The Trans-Allegheny Lunatic Asylum (Photos after jump – Part I of III)

People forget, today, that once, the streets of the nation weren’t full of “homeless,” babbling nonsense in their disconnection from reality, until they finally do something violent enough to get whacked or locked up by the cops. Those people, who have been with us since time out of mind, were once housed in asylums. But thanks to the ruinous 1960s/70s policy of “deinstitutionalization,” they were cut loose to fend for themselves in the streets. It wasn’t supposed to be that way: closing the booby hatches, which had come to be thought of as decrepit and brutal warehouses for mentally weak and helpless human beings, was supposed to usher in a new age of peace, love and brotherhood.

Weston State Hospital, formerly the Trans-Allegheny Lunatic Asylum.

Weston State Hospital, formerly the Trans-Allegheny Lunatic Asylum; now a remarkable museum.

Well, the curtain of peace, love and brotherhood is always descending on us, but generally seems to land jackboots-first. In the case of the mentally ill, those valiant warriors of the Atheist Criminal Lovers Union have gone to court to make sure that the mentally ill can live in conditions that would be felony cruelty and neglect, if inflicted on a dog or a cat.

If people today have forgotten (or not learned) the lessons of deinstitutionalization, no less did the authors of deinstitutionalization forget (or never learned) the lessons of the asylum builders. The asylums were not built, as the deinstitutionalizers’ heirs have written in kids’ textbooks, by cruel monsters in black hats. They were, like early prisons, the product of well-meaning reformers, who found the mentally ill suffering in public all across the land (rather like they are today). The most famous of these reformers was Dorothea Dix, an heiress who probably struggled with mental illness herself, but was financially insulated from the consequences, unlike most middle or working class people. Dix advocated for hospitals for the mentally ill, and for humane treatment of their inmates, radical ideas in the early 19th Century. Dix’s philosophy was given physical form by a Philadelphia psychologist — then a new and much disputed profession — turned architect, Thomas S. Kirkbride. Kirkbride believed that the mentally ill could be helped by light and airy buildings, and in his 1854 On the Construction, Organization, and General Arrangements of Hospitals for the Insane, he conceived hospitals with wings that were echeloned back as they extended further from a central administrative core, so as to ensure the constant availability of daylight and fresh air in all rooms.

What did you get in this place for? They'll sell you a t-shirt with the list....

What did you get in this place for? They’ll sell you a t-shirt with the list….

And here before you, is the largest surviving mental hospital built to the Kirkbride Plan, the Trans-Allegheny Lunatic Asylum in Weston, West Virginia. The Kirkbride plan was to uplift, help, and cure the mentally ill explicitly by institutionalization, as Dix promoted; Kirkbride extended her argument to propose that if the building was right, and the grounds were well-designed and -groomed, they would help ease the mentally ill back to health. While it was a plausible argument in 1854, fifty years of pursuing it at a national level proved it didn’t work. (We know more about mental illness today — but certainly not enough to cure it).

Other once-common treatments, like the prefrontal lobotomy, have been found to be something other than the cure-alls they were claimed to be. The intent may not have been cruel, but could the result be anything but?

This room was once packed with beds of suffering patients. It was the lobotomy recovery room.

This room was once packed with beds of suffering patients. It was the lobotomy recovery room.

By the late 20th Century, the Government interests which had initially neglected the mentally ill, and then institutionalized them “for their own good,” no longer defined Government’s duty as taking care of the few most helpless; its priority now was on bestowing the greatest variety of benefits on as many as possible, and the vast resources embedded in Kirkbride Plan institutions such as this asylum, for the benefit of only a few inmates, could not be justified. And with the growth of populations, even this massive building, the second largest cut-stone building on the planet (the largest is the Kremlin), was overcrowded by over ten times. Designed for 240 inmates, it held 2,600 at its peak, in conditions which rivaled the bestiality that had produced Dix’s call for reforms in the first place.

A couple of online sources say 2,600, but during OTR’s recent tour, they told him, “The facility was designed to hold 250 patients and held over 4,000 patients at one time.”

