Located in the Dix Hills area (West Brentwood) of western Long Island, New York, Pilgrim State Hospital was created by the Legislature in 1929 and named for Dr. Charles W. Pilgrim, commissioner of mental health in the early 1900s. It opened on 825 acres with 100 patients transferred from Central Islip. Nine months later it had 2,018 patients. By 1935, it housed nearly 9,000 patients. The peak census was in 1954, with 13,875 patients. At times, Pilgrim had been the world's largest mental hospital. As of 1999, the Pilgrim campus contained 75 structures.
In 1998, the state government of New York announced the transfer of 86 acres of pine barrens forest from the Pilgrim State Hospital lands to the State Department of Environmental Conservation. In an auction in 1998 that was not completed (see this article in the Times Review), the 650-acre complex was sold in an auction for $32 million. The monumental towering main building can easily been seen looming off to the side as you drive through this area on the Long Island Expressway.