In 1870, a new hospital was to be constructed in upstate New York called the Buffalo State Asylum for the Insane. Architect Henry Hobson Richardson was appointed to design the new hospital, and was given an opportunity to display his own style of architecture, which is now known as Richardsonian Romanesque. The administration building went through several designs, including a low, chapel-like structure with a tall spire, inspired by the asylums Richardson had viewed in France at the time. The final draft settled on a graceful yet fortress-like edifice: two massive 185 ft. tall towers would rise from a four-story structure, with five stepped wards stretching out from both sides. The idyllic hospital grounds were designed by landscape architects Frederick Law Olmsted and Calvert Vaux, who most notably designed Central Park in New York City. About 200 acres of farmland behind the building would be used to sustain the hospital's food supply and provide therapeutic work and skills for the patients.
Construction began in 1872. The general layout of the hospital followed the symmetrical linear plan devised by Dr. Thomas Kirkbride (also known as the Kirkbride Plan), which included 16-foot tall rooms for adequate ventilation, a southern exposure for maximum sunlight, violent patients to be housed at the ends of the wings, and the building to be separated by sex on either side of the central administration area. One notable aspect that did not follow Kirkbride's plan was the location – although the building was situated just outside the city of Buffalo at the time, Kirkbride recommended a much more remote setting, far away from the evils of a crowded and congested metropolis.
The entire building was to use red Medina sandstone for the exterior masonry, however due to budget concerns in 1876, only the administration and the first two wards on either side used this material; the other six wards were constructed in brick. The asylum at Buffalo also featured a notable architectural element: curved connecting corridors which linked the ten wards together. The purpose of the curvature was to prevent beds from being placed in these areas, a common practice in overcrowded asylums at the time. The connections also featured massive iron doors that could be closed off to prevent a fire spreading from one ward to the rest of the building.
The hospital was still under construction when it first admitted patients in 1880. The administration area and the eastern wing for male patients was completed first, giving the hospital an odd asymmetrical look. The female wing was completed in 1895, however H.H. Richardson never saw his work completed, as he died in 1896.
Buffalo State Hospital's history thereon is sadly much like other state-funded hospitals in America; a surge of patients in the first half of the 20th century crippled Dr. Thomas Kirkbride's vision of peaceful, sanitary living conditions for the mentally ill. Patients slept in the halls or even outside, as the occupancy exceeded the building's design by the thousands. The city's expanding boundaries also swallowed up the hospital – in 1927, the hospital grounds were reduced by half to accommodate Buffalo State College on the north side, replacing much of the open space and farmland. In the 1930s, parts of the south lawn were paved over for parking spaces.
In the late 1960s, modern buildings were constructed nearby to provide better patient care, but unfortunately the last three wards on the eastern side of the Kirkbride building were demolished to make way for the new structures despite long-term preservation campaigns. In 1974, the hospital was re-named Buffalo Psychiatric Center, and during this year all patients were moved out of the outdated Kirkbride building. Maintenance was not performed and the structure fell into disrepair, however the administration area was used for storage until 1994 and suffered less damage than the wards.
After a successful lawsuit filed by the Preservation Coalition of Erie County in 2008, the state of New York committed $100 million to rehabilitation of the structure. Initial repairs were made that year for severely damaged portions of the building. More intensive repairs followed in 2013 as "Phase I," which involved re-developing the space into a hotel and conference space.