Many of the patients were restrained — and only the worker who put you in restraints was authorized to release you, so if you went in on a Friday, you were probably bound up until Monday. If people didn’t come in insane, wouldn’t they go that way?

Along with straitjackets, there were five-point restraints, and wall points to which a lunatic might be chained.

This is the Trans-Allegheny Lunatic Asylum, construction of which began before the ink was dry on Kirkbride’s 1854 volume (and which continued, after resolving a dispute about funding, after WV broke from VA at the outbreak of the Civil War. As the Historian for the site wrote in his book Lunatic: The Rise and Fall of an American Asylum (available at the onsite giftshop for less than at Amazon), “This Gothic structure was the end of the line for West Virginia’s insane for 130 years.”

If that seems cruel, consider today’s end of the line for the insane: a cardboard box in a traffic island, a sleeping bag under a bridge, or the point of a policeman’s bullet.

Of the surviving Kirkbride Plan mental hospitals, Trans-Allegheny is unusual in three things: it is being maintained, not allowed to decay; it holds several kinds of tours, including straightforward historical tours and spooky night “ghost” tours; and it is in private hands, away from the neglect of government ownership. Recently Our Traveling Reporter traveled to the site and took the non-ghost tour. (We’re thinking that an obsession with the “paranormal” is a marker for someone whose presence at a lunatic asylum should not be constrained to a mere visit. There may be reasons to lock up OTR, but a lack of sense is not one of them).

Some things change over time, but some do not. Here is the grounds plan from its early years:

weston_hist_1884_layout

Did you see the segregated “colored patients” area? No surprise, in the West Virginia that gave us Exalted Octopus Robert Byrd. Here’s a period (late-19th-Century) shot of the “Colored Annex,” probably from the clock-tower spire of the administration core:

weston_hist_colordsannex

What do you think this had become by 1989, shortly before closing? (The functional map is of 2nd floor offices as of 1989).

weston_hist_1989_layout_2

Yep. The veterans’ unit. Note also the improvement in illustration standards over the century plus between the two sketches.

For more of Our Traveling Reporter’s photos and captions, hit “more” after the FMI links below

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OTR learned a lot from the tour, and came away with an abiding gratitude for the gift of sanity.

Dr Freeman was not a licensed physician. He was licensed for medical research. But he was intent on performing the procedure he saw as a cure for mental illness: full craniotomy lobotomy. He could not get licensed as a neurologist. He got together with another doctor, and did 17. Then he presented his research.

He went to a board (aka a “doctor dinner”) and they were outraged. He went to the media and got support for his radical new therapy, and was licensed. Then it was off to the races! He did 238 lobotomies in a 30 day period.

Freeman reinvented the procedure and used his wife’s ice pick. He used no pain medicine and did not clean his hands. 30% of his surgical patients died due to infection.

Recovery time was ostensibly 25 to 30 minutes. In reality, that recovery room illustrated above is where the clearly botched ones came to die. Why? Because the lobotomy area is 2 buildings away and the would not wheel the patient here for a short time.

Next to the lobotomy ward is one with an even more chilling story:

Trans-Allegheny Lunatic Asylum's pediatric ward.

Trans-Allegheny Lunatic Asylum’s pediatric infant ward.

Why was there an infant ward in a laughing academy? Because the dominant theory of the age was that insanity was produced by inbreeding or otherwise heritable, it was assumed any baby born to an inmate mother would be insane, also. “If you were born to a patient you lived your life here.”

They estimate that over 100,000 people died here. They’re pretty sure it’s an underestimate.

They could not transport the insane in passenger cars. They came naked by train in cattle cars. The townspeople would line up to watch.

When people finally complained they put patients in burlap sacks for transport.

 Next stop here, the admissions area:

Cheerful welcome sign... beats "All Hope Abandon, Ye Who Enter Here," but the latter might have been more accurate.

Cheerful welcome sign… beats “All Hope Abandon, Ye Who Enter Here,” but the latter might have been more accurate.

Main (male) admissions area:

trans-allegheny05

Female admissions area:

trans-allegheny06

The colors were supposed to help. It turns out they didn’t. Long term exposure to these pinks and greens caused aggression.

