The Oregon State Hospital (originally called the Oregon State Insane Asylum until 1913) is Oregon’s oldest continuing institution for mental health treatment. Opened in 1883, the hospital in Salem is significant for both its central role in the history of mental health care in Oregon and its distinctive institutional buildings. The OSH campus is bisected by Center Street Northeast (formerly Asylum Avenue), creating North Campus and South Campus.  

Intact historic-period features found on the North Campus led to archaeological excavations by Archaeological Investigations Northwest in 2021. The land is within the traditional territory of the Kalapuya, who lived in the Willamette Valley long before non-Indigenous groups arrived in the region, and investigators found lithic flakes from stone tool manufacture in addition to historic-period materials that confirmed the longtime presence of Native people in the area. Researchers also found that the Oregon State Hospital admitted Native patients from Washington, Idaho, Alaska, and Oregon, and there are accounts of members of the Confederated Tribes of the Grand Ronde, the Confederated Tribes of Siletz Indians, the Burns Paiute, and the Confederated Tribes of the Umatilla Indian Reservation being hospitalized at OSH. Archaeologists coordinated with tribes throughout the project, and some tribal members visited the site during excavations. The project was completed in 2023, and the OSH North Campus was recommended to be eligible for listing on the National Register of Historic Places (the Oregon State Hospital Historic District was added to the register in 2008).

The earliest building on the OSH North Campus was the 1869 Glen Oaks Orphans’ Home, near the corner of 23rd Street Northeast and Center Street Northeast. Orphaned children, ranging from infants to thirteen-year-olds, were cared for at the two-story home, which was built on ten acres of a land claim donated by Elizabeth Parrish to the Children’s Aid Society. In about 1887, the building was replaced with a new structure in the same location. The orphanage closed in 1899 due to lack of funding, and the house was transferred to the Salem Hospital, founded in 1896, with the stipulation that at least three beds would be reserved for children in need.

Construction of Oregon State Hospital buildings began in 1881 on land that adjoined the Oregon State Penitentiary. The J Building (Cascade Hall), the earliest main hospital building, was located on the south side of Center Street Northeast. The building was constructed in the institutional style developed by Pennsylvania psychiatrist Thomas Story Kirkbride—called the Kirkbride Plan—that considered natural light, air, and other environmental factors an important part of mental health treatment.

Following the Kirkbride Plan, which advocated for a bat-wing building construction, administration facilities were located at the center of the J Building, with the patient wards spreading out on either side. When the new building opened, patients from the Oregon Hospital for the Insane in East Portland (also known as the Hawthorne Asylum) were transferred to OSH. The landscape had a parklike quality, with curved pathways, lawns, trees, and shrubs. By the end of 1883, an Asylum Cemetery had been established to the west of the North Campus, east of the Lee Mission Cemetery, south of D Street Northeast, and west of 23rd Street Northeast.

By 1895, the North Campus included an orchard, a poultry yard with laying houses, and three residences for staff. The west side of the North Campus was further developed in 1912 with the construction of the Dome Building (the Receiving Hospital) to the north of Center Street Northeast. The Griffith Nurses’ Home, northwest of the Dome Building, opened in 1929 to house female nurses and attendants, and tunnels with a rail-trolley system connected the Dome Building to other OSH buildings, including the J Building.

Salem Hospital was moved in 1900 from 204 12th Street Northeast to the renovated Glen Oaks Orphans’ Home and began admitting patients. It operated at that location until about 1919. In 1923, the new Salem Hospital (later named the Salem General Hospital) opened west of 23rd Street Northeast, and within three years the Glen Oaks building was being used for OSH employee housing. That building was removed in about 1956.

After World War II, the poultry yard structures and the staff houses were demolished to accommodate an expansion on North Campus, including Yaquina Hall in 1947, which included dorms and classrooms for training nurses. From 1948 to 1956, new buildings were built on the eastern portion of the campus: Breitenbush Hall (1948), a modern treatment hospital; McKenzie Hall (1948), a general hospital ward later used for children and adolescents; Santiam Hall (1950), a tuberculosis ward; and Eola Hall (1954–1956), a geriatrics ward that later housed forensic patients.

The entire OSH North Campus is an archaeological site. One historic-period debris pit found on the OSH North Campus was associated with the Glen Oaks Orphans’ Home during the 1890s. Items such as toys and nursing bottles, found in the pit of what is likely an abandoned privy, confirmed the presence of children at the home. Medical bottles indicate that they received medical care.

Three additional historic-period pits found to the north of the former Glen Oaks Orphans’ Home contained burned materials, including medical-related waste from the Salem Hospital from 1899 to the 1920s. Hospital-branded medicinal glasses and thermometers, institutional ceramic tableware, and clothing items connect the waste to the hospital. Marbles, fragments of porcelain dolls, and jars for malted milk indicate that children were among the patients.  

The J Building on the OSH South Campus has undergone many modifications, but it continues to be one of the best surviving examples of a Kirkbride-style hospital on the West Coast. Landscaped features designed to provide a therapeutic open setting, including entry gate pillars on the north side of Center Street Northeast, remain on the OSH North Campus. The Dome Building and Yaquina Hall still stand in the southwestern portion of the block that forms the OSH Historic District with the South Campus.

Changes at the North Campus since the late nineteenth century reflect shifts in national trends toward mental health treatment. OSH would have initially used the land for occupational therapy, with patients tending to the poultry farm. During the 1940s and 1950s, as the hospital faced overcrowding and there was more emphasis on specialized medical and surgical treatments, OSH constructed large institutional buildings in the open spaces of the North Campus. The removal of those specialized buildings on the east side of the North Campus in 2017 was a response to moving some mental health care into smaller facilities. The OSH facilities were centralized on the South Campus during the 2010s, with the focus on intensive psychiatric care for adults. There is now a multifamily housing development on the east side of the OSH North Campus block.

In 2014, the OSH Museum of Mental Health dedicated a memorial on the South Campus to those who were cremated at the Oregon State Hospital but whose remains were never claimed.