Support Your Local Asylum: Why America’s Historic Psychiatric Hospitals Are Worth Saving
Laura Wright 
There is something immediately unsettling about an abandoned asylum.
Long corridors disappear into darkness.
Paint peels from walls.
Doors stand open to rooms that haven’t held patients for decades.
Nature pushes through broken windows.
Perhaps that atmosphere explains why these buildings have become so closely associated with ghosts, horror films and paranormal investigation.
But before they became haunted attractions and urban-exploration destinations, they were something considerably more important.
They were hospitals.
Some represented the most progressive ideas about mental health care available when they were constructed. Others eventually became places of terrible overcrowding, neglect and abuse.
Their histories are complicated.
And that is precisely why the surviving buildings deserve to be preserved.
Before They Were Abandoned
It is easy to look at a decaying nineteenth-century psychiatric hospital and assume it must always have been a dreadful place.
That isn’t necessarily true.
Many early American psychiatric institutions were created during a period of reform.
The movement known as moral treatment argued that people suffering from mental illness should be removed from jails, poorhouses and other degrading conditions and treated in peaceful, orderly surroundings.
Fresh air mattered.
Sunlight mattered.
Exercise mattered.
Meaningful work and recreation mattered.
Architecture itself became part of the treatment.
The buildings were not originally designed to frighten people.
Quite the opposite.
The Kirkbride Plan
One of the most influential figures in nineteenth-century American psychiatric hospital design was physician Thomas Story Kirkbride.
Kirkbride advocated a particular hospital arrangement consisting of a central administrative building with long, staggered wings extending outward.
Different groups of patients could be housed separately.
Rooms received natural light and ventilation.
Windows overlooked landscaped grounds.
The hospitals were often constructed outside crowded cities, where patients could experience quiet surroundings, gardens and farmland.
The resulting structures became known as Kirkbride hospitals.
Many were enormous.
They could also be beautiful.
Towers, cupolas, elaborate brickwork, stone arches and carefully landscaped grounds reflected an extraordinary amount of architectural ambition.
The buildings themselves were intended to participate in healing.
That original purpose is easily forgotten when we encounter them today as ruins.
Then Everything Went Wrong
The ideals behind the hospitals did not always survive reality.
As state hospital populations increased, many institutions became desperately overcrowded.
Facilities intended for hundreds could eventually contain thousands.
Funding failed to keep pace.
Staffing became inadequate.
Buildings deteriorated.
Treatment philosophies changed.
Some institutions became notorious for restraint, isolation and questionable medical procedures. During the twentieth century, psychiatric history would also include insulin coma therapy, electroconvulsive therapy as historically administered, and psychosurgery such as lobotomy.
Some patients spent years or decades institutionalized.
Others undoubtedly suffered abuse.
Those histories should not be softened merely because the buildings were beautiful.
But neither should the buildings be reduced to places where monsters in white coats tortured helpless patients.
The truth is much more complicated.
People Tried to Help There Too
Thousands of physicians, nurses, attendants, cooks, cleaners, gardeners and other employees spent their careers inside state hospitals.
Some were undoubtedly cruel.
Others were compassionate people working under extraordinarily difficult circumstances.
Patients also experienced these institutions differently.
For some, hospitalization was traumatic.
For others, an institution provided shelter, treatment and stability unavailable elsewhere.
The history of psychiatric care cannot be divided neatly into villains and victims.
That complexity is one reason preserving these places matters.
Once the physical institution disappears, it becomes considerably easier to replace its history with stereotypes.
The Great Closures
During the twentieth century, America’s enormous state hospital system began collapsing.
New psychiatric medications offered alternatives to long-term institutionalization. Ideas about civil liberties and mental health treatment changed. Community-based care was increasingly favored over confinement in enormous state institutions.
Beginning particularly during the 1950s and accelerating afterward, deinstitutionalization dramatically reduced state hospital populations.
In principle, patients would receive treatment within their communities.
In practice, adequate community mental-health resources were not always created to replace the institutions being closed.
The old hospitals emptied.
And governments were left with enormous buildings they no longer needed.
What Do You Do With a 500,000-Square-Foot Asylum?
That became the problem.
Historic psychiatric hospitals are extraordinarily difficult to preserve.
They are huge.
Heating them is expensive.
Roofs fail.
Water enters.
Asbestos and lead paint may require remediation.
Vandalism accelerates deterioration.
Restoring hundreds of rooms can cost millions upon millions of dollars.
Developers look at an abandoned hospital and see an economic nightmare.
Demolition can appear considerably easier.
And so many disappeared.
One building at a time, an extraordinary chapter of American architectural and medical history began vanishing.
Danvers State Hospital
Massachusetts’ Danvers State Hospital is one of the most famous examples.
Opened in 1878, its enormous Kirkbride building became an icon of asylum architecture.
It eventually closed in 1992.
For years the abandoned complex became legendary among urban explorers and paranormal enthusiasts. It also became associated with horror through the 2001 film Session 9, which was filmed there.
