Southwestern State Hospital

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Southwestern State Hospital
Established 1884
Opened 1887
Current Status Active
Building Style Cottage Plan
Architect(s) Harry and Kenneth McDonald
Location Marion, VA
Peak Patient Population 1,583 in 1968
Alternate Names
  • Southwestern Lunatic Asylum
  • Southwestern Virginia Mental Health Institute


In March 1884 the Virginia General Assembly appointed a board of commissioners to select a site for a new lunatic asylum for white citizens to be built west of New River. The board selected a 208-acre site in Smyth County and in August 1884 the General Assembly gave the board the power to purchase the land for thirty thousand dollars and granted the county the right to issue bonds as well. In November 1884 the General Assembly formally established the Southwestern Lunatic Asylum, near Marion, Virginia. Dr. Harvey Black, J. Hoge Tyler, Thomas J. Boyd, D.D. Hull, Dr. John S. Apperson, N.L. Look and F.B. Hurt were appointed to the building committee which was tasked with overseeing the construction of the hospital.

An article in The Conservative Democrat of Richmond, Virginia, dated February 3, 1887, stated that the Southwestern Lunatic Asylum, as it was then named,was considered “the most modernized and convenient institution, as well as the most economical in cost that had been built.” When it opened, the building could accommodate 280 patients, but it was expected that 800 patients would be housed when the wings were expanded at a future date. The original building included six patient wards that were attached to the rear (south) of the current Henderson Building; Wards A, B and C were for women, and Wards 1, 2 and 3 were for men. An additional ward called Ward D was located on the third floor of the Central Building. The building also housed a kitchen, laundry, bakery, two dining rooms (one for men and one for women), a sewing room, elevator, and patient and attendants’ rooms.

Dr. Harvey Black became the first superintendent of Southwestern Lunatic Asylum when it opened in May 1887. Dr. Robert J. Preston and Dr. John S. Apperson served as assistant physicians, and Mr. C.W. White was appointed as steward to oversee the day-to-day business operations of the hospital. The hospital received its first two patients on May 17, 1887, both of whom were from Washington County, Virginia. Adam Surratt, a 27-year-old laborer, died on June 17, 1903 with a diagnosis of “abscess of the brain” and is buried on the grounds of Southwestern Virginia Mental Health Institute. The second patient was Elizabeth Barker, a 53-year-old woman who was discharged on September 30,1890 as “recovered.” The patient population grew steadily and over time several buildings were added to the hospital's campus including a tuberculosis treatment building, a building for the criminally insane, the Davis Clinic, and the Harmon Building. For much of its early history, the hospital was mostly self-sufficient through the utilization of its own farm for meat, milk, and vegetables. Other early hospital superintendents include Dr. Robert J. Preston (1888-1906), Dr. Daniel Trigg (1906-1908), Dr. J.C. King (1908-1915), Dr. E.H. Henderson (1915-1927), and Dr. George A. Wright (1927-1937).

Eight acres of land was bought that bordered the front lawn and was within 300 feet of the main building in 1910. Three dwelling houses,each containing seven rooms, were built near the hospital to be rented to employees. A complete brick plant with the capacity for 25,000 bricks per day was also built in preparation for building the new Criminal Insane Building. It was anticipated the new building would accommodate 100 to 125 individuals and work was begun on this building in early July 1910. The transfer of 30 epileptics to the Virginia State Epileptic Colony in 1911 gave temporary relief of the overcrowded conditions in the male department; their places, however, were quickly filled with new admissions. The Criminal Insane Building was completed and received its first patients on January 6,1913.

A new Power Plant was built in 1923, along with a tunnel 7 x 5 feet and 556 feet long extending from the power plant to the main hospital building. This tunnel carried all the steam, hot water, electric and telephone lines. A brick garage was also built at that time that could accommodate 14 cars. It was steam heated and the spaces were rented to employees at a nominal fee. The old Power Plant and kitchen were subsequently torn down and a new wing, four stories high, was added to the extreme southern end of the main building. This addition contained bed space for 150 patients on Wards D and L, along with a new kitchen, sewing room, laundry, storeroom, refrigeration plant, bakery, employee’s dining room, and dumbwaiters to each patient floor, and was ready for occupancy on June 15, 1927. The attic of this new addition was built to provide attractive, comfortable living quarters for nurses and attendants. Following these renovations the building was named after Dr. E. H. Henderson, who served as Superintendent from November 10, 1915 until his death on February 25, 1927.

