The history of mental illness is fascinating, to say the least. Like many conditions, our understanding and knowledge of mental illness have come a far way from the treatments and perceptions of the past. Up until the end of the 20th century, treatment of the mentally ill in Virginia, and around the world, ranged from severe cruelty and deplorable conditions, to misguided, but well-intended practices. The following 5 old asylums in Virginia, including the first-ever mental hospital in the United States, show the variance of care and conditions provided to those with mental afflictions. All but one has been abandoned, but the eerie ghosts of times past clearly remain.

1. Public Hospital for Persons of Insane and Disordered Minds, Williamsburg

The Public Hospital in Colonial Williamsburg is the oldest psychiatric hospital in the nation and the first hospital specifically purposed for treatment of the mentally ill. Founded in 1773, the Public Hospital was built at a time when mental illness was not diagnosed by a doctor, but rather by a jury-like group of 12 citizens who gave a verdict of "criminal, lunatic, or idiot".

As with many early asylums, conditions were barbaric and patients lived in small cells outfitted with only a straw mattress and chamber pot. When John Minson Galt II took over the hospital in 1841, conditions improved as "moral management" began being used for treatment, emphasizing self-control, work therapy, and leisure activities. Patients were given beds and other "luxuries," while activities like lectures, concerts, and visits into town were provided along with a library and workshops for sewing, carpentry, and shoemaking to teach practical skills.

The hospital thrived for a time, but a fire in 1865 and continued overcrowding forced the creation of a new facility at Dunbar Farm. The new hospital, now called Eastern State Hospital, remains in operation today.

In 1972, excavation of the original building began and in 1985, a replica, known simply as the "Public Hospital," opened as a museum in Colonial Williamsburg where visitors can see examples of patients' cells and learn about early treatment of mental illness.

2. Central Lunatic Asylum (Central State Mental Hospital), Petersburg

The hospital, once known as Central Lunatic Asylum, was the first facility designated for "colored persons of unsound mind." Before the end of the Civil War, enslaved people could be sent to private asylums if their owners could pay, however, many couldn’t and whites always received priority. The classification of mental illness, particularly among enslaved people, was broad as those who tried to escape were said to be suffering a condition called "drapetomania," believed to be the result of an overly indulgent master. In 1870, the former Howard’s Grove hospital was turned into an asylum specifically for these patients and the current building was built in 1885.

Over the years, causes of "insanity" or "psychosis" included epilepsy, abortion, emancipation, marriage, and typhoid fever. The site eventually included buildings for chronically ill females, delinquent females, and psychopathic men. More of a prison than a hospital, overcrowding, forced restraint, physical cruelty, and forced sterilization are just a few of the atrocities recorded at this site.

The hospital remained exclusive to African Americans until the Civil Rights Acts of 1964. In 1980, more than 1500 patients underwent involuntary sterilization, an act that later played a part in a class-action lawsuit filed by some of the victims requiring the Commonwealth to provide optional reversal procedure to every patient sterilized between 1924 and 1973.

3. Western State Lunatic Asylum (Western State Hospital), Staunton

Western State Lunatic Asylum was opened in 1828. At first, it was a resort-style asylum, focusing on treatment and healing with serene surroundings, terraced gardens, and mountain views. However, by the mid 19th century, practices started to shift to more common and cruel practices of the day, including straitjackets, restraints, lobotomies, and forced sterilization. Dr. Joseph DeJarnette served as superintendent from 1905-1943 and was perhaps one the most vocal advocates of eugenics, or compulsory sterilization of the mentally ill. Although forced sterilizations ended with a federal ban in the 1970s, electroshock therapy, and lobotomies continued.

The facility relocated in the 1970s and the grounds were turned into a prison until closing in the early 2000s. The adjoining cemetery holds nearly 3,000 graves, many unmarked.

In 2008, the Western State Hospital buildings were converted into the "Villages at Staunton" luxury condos.

4. DeJarnette Sanitarium, Staunton

The DeJarnette Sanitarium began in 1932 as a semi-private facility associated with Western State Hospital. Named after Dr. Joseph DeJarnette, Western State's superintendent, it broke away from the hospital in 1946 and became a fully private institution for the mentally ill and those with drug and alcohol addictions. DeJarnette was a notorious proponent of forced sterilization of anyone seen as "unfit," including the mentally ill, although it is unlikely that sterilizations were performed at the Sanitarium.

In 1972, the Sanitarium was renamed the DeJarnette Center for Human Development and switched its focus to children and adolescents with severe mental disturbance. In the late 80s, lack of funding and deteriorating buildings caused patients to be relocated to the new adolescent ward of the Western State Hospital at its new (and current) location and the building was abandoned in 1996. Now owned by the Frontier Culture Museum, the fate of the DeJarnette buildings are in question as plans are being considered for a shopping mall.

5. Southwestern Lunatic Asylum (Southwestern State Hospital), Marion

When it was built in 1887, the Southwestern Lunatic Asylum was considered to be the most modern and economical asylum of its time. The asylum was founded to meet the needs of the mentally ill in southwest Virginia, because the nearest hospitals in Williamsburg and Staunton already faced overcrowding. For the first several decades of its operation, the facility was self-sustaining, providing a farm-like atmosphere including livestock and patient-farmed crops that fed both staff and patients. In 1902, the facility was renamed Southwestern State Hospital. Over time, the hospital continued to add recreational and farming opportunities, as well as expanding its patient base with the creation of a ward for the criminally insane in 1913.

Many of the patients in the early part of the 20th century suffered from conditions like syphilis-related dementia, tuberculosis, and pellagra, a vitamin deficiency that caused dementia, although the hospital also cared for mentally and emotionally disturbed patients, as well as those with physical ailments like epilepsy. In 1951, the first lobotomies were performed, but the practice was short-lived.

Still in operation today, Southwestern State Hospital has seen many changes over 125 years, both in diagnoses and subsequent treatments. However, they have remained true to their original operating principle of "swift recovery for the mentally ill" and continue to provide high-quality care for psychiatric patients.

I think there is one thing that we can all agree on when looking back on these old asylums in Virginia, and that is that we've come a long way in both understanding and care at mental health facilities. It's hard to imagine a time when things were so primitive. What do you know about these old asylums in Virginia? Tell us in the comments below?