Much of the complex was eventually demolished during redevelopment.
A portion of the historic central structure was preserved and incorporated into residential development.
It isn’t the old Danvers.
But neither is it completely gone.
That compromise may be frustrating to preservation purists, yet adaptive reuse is often the only financially realistic way these enormous buildings survive.
Trans-Allegheny
West Virginia provides a much happier example.
The former Trans-Allegheny Lunatic Asylum, originally the Weston State Hospital, opened in the nineteenth century and eventually grew into an enormous psychiatric institution.
Its main Kirkbride building is monumental.
After the hospital closed in 1994, the property faced the same uncertain future as countless former institutions.
Instead of disappearing, much of it survived.
Today the property offers historical tours as well as paranormal events.
That combination may make some historians uncomfortable.
But it has accomplished something important.
The building is still there.
Tourism provides money.
Money provides maintenance.
Maintenance keeps the roof on.
Sometimes preservation requires an alliance with the ghosts.
Waverly Hills
The original version of this article used Waverly Hills Sanatorium in Louisville, Kentucky, as its central example.
Technically, Waverly wasn’t an asylum.
It was a tuberculosis hospital.
But it illustrates exactly the same preservation problem.
The enormous Gothic-looking structure became internationally famous because of its alleged paranormal activity.
Ghost stories brought visitors.
Visitors brought money.
And interest in the building helped prevent it from simply becoming another abandoned institutional ruin.
That doesn’t mean every story told about Waverly is historically accurate.
Some decidedly aren’t.
But the building survived.
And because it survived, its real history can still be investigated.
Ghost Hunters Accidentally Became Preservationists
There is a delicious irony here.
Paranormal tourism has probably helped save buildings that conventional historical tourism alone might not have supported.
People will pay to spend the night in an allegedly haunted hospital.
They will take ghost tours.
They will attend investigations.
They will buy shirts.
They will travel hundreds of miles hoping something whispers into a recorder at two in the morning.
If part of that money repairs roofs, stabilizes masonry and preserves historic architecture, the dead may be doing the living a considerable favor.
That doesn’t mean every abandoned hospital should become a haunted attraction.
It does mean paranormal interest can become a useful component of preservation when handled responsibly.
But Don’t Invent Atrocities
There is a danger.
Haunted attractions need stories.
And genuine history doesn’t always provide sufficiently theatrical ones.
So legends develop.
Thousands supposedly died in a building where the documented number was far smaller.
A perfectly ordinary corridor becomes a “death tunnel.”
Patients were supposedly murdered in rooms where no such event can be established.
Doctors become sadists.
Nurses become killers.
Every surgical instrument becomes an instrument of torture.
Every unusual treatment is stripped of its historical context.
Eventually the real institution disappears beneath the ghost story.
That isn’t preservation.
It is another form of destruction.
Patients Were Real People
This matters particularly with psychiatric hospitals.
The people who lived there were not props in a haunted house.
They had names.
Families.
Occupations.
Illnesses.
Personalities.
Some recovered and went home.
Some remained institutionalized for life.
Some died there.
When we casually transform them into “insane spirits” roaming corridors, we repeat some of the same dehumanization that made historical psychiatric abuse possible in the first place.
There is nothing wrong with investigating reports of apparitions in an old hospital.
There is something wrong with treating former patients as monsters because they once received psychiatric care.
The haunting, if there is one, should never erase the human being.
Cemeteries Are Part of the Story
Many state hospitals maintained cemeteries.
Some contain hundreds or thousands of former patients.
In certain institutions, graves were marked only with numbers.
Records were lost.
Markers sank into the earth.
Vegetation swallowed burial grounds.
Preserving these cemeteries is every bit as important as preserving the impressive administration buildings.
Perhaps more so.
Architecture attracts photographers.
A numbered stone in the grass does not.
But that stone represents someone who lived.
Modern preservation projects have sometimes attempted to restore patient names to numbered graves, reconstruct burial records and recognize people who were largely forgotten after death.
That is preservation at its most meaningful.
Don’t Sneak Into Abandoned Hospitals
There is another way to support historic asylums:
Don’t destroy them while trying to appreciate them.
Trespassing has become a serious problem at abandoned institutions.
Urban explorers enter unstable buildings.
Windows are broken.
Doors are forced.
Graffiti appears.
Objects are stolen as souvenirs.
Fire follows surprisingly often.
And eventually officials point to the vandalized ruin and say the building has become too dangerous to save.
They may be right.
An abandoned hospital can contain collapsed floors, open elevator shafts, unstable ceilings, asbestos, mold, broken glass and other hazards.
If a site isn’t legally open to visitors, admire it from somewhere you are allowed to stand.
A photograph isn’t worth dying for.
What Preservation Actually Means
Saving a historic hospital does not necessarily mean freezing it exactly as it appeared in 1890.
That is often impossible.
Preservation can mean restoration.
It can mean stabilization.
It can mean converting a hospital into apartments, offices, a hotel, museum or community space while retaining historically important architecture.
