It was supposed to be a school. When Willowbrook State Hospital opened its doors on Staten Island in 1947, the pitch was simple: a clean, modern facility for children with intellectual disabilities. A place where they could learn. A place where they would be safe.
Reality was different. By the 1960s, it had become a warehouse for human beings.
If you grew up in New York or follow disability rights, you’ve likely heard the name. But most people don't realize just how close we came to letting places like this become the permanent standard for care in America. It wasn't just a "bad hospital." It was a systemic collapse of ethics that eventually required a young, local journalist named Geraldo Rivera to sneak in with a camera to show the world what was happening behind those brick walls.
What he found was worse than anyone imagined.
The Overcrowding Nightmare at Willowbrook State Hospital
Robert Kennedy visited in 1965. He didn't mince words. He called it a "snake pit."
The facility was designed to hold maybe 4,000 people at most. By the time the scandal broke wide open, nearly 6,000 people were crammed inside. Think about that for a second. You have wards meant for a dozen children holding fifty or sixty. There weren't enough clothes. There weren't enough towels. Most importantly, there weren't enough staff members to keep anyone clean or fed.
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People lived in filth.
Honestly, the smells alone were reportedly enough to make grown men vomit. Because there was so little supervision, patients—many of whom had severe physical and mental challenges—were left to wander aimlessly in large, tiled dayrooms. No furniture. No toys. Just bare floors and the constant hum of institutional neglect.
Why did it get so bad?
Money, mostly. Or the lack of it. The state of New York kept cutting the budget while the courts and families kept sending more residents. It was a math problem with a tragic solution: less care for more people. By 1971, the budget was slashed again, leading to a hiring freeze that basically ensured the staff-to-patient ratio was impossible.
One attendant might be responsible for 40 patients. It’s physically impossible to bathe, feed, and change 40 people in an eight-hour shift. So, they didn't. They couldn't.
The Saul Krugman Hepatitis Studies: A Dark Ethical Line
This is the part that usually makes people's skin crawl. Between 1955 and 1970, a researcher named Dr. Saul Krugman conducted a series of medical experiments at Willowbrook State Hospital. He was trying to develop a vaccine for hepatitis, which was rampant in the facility because of the poor sanitation.
His method? Intentionally infecting healthy children with the virus.
He argued that since they were probably going to get hepatitis anyway while living there, it was "more ethical" to give it to them in a controlled setting where he could study it. He even fed some children chocolate milk mixed with the feces of infected patients to see how the disease spread.
Parents were often told their children couldn't get into the school—which was the only option for many—unless they agreed to let their kids join the "research unit."
Consent is a loose term when you're desperate for help and the state is holding the keys to the only door. While Krugman’s work actually did lead to the discovery of the Hepatitis B vaccine and the distinction between Hepatitis A and B, the way he got there remains a massive stain on medical history. It's taught in ethics classes today as a "what not to do" scenario, right alongside the Tuskegee Syphilis Study.
Geraldo Rivera and the 1972 Exposé
The tipping point happened when a doctor named Michael Wilkins and a social worker named Elizabeth Lee were fired for trying to organize parents to demand better conditions. They contacted a young reporter at WABC-TV.
Geraldo Rivera used a stolen key to get into Ward 6.
The footage he captured changed the course of American law. You saw children huddled on the floor, rocking back and forth. You saw the "piles" of laundry that were actually just soiled rags. You heard the sounds. Rivera didn't use a polished, "news-anchor" voice. He sounded horrified. He was crying on camera.
That broadcast, Willowbrook: The Last Great Disgrace, brought the reality of Staten Island into living rooms across the country. It wasn't just a local story anymore. It was a national emergency.
The Legal Aftermath and the "Willowbrook Decree"
The fallout was massive. Parents, led by activists like Bernard Carabello—a man who had been misdiagnosed and spent 18 years living at Willowbrook despite having normal intelligence—filed a class-action lawsuit.
In 1975, a landmark settlement known as the "Willowbrook Decree" was signed.
It mandated that the state drastically reduce the population of the hospital and move people into smaller, community-based group homes. It established the right to "the least restrictive environment." Basically, it said that just because you have a disability doesn't mean the state has the right to lock you away in a warehouse.
This legal victory was the catalyst for the Civil Rights of Institutionalized Persons Act (CRIPA) of 1980. It changed how every state-run facility in America operates.
What Most People Get Wrong About the Closing
A common misconception is that Willowbrook State Hospital closed the day after the news report.
It didn't.
It took fifteen years of legal bickering, funding fights, and logistical nightmares to finally shut the doors. It wasn't until 1987 that the last residents were moved out. Even then, the transition wasn't perfect. Moving people who had spent their entire lives in a chaotic institution into quiet suburban neighborhoods was a massive undertaking that the state wasn't always prepared for.
Today, the site is home to the College of Staten Island. Some of the original buildings are still there, renovated and filled with students who might not even know what happened in the very rooms where they’re taking psych 101.
Lessons for the Modern Era
We like to think this is ancient history. It isn't. The people who lived there are still alive. The staff members are still around. The "Willowbrook mentality"—the idea that some lives are less valuable than others and can be tucked away for the sake of a budget—is something we still fight in the healthcare system today.
If you want to understand the current state of disability rights, you have to look at these ruins. You have to understand that progress wasn't a natural evolution; it was forced by whistleblowers and angry parents.
What You Can Do Now
If you're interested in the legacy of Willowbrook or the history of disability rights, there are specific steps to take to deepen your understanding or contribute to the cause of dignified care:
- Watch the Original Footage: Find the 1972 WABC documentary Willowbrook: The Last Great Disgrace. It is difficult to watch but remains the most vital piece of primary evidence regarding the conditions of the era.
- Visit the Willowbrook Mile: If you are in New York, visit the College of Staten Island campus. There is a designated walking trail with 12 stations that tell the story of the institution, ensuring the history isn't erased by the new construction.
- Support the "Protection and Advocacy" System: Every state now has a federally mandated P&A system (like Disability Rights New York) that grew out of the Willowbrook scandal. These organizations provide legal services to people with disabilities to ensure history doesn't repeat itself.
- Research the Civil Rights of Institutionalized Persons Act (CRIPA): Look into how the Department of Justice uses this law today to investigate modern nursing homes and psychiatric centers. It is the direct legal descendant of the Willowbrook lawsuit.
- Read "The Willowbrook Wars": This book by David Rothman and Sheila Rothman provides the most detailed account of the legal battle and the messy, complicated process of closing the facility.
The history of Willowbrook State Hospital serves as a permanent reminder that without transparency and advocacy, institutions can quickly become instruments of trauma rather than healing. Keeping this history visible is the best way to ensure that "never again" actually means something.