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Tuesday, December 9, 2014

The Western Lunatic Asylum--In 1828, A State Of The Art Facility

Western State Hospital photo
It seemed like a great idea at the time. Get all of the mentally ill off the streets and into a hospital-like setting. What could go wrong?

Virginia was the first of the colonies to build a facility devoted solely to house the "insane and feeble minded". A Quaker hospital in Philadelphia had a unit for such unfortunates, but they were all confined in the basement of the facility.

In a November, 1766, session of the House of Burgesses, Francis Fauquier, then Royal Governor of the colony of Virginia, proposed: "It is expedient I should also recommend to your Consideration and Humanity a poor unhappy set of People who are deprived of their senses and wander about the Country, terrifying the Rest of their fellow creatures. A legal Confinement, and proper Provision, ought to be appointed for these miserable Objects, who cannot help themselves. Every civilized Country has an Hospital for these People, where they are confined, maintained and attended by able Physicians, to endeavor to restore to them their lost reason."[1]
 
In that day this kind of "legal confinement" was seen as the most humane and enlightened way to deal with the mentally ill, and in 1770, the Public Hospital for Persons of Insane and Disordered Minds was established in Willamsburg. When this institution became overcrowded, a second asylum was approved by the General Assembly, the Staunton-based "Western Lunatic Asylum" that later became Western State Hospital. Opened in 1828, it was originally designed provide a calming and comfortable setting in which people could regain their sanity and return to normal life.

(In 1861 the Staunton-based facility renamed the Central Lunatic Asylum, but a new hospital built in Petersburg for people of color would soon take on this name, and in 1894 the former "lunatic asylum" was officially named Western State Hospital.)

The enlightened plans of the hospital's founder and director, Dr. Francis Stribling, were soon compromised, however, by lack of sufficient state funds allocated to maintain this kind of idyllic setting. As more and more beds were added, Western State became just another place where society's undesirables could be conveniently put away and warehoused, many of them for life.

In time it became apparent that the best and most therapeutic environment for people to receive mental health care was in the context of their own families and communities, and a program of "de-institutionalization" in the 60's and '70's resulted in the formation of Community Service Boards throughout the state to provide care and treatment. For a time the main campus of Western State was turned into a state prison, the Staunton Correctional Center. Little renovation was necessary since WHS had become largely a place for confining people and keeping them separate from the rest of society.

During its long history, Western State, like other institutions of its time, practiced inhumane forms of restraint, seclusion, and even prefrontal lobotomies. Dr. Josepf DeJarnette, a well known physician and a strong proponent of eugenics, became superintendent in 1905, and during his 38-year tenure many patients were sterilized based on the belief that mental illness was largely a genetic condition.

After World War II, the use of electroconvulsive therapy (ECT) and new psychotropic drugs changed many of the ways society treated mental illness. Today, the old site of the former Western State hospital, which at its peak housed 3000 patients, is being renovated into upscale condominiums called Villages at Staunton. Swords into plowshares?

What are the lessons to be learned as we attempt to address other social problems today? How can we employ proven best practices in treating people with substance addictions, for example, or who are charged with violating the law?
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