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Marking the passage of time

July 01, 2009

In this photo of the 1877 worcester state hospital, the round building is hooper turret which, along with the central administration building and clock tower, survived a 1991 fire
In this photo of the 1877 Worcester State Hospital, the round building is Hooper Turret which, along with the central administration building and clock tower, survived a 1991 fire. Photos by Patricia H. Bazemore, MD.

In 1873, construction of the Worcester Lunatic Hospital began on a 275-acre site along a bluff overlooking Lake Quinsigamond on the eastern outskirts of Worcester, Massachusetts.1 This is a substantial building, measuring 1,100 feet long with multiple wings and setbacks. The central administration building is crowned with a clock tower with a 9-foot in diameter Seth Thomas clock and an 800-pound bell.2 The clock tower serves as an important link to the past as the state constructs the hospital's latest iteration.

The 1877 structure

Worcester State Hospital is the second-oldest public mental health facility in the United States (Eastern State Hospital in Williamsburg, Virginia, is the oldest). Its first iteration was a symmetrical, two-winged structure with a simple central administration section on Summer Street in Worcester, which opened in 1833.

As the census climbed over 500 in the 1850s, Superintendent Merrick Bemis realized that more space was needed and began studying European hospitals to gain inspiration. He became convinced that a decentralized cottage hospital would serve patients best by providing family-style accommodations for the majority. His model was finally discarded due to its high per capita cost and concerns for community security.3

Bemis fell out of favor due to his association with the decentralized plan and was replaced in August 1872 by his assistant, Barnard D. Eastman.4 Eastman supported a Kirkbride design, by that time the traditional model for asylums. Kirkbride asylums were large, housing more than 250 patients, and characterized by a central administration building with symmetrical wings to divide the patients by sex. Thus, males might be on the right wing and females on the left, with the sexes mixing to attend chapel and social events in the central building.

With Eastman in place, planning was rapidly completed by late 1872.5 The building was designed by the major Boston architecture firm Weston and Rand, who first drew plans on paper and then copied them onto cloth for use by on-site engineers.6 This new site on Belmont Street offered several important features, including a pastoral view to uplift depressed patients, space for exercise, and a large farm to feed both patients and staff (Both groups worked on the farm). The site had a good water supply and natural drainage for sewage.7 As with typical Kirkbride design, the hospital featured large left and right wings in a staggered arrangement, with males in one wing and females in the other. The central administration building, with neighboring laundry, kitchen, and steam buildings, joined the wings. Moving laterally from the center section, each successive wing was set slightly farther back. This configuration allowed air to circulate from the front, back, and sides of each section and permitted an unobstructed view in four directions.

The legislature originally approved a facility to house 400 patients, but before construction began Eastman received approval to increase the number of beds to 500. By 1890, the census was 811 and increased substantially more during the next 60 years.8

Set immediately behind the clock tower (described in detail below) was Sergeant Hall, which had a large, high-ceiling chapel where male and female patients would attend church services, dances, and musical events. The hall had a large pipe organ, a 9-foot concert grand piano, and an at least 8 x 8-foot painting of St. Peter being let out of chains by an angel, speaking directly to patients who may have been chained or restrained themselves. Unfortunately, Sergeant Hall and its contents were among the sections lost in a 1991 fire, although the clock tower survived. 9 Patients are now treated in the Bryan building, which opened in 1957 and at one time housed up to 600 (Current census is 150).

The 1877 worcester state hospital central administration building and clock tower
The 1877 Worcester State Hospital central administration building and clock tower.

A community symbol

When the hospital was completed in October 1877,5 the clock tower became the focal point of Worcester, which then had 175,000 residents. Four stories high with a 107 x 94-foot footprint,9 the clock tower rises 250 feet above 7-mile long Lake Quinsigamond (the area's largest natural landmark) and 500 feet above sea level; porches on the front overlook the city. Today, the clock tower is clearly visible from Interstate 290.

Because of its high visibility, the clock tower demonstrated that the hospital was an integral part of Worcester, although the rest of the hospital was self-contained and less manifest in the style of the times. 10 Staff and patients were spread out widely not only in the buildings but also on the farm, in the dairy, and in the laundry, kitchen, and steam house, so the bell tolled every half hour to notify them of the time and signal meals. Current employees can remember the bell ringing through the early 1970s and say it sounded like a bell tolling in a European cathedral (personal communication, Tom Martocci, hospital employee).

Many of the fire-damaged 1877 hospital buildings were demolished to make room for the new worcester state hospital, scheduled to open in 2012
Many of the fire-damaged 1877 hospital buildings were demolished to make room for the new Worcester State Hospital, scheduled to open in 2012.
The clock tower/central administration building and Hooper Hall, a round building used for patient care and also in remarkable condition, are the only parts of the 1877 hospital that will be part of the new Worcester State Hospital scheduled to open in 2012 (Its proposed cost is $302 million, which would make it the most expensive state building ever erected in Massachusetts 11). Although plans call for the clock tower to be at the front of the new hospital, which will merge the patient populations of Worcester and Westborough State Hospitals, the clock tower is on the “most endangered list” of Preservation Worcester, a private nonprofit organization devoted to preserving Worcester's architectural history. Through the efforts of this organization and the Massachusetts Department of Mental Health (DMH) and Division of Capital Asset Management, the state commissioned a $200,000 reuse and redevelopment feasibility study of the historic buildings. According to Deborah Packard, director of Preservation Worcester, the study suggested that the buildings could be used for office space, private residential use, lodging, a conference facility, or a historic or visitors' center. The study determined that the clock tower and Hooper Turret can be reused provided that federal and state historic tax credits are obtained; a user is found for the buildings; sufficient parking is secured; and DMH declares the land “surplus” (a legal procedure clearing the way for private development). A local, highly visible, and successful model for this process is the former Worcester train station, which is now a beautifully restored restaurant mall that is widely used and much admired.
Some feel that the natural role for the clock tower and Hooper Turret is a psychiatric museum and conference center, providing an important educational experience for the public by describing mental health treatment through first-person accounts by patients and staff. As of this writing, the ultimate use of these beautiful buildings, and whether they will remain in the public domain, remains to be decided at the highest levels of state government.

