When the Department of Charities and Correction was formed in 1860, it greatly expanded the city’s healthcare and reform-oriented penal institutions. The Pavilion on Hart Island was among the first buildings constructed in an area named “The Hollow,” on the south end of Hart Island. The building was first used as a Lunatic Asylum for 300 Women. Prior to its construction in 1882, George A Smith arrived as a young doctor from Bellevue. He became one of the city’s first resident physicians in clinical psychiatry and he lived on Hart Island year round up until all city asylums were closed and mental hospitals were taken over by New York State in 1895. He describes his experience:
“My first month was rather discouraging. I was afraid I would not be able to stay 6 months, but before 6 months was up I was intensely interested, and there was something magnetic and pleasant about Hart’s Island on the sound. I became more and more interested in the work, and made up my mind to continue this work in the care and treatment of the insane. I felt that the condition of the insane, their improvement, by occupation, diversion, attention and suggestion, was really the greatest medicine. We found many cases that were given up as incurable, sufficiently improved under this treatment to go home to their families and become useful citizens.”
The Pavilion was where meals were prepared and distributed for all residents of the Hollow. The buildings were heated with stoves, lighted with kerosene and water was collected in cisterns until a water supply from the mainland was connected to Hart Island. The population on Hart Island then expanded and new buildings were constructed and remained occupied until 1976.