At times, it treated mental illness, tuberculosis, and provided federally funded care for veterans.

The hospital's site, which included a patient-staffed farm reached a maximum of 1,139 acres (461 ha) after World War II.

The site is/was popular among teens and in the paranormal world due to its claims of hauntings in the older buildings and the hospital's cemetery.

The next step was to secure a location near Chicago which led to many new and growing towns to compete for the selection of the hospital.

The Trustees followed the recommendations of the Association of Medical Superintendents of American Institutions for the Insane (AMSAII), in terms of the amount of land required and also by adopting the Kirkbride Plan for the Central Building.

Construction soon began on the North wing of the Kirkbride type structure with the second phase beginning on July 1, 1873.

The front expanse of the Center Building was just over 776 ft (236.6 m) long and was designed to be narrow in order to offer natural light and ventilation.

[6] Prior to 1894, many physically ill patients were denied admission to the state hospitals as being too infirm to benefit from care and were kept in local almshouses.

As a result, in 1894, Wing Hall opened as a detached infirmary building, bringing the total hospital capacity to 1,107 beds.

[7] In 1910, a 110-bed infirmary for female patients opened in an addition to the north end of the Center Building called "D-North" bringing the bed capacity to 1,210.

Although the Institute moved to the Medical campus of the University of Illinois in 1935, its laboratory remained at Elgin State.

[17] In 1987, Illinois and the United States Justice Department entered into a consent decree committing to greater resources at Elgin and improved patient care.

The farm was adjacent to McLean Blvd on the west end of the grounds with three wards, a central kitchen, a power plant, a large dairy barn and a water tower.

During the 1930s and 1940s the farm not only grew crops such as corn, but also raised 100 to 150 dairy cattle, 500 to 1,500 hogs, and 5,000 chicken at any time.

The farm colony contributed approximately one-third of the total cost of food used at the hospital, which fed both patients and staff.

After World War II, the hospital reached its maximum size of 1,139 acres, but later shrunk as a portion of the grounds were assigned to the State Highway Department for the construction of US Route 20 and the Elgin Community College campus.

As of 2018, only the Powerhouse which is still in operation, along with the New Administration Building (built in 1967), as well as some of the original asphalt roads, curbs, and sidewalks remain.

[23] Elgin Mental Health Center also serves as a training site for Psychiatry Residents from Chicago Medical School and Loyola University.