St Elizabeths Hospital

St Elizabeths Hospital
Established	1852
Construction Began	1852
Construction Ended	1855
Opened	1855
Current Status	Active
Building Style	Kirkbride Plan
Architect(s)	Thomas U. Walter; Shepley, Rutan & Coolidge
Location	Washington, DC
Architecture Style	Gothic Revival, Gothic
Peak Patient Population	7,000
Alternate Names	Government Hospital for the Insane United States Government Hospital for the Insane

History

The west campus

In November of 1852 a tract of land overlooking the Anacostia River was purchased for $25,000 from Thomas Blagden. Construction began almost immediately on the center building, a red brick fortress designed in Gothic revival style by Thomas U. Walter, who also designed the dome of the Capital Building. The hospital was built following the Kirkbride Plan, most of the construction of the center building was done by slaves. It opened in 1855 as the Government Hospital for the Insane. The Hospital's early mission, as defined by its founder, the leading mental health reformer Dorothea Dix, was to provide the "most humane care and enlightened curative treatment of the insane of the Army, Navy, and District of Columbia." During the Civil War, wounded soldiers treated here were reluctant to admit that they were in an insane asylum, and said they were at St. Elizabeth's, the colonial name of the land where the Hospital is located. Congress officially changed the Hospital's name to St. Elizabeth's in 1916. By the 1940s, the Hospital complex covering an area of over 300 acres. At its peak, 4,000 people worked and 7,000 patients lived there. It was the first and only federal mental facility with a national scope. The first appropriation towards building the Government Hospital for the Insane was of $100,000, and was made by Congress in 1852 for the purchase of land. The organic act creating the institution and outlining the duties of its officers and providing for the admission of various classes of insane patients was not approved until March 3, 1855. The hospital, however, had been opened for the reception of patients on January 15,1855.

The creation of the hospital was due very largely to the activity of Dorothea L. Lix. She grew up with her own pen the outlines of the organic act establishing the institution, and virtually named its first superintendent , Dr. C. H. Nicholas. During the latter part of her life Miss dix spent much of her time at the hospital, where quarters were always reserved for her, and the little desk upon which she drew up the original act creating the hospital stands in the board room in the main building.

On the first of July, 1855, the President named a board of visitors, as follows: Benjamin F. Bohrer, M. D., president; William W. Corcoran, Jacob Gideon, Professor Grafton Tyler, M. D., Daniel Ratcliff, Professor Thomas Miller, M. D., William Whelan, M. D., U.S.N., Robert C. Wood, M. D., U.S.A., and Rev. P. D. Gurley, D. D. The make-up of the board has, in the main, followed the plan of the first board, namely, to name as members of the board on representative of each of the classes card for in the Public Health and Marine Hospital Service, usually the acting or the retired surgeon-general of these several services, a lay physician, a lawyer, a clergyman, a layman, and in recent years two women.

The east campus

The original main building was built from brick made on the place, and in architectural style is a modification of the Kirkbride plan, each wing receding for the center, in echelon. The building itself is in the collegiate Gothic style. This main building was several years in building and wings were added to it from time to time. Other construction, however, was undertaken in the meant time, and shortly after the opening of the hospital, during fiscal year 1855-6, a building was opened for the colored insane, which the superintendent state in his report he believed to be the "first and only special provision for the suitable care of the African when afflicted with insanity which has yet been made in any part of the world."

While it was undoubtedly very largely in Miss Dix's mind that the Government Hospital for the Insane should be essentially a military institution, still the organic act provided also for the admission of patients from the District of Columbia. The District of Columbia in those years, however, was a rather small affair and so the number admitted to the hospital was not very great. The total number of patients admitted from all sources during the first year was only 63. During the Civil War, however, the hospital was conveniently located for utilization by the army and navy, and in 1861 on the its buildings, the West Lodge, was set aside for the wounded seamen of the Chesapeake and Potomac fleets, and a little later a couple of wards in the main building were prepared for the reception of sick and wounded soldiers. The following year the annual report shows that the General and Quarantine Naval Hospitals, with 70 beds, in charge of Surgeon N. Pinkney, of the Navy, and the General Army Hospital, with 250 beds, in charge of the medical officers of the Government Hospital for the Insane, "have been successful operation during all of the past year"; while in the following year it is again noted that the General Hospital, with 250 beds, known as the St. Elizabeth Hospital, and the separate General and Quarantine Naval Hospitals, with 60 beds in both, "all free tenants of the institution, under our supervision, are maintained in full activity and usefulness."

