Oregon State Hospital is a public psychiatric hospital in the U.S. state of Oregon, located in the state's capital city of Salem with a smaller satellite campus in Junction City opened in 2014. Founded in 1862 and constructed in the Kirkbride Plan design in 1883, it is the oldest operating psychiatric hospital in the state of Oregon, and one of the oldest continuously operated hospitals on the West Coast. The hospital was established after the closure of the Oregon Hospital for the Insane in Portland, located 47 miles (76 km) north of Salem. The Oregon State Hospital was active in the fields of electroconvulsive therapy, lobotomies, eugenics, and hydrotherapy. In the mid-twentieth century, the facility experienced significant overcrowding problems, with a peak of nearly 3,600 patients. In 1961, Dammasch State Hospital opened in Clackamas County near Portland, which served to mitigate the hospital's overcrowding issues. Dammasch would close in 1995. In the early twenty-first century, the hospital received public criticism for its aging facilities and treatment of patients, and the hospital's management of 5,000 canisters of unclaimed human cremains was the subject of a 2005 Pulitzer Prize-winning series published in The Oregonian. The discovery of these remains is the subject of the 2011 documentary "Library of Dust". In 2007, the state of Oregon approved a $458 million plan to rebuild the main hospital to a downsized 620-bed facility, which was completed in 2013. Portions of the original hospital buildings were demolished, though the center of the Kirkbride building was salvaged and renovated, and now houses a mental health museum. Oregon State Hospital is located in the eponymous Oregon State Hospital Historic District, and was registered with the National Register for Historic Places in 2008. It was the primary filming location for the 1975 film One Flew Over the Cuckoo's Nest, as well as being the subject of a series of photographs by photographer Mary Ellen Mark in 1976.
History
1862–1900: Establishment and early years
The original Oregon Hospital for the Insane was established by American physician James C. Hawthorne in what was then East Portland, Oregon, (now the Hawthorne District). The facility was built in 1862, and the street on which it was built was renamed Asylum Avenue. Local residents protested about the name, however, and it was renamed Hawthorne in honor of the hospital's founder in 1888. The street in Salem on which the current hospital is located, Center Street, was also originally named Asylum Avenue. Activist Dorothea Dix was an advocate of Hawthorne's original hospital, which she had visited twice, but was a vocal critic of the opening of the new state hospital, believing the state was ill-prepared to care for patients adequately. The Oregon constitution mandated that state hospitals be built in the capital city of Salem. Groundbreaking began May 1, 1881, and the hospital was completed in 1883. The newly built, state-funded hospital opened as the Oregon State Insane Asylum on October 23, 1883, and was constructed based on the Kirkbride Plan for a total of $184,000 (equivalent to $6,357,857 in 2025). Its architecture is Italianate in style, and was designed by W.F. Boothby. Dr. Simeon Josephi was appointed superintendent of the hospital from its opening until May 1887, and strived to base his treatment methods on those used by Dr. Hawthorne. He was succeeded by Dr. Harry Lane, who implemented an "aggressive" vaccination program to combat smallpox outbreaks. By 1891, the hospital housed a total of 478 male and 212 female patients; the growing influx of patients led to two additional wings being added onto the hospital, followed by a conversion from gas to electric lighting. Additionally, the hospital infirmary was completed in 1892. In 1896, the most commonly reported causes for insanity at the hospital were epilepsy, intemperance, masturbation, and religious paranoia. In 1900, the hospital began to expand its campus, with two additional women's wards and four men's being added to the main building. According to historical documents, the hospital had admitted a total of 5,046 patients since its opening, 1,243 of which had been "released as recovered", 1,051 "improved", while at least 1,058 had died in the hospital.
Tunnels and narrow-gauge railroad A narrow gauge railroad was established on the grounds of the hospital during its construction, leading into different tunnels and buildings. These tunnels allowed the hospital to move patients between buildings without the public observing and are marked by purple-colored glass prisms embedded in the roads to provide lighting. The tunnels connect different buildings of the State Hospital together. The narrow gauge railroad did extend to the penitentiary but not within a tunnel; remnants of this line still existed as of February 2009. The State Capitol and associated buildings also have a tunnel system to this day (parts of which are publicly accessible) but they have never been connected to the State Hospital. While the narrow gauge railroad is no longer used, the tunnels were once used daily to deliver food, laundry, and other items—and occasionally patients—between different buildings. The rails are no longer evident in many places and the flangeways are filled in, leaving only the head of the rail exposed. At one point transport within the tunnels was by means of electric carts and occasionally bicycles. When the railroad was used, cars made of bamboo were pushed to their destinations. Few spurs or sidings were found on the railroad, so cars were simply stopped on the track where it was necessary to load or unload them, and then pushed away. A number of the bamboo railroad cars were converted to non-rail cars by removing the railroad wheels and adding casters; one of these cars is displayed in the Oregon State Hospital Mental Health Museum. In addition to the narrow gauge railroad, a standard gauge railroad spur from the Southern Pacific's Geer Branch extended north from the penitentiary to the State Hospital. A portion of the grade of this spur remains along with two short portions of the standard gauge rails embedded in asphalt within and outside of Buildings 61 and 73 on the hospital grounds.
1901–2000: Expansion and overcrowding
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