There was actually a doctors’ quarters on site. It wasn’t quite as spartan as the inmates’ spaces, and it has been restored to its former glory.

trans-allegheny08

Hey, the physicians had standards to uphold. The next picture was shot at 90º from the one above. (The fire extinguishers should help you orient yourself).

trans-allegheny09

When they go to restore the Colored Wards, they’re probably not going to look like this, don’t you think?

Along with the routine deaths of inmates due to natural causes, and the butcher’s bill for botched lobotomies, there were some real tragedies here. At this place, one inmate demanded a sexual favor (unspecified) from another. The propositioned inmate declined the honor. The rebuffed suitor drew a knife…

trans-allegheny10

… and stabbed him 17 times with a butter knife. (That’s a pretty emphatic “no.”) Ghost buffs insist that the asylum is haunted by both “Frank” and “Larry,” and that the two ghosts have reconciled and are buddies now. Part of the tour is an attempt to call their spirits up using flashlights.

trans-allegheny11

OTR did not report personally sighting either shade, and no one called 911 to report the shooting of a paranormal apparition.

A different kind of tragedy is embodied in the Children’s Ward. Shorn of its personnel and equipment, it doesn’t look much different from the adult wings of the warehouse. These children would include mentally ill children, but also the neurotypical children of inmate mothers, some of whom lived their entire lives locked inside these bleak walls.

trans-allegheny12There were rules to obey, for the staff as well as for the inmates. There was no drinking, on duty or off.

trans-allegheny13

Along with the inmates, a variety of personnel came to the asylum to work daily. Along with the doctors, nurses, and matron on daily duty, there were night watch and night matrons on duty around the clock. Their are plaques explaining the duties of each of these specialized workers, as described in the asylum’s 1882 regulations.
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And an interesting display of staff gowns and clothing.

trans-allegheny16 trans-allegheny15

Wheelchairs were not the ultralight, space-age and durable folding contraptions that have given some disabled people unprecedent access to daily life today.

trans-allegheny17

They were heavy machines of wood, iron and wicker. Some of the mentally ill were also physically disabled by disease (remember polio was epidemic until the discovery of vaccines in the 1950s), or as a consequence of Dr Freeman’s crude lobotomies.

In the Hotel Trans-Allegheny Lunatic Asylum, you can check out any time you like, but you can never leave. Those inmates who weren’t claimed by their families on demise were buried on the grounds, in cemeteries with rough stone markers. The numbers on the markers were presumably tabulated with the late patients’ names in a book or books that have long since been lost. And over the years, the cemeteries, too, became lost. This display reflects these bleak, lost graveyards.

trans-allegheny18

The story resting on a stone in the second row:

The grave stones below are original to the Trans-Allegheny Lunatic Asylum.

It is rumored that state maintenance workers or patients moved the stones to make cemetery maintenance less time-consuming. Another rumor was that the asylum hogs rooted the stones up, but that story is less likely.

In 2009 we received a call from a local man who was rebuilding his furnace in the basement of his new home. After removing his furnace he realized that the base was built with over sixteen stones from the Asylum.

After recovering the stones, we removed the mortar, and discovered numbers at the head of each stone.

The only problem? Duplicate numbers. Did they use the same numbers in each cemetery?

Indeed, the current owners and historian know that there are graveyards on the grounds, but they have no solid idea where they are.

Among about 50,000 people who died here between 1864 and 1994, there were thousands, wards of the State, whose remains went unclaimed. They were placed in simple wooden coffins next to their vital statistics enclosed in glass jars. Then buried, unidentified, in one of three graveyards located in the hills behind the Asylum.

The Asylum wasn’t only a hospital, it was also a farm, which was intended to give it it self-sufficiency in food.

The availability of farm land  was an important element in the decision to build the Trans-Allegheny Lunatic Asylum in Weston.

It was the third mental asylum in Virginia, and the first to be on the”other” side of the Allegheny Mountain range. A flat area large enough to hold a Kirkbride building, and the presence of the nearby river (and later) train transportation were also important elements.

The problem of periodic flooding of the town apparently was outweighed by the positives. And there was land suitable for farming right behind the building site – beginning with the purchase of 200 acres and ultimately, some say, making up 666 acres, but at any rate hundreds of acres.

