First U.S. insane asylum: Oct. 12, 1773

For the first time in America, a facility dedicated solely to housing the mentally ill opens its doors in Williamsburg, Virginia.  Called the “Public Hospital for Persons of Insane and Disordered Minds,” it’s a response to an appeal six years earlier by the colony’s royal governor, Francis Fauquier, to provide a hospital for “People who are deprived of their senses and wander about the Country, terrifying the Rest of their fellow creatures.”

It’s not intended, however, as a hospital where the mentally ill can receive long-term care, but rather a place where they can live apart from the rest of society until they’re “cured.”  Back then, “insane” behavior was thought to be both a moral failing and a conscious choice from which people could be dissuaded by treatments such as dunking in cold water, application of hot cupping glasses and bloodletting. By the turn of the century, patients were being treated with electrostatic machines which produced static electricity shocks.

In 1790, fences 10 feet high and 80 feet long were added to each end of the hospital to provide exercise yards for both sexes and then, in 1799, two dungeon-like cells were dug "under the first floor of the hospital for patients who may be in a state of raving  phrenzy."

But in the 1840s, the hospital, renamed the Eastern Lunatic Asylum  (At one point, it was called simply the “Mad House.”) began moving in a new direction, permitting patients to travel into the town and interact with members of the public during the day, then return to the asylum at night.  That humane practice, however, was discontinued after the Civil War, and the staff returned to more regressive treatments such as shock therapy, lobotomy and drug experimentation.

The original building burned down in 1885 in a fire that started in electrical wiring that had been installed for the first time.  It was replaced by a facility known simply as Eastern State Hospital and its population continued growing until more than 2,000 patients lived there in the 1930s.  But with the development of Colonial Williamsburg in the middle of the 20th century, Eastern State—located in the midst of the historic restoration project—was moved to a suburban area of the city.

Around that time, attitudes about the treatment of mental health patients also began changing, with growing emphasis on de-institutionalization, with the goal of allowing them to live outside huge hospitals and instead be treated in community-based mental health care programs. But Eastern State Hospital remains in business as a psychiatric hospital, now with 300 beds.

The original hospital is back in Colonial Williamsburg, now as a small museum. It includes six patient cells, including some modeled after the original ones—those with shackles attached to the wall.