By 1931, the average census for patients actually in the hospital was 988.03 and the facility employed a total of 166 employees. A front porch was built extending across the entire width of the Henderson Building of the colonial type of architecture, two stories high. The old clock tower was removed as it was considered too dangerous; however, the dome over the rotunda situated directly behind the old tower was left intact. A paved driveway from the Henderson Building was constructed from the intersection of the main hospital entrance with Main Street, and concrete curbing was laid. A sunken garden was added to the grounds with a water pool and stocked with rainbow trout. A sun porch and additional bathroom was constructed and installed in the home occupied by the superintendent, and a 10-stall garage was also built to store the fire hose and accessory equipment. A Craft Shop was established at the facility and it was determined there was a need for the establishment of a standardized occupational therapy department for the entire institution.

One of the hospital's most influential superintendents, Dr. Joseph R. Blalock, served from 1938 to 1971 and was the force behind many changes in treatment including the use of psycho-surgery, drug therapy, and vocational rehabilitation. On July 26, 1951, 12 patients underwent the first operations of prefrontal lobotomy. This new procedure had necessitated the purchase of additional surgical instruments so that the facilities for brain surgery, as well as other types of surgery, were greatly improved. The first trans-orbital lobotomies were performed in 1953, with a total of 26 being performed that year. The cases for transorbital lobotomy were very carefully selected based on the following criteria: duration of mental illness for at least two years, a trial of other therapies, and the approval of the staff and the Commission of the Department of Mental Hygiene and Hospitals. Fortunately, this practice was soon discontinued. Serpasil and Thorazine were also tried on an experimental basis that year.

A survey on April 3, 1961, showed that 26.5% of the hospital’s patients were 65 years or older. Providing for an increasing geriatric population led to approval for remodeling the old Criminal Insane Building (“C” Building) after the “criminally insane” patients were relocated to the Finley Gayle Building. This remodeling project was completed in March, 1961, at a cost of $158,308.72. The building contained four wards with a total bed capacity of 152 patients on the first and second floors, an elevator and adequate provision for food service. At this time the building was designated the Geriatric Building. The completion of this building gave the opportunity to vacate the Davis Clinic Building, which was eventually torn down to provide room for additional parking space.[1]

By the mid-1970s, deinstitutionalization had greatly diminished the patient population as mental health treatment became more community-focused. In 1981, the Virginia Department of Corrections took over the care and treatment of adjudicated criminally insane patients at the hospital. This institution is adjacent to the hospital and is known as the Marion Correctional Treatment Center. In 1986, the General Assembly passed legislation providing for the demolition and reconstruction of much of Southwestern State Hospital. The new Bagley Building was constructed to house 177 patients in an integrated care design with living and treatment areas in one place. All adult patients were moved to the new complex in March 1990.

The hospital has gone through two name changes in its history. In 1935 the General Assembly passed legislation changing the name from Southwestern Lunatic Asylum to Southwestern State Hospital. In 1988, the name was changed to Southwestern Virginia Mental Health Institute.

Images of Southwestern State Hospital[edit]

Main Image Gallery: Southwestern State Hospital


The original hospital cemetery was located directly in the proposed path of the new interstate being built through Southwest Virginia necessitating the Virginia Department of Transportation to relocate the cemetery to its present site in 1961 so that construction of Interstate 81 could commence across the property. The current cemetery sits on a hill above the hospital and is a place of panoramic views and quiet solitude. Graves in the cemetery date back to the late 1880’s when the hospital was opened. The cemetery also contains the graves of several confederate veterans from the Civil War. Very few patients have been buried in the cemetery in recent years, but there are presently approximately 1,210 grave sites located at the cemetery. The identity and location of each person buried in the cemetery is known and has been plotted on a grid. Anyone wishing to visit the cemetery should contact the hospital to arrange a date and time to visit as all visitors must be escorted to the cemetery.