Mind Over Matter

How Historic Asylums Are Faring

On a hillside in North Carolina, a castle-like building more than a century old and adorned with classically influenced architectural details rises five stories, overlooking fields and the Blue Ridge Mountains. No, it's not the Biltmore Estate. It's the Avery Building (built 1875-1882), the centerpiece of Broughton Hospital, the former Western North Carolina Insane Asylum, located in Morganton, about 50 miles east of Asheville.

"Ever since it opened, my family [members] have been patients or employees at Broughton," says William Brown, who served as chief of safety at the hospital for 30 years. Like many locals, Brown is worried about state plans to build a new $138 million hospital building on the 240-acre site and potentially raze two dozen historic structures, clear a significant swath of the landscape for parking, and compromise the integrity of the Avery Building.

The North Carolina Department of Health and Human Services plans to move all operations to the new hospital building by October 2013. It has not yet released plans for the Avery Building and the other structures at Broughton. "They're just going to let Avery stand there, which is going to be demolition by neglect," says Dottie Ervin, executive director of the Historic Burke Foundation, the local historic preservation advocacy group. (Department of Health and Human Services staff did not respond to interview requests.)

Jennifer Cathey, a restoration specialist for the N.C. State Historic Preservation Office, has documented the buildings on site, as well as several of the staff houses, all slated for demolition. "I was struck by the excellent condition of all the buildings," she says. William Brown agrees: "The physical structure of Avery is as sound as the day it was built."

Although it remains in operation, Broughton Hospital, which was treating as many as 3,600 patients at a time in the 1940s, now maintains only 278 beds, according to the state's website.

The story is the same in many states. Reduced resident in-patient populations and dwindling state budgets have led to historic mental hospitals being neglected, gradually abandoned, or demolished outright.

A Therapeutic Environment

Sites like Broughton "represent a period when people had incredible faith in the healing power of the environment," says Carla Yanni, a professor at Rutgers University New Brunswick and author of "Architecture of Madness," a 2007 study of 19th-century asylum buildings.

One of the dominant figures in asylum construction was Dr. Thomas Kirkbride, of Philadelphia, author of a widely read 1854 guide on the planning and construction of "hospitals for the insane." A reformer with a deep faith in the therapeutic properties of place, he promoted large hospitals where the natural setting, light, harmonious architecture, and farming or other productive community work would bring patients from madness to sanity. "Between 80 and 90 percent" of cases of insanity were curable, Kirkbride wrote. Patients just needed care in a calm, hospitable environment in which they could work and interact.

Kirkbride Online

Since Massachusetts resident Ethan McElroy launched KirkbrideBuildings.com in 2001, employees or children of hospital employees who lived on these hospital campuses have contacted him, he says. Despite the stigma attached to asylums, McElroy says, "Most of them had warm memories and feelings about the hospitals and the patients."

Kirkbride's designs, characterized by a central block with a series of stepped-back wings, served as a template for dozens of state-funded asylums in the late 19th century. When North Carolinians looking to establish a new asylum consulted Kirkbride, he recommended architect Samuel Sloan to design it. Sloan took the job and would go on to receive other important commissions in North Carolina, including the Executive Mansion in Raleigh.

Sloan's plan for what would be known as the Avery Building took advantage of the hilltop site just southwest of the center of Morganton. The massive brick edifice, which eventually grew to more than 500,000 square feet, features an elaborate entryway with pilasters and stained glass. The roof is topped with a tall dome.

As the patient population grew in Morganton, buildings were added, and the grounds expanded. There were farms and stables, a bowling alley and billiard room, a bake house and dairy, and a greenhouse (still standing but slated for demolition). A colony treatment approach adopted in the early 1900s led to the building of detached houses for residents, with gardens and orchards. There were new wards for tuberculosis patients, dormitories for nurses and orderlies, and a neighborhood of small, neat homes built for resident psychiatrists and their families.

Other Solutions

So what is a state to do with enormous hospital complexes that are too big, too expensive to maintain, and too challenging to retrofit for current treatment practices?

Some historic hospitals still serve patients, though that number is shrinking. Pennsylvania maintains two Kirkbride hospitals: Danville State and Warren State. In North Carolina, Raleigh's 1856 Dorothea Dix Hospital is scheduled to close by year end. In Minnesota, the Fergus Falls State Hospital was recently advertised on Craigslist to anyone with $1 and a feasible redevelopment plan. In Morristown, N.J., Preserve Greystone has been fighting to prevent demolition of Greystone Hospital, another Samuel Sloan design, since 2008.

One challenge to preserving former asylums, Yanni notes, is the social stigma attached to mental illness and the often-tragic histories of poor care and treatment of residents. Still, she says, in smaller towns, like Morganton, "the institution and the community are so intricately intertwined" that there are powerful advocates for preserving these places.

In Buffalo, for example, the nonprofit Richardson Center Corporation is working with the state of New York to come up with a plan to preserve and reuse the magnificent H. H. Richardson-designed former Buffalo State Asylum, which sits on grounds landscaped by Frederick Law Olmsted. A long-shuttered mental hospital complex in Foxboro, Mass., has been partially restored as condominiums. And developers in Traverse City, Mich., have worked to convert a former hospital into a mixed-use development called The Village at Grand Traverse Commons.

Back in Morganton, N.C., Brown, Ervin, and other fans of Broughton Hospital hope the state will consider finding a way to preserve their town's historic asylum.

Read more about historic asylums

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Submitted by psychiatrist at: December 16, 2010
So many of these buildings slated for demolition or collapse by neglect (to avoid intervention by historic preservation groups) could be used as assisted living facilities. There is a great need for residential placements in NC (and other states) and the campus would be a wonderful place to develop transitional housing for the mentally ill ready to leave the hospital and move into the community if there were only some place to go. Broughton staff would likely step up to moonlighting opportunities for the extra income. So many of the things necessary to make a transitional home operate would be close at hand. But someone at the state level has to "bless" it and fund it. Tearing down these buildings that are exactly what is needed for transitional housing is a shame and an absolute WASTE of money, materials and opportunities. Proposals raised time and again to utilize these buildings and available staff to run these transitional homes have been ignored.

Submitted by Catherine at: December 16, 2010
Is there anything we can do to halt the state's cutting madness - at least get their attention? I've found that they don't seem to be thinking anything through. I've literally begged to repair the Dix Cemetery (I'm trained & know what to do) so the markers are visible - you can't find much of anything now. I've contacted numerous people at Dix & the governor's office - not even a return call or note. I'm offering my time & supplies for free. I fear how many sites may be lost during the next few years...

Submitted by GlennP at: December 15, 2010
Historic Burke Foundation set up a Facebook page for Save Broughton Hospital. If you're interested, take a look here: http://www.facebook.com/pages/Save-Broughton-Hospital/118989834806515

Submitted by Tyler at: December 13, 2010
If that greenhouse is torn down, it will be a travesty. Hopefully they will allow someone to purchase it and reassemble it (very easily done with Victorian steel greenhouses) rather than have it end up in a pile of metal and glass.