It can mean preserving only the most significant portion of a complex when saving everything is financially impossible.
Sometimes the choice isn’t between perfect preservation and redevelopment.
It is between adaptive reuse and a bulldozer.
I will take the apartments.
Why Keep Buildings Associated With Suffering?
This question inevitably arises.
Why preserve places where people suffered?
Why not tear them down and allow the past to disappear?
Because history isn’t preserved only when it is pleasant.
We preserve battlefields.
Prisons.
Slave quarters.
Factories where workers died.
Hospitals where medicine failed.
Places where terrible things happened can teach us precisely because they make history physical.
Reading that psychiatric hospitals became overcrowded is one thing.
Standing in a corridor built for a few hundred patients and learning that thousands were eventually housed within the institution makes the scale tangible.
The building becomes evidence.
They Also Preserve Good Intentions
There is another reason.
These hospitals preserve failed idealism.
Many were created because reformers genuinely believed people with mental illness deserved something better than confinement in jails and poorhouses.
They built enormous hospitals filled with sunlight.
They surrounded them with lawns and trees.
They created farms.
They believed environment could heal.
Then population, economics, changing medicine and institutional bureaucracy overwhelmed many of those ideals.
That history is worth remembering.
Not because everything the reformers believed was correct.
Because they were attempting to solve a human problem that we are still trying to solve.
And Perhaps They Preserve Something Else
Then there are the ghost stories.
Old hospitals generate them with remarkable regularity.
Former employees report footsteps in empty wards.
Visitors describe figures at windows.
Doors move.
Voices are heard.
People occasionally report experiences in locations whose histories they claim not to have known beforehand.
Many of those stories undoubtedly have ordinary explanations.
Large institutional buildings are noisy.
Pipes move.
Air travels through enormous ventilation systems.
Sound carries through corridors.
Expectations influence perception.
But every once in a while, a story refuses to settle comfortably into any of those categories.
That is part of these buildings’ cultural history too.
We don’t have to choose between preserving architecture and preserving folklore.
We can preserve both while being clear about which is which.
Support Your Local Asylum
The title of the original article was deliberately playful, but the argument behind it was serious.
Once these buildings are gone, we cannot build another nineteenth-century state hospital.
We can imitate one.
We can reconstruct portions.
We can create museum exhibits.
But the original building, constructed by the people who believed in its purpose and occupied by generations who experienced its successes and failures, is irreplaceable.
The original article made that point very simply: these institutions provide a glimpse into the past, and once destroyed, they cannot be replaced.
That remains true.
Support historical societies.
Visit preserved hospitals legally.
Take the history tours as well as the ghost tours.
Donate to restoration projects when you can.
Learn the names of the people who lived there.
Correct legends when they overwhelm the history.
And if paranormal tourism helps keep another magnificent old hospital standing, I’m perfectly willing to let the ghosts earn their keep.
Leave the Lights On
Perhaps someday we will look back on the great American asylum era with greater clarity than we have now.
The buildings can help us do that.
They preserve the optimism of reformers.
They preserve architectural ambition.
They preserve medical history.
They preserve institutional failure.
They preserve uncomfortable questions about how societies treat people who cannot easily care for themselves.
And yes, they preserve mysteries.
There may be no ghost standing at the end of the corridor.
But there were once people there.
Thousands of them.
Their lives deserve something better than a bulldozer followed by a subdivision whose residents never know what occupied the land before them.
So preserve the towers.
Preserve the wards.
Preserve the cemeteries.
Preserve the records.
Preserve the uncomfortable history along with the beautiful architecture.
And if an occasional unexplained footstep continues down one of those restored corridors after everyone has gone home for the night?
Well.
Consider it the building’s way of reminding us why we saved it.
About the Author
Loverly,
I think it is interesting that you chose a photo of Waverly for this post, since it is considered, or is, at least, believed to be, one of the most haunted structures in the United States. I presumed you would elaborate on that aspect of many of these buildings, since death is a major part of their history.
Do you think that a structure’s reputation of being haunted plays a part in how such edifices are treated?
That aside, I agree with the issue regarding historical preservation. We can learn quite a bit by maintaining these structures instead of having them razed. Luckily, the owners of Waverly are not planning on destroying this hospital any time soon, and are thinking about transforming it into a hotel. In the meantime, they conduct tours (many of them “ghost” tours) and allow paranormal investigations on a regular basis to raise the money needed for renovations (see here).
I know we had a recent discussion about this on my blog. I would certainly like to visit Waverly some day.
Do you have a current update on the place? I haven’t had the time to look further.
R1
Hi!
Actually, the paranormal group I’m in looked into visiting for a long time. I don’t think they were able to arrange it, I know there’s a pretty good fee for groups who want to investigate. I’ve thought about providing insight into each structure, specifically, but I’m still hashing out ideas for them:-)
Waverly is a shining example of historic buildings that have been saved because someone took an interest in them. Any interest is better than none.
Hm, I’m happy with this nevertheless not utterly confident, thus i am gonna research a little more.
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