Given the length of this post already, we’re going to stop here. But there’s more to come, including a possible message from the sufferers of bygone years to Our Traveling Reporter and his lady friend, and a view of some of the instruments used by the physicians of the Asylum.

34 thoughts on “The Trans-Allegheny Lunatic Asylum (Photos after jump – Part I of III)

  1. Joe

    I could rant for hours here.

    I earn my living working in such an institution.

    There but for the grace of God go you and I.

    If you have the time look up the reason why just over half of the pauper lunatics in Scotland (Where I come from and live) ended up in Musselburgh in the 1850’s.

    And the death rate was around 70% per annum.

    The Nazis started out by murdering psychiatric patients. That is where they discovered what you need to do to carry out murder on an industrial scale.

    1. Hognose Post author

      Well, Joe, what’s the answer? As I see it, the real problem is that we do not have any real viable treatments for most mental illness, despite the advances of the last few decades in using medications. There’s no answer for it, is there? Like the drug addicts, each mentally ill person is a tragedy (of a whole family, usually) for which neither public policy nor science can offer a solution at this time.

      Each generation, each century, we have well-meaning people try to solve this problem, whether it was an exorcist in 1690 or Dorothea Dix and Kirkbride in 1850 or the deinstitutionalization proponents in 1970. It’s a rotten business with no clear answer.

      1. Kirk

        Well, I think there is at least one clear answer: What we’re doing here in the US right now is not working, is not humane, and is a disgrace.

        Personally, I’ve got every sympathy in the world for the mentally ill. I have a couple of folks in my family who are mildly “of issues”, and I don’t want them mistreated any more than I would want a random stranger to be. But… Here’s the rub: The open-air mental institutions we’re currently turning our streets and parks into aren’t good for either the people who’re living in that circumstance, and they constitute a serious blight on the community. Every year, we’re seeing more and more dysfunctional people living under bridges like trolls (makes ya wonder where that particular myth got started, doesn’t it?), and crapping up the public facilities and parks my tax dollars are paying for. So, I wind up getting triple-billed for the same issue–They use tax dollars to “treat” these poor bastards, they collect for running the parks and other facilities, and then they have to pay for cleaning them up after they get trashed. Let’s not even get into the fire they started last year, in one of the camps, that took two days to put out, and cost a couple of million dollars to fight.

        You look at the whole picture, from the period when they shut down the mental hospitals and did everything else, and the inescapable conclusion is that if they’d set out to destabilize and destroy the public commons and confidence, they couldn’t have done it better than if they’d set out to do so with a set plan and full intent. Liberalize law enforcement, and put lots of low-level criminals on the street? Dump the contents of the mental institutions on the same streets? All while we’re dealing with major social dislocations, and a massive increase in the illegal drug trade? And, then focusing the majority of law enforcement efforts on that drug trade?

        It’s a wonder any of our major cities are still inhabitable, for a certain given value of “inhabitable”. Examine everything that happened from the 1950s forward, and ask yourself this: “Could this have done more damage if it had been planned, and the result of some insane cabal of maniacs running things…?”.

        Frankly, I used to just nod politely whenever I encountered anyone espousing conspiracy theories about such things. These days? I’m not so sure that I shouldn’t be listening more carefully, because I swear before God, they couldn’t have done more damage to the body politic and the cultural commons of this nation if they’d set out to deliberately do it.

        Too many coincidences, too many interlocking issues and programs went into creating this entire nightmare of issues, for my taste. Things happen once? Hell, that’s just “shit happening”. Twice? Hmmm… Three times? Yeah, time to start looking for enemy action. At this point, we’ve got not one or two things that have happened or “been done”, we’ve got dozens, from the ACLU working to shut down mental hospitals and making the involuntary commitment of dangerous mentally ill people virtually impossible to accomplish. You really have to wonder, sometimes–It all interlocks, and it has this dreadful synergy to it, whether it was the remorseless demonization of the police and law enforcement, or the same sort of attack made on the institutions where the mentally ill were given respite from the workday world.

