The hospital was the result of the successful lobbying efforts of 19th century social reformer, Dorothea Dix.

A nine-member board of trustees was empowered to appoint a superintendent, purchase land, and construct facilities near Harrisburg.

Patients from all parts of the state would be accepted at the hospital, at the expense of the counties that they belonged; or, if able they would pay for themselves at a cost of $2.50 per week.

The boarding charges for private patients were scheduled to vary between $3.00 and $10.00 based upon ability to pay.

For four decades this unpaid Board and its small staff had no authority to correct the conditions it found within state institutions.

A Committee on Lunacy was created within the Board of Public Charities in 1883 to oversee the operations of these mental institutions.

Designed and constructed by Pennsylvania architects Addison Hutton and John A. Dempwolf, the campus and buildings were meant to represent an Italianate window.

Like other institutions, Harrisburg State Hospital's patient population began to fall in the late 20th century.

[6] Many of the buildings on the Harrisburg State Hospital campus are set to be demolished and one was destroyed in a fire in December 2024.