phoenix House, a residential treatment centre for those with substance abuse diagnosis. Development of the surrounding acreage has been planned for the near future. The campus is within easy access to parkways, public transportation, and local shopping.
Inpatient Services are located in three modern complexes and offer a wide variety of treatment options. The focus of treatment is rapid recovery with symptom reduction, access to programs which develop skills to manage psychiatric illness and better function in the community, and active discharge planning and support for individuals returning to community living. Treatment is provided by multi–disciplinary teams of professional and paraprofessional staff offered in individual and group format. On–ward treatment spaces reflect state–of–the art design and a therapeutic environment. Each ward includes private and semi–private bedroom areas and bathroom facilities, a living room, program room, activity area, and dining room. Off–ward program and recreational space are available within each building.
There are 15 inpatient wards including 3 admission wards, 3 geriatric wards (1 admission), and 9 Psychiatric Rehabilitation wards which include 2 behavioural treatment wards.
Active Treatment and Program Activities
In addition to on–ward treatment, Pilgrim offers a variety of off–ward locations for treatment, recreation, and programming. Alternate treatment environments are available to address the needs of patients.
- Centralized Treatment Programs provide a variety of active treatment groups within a lesser restrictive environment and using additional available resources. The Treatment and Learning Center is a daily program offering classes in many areas of recovery including: medication education, social skills training, constructive use of leisure time, self-management skills, and related group sessions aimed at helping patients acquire the skills needed to become ready for discharge and function successfully in the community. A model apartment setting assists patients in community living preparation. Professional staff uses discussion groups, visual aids, and multi-media presentations to engage groups in the learning process.
- The MSTE ROOM (multi-sensory therapeutic environment) is a dedicated room that brings together a variety of multi-sensory equipment in one place to stimulate senses at the desired level. This area promotes feelings of well being and is utilized in treatment to promote choice, interaction, and relaxation through planned sensory stimulation. The patient is the one who sets the tone for each session as the staff facilitate the development of self-regulatory skills.
- Vocational Rehabilitation Programs include treatment, work adjustment, and job skill training in Computer Skills and Desk–top Publishing, Picture Framing and Matting, Furniture Repair and Refinishing, Electronics Repair, and Porter–Maintenance.
- The Nature Center consists of a greenhouse and surrounding gardens where patients have the opportunity to participate in horticulture therapy.
- E.P.I.C., a creative arts living museum, provides a large environment for therapeutic participation using varying art forms and media and allows for the ongoing display of completed artwork.
- The Barn hosts an Animal–Assisted Therapy and Activities program in which therapeutic treatment takes place using the interactions between patients and farm animals as the intervention.
Professional Departments Include:
- Psychiatry – pharmacological treatment and individual/group support and counselling provided by M.D. staff. A schedule of weekly Grand Rounds provides presentation by recognized leaders in the field of new and current information for our Psychiatric staff.
- Nursing – The provision of nursing services is an integral part of the overall facility organization and mission. Psychiatric nursing is a specialized area of nursing practice employing theories of human responses and the knowledge and skill of nursing intervention. We are committed to the holistic approach to patient care, viewing the individual with a multiplicity of interrelated and independent needs (physical, spiritual, psychological, and economic), and through the utilization of the Nursing Process. The Professional Nurse assists the patient in addressing both psychiatric and physical self–care needs. Our conceptual framework embraces the collaborative efforts of both patient and nurse to meet self care deficits resulting from the patient’s illness.
- Psychology – provides testing and evaluation, treatment planning, consultation, and individual and group counselling.
- Social Work – Certified and paraprofessional staff provide assessment, treatment planning, individual, group and family counselling, discharge planning and placement.
- Medicine – Routine physical assessment and medical care and referral for special services, care and consultation is provided, either in the facility’s medical and Dental Clinics or in the local community. EMSS, the emergency medical service system, provides BLS/Intermediate Cardiac Response. All of our physicians and nurses are AHA/BLS certified.
- Rehabilitation – Vocational Rehabilitation Programs provided by Rehabilitation Counsellors and paraprofessional staff offer a variety of work–related opportunities to enable the individual to address treatment issues and work behaviours.
- Pharmacy – Medications are dispensed by our three pharmacies located in each patient building, using a computerized patient profiling system which includes a medication intervention program.
- Infection Control – provides surveillance, prevention, and control of nosocomial infections.
- Dietary and Nutrition Services – Registered Dieticians assess patients’ nutritional needs in consultation with medical staff and are available for individual counselling and consultation. Patients are provided with three well–balanced meals and snacks daily.
- Therapeutic Recreation – Recreation Therapists and paraprofessional staff provide active treatment interventions and therapeutic leisure activities with patients. Community trips, holiday celebrations, and special activities are organized.
- Patient Education Services – Licensed teachers provide academic remediation via individual and classroom setting and GED preparation and exam.
- Volunteer Services – The facility is fortunate to have a host of Volunteers from the local community. Varying VFW posts and church groups make up the majority of those who visit regularly to provide activities for our patients and host our patients at their location. Individual volunteers work closely with staff and patients, as well.
- Pastoral Care – Addresses the spiritual and religious needs of the patients, their families, and the staff of Pilgrim Psychiatric Center. The Pastoral Care Department ensures that every patient in the facility has access to pastoral care and other spiritual services.
The Long Island Psychiatric Museum is located on the Pilgrim campus and open to the public Monday through Friday from 8 am – 4 pm. The Museum offers a vast collection of memorabilia, artefacts, and photos representing the history of the three Long Island hospitals (Kings Park, Central Islip, Pilgrim) that were active at one time and have since been merged with Pilgrim Psychiatric Center. Access to the Museum is made by appointment only.