Eastern State Hospital

Eastern State Hospital is the second-oldest psychiatric facility in the United States, and the first west of the Appalachian Mountains, and is located in Lexington, Kentucky. It is proposed that the campus be relocated to the Coldstream Research center along Newtown Pike.

History

Eastern State Hospital’s roots date to 1816-1817, when a hospital was constructed to serve the poor, disabled and “lunatic” residents of the region. Previously, such patients had to be transported to Eastern State Hospital in Williamsburg, Virginia. A main building was constructed to house Fayette Hospital, and was dedicated on June 30, 1817 by Henry Clay and other dignitaries.(3) The hospital, however, was never fully completed or occupied, and was forced to close two years later during the Panic of 1819.(4)

The hospital was restablished by an Act of Legislature as the Lunatic Asylum on December 7, 1822, and two years later, on May 1, the hospital admitted its first patient.(3)(4) In 1825, the first of two new wings was added to the main building at a cost of $5,735.74, and the second was finished in the following year at a cost of $4,405.39.

Between 1829-1830, two new wings were constructed onto the previous wings, followed by a new building in 1832 that was completed at a cost of $5,480.06.(3) Additional buildings were constructed in 1836 and 1840, followed by a new two-story structure added to the back of the “main building” in 1844.

In 1845, the hospital’s library was established.(3)

Two years after the prison’s opening, Eastern State housed 54, nearly doubling by 1830, where the population remained relatively stable until the late 1840s.(3) By then, the mental population had increased to 153 in 1845, increasing to 271 just three years later. The hospital only boasted 180 rooms by this time.(3)

In 1850, a new brick stable, grainery, corn-house and ice-house was constructed on Eastern State’s grounds, which at the time totaled 40 acres.(3) This came after a fire a few months prior destroyed the previous wooden stables and ice-house. In 1851, a new ward was constructed that featured two dayrooms, a veranda, bathrooms and dressing rooms on each floor, and a promenade of nearly 300 feet. Each ward had its own dining room and was serviced by a central kitchen.

On February 14, 1852, a fire swept through portions of the hospital, killing two patients, dayrooms, three halls, 70 lodges and three latticed verandas.(3) By this time, the hospital featured around 200 patients.

By 1860, however, overcrowding conditions forced the hospital to admit only residents from Kentucky, although numerous applications from abroad were received.(3) As a result of this, Eastern State began a capital improvement campaign that led to the construction of several new structures in 1868. The first constructed was a new building for females, the center featuring four-stories with a basement, and the wings three-stories high. A new three-story building for African-Americans was constructed soon after, followed by a new laundry and boiler house that stood two-stories high. By the end of the decade, the facility accommodated 320 with room for up to 520 on 238 acres.(3)

Only two years later, in 1870, maximum capacity was obtained at Eastern State. The Superintendent at the time, Dr. John W. Whitney, M.D., refused to admit an additional 150 patients and resigned in 1872.(3)

In 1876, the hospital was renamed the Eastern Kentucky Lunatic Asylum.(4)

In 1885, a new three-story structure was constructed to fill the gap between the male and female wards. The first story housed offices, while the remainder was used for wards.(3) This was followed up with an addition to the building housing the African-Americans in 1889. In 1894, a new administration building, with sleeping apartments for physicians, was constructed, followed by a new residence for the superintendent and family.(3) By the end of the century, Eastern State housed 861 patients.

The start of the 20th century saw a new construction projects and upgrades. The first involved a new bowling alley constructed for the patients in 1905, followed by a new laundry facility in 1906, and a dairy barn and slaughter house in 1911-1913. On April 25, 1928, a nurse’s home and living quarters containing 36 beds was completed.

The asylum was renamed on January 2, 1912 to Eastern State Hospital, and comprised of 400 acres, most of it farm land.(3)(4)

By the mid-1910s, the hospital had a census of 1,431 with a capacity of 1,200, but the start of the third decade saw an overwhelming number of patients admitted to the hospital, increasing the census to 1,756 in a facility designed to hold only 920.(3) It increased further to 1,996 in 1945, the largest that it ever held.(1) The population only marginally declined to 1,725 by 1957 and to a little over 1,000 in 1967.(4)

By the mid 1940s, new therapies designed to treat mentally-instable patients were put into use, including electro- and Metrozol-shock treatments, and Malarial fever therapy.(3) Insulin therapy began in May 1952, although it declined in use after 1954 when tranquilizing drugs were introduced for use.(4)

In 1951, the Wendell building was constructed, followed by the renovation of the administrative building employee quarters into offices three years later.(3) In 1956, Eastern State sold 300 acres to International Business Machines (IBM) for a new research park and manufacturing plant, and one year later, all farming at the institution ceased. The Allen Building opened in 1957 with 160 beds for the acutely ill.(3)

