The History of Medfield State Hospital

This series explores the rich history of Medfield State Hospital, guided by the extensive knowledge and research of Richard DeSorgher. A lifelong Medfield resident and the Town Historian, Richard has dedicated himself to preserving the town’s heritage through books, articles, and a long-running newspaper column.

As a member of the Medfield Historical Society and a contributor to numerous Massachusetts state commissions, he is a trusted authority on the area’s past. Together, we’ll uncover the legacy of Medfield State Hospital, reflecting on its profound impact on the community and the lives it touched over the years.

The Cottage Plan: Redefining Mental Health Care in Medfield

When Medfield State Hospital opened in 1896, it wasn’t just a new facility—it was the embodiment of a revolutionary idea in mental health care. Unlike the towering, fortress-like institutions of the past, Medfield adopted the cottage plan, an innovative approach that prioritized humanity, comfort, and community. The hospital’s design reflected a growing understanding that mental health could be better supported in spaces that felt more like home.

A Break from the Past

Before the cottage plan, most asylums followed the Kirkbride model, characterized by sprawling, bat-wing-shaped buildings with massive, intimidating facades. While these structures allowed for large patient populations, they often felt impersonal and isolating. The Kirkbride plan, though progressive in its time, came to symbolize the institutionalization of mental illness rather than its treatment.

The cottage plan was a response to this. It prioritized smaller, decentralized buildings arranged in a village-like layout. This design promoted natural light, fresh air, and a sense of personal space, which were believed to have therapeutic benefits for patients. Medfield State Hospital was the first institution in Massachusetts to fully embrace this approach.

The Medfield State Hospital
Credit: President and Fellows of Harvard College Archives

The Layout: A Village of Care

The hospital’s 58 buildings were arranged around a central quadrangle, reminiscent of a New England town common. This layout fostered a sense of community among patients and staff while also providing clear functional zones.

At the front of the quadrangle stood the administration building and wards for quieter patients, creating a welcoming and organized entrance. Further back, wards housed patients requiring more intensive care, ensuring their needs were met without disrupting the hospital’s broader operations. Facilities for dining, worship, and recreation were located in the center, emphasizing the integration of daily life and therapeutic care.

The cottages themselves mimicked home environments. Each building housed about 50 patients, with sleeping quarters on the second floor and communal areas, such as sitting rooms and workspaces, on the first. This setup allowed patients to experience a more normalized daily routine, helping them feel connected to a sense of home.

A Therapeutic Environment

The cottage plan was more than just an architectural choice—it was a reflection of a changing philosophy in mental health care. Proponents of the plan believed that peaceful, beautiful surroundings could have a profound impact on a patient’s recovery. The buildings at Medfield were designed in the Queen Anne and Greek Revival styles, with intricate details that made them feel warm and inviting rather than cold and institutional.

Patients could take walks among the rolling hills, sit under shady trees, or enjoy the views from Castle Hill, which overlooked the Charles River. Gardens and greenhouses dotted the property, offering spaces for quiet reflection and hands-on therapeutic activities. This connection to nature was a core element of the hospital’s mission.

Nurses Home for Females, M.I.A., Medfield, Massachusetts – Postcard

Fostering Community

The village-like design of the cottage plan extended beyond the physical layout to the social structure of the hospital. Smaller buildings created a sense of intimacy, where patients and staff could form closer relationships. This fostered a more personal and compassionate approach to care.

Recreational activities further strengthened this sense of community. Patients participated in sports, dances, and chapel services, often alongside staff members. These activities were not just diversions—they were integral to the therapeutic philosophy of the hospital, providing opportunities for socialization and joy.

A Model for the Future

Medfield State Hospital’s adoption of the cottage plan was a bold step forward in mental health care, and it became a model for other institutions. The idea that environment could play a crucial role in treatment resonated with architects and healthcare professionals alike, inspiring similar designs across the country.

Even today, the remains of Medfield’s quadrangle and cottages stand as a testament to this transformative approach. The hospital’s commitment to creating a humane, supportive environment continues to influence how we think about mental health care and the spaces where it takes place.

Looking Back, Moving Forward

The cottage plan at Medfield State Hospital was not just about buildings—it was about building a better way of life for those in need of care. By prioritizing light, space, and community, the hospital offered patients a chance to heal in an environment that respected their humanity. It was a groundbreaking shift, one that reminds us of the enduring importance of compassion in design and care.