Here is the first mention of the name of St. Elizabeth as applied to the hospital. It was taken from the name of the tract of land upon which the hospital stood, which has been known ever since the settlement of the country as the St. Elizabeth tract. The application of the name St. Elizabeth to the hospital was the result of the disinclination of many of the soldiers who were not insane to have the institution in which they were temporarily resident called the Government Hospital for the Insane. In January of 1863, at the request of the Surgeon-General of the army, certain rooms of the hospital were set aside for the convenience of one of the manufacturers of artificial legs, and soldiers who had lost a limb by amputation in any one of the district of neighboring hospitals might, if they wished, be transferred to the St. Elizabeth Hospital as soon as the stump was healed, to be fitted with an artificial leg. These were the men who, while resident in the hospital and getting their artificial limbs adjusted, did not wish to be considered patients in an institution for the insane, and so St. Elizabeth Hospital came to be a name applied to the institution. The St. Elizabeth referred to is the Hungarian saint about whom many legends of kindness to the sick and afflicted folks were written, and so the name came to be retained because of its singular appropriateness.

Dr. Godding had been appointed upon the hospital staff some time 1863. He came from Fitchburg, Mass., and previous to hist connection with the Government Hospital for the Insane had been connected with the New Hampshire Hospital for the Insane at Concord. Later he had been superintendent of the Taunton State Hospital for a number of years and resigned the position to return to Washington.

During Dr. Godding's incumbency of 22 years the institution grew rapidly. WHen he took charge of the hospital in 1877 he found only six buildings. During his superintendency he erected 22 buildings and various extensions and additions. The larger buildings erected were the Relief Building, the Home Building, Howard Hall for the criminal insane, the Toner Building and Infirmary, a large refectory, the Oaks Building for the epileptic insane, with its large kitchen, a power house with electrical installation, and the Allison Building. When he took charge there were 765 patients; when he died he left a population of 1967 patients. He found, in 1877, 227 employees. He left and organization of 540 employees, or a total of over 2500 patients and attendants. Besides the erection of these buildings he added over 500 acres to the hospital grounds and established a farm colony at Godding Croft. During this period of growth the appropriations for the support of the institution trebled, and at the time of his death he was annually disbursing of $500,000.

The Government Hospital for the Insane was one of the early institutions in the country to recognize the value of scientific work and one of the first to appoint a pathologist. Dr. I. W. Blackburn, who had been associated with Professor Formad of Philadelphia, was appointed special pathologist in the fiscal year 1883-4. In after his work became well known, and at the time of his death-June 18, 1911-he established for himself a national reputation among workers in his field.

The Government Hospital for the Insane was also one of the first to take up the systematic application of hydrotherapeutic measures to the treatment of the insane. The active man on the staff in this work was Dr. G. W. Foster, who had charge of the Toner infirmary. The report for 1895-6 shows that during the previous two years he had been actively engaged in using hydroterapeutic measures and had made special application of the form of treatment to general paresis. Subsequent reports made considerable mention of this treatment, describing both Dr. Foster's methods and his conclusions. During the first three years no special hydrotherapeutic apparatus was installed, the treatment consisting mostly of the application of the cold pack accopanied by cold to the head in the form of a wet towel or ice pack. During the fiscal year 1897-8 a complete hydrotherapeutic outfit was installed, the form of apparatus bering that designed by Dr. S. Baruch, of New York City. Dr. Godding died in office on the 6th of May, 1899.

