Even though I’ve lived in Georgia for almost 25 years now and have heard off and on about the state hospital in Milledgeville, I really didn’t know much about it. Friends would say that misbehaving children were threatened with being sent there. One of the cooks who worked in Barney’s home when he was a child in Buckhead was sent there because of her mental problems. Needless to say, this place and its history have drawn me to know more about it. You too?
Much of the information in this post comes from websites about the hospital. These websites are referenced and often include personal experience from people who had worked there or had relatives who had stayed there. How we take care of those with mental illness is a confusing topic. They could be in hospitals that may or may not be good, or they could be out on the street, homeless and often on drugs. I wish we as a society could find out a good answer for those who need help.
big picture look at this hospital (info from the Georgia Trust for Historic Preservation)
“Central State Hospital was Georgia’s first psychiatric institution, eventually becoming the largest mental hospital in the United States and the second largest in the world [after one in New York]. Central State was chartered by the legislature in 1837 with the intent of providing Georgians suffering from mental illness or developmental disabilities with a safe and humane environment.
“The complex includes nearly 200 buildings, dating from 1842 to the mid-twentieth century, and features a remarkable variety of architectural styles situated on nearly 2,000 acres.”
background of this hospital (from New Georgia Encyclopedia)
“Founded amid the social reform movements of the nineteenth century and expanded to one of the nation’s largest mental health institutions in the twentieth century, Central State Hospital at Milledgeville has been at the center of debates over the role of government in public health.
“The hospital’s turbulent history, spanning three centuries, has included major changes in how mental illness and people with mental illness are viewed by society and treated by medicine.
“Movements to reform prisons, create public schools, and establish state-run hospitals for the mentally ill swept across the nation during the first decades of the nineteenth century. In 1837 Georgia politicians responded by passing a bill calling for the creation of a ‘State Lunatic, Idiot, and Epileptic Asylum.’” A 4-story building was opened on this site in 1842; later, with other additions, it became known as the Center Building. Originally only for pauper patients, eventually services became available for everyone.
“Initially, politicians expected the asylum would become self-sustaining with healthier patients paying for their upkeep. They also hoped recovered patients could quickly return to society.
“Care of patients was based on the ‘institution as family’ model, which asserted that hospitals were best organized when they resembled extended families. This model was applied at Milledgeville under the leadership of Dr. Thomas A. Green, who served at the hospital from 1845 to 1879. Green ate with staff and patients daily and abolished such physical restraints as chains and ropes. Despite these improvements, treatment for patients often varied according to social class, with wealthier patients receiving more attention and treatment than impoverished charges. One wealthy patient stayed in Green’s personal residence (instead of an asylum ward) and married into the superintendent’s family.”
While the hospital had a good start, changes over the years made it be not as beneficial for the citizens of Georgia.
after the Civil War to today (more from New Georgia Encyclopedia)
“The hospital became increasingly custodial as the population evolved from the acutely disturbed to the chronically ill and organically disabled, many of whom were veterans of the Civil War (1861-65) with little chance of successfully returning to their families. Freed African Americans also entered the institution for the first time in 1866, which previously had serviced white patients only.
1872-1877
“In 1872 the Georgia Lunatic Asylum possessed a ratio of 112 patients per physician, a number that would not improve for almost a century. The asylum underwent a dramatic increase in patient population when local communities began sending unwanted or problematic residents to the asylum, regardless of their diagnoses. This included many freedpeople who were deemed unfit for independent living according to the principles of scientific racism. The asylum’s population further accelerated in 1877 when it ended any expectation that patients or their families pay for their upkeep at the institution.
1879-1907
“The asylum adjusted to this increase by developing more specific methods of diagnosis and implementing differentiated ward placements under Superintendent Dr. Theophilus O. Powell, a noted scholar of psychiatry, who served from 1879 to 1907. Powell segregated Black patients into their own building, one of several additional brick buildings and numerous auxiliary facilities constructed to handle the increase of patients. New construction often failed to keep up with overcrowded wards, however—a problem exacerbated when the building for African Americans burned in 1897. Powell resorted to housing Black patients in underground tunnels until the building could be rebuilt. That same year, the Georgia Lunatic Asylum changed its name to the Georgia State Sanitarium.”
why a woman could be committed to the hospital
- a 22-year-old white female whose family could pay: she’d been mentally ill for 8 years, was indecent and immodest, had ulcerated legs, and some other minor complaints; some improvement was noted
- a 23-year-old female who was “lunatic and epileptic,” convulsions seemed to follow disappointment in love; violent and hostile; auditory and visual hallucinations
Such sad situations (continuing New Georgia Encyclopedia)
“Crowded conditions led to the spread of infectious diseases like tuberculosis, which prompted a legislative inquiry into management at the sanitarium in 1909. Nevertheless, counties continued to send unwanted residents to the sanitarium, and the increase in numbers meant a concurrent decrease in the quality of care.
1910
“Feeding the sanitarium’s population (which numbered 3,206 patients at the start of 1910) became prohibitively expensive, so officials sought to become self-sufficient. Part of the extensive hospital grounds had been reserved for the planting of crops, and administrators had patients undertake the strenuous work of farming these acres. The work entailed little treatment on the part of the staff but often proved beneficial to those patients who would return to farm life when discharged. The overwhelming number of patients also led to a pattern of conscious neglect, whereby hospital staff met the basic daily needs of their charges but were unable to provide appropriate treatment for their illnesses.
