Known first as the "City on the Hill," Harrisburg State Hospital opened in 1851 as Pennsylvania's first institution built for the care and treatment of the mentally ill and one of the first such facilities in the United States. By the 1840's, it had become clear that the country's poor houses and jails were not conducive to properly caring for people with emotional and mental disturbances. After achieving success in Massachusetts, social reformer Dorothea Dix brought her cause to Pennsylvania and persuaded the state legislature to authorize an institution for the psychologically disabled. Founded by an act of the Pennsylvania General Assembly in 1845 as the Pennsylvania State Lunatic Asylum, the hospital developed into a self-contained community with landscaped grounds and farmland intended to produce food and to provide an idyllic setting that would protect patients from the disruptive influences of the outside world rather than incarcerate them. The hospital expanded from 130 acres to more than 1000 and came to include over 70 buildings, with the most significant designed by noted Pennsylvania architects. Its campus also marked an important transition in hospital design from the Kirkbride plan, in which patients lived in one large building, to the Cottage plan, in which smaller buildings served as residences and reinforced a sense of home and open space. Listed in the National Register of Historic Places, the hospital has also been the site of at least one major film production and continues to serve those in need.