By June 24, 1967, the hospital’s census decreased to 999, the first time under 1,000 since the 1890s, and declined further to 639 by 1970.(1)(3) Advancements in treatments first introduced in the 1940s led to a sharp increase in outpatient treatments versus in house care.(3) In-house populations also declined due to an increase in mental treatment centers throughout the state.(4) By 2007, the number of mentally-ill residents had fallen to just 150.(1)(5)

In 1984 the city of Lexington discovered the remains of patients buried in unmarked graves while working on the Loudon Avenue extension, resulting in the re-burial of over 4,000 bodies now buried behind the Hope Center. Then in 2005 remains of 11 patients were found digging a new waterline. The graves of many more are believed to be scattered around the current and former grounds of the hospital and not yet discovered.

In 1993, the non-profit organization, Bluegrass Regional Mental Health-Mental Retardation Board Inc. became concerned when rumors circulated that Eastern State Hospital was to close its doors to inpatient care.(4) The rapid closure of mental institutions nationwide, as part of cost-cutting efforts by state agencies, left few inpatient options and limited options for care to many, and as a result, Bluegrass Regional began discussions with the state in taking over day-to-day operations of Eastern State. As a result, in September of 1995, Bluegrass Regional MH-MR took over management of Eastern State Hospital under a contact with the Commonwealth of Kentucky, however, the buildings are still property of the state.(1)(5) Bluegrass Regional receives $31.7 million in state funds annually to operate the facility.(6)

Of the more than one-dozen structures that housed patients, only three are in use and several are abandoned. As the population declined, many of the buildings were closed and the ones that remained in use were minimally upgraded or renovated. A lack of state funding and antiquated facilities led to an increasing number of safety and health violations. In July 2007, a Herald-Leader investigation found asbestos, lead paint, exposed wiring and poor fire protection systems in buildings that were still be used.(1) A temperamental heating and cooling system led to a wild degree of temperatures in many of the buildings.

New facility

Soon after Bluegrass Regional took control of Eastern State, Joseph Toy, the executive director and CEO of Bluegrass Regional, stated that, “It (Eastern State) feels like an institution, not a hospital,” adding that the facilities were woefully outdated in form and function.(5) As a result, Toy approached James Holsinger in 2004, then secretary for the Cabinet for Health and Family Services, in regards to finding a way to fund for a new psychiatric hospital. Holsinger agreed that the facilities were outdated.(5) The estimated cost for a new facility was $130 million, with annual payments by the state to pay off the debt would be approximately $8 million per year.

Various proposals came about soon after for the new facility, including locating a new psychiatric hospital between Louisville and Lexington that would combine Eastern State with Central State Hospital in Louisville.(5) Another proposal involved relocating Eastern State to the Veterans Administration complex on Leestown Road.

On June 14, 2005, plans were unveiled by Bluegrass Regional that outlined the goal of a model mental institution with additional capacity and functionality built on 30 acres along Newtown Pike at Coldstream Research Park.(6) New, specialized programs for veterans, those with substance abuse and mental illness would be introduced. Initial costs to construct the hospital decreased from $130 million to $86 million, although only preliminary architectural plans were completed.(1)(6) The state would lease the hospital from the city until the bonds are paid off. Bluegrass Regional had been in discussions with the University of Kentucky, who manages the park, in constructing a new facility on the grounds.(2)(6)

On August 21, 2007, the Bluegrass Regional and the Cabinet for Health and Family Services signed an agreement giving Bluegrass Regional $1 million and the authority to move ahead with plans for a new mental health care facility.(1) The money would be used towards employing an architect to finalize designs and obtain cost estimates on construction.

On February 28, 2008, Governor Beshear announced a land swap proposal for Eastern State.(7) Under the proposal, Eastern State Hospital would relocate to a state-of-the-art facility at Coldstream, while the Bluegrass Community and Technical College would relocate its primary campus on Cooper Drive and two satellite campuses on Leestown and Regency roads to the hospital property. The college would have the option to occupy all 68 acres of the old hospital property.

The plan would give the University of Kentucky further room to expand its campus and would allow the community college to be located adjacent to downtown and near Transylvania University. The deal was spearheaded from state Representative Rep. Jimmie Lee.(7)

In late-March, the Kentucky House and Senate clashed over who should operate the new Eastern State. The Senate budget bill guarantees a contract to build and operate the mental hospital to Bluegrass Regional, the current operator, while the House budget bill states that the construction and operational contract would be open to competition.(9) Under a House-Senate agreement, Bluegrass Regional would be allowed to receive the first bid at proposing a plan for operating the new hospital. It would receive the contract if its plan met the state’s minimum standards. If it would somehow not meet the minimum standards, the operation of the facility would be open to competitive bid.

Gallery

Links

1. The Eastern State Hospital Project

Sources