        1. John M.

          Think of the Left as being like a riot. Disorganized, leaderless, and devoted to destruction. No conspiracy per se is required: simply a shared goal to burn, baby, burn. When the riot encounters an edifice such as presented here by OTR, they will find it impossible to demolish and satisfy themselves with a few broken windows and some petty thievery until someone points out that the stop-and-rob on the corner is made of inflammable materials and there is gasoline conveniently located on-site. The mob will then move toward the stop-and-rob and burn it to the ground. Then it’ll repeat the process for the strip mall next door.

          If given sufficient time to burn, the Left, er, the riot, will come back around to the harder targets. Occasionally a leader will arise and coordinate the actions of the mob to tear down an edifice like this one, by hand if necessary, or by whatever appropriated equipment can be found.

          So if you wonder why the Left picked the items you picked up on, to wit:
          mental hospitals
          wussy policing/sentencing
          social dislocations
          drugs
          And I’ll add no fault divorce to the list

          The answer is that they needed no coordination. They needed no master plan. A few members of the disorganized mob started attacking some institutions and found them to be vulnerable. They started to crumble and the rest of the mob showed up in time to pull it down, and burn it to ashes. Then they started looking for other edifices to destroy. Gay mirrage, trannies down your throat, speech codes, and on and on, the riot continues apace until someone arises to stop it, or at least check its advance for a bit.

          Watch this pattern: the left is unified when it is weak, but dis-unified when it is strong. When it is weak, the Left will organize around any mini mart or hardware store that looks burnable. When they are strong, the mini marts are all in ashes and all that’s left are the hard edifices and they can’t decide whether they should tear apart the insane asylum or the county courthouse that was built in 1900 (and therefore built like a castle).

          The right is unified when it is strong, but dis-unified when it is weak. When the right is strong, it is building according to a pattern, and success in building draws more builders. When the right is weak, there is disagreement over what to build. Each faction of the right has its own vision for what should be built (a cathedral! no, a prison! no, an office tower! no, an apartment block!) and has a hard time unifying around one vision. Unique leaders are needed for this phase of civilization.

          The Left, always and everywhere, is devoted to the destruction of property, family and tradition. Watch for it.

          -John M.

          1. Hognose Post author

            Ah, a bit like a flock of birds or school of fish. What seems like a master plan is explained by each individual following rather simple, almost ladder-logic-like, rules.

          2. John M.

            @Hognose:

            Bingo. This has the advantage of allowing better sleep at night, knowing that there isn’t a grand conspiracy of people out to get you. OTOH, it induces loss of sleep due to knowing that there’s something far, far worse than a grand conspiracy afoot.

            -John

          3. 11B-Mailclerk

            There is an added dimension:

            Our human egos are usually much more comfortable believing that a vast and sinister cabal is working secretly against oneself,

            than believing that a vast universe (or vast mass of folks) might not care what “shit happens” means to oneself.

            Atheist to Evangelical, the former option seems the default human pattern.

  2. Joe

    Seems like i went off on my rant too early.

    Here in the UK. the prisons, the psychiatric hospitals and the poorhouses (workhouses) were mostly built around the same time in the 1830s. In each case, the intent was the same. To sweep inconvenient poor people off the streets.

    It was mostly a matter of chance whether you ended up in the prison, the poorhouse, or the asylum.

  3. Nadnerbus

    The ongoing disaster that is mental health in the US is one of the biggest blight on our country. I have seen it argued from both sides of the political aisle that nothing can be done. The ones on the left because compulsory treatment would violate their rights, and the ones on the right because it would be a tool of the state to wield as an instrument of oppression.

    And every time there is a shooting, or some mentally ill person on the streets dies of exposure, everyone shrugs and says, “what a shame.”

    Perhaps if there was some political profit to be had, it would finally be addressed.

      1. Scott

        I appreciate the blog! I’m not working on the computer every day (building my house 2-3 days a week), but when I’m programming, I can use a sanity break from time to time. This works … and if I can help in a small way, I’m more than willing to try to do so.

  4. LSWCHP

    If that T-shirt is to be believed those old-timers sure had a negative obsession with sex in general and what they call “self abuse” in particular. Like, masturbating for 29 years in a row is apparently OK, but if you do it for 30 years then off you go to the asylum! WTF is that about? And I wonder about the difference between deranged versus non-deranged masturbation? Sheesh….