Decline began in the 1950s. Massive institutions came to be seen as a problem, not the solution and mental hospitals began to deinstitutionalize patients. The idea was that they could get personalized treatment in community-based facilities and that new psychiatric drugs would allow them near-normal lives. Many patients ended up homeless after leaving the hospital. In 1987, the federal government deeded St. Elizabeths to the District of Columbia to come up with an alternate use. But the District's mental health program was in receivership, and long-range planning was not a high priority. By 1996, the remaining 850 patients had to cope with medicine shortages, a lack of equipment and a heating system that failed so frequently patients went weeks without showers. Life at St. Elizabeths had regressed to a condition disturbingly similar to those that inspired the creation of the hospital in the first place. The last patients were moved from the west campus in 2002. All became quiet in the once-magnificent center building, the ghostly structure slowly succumbing to time and neglect. It was estimated to cost $50 million to $100 million to bring the buildings on the west campus back up to code. The District of Columbia tried several times to sell the hospital, but each time the deal fell through. With no answer in sight, the federal government took over the west campus again in 2004. The General Services Administration began nailing plywood over windows and shoring up roofs until a tenant could be found.

Homeland Security made a pitch to Congress in 2006 for the west campus. They claimed that St. Elizabeths was the only site large enough to allow the agency to consolidate. On March 20, 2007 it was announced that DHS would spend approximately $4.1 billion to move its headquarters and most of its Washington-based offices to a new 4,500,000-square-foot facility on the site, beginning with the United States Coast Guard in 2010. DHS, whose operations are scattered around dozens of buildings in the Washington, D.C. area, hopes to consolidate at least 60 of its facilities at St. Elizabeths and to save $64 million per year in rental costs. DHS also hopes to improve employee morale and unity by having a central location from which to operate. The plans to locate DHS to St. Elizabeths have been met with criticism, however. Historic preservationists argue that the move will destroy dozens of historic buildings located on the campus and that other alternatives should be considered. Community activists have also expressed concern that the planned high-security facility will not be interactive with the community, and will do little to revitalize the economically depressed area. A ceremonial groundbreaking for the DHS consolidated headquarters took place at St. Elizabeths on September 9, 2009. The event was attended by Sen. Joseph Lieberman, DHS Secretary Janet Napolitano, DC Delegate Eleanor Holmes Norton, DC Mayor Adrian Fenty, and acting GSA Administrator Paul Prouty. In 2005, the Hospital celebrated the 150th anniversary of its founding and honored members of the Armed Forces who became mentally ill while serving their country.

West Campus

The western campus of St. Elizabeth's contains many historical buildings, including the original 1850s Kirkbride style center building, which was designated a National Historic Landmark in 1990. There is also a Civil War cemetery where 300 Union and Confederate soldiers who died here are buried. The Hospital complex is located on a hill in southeast Washington, overlooking the Potomac and Anacostia Rivers. In 1987, the federal government transferred the hospital operations and the east hospital campus to the DC Department of Mental Health, while retaining ownership of the western campus.

East Campus

The eastern campus contains many newer buildings, built during the 20th century. This include many smaller two story pavilion style buildings and other large 5+ story buildings. The east campus is still an active medical center, owned by the DC Department of Mental Health. Construction began in 2006 on a new 450,000 square foot, state-of-the-art facility to replace the 150-year old Hospital. The new hospital incorporates the best practices in modern, in patient mental health care with an environmentally sensitive design and sustainable strategies. The new building’s therapeutic design includes bright and airy living and treatment areas, green spaces off each patient unit, and enclosed courtyards. A 28,000 square-foot green roof is likely the largest on any psychiatric facility in the country. The new hospital was completed in November of 2009.

Images of St Elizabeths Hospital

Main Image Gallery: St Elizabeths Hospital

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Links & Additional Information

• St Elizabeths @ Kirkbride Buildings.com
• St Elizabeths @ Wikipedia
• DC Department of Mental Health
• A Detailed History of the Hospital
• A Washington Post Article on the Hospital
• National Historic Landmark Entry
• Photos of the Kirkbride Building (from 2007)
• Historic Medical Sites in the Washington, DC Area
• A Website Dedicated to the Historic West Campus
• Photos of the Construction of the new Hospital (2006-2009)