1929
“In 1929 the state legislature changed the name of the sanitarium to Milledgeville State Hospital, reflecting a focus on rehabilitating its 5,000-plus patients. But significant interventions like insulin shock and electro-convulsive therapy became common to manage the exploding patient load. Federal funds assisted in the construction of needed additional buildings by 1940, but the dislocations of the Great Depression swelled the hospital’s patient count past 9,000.
political challenges
“The advent of psychotropic drugs reduced the length of stay and made home return more feasible for acute patients, but the ultimate goal of reducing the patient population clashed with the institution’s political self-interest. Politicians frequently interfered with the hospital.
late 1950s
“By the late 1950s, the hospital had an average of over 11,800 patients, making it the nation’s largest mental hospital next to New York’s Pilgrim State Hospital. A series of damning articles in 1959 by Atlanta Constitution reporter Jack Nelson (who would win a Pulitzer Prize for his coverage) revealed several abuses at Milledgeville State Hospital: experimental drugs being given to patients without their or their family’s consent, a nurse performing major surgery without supervision, and staff and doctors being drunk while on duty. In response, Governor Ernes Vandiver, Jr. called on a commission to investigate and recommend legislative action.
1967
“Despite concerns that another investigation would not materially improve the hospital’s staffing crisis and treatment of its patients, state officials nevertheless took measurable action. A regional system of six additional mental hospitals was established, with Milledgeville State Hospital being renamed Central State Hospital in 1967 to reflect its central location. With a shift from a medical to a mixed-therapy model, patients were increasingly released from Central State, which in 1968 dropped below 10,000 patients for the first time in two decades. That same year, the hospital closed its farm, and the land was parceled out among other state agencies, including the Georgia Department of Corrections.
1976-1999
In the last three decades of the twentieth century, advocates for the mentally ill, including Rosalynn and Jimmy Carter, pushed for more flexibility in getting patients back into society. A U.S. Supreme Court case involving Georgia’s mental hospitals, Olmstead v. L.C. in 1999, accelerated this trend by requiring hospitals to allow patients to leave if community treatment was possible and the patients desired it. Advocates also began the process of identifying and marking thousands of unmarked graves at Central State Hospital. More than 25,000 patients were buried in unmarked graves throughout the hospital grounds
[While Jimmy Carter started the process of closing down these hospitals when he was president, I remember Ronald Reagan actually being the president making it happen because he was following the law.]
2000-2010
“The first decades of the twenty-first century presented new challenges for Georgians with mental illness. Years of budget cuts at the seven state hospitals led to severe staff shortages and several preventable patient deaths. An investigation by the Atlanta Journal-Constitution in 2007 called “A Hidden Shame” prompted another public outcry and a threatened lawsuit against the state by the U.S. Department of Justice. As part of the settlement, Georgia’s hospitals were largely shut in favor of community treatment. But with state revenue depleted during the Great Recession, community treatment programs ran into many of the same obstacles that plagued the old hospitals, including inadequate funding and poor standards of care. Even so, by the start of 2010, only thirty patients remained at Central State, and by year’s end only a unit to temporarily house and treat mentally ill criminal defendants remained.
today
“With patients all but gone, the dozens of deteriorating buildings are all that remains of Central State Hospital. The site is now a patchwork of state and private ownership, with much of the area managed by a local redevelopment authority. Preservationists have campaigned to save the many structures still left, and the Georgia Trust for Historic Preservation has twice selected Central State Hospital for its annual ‘Places in Peril’ list.”
We walked around the grounds and took pictures of buildings, most of which we didn’t know anything about. As I’ve researched the hospital for this post, I’ve been able to fill in the blanks. If you have any more information, please let me know.
The Jones Building at Central State Hospital was completed in the late 1920s. It originally housed the Psychopathic Hospital of Milledgeville State Hospital. Largely abandoned decades ago, its condition has deteriorated extensively as shown in this photo.
More about the Jones Building (Remembering Central State’s Jones Building) and an interview of Marshall Berry
“The Jones building, named after Central State Hospitals’ fifth superintendent, Dr. Loderick Jones opened in 1929. Marshall Berry, [the man being interviewed,] says ‘It was the area’s only hospital until 1957 when the Baldwin County Hospital was built. So, before then, it’d be very likely that folks would’ve been born there. The mental, the physical– all of that was attended here in the Jones building,’ he said.
“It’s also the place that built the Berry family. ‘My grandfather worked here as an attendant and also as a nurse assistant in which he participated in transporting patients from Central State back to their home county, and also bringing ones from Atlanta down to Milledgeville,’ Berry explains. ‘He unfortunately was killed in a car accident in 1921 right outside the state grounds. He was just a couple of yards from being back on campus from the hospital.’
“However, Berry says that his grandmother didn’t let that stop their family from contributing to the hospital. ‘My grandmother ran what was called the Smith-Berry hotel,’ he explained. ‘She housed the relatives of patients that were in the Jones Building.’ His mother, Julia Berry had a history with the hospital, too. ‘Her real work was here as a nurse for 35 years,’ Berry said. Trained in the Jones building and graduating from nursing school there, his mother saw up to 250 patients a day.
“Berry followed in their footsteps. ‘I was able to get a job, fortunate to be in it and I worked 32 years,’ he said.
“After five decades, the Jones building closed in 1977 too