    I wonder how many perfectly sane people, and particularly women, ended up in these places simply because they did things that others disapproved of.

    I agree though that nothing good comes from mental illness. We’re a bit better off than we were in the 19th century, but not by much.

    1. Hognose Post author

      Yeah. It bothers me the extent to which we look at a facility like this — and there’s more to come in a coming post — and congratulate ourselves about how far we’ve come from this benighted age. We haven’t, we’re as full of $#!+ as old Freeman ever was.

      1. bloke_from_ohio

        “At least we are not THAT bad” is a huge lie. It gets things completely backwards. Strive for excellence not to just suck less.

        We look at the past through the cultural lens of today and think “we are not that bad.” And by doing so we fail to realize that we are not good yet either.

        It is like the fallacy of comparing yourself to the train wrecks you see on reality television. Sure, your life is better than the dumpster fires being covered on the E! network. But, you probably have quite a bit of work to do yourself. Comparing yourself or your society to another, especially one you perceive as demonstrably worse, is flirting with failure. You need some sort of standard some point of excellence.

        There is theological argument to be made here about failing to live up to divine standards. You know, “the all have sinned and fallen short…” stuff. But, it can just as easily apply in a secular manner. If your measuring stick is garbage, you won’t grow. That stick can be religious in nature, or some other form of defined standard. You have to have some sort of first principals.

        Remember a car wreck is better than a train wreck, but they both suck!

        1. Hognose Post author

          Excellent points on measuring sticks. One of the major issues in B-School is that larval MBAs are taught 8,000 ways to measure stuff and left to their own judgment, mostly, about what to measure. Which is really the key question, because what you build a metric and measure is what you’re going to get, whether it’s the right thing (i.e. measuring a football team by whether it wins games) or the wrong thing (measuring progress in a war by an irrelevant statistic — Vietnam’s body count — or by input stats of money spent and efforts taken, as in the GWOT).

          The problem with building a measurement array in terms of “mental health” is that we’re rather blind to “what right looks like.” What the hell do we measure? How do we achieve Dorothea Dix’s goal of treating the mentally ill with compassion and dignity, and treating Dr Freeman’s goal of curing them, in the context of a free society where even the nuts have rights? The guy who figures that out deserves the Nobel Peace Prize more than anybody who ever got one, because he’s done more for the human race; but that guy is not visible on the horizon yet.

          1. Ward Hopper

            Hey Mr Hognose, wheredja go to B-school? I went to one of the fancy pants ones slightly south of you which you incessantly mock and deride … We solved the measurement conundrum you bring up with an invention called “The Balanced Scorecard”, wherein you measure everything. Problem solved.

            As to the serious question of what to do with 2016’s mentally ill? Let’s just do our best to keep them out of the White House.

          2. Hognose Post author

            I think it’s too late for that.

            I went to a no name school, but later when I worked with HBS and Chicago guys I held my own. Oddly enough, we all had different quant stuff we were strong in.

            I went back to school after hitting a home run in a startup, and then striking out. Thought there might be some wisdom in the school. There was.

            Still, HBS is not the Kennedy School of Defeated Politicians.

      2. ToastieTheCoastie

        Just look at the transexual business. We’ll look back on how society accepts and promotes that now with the same horror we look at lobotomies nowadays.

    2. aGrimm

      I witnessed exactly what could be described as deranged masturbation. A bunch of us are at the enlisted men’s club ( Naval Hospital – Guam). One guy goes to our barracks and comes back to report that Hospitalman X is doing the Mary and her four sisters on his top bunk. Big yuks from all. About an hour later another guy does the same thing returning to report that X is still at it. Okay, this is weird we all agree. Club closes, so we all decide to see if he is still at it. He is! A bucket of water was found and dumped on him from the other side of the bunk bed divider wall while the rest of us watched. X got wet, looked up and around, then went right back to doing it. We heard he got a Section Eight a few weeks later. Gee, I wonder why? By far and away the weirdest thing I saw in the service, and you see some weird shit as a corpsman.

