Mayview State Hospital closed on Monday, bringing an end to a 115-year history of care for mentally ill individuals that tracked with the evolution of modern mental health treatment.

When Mayview opened its doors, it was as a home for the disenfranchised, some of whom were poor or sick, particularly with tuberculosis, while others were mentally ill or unwed and pregnant. Gradually, the facility came to treat mental illness exclusively, including individuals sent there by the criminal court system. But as psychiatric and medical practices improved, the large, isolated facility became outmoded. By the time the closure was announced in August 2007, just 225 patients remained.

Finding appropriate placements for all of them has been the most crucial element of phasing out the use of Mayview's buildings, and the violent deaths of two former residents -- one leapt or fell from a bridge and the other was hit by a train -- underscored concerns about the care patients would receive in the community.

By now, most patients have moved either to Torrance State Hospital in Westmoreland County or to various forms of specialized housing throughout the region. The goal and hope is that they will be safe, able to live with as few restrictions as their abilities require, and have access to appropriate treatment and support.

But 17 patients are trapped by fear and bitterness, the outcome of a zoning dispute, between Baldwin Township residents on one side and the Department of Public Welfare and Mercy Behavioral Health on the other.

Mercy was contracted to provide care for patients who need a long-term, highly structured therapeutic residence with 24-hour supervision, and it thought it had found an appropriate facility in the former Rolling Hills Manor Assisted Living Center. But neighbors of the former nursing home are fighting the plan.

As a result, a small unit at Mayview had to open one minute after the rest of the facility shut down at 4:30 p.m. Monday to accommodate those patients. Officials are hoping to have them moved to a permanent site by February.

Mayview had much success during its long life, but sadness always has been a part of it. How disappointing that the kind of isolation and misguided fear that was common at its birth persists at its death.