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Maine's Latest Psychiatric Hospital

September 1, 2005
by Todd Hanson, AIA
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Maine Insane Hospital/Augusta Mental Health Institute
L ocation: Augusta, Maine
Capacity: Designed for 30 patients
Cost: $20,000
Opened: 1840

Riverview Psychiatric Center
Location: Augusta, Maine
Capacity: Designed for 92 patients
Cost: $22 mill ion
Square Feet: 125,000
Opened: 2004
It was 1840 when the doors opened to the Maine Insane Hospital , later renamed the Augusta Mental Health Institute (AMHI). Nearly ten years passed from the time the state legislature appropriated $20,000 for the construction to the day the first patient arrived. It would be 164 years before the last patient would leave and a new facility wou ld take its place. This is the story of the transformation of a mental health “institution” from state-of-the-art in the 1840s t o state-of-the-art at the turn of the 21st century.

Ahead of Its Time
Originally built to care for ju st 30 patients, AMHI was constructed on a pastoral setting overlooking the Kennebec River in the recently relocated capital of Augusta. The hospital was carefully sited within clear view across the river from the statehouse so each successive governor and members of the legislatu re would never forget the hospital or those cared for there.

The mid-19th century saw a number of majestic American asylums construct ed, and they became a source of great pride within their communities. The new hospital in Augusta was a national model with state-of-the-art technology: It had a ventilation system, a central heating system, gas lighting, and running water. Male and female patients had dedicated wings. Neighboring residents of New Hampshire were inspired to follow suit two years later. They opened a similar facility also located a st one’s throw from the state capitol.

During the period when AMHI was built, a revolutionary new treatment concept was introduced —moral management.” The premise was that the environment could play an important role in the treatment of people with men tal illnesses. Shackles, chains, and dark cells were being replaced with picturesque settings and grand institutions. After centuries of bru tal treatment of people with mental illnesses, this treatment philosophy finally started to make an attempt at improving patients’ dai ly conditions. Treatment methods in Maine that first year touted “prayer and Bible reading, farm labor, good food, and clean living co nditions.”

Unfortunately, it didn’t take long before a national overcrowding crisis became epidemic. Like most asylums of the 19th century, the limitation of current treatment methods mixed with constant overcrowding. The outcome was often dismal. It wasn’ ;t long before the original compassionate missions gave way to the reality of being overwhelmed by the sheer numbers of a diverse patient po pulation. Like the situation at similar facilities in other states, the census at AMHI grew until eventually 1,800 individuals crowded onto the original pastoral setting. Across the border in New Hampshire, the census peaked at 2,700 patients.

Initially the Civil War cause d a flood of new patients suffering from what we now know as post-traumatic stress syndrome. On top of that, the asylums became a depository for the poor, for elderly that families couldn’t care for, and for social outcasts. Overcrowding continued to escalate through the 19 50s. Same Vista, but a New View
In 1 988, New Hampshire built a new inpatient mental health treatment center to replace the facility constructed soon after AMHI was built. In 20 00, Maine consulted JSA, Inc., who had designed the new facility in New Hampshire, to help plan a new national model, once more in Augusta. Directly across the lawn from AMHI, still within direct view of the state capitol, the new facility has opened recently: Riverview Psychiatr ic Center, so named because every bedroom has a view of the Kennebec River valley. In June 2004, the last patient moved out of the original gray granite building (AMHI will be reused in some other capacity by the state).

Riverview represents the next generation of treatmen t centers, designed with sensitivity to create healing environments while being always mindful of staff and patient safety. Creating therape utic environments that respect the dignity of the individual patients was paramount in the design philosophy at Riverview. The goal was not to create a large institutional facility, but instead to treat the center as a village of diverse components that individually addressed eac h functional need while maintaining a human scale.

A large inner courtyard supplies treatment areas and major corridors with sunlight and creates opportunities for outdoor dining, relaxing, or gardening. Larger, secure, and easily monitored, yet discreet, courtyards off th e residential wings allow frequent chances to step outside for a breath of fresh air or to get some exercise.

The unique functional a reas are treated as “separate but connected” buildings. There is an administrative office building, a recreation center, pitched -roof housing, a support/service building, a public meeting center, etc. The scale, mass, and materials of each of these diverse areas inten tionally change to reflect the use within.