  5. Mr. 308

    Political excitement? Overtaxing mental powers? Bad company? Women trouble?

    I should be a patient.

  6. BAP45

    I had an uncle who was schizophrenic and luckily for him my grandmother and then my dad took turns making sure he had a place to live. But it was expensive. Finally they did find a place that seems to have the right idea. It was this big old house and they ran it on a very strict regiment but the patients were free to come and go. They just hand to ne home in time for dinner. The staff would then make them all pitch in to make dinner then all sit down together to eat and talk. There was more to it than just that but it really seemed to help.

    I remember my uncles favorite thing was to take his allowance down to Starbucks and talk to everybody. It would be nice if they could apply something similar on the scale of the asylums because as you noted most of these poor souls have no one.

  7. ToastieTheCoastie

    I once happened accidentally on the Norwich Asylum in Connecticut. Very large, very spooky, and abandoned.

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  10. 11B-Mailclerk

    Sadly, madness does not respond to good intentions in a sane and rational manner. Expecting the mad to respond in sane ways is, not rational.

    Concentration of the severely mentally ill does not seem to be a positive thing. Profound mental illness seems to be somewhat infectious, except for the very, very strong personality people. Live with it at close range, and your own behaviors can become somewhat dysfunctional. (if only from profound helplessness and grief.)

    Authority over the severely mentally ill usually winds up as folly. Again, they do not usually have positive rational responses to it.

    I sometimes wonder if -dispersion- into the edges of civilization is the answer. Get them out where the population density is so low as to allow them to putter about relatively low-impact on the rest of society, and where our ‘rational’ structure is minimally impactful on them, yet some sort of support station might be supplied and staffed. Perhaps the frontier was what “managed” most of them until we no longer had a frontier. (The Darwinian aspects of this approach are quite grim, however.)

    Most of my youth was out in the country, in farmland, with a few factories also. There was a kid in the neighborhood who was rather severely developmentally limited. His mother let him live in a tent in his grandfather’s field, because he seldom could safely mange a built-up home. and when he became fascinated with a lawn tractor, and was able to manage -it- safely, bough him one to mow laws for neighbors, and plow snow in winter. He moved into a heated garage in winter. He bathed, etc on irregular occasion, and his mother coached the desired results as best she could. Neighbors, as they were able, bought parts for the mower, and gassed it up when he cut their lawn or plowed their driveway. He tootled around the area looking for work that needed done that he understood. Conversations with him could be decidedly wierd, but as far as I know, he never tried to hurt anyone unless they struck him or stole from him, or seriously annoyed his mom.

    The guy had a place to live, food, a caretaker system, and some sort of constructive purpose in life. Unique? Perhaps, but that had to beat living 20 deep with shrieking psychosis. He always seemed happy, in his weird way. Last I heard, he was still at it. I recognize, that he would be considered at least “moderately functional”.

    I haven’t got a better answer. What works better than what we have tried? Is this properly a “let go” scenario?

  11. Mark

    Thanks for posting this interesting piece. By pure happenstance I will be driving right by Weston, WV the week of Thanksgiving. Seriously thinking of checking it out.

  12. Mike_C

    > masturbating for 29 years in a row is apparently OK, but if you do it for 30 years then off you go to the asylum! WTF is that
    I think the list on the T-shirt is comprised of what we would call “Chief Complaint” (in medical note-writing parlance) rather than a list of “diagnostic criteria” ;-) The CC translates to “why is this patient here?” so I might write a note with CC=chest pain on exertion. It doesn’t say what the cause of the chest pain is (myocardial ischemia, pleurisy, crazy-not-right-in-the-head, or whatever).

    >deranged masturbation
    Every once in a while you meet some poor old guy who’s had a stroke that damaged his frontal lobe. The little voice inside your head that says “Don’t DO that! People are watching,” or “It would be rude to say that” lives in your frontal lobe. Long ago, as a student on the Psych consult team we were asked to help with an old fellow who sat in his hospital bed with his gown pulled up, cheerfully tugging away before God and the assembled company. IIRC we had nothing to offer, other than suggesting that he be put in the bed farther from the door, so as to be less visible to passersby in the hallway.

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