Dr Frederic Norton Manning rejected the asylum as 'a cemetery for deceased intellects'. In 1876 he toured asylums in England, France, Germany and the United States, returning with drawings of Chartham Down Hospital in Kent. Working with Colonial Architect James Barnet and Botanic Gardens director Charles Moore, he built Australia's first hospital purpose-built for moral therapy treatment on the Iron Cove foreshore.
The Kirkbride Complex took five years to build. Ten ward blocks of Victorian sandstone, five male and five female, linked by a continuous covered veranda and arranged around landscaped airing courts surrounded by walls and ha-has. Moore's grounds were part of the treatment itself, designed alongside the buildings for around 600 patients.
By 1930 the hospital held 1,500 patients against a designed capacity of about 600. Public inquiries into overcrowding ran in 1923, 1948, 1955 and 1961, the last as a Royal Commission. The pavilion design Manning had built around light, air and landscape was carrying more than twice its intended load.
The hospital closed entirely on 30 April 2008. Sydney College of the Arts occupied the Kirkbride Complex on a 99-year lease from 1996, then vacated at the end of 2019. The site sits on the NSW State Heritage Register, the Iron Cove foreshore was protected in perpetuity by an Act of Parliament in 2002, and most of the parkland is now managed by Greater Sydney Parklands Trust.