The public's opinion of the clock tower is mixed. Some see it as a symbol of harsh treatments and past cruelty toward people with mental illness. In fact, the clock tower is featured as the most prominent of the “scary places” in a new book series for children.12 However, most now recognize that the treatments offered in the old hospital were among the very best offered anywhere at that time. The 1877 hospital had a vast farm; served as a training center for nursing, medical, dentistry, psychiatry, psychology, social work, occupational therapy, and chaplaincy students; and provided “moral treatment,” which emphasized caring for patients humanely and providing them with work and a nurturing environment. In fact, annual reports show superintendents' commitment to active treatment and to shunning custodial care.13 This tradition continues today and grows with the passage of time. Thus, the clock tower is an important symbol of active treatment, teaching, innovation, and community.

Patricia H. Bazemore, MD, is an Associate Professor in the Departments of Psychiatry and Family Medicine and Community Health at the University of Massachusetts Medical School in Worcester. She also is a member of the medical staff at Worcester State Hospital. Stephen M. Soreff, MD, is President of Education Initiatives in Nottingham, New Hampshire, and is on the faculty of Metropolitan College at Boston University, Fisher College, Worcester State College, and Southern New Hampshire University.

To contact the authors, e-mail


  1. The dominion: the Pacific Railroad scandal-fresh developments-startling letter from M'Mullen-probable disruption of the dominion cabinet. Ireland. South America. Temple of Honor. Worcester Lunatic Asylum. Boston Daily Globe. August 13, 1873: 1. Retrieved from ProQuest Historical Newspapers Boston Globe (1872-1925) database. Document ID: 537243422.
  2. 53rd Annual Report of the Trustees. Worcester Lunatic Hospital year ending September 30, 1885. Boston: Wright and Potter Printing Co., State Printers; 1886.
  3. Grob GN. The State and the Mentally Ill. Chapel Hill, N.C.:University of North Carolina Press; 1966:222.
  4. Worcester Lunatic Hospital :Special dispatch to the Boston Globe. Boston Daily Globe. July 11, 1872: 5. Retrieved from ProQuest Historical Newspapers Boston Globe (1872-1925) database. Document ID: 537542262.
  5. Miscellaneous Notes. Boston Daily Globe. October 8, 1877:3. Retrieved from ProQuest Historical Newspapers Boston Globe (1872-1925) database. Document ID: 541927572.
  6. Architectural plans, Worcester State Hospital, signed by Weston and Rand, Worcester Historical Museum.
  7. The lunatic hospital. Worcester Evening Gazette. May 24, 1879.
  8. Morrissey JP, Goldman HH, Klerman LV. The Enduring Asylum: Cycles of Institutional Reform at Worcester State Hospital. New York:Grune and Stratton; 1980.
  9. An important public structure completed, description of the edifice. Worcester Evening Gazette. August 11, 1877.
  10. Soreff SM, Bazemore PH. When state hospitals were communities. Behav Health Manage 2005; 25 (4): 10-12.
  11. Hammel L. Hospital funding backed: new psychiatric facility in city. Telegram & Gazette. June 21, 2008: A1. Retrieved from Massachusetts Newsstand database. Document ID: 1498664001.
  12. Williams D. Scary Places: Abandoned Insane Asylums. New York:Bearport Publishing; 2008:4.
  13. 44th Annual Report of the Trustees of the State Lunatic Hospital at Worcester, October 1876. Boston: Albert J. Wright, state printer; 1877:20.


The Bay State's new psychiatric hospital

The new psychiatric hospital rising on the grounds of Worcester State Hospital in Massachusetts will consolidate the patient populations of the current Worcester and Westborough State Hospitals. The $302 million, 428,000-square-foot facility will have 320 beds, with 260 beds for adults, 30 inpatient adolescent beds, and 30 intensive residential adolescent beds. Clusters of 8 to 10 bedrooms will share living areas and dining facilities. Designed with a village-like arrangement to promote recovery and provide the functions of everyday life, the facility will have:

  • Classrooms

  • Bank

  • Medical and dental clinics

  • Gym and fitness areas

  • Outdoor courtyards

  • Conference center

  • Hair salon

  • Library

  • Retail space

  • Pharmacy

  • Chapel

  • Arts and crafts areas

  • Music room

The facility will be environmentally friendly, too, and LEED Gold certification (a green building industry standard) will be pursued.

The new hospital is scheduled to be completed in March 2012. Ellenzweig of Cambridge, Massachusetts, is the design architect and architect of record, and architecture+ of Troy, New York, provided mental health programming expertise. Gilbane Building Co. is constructing the facility. -Douglas J. Edwards
Renderings provided

Renderings provided by Ellenzweig.


Patricia Bazemore is photographing the new hospital's progress, and you can follow its construction at


For more photos of the clock tower, visit

Behavioral Healthcare 2009 July-August;29(7):16-20

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