Democracy Dies in Darkness


When we thought mental illness could be cured with architecture

March 23, 2017 at 7:36 AM

The U.S. government was so proud of St. Elizabeths, it had a model made and trotted it around to exhibitions. (NBM)

When the Government Hospital for the Insane opened in Anacostia in 1855, the asylum’s supervising physician, Charles Nichols, predicted that 50 percent of the mentally ill people treated there would make a full recovery. What made him so confident? The building. He’d designed it in accordance with the most cutting-edge theories of the day, which called for sunny, well-ventilated asylums in the countryside.

St. Elizabeths’ sleeping porch in 1910. (National Archives)

“They idealistically thought the right kind of building in the right kind of place could cure people,” says Sarah Leavitt, curator of “Architecture of an Asylum: St. Elizabeths, 1852-2017,” an exhibit opening at the National Building Museum on Saturday. “It turns out that’s not true. You can’t fix brain chemistry with architecture.”

The exhibit traces evolving theories about mental health care through the changing architecture of the asylum, which was renamed St. Elizabeths in 1916 and grew to include upward of 100 buildings, about 75 of which now stand empty on a bluff overlooking the Anacostia River. The exhibit includes furniture from the asylum, historical photos and architectural plans, and a huge scale model of the campus that was made to showcase the then state-of-the-art facility at the 1904 World’s Fair.

A patient’s room in 1905. (National Archives)

“St. Elizabeths is part of a bigger story about the infrastructures that America built to take care of mental health patients in the mid- to late 19th century, when we led the world in building such structures,” Leavitt says, “and the story of how, over the last 50 years, we’ve abandoned or destroyed it all.”

The first federal mental hospital, St. Elizabeths was built to treat D.C. residents and members of the Army and Navy. The original building, which still stands, consists of a central tower flanked by two long corridors that zigzag back in order to provide ventilation and light. Patients lived in simply furnished rooms and were often taken outside for recreation or to work on the on-campus farm.

This “old electric shock machine” was used for patient therapy at St. Elizabeths in the early 20th century. (National Archives)

Fresh air and exercise failed to provide the cure Nichols had hoped for, though, and St. Elizabeths became overcrowded as patients settled in for long-term care. That problem intensified after the Civil War, when veterans suffering from what we’d now call alcoholism and PTSD swelled the hospital’s population.

The superintendent who took over in 1877, William Godding, believed patients would do better in smaller, cottage-like buildings, so he had more buildings constructed. Scattering patients around the campus turned out to be inefficient, however, so Godding and his successors returned to building large structures. They also became less interested in architecture and more interested in science as a source for cures. Superintendent Alonzo Richardson, appointed in 1899, expanded the hospital’s autopsy and research programs and created a nursing school.

Lab technicians in 1966. (National Library of Medicine)

“At the turn of the century, St. Elizabeths had some of the best and most impressive research labs into neuropathology and mental illness in the world,” Leavitt says.

Veterans from the two world wars further swelled the population at St. Elizabeths. At its peak in the 1960s, the massive hospital complex spidered across some 350 acres and housed nearly 8,000 patients, Leavitt says. Then, a series of events started emptying the hospital, beginning with the creation of the Veterans Administration in 1930, which transferred mentally
ill vets to a system of VA hospitals.

The Department of Homeland Security is taking over old buildings on St. Elizabeths west campus.

“In ’63 [President John F.] Kennedy signs a bill that’s going to restrict money from huge hospitals and funnel money into smaller community health centers, most of which were never built,” Leavitt says. “A lot of patients left these hospitals and had nowhere to go. Funding decreased even more under [President Ronald] Reagan in the ’80s, and buildings at St. Elizabeths and elsewhere were being emptied out and stood abandoned for decades.”

If you visit the west campus of St. Elizabeths today, you’ll find about 50 buildings in various states of decay. The Department of Homeland Security has taken over that side of the campus and is building a new headquarters there. On the east campus there are about 25 old buildings, plus a new one: Built in 2010, the new St. Elizabeths is a mental hospital operated by the District.

A new hospital was built in 2010 on the east campus.

Leavitt says she hopes people leave the Building Museum exhibit with a better sense of D.C. history and the state of mental health care in America: “The question I want people to ask is, ‘What should we do with these parcels of land, and what can we do for the mental health patients that still need help?’ ”

National Building Museum, 401 F St. NW; Sat. through Jan. 15, $10.

I'm the "Staycationer," author of a biweekly column reviewing tourist hotspots in the Washington, D.C. area. I also preview upcoming performances and write quirky and fun feature stories on museums, monuments, music, dance, arts, animal behavior, science, travel, tourism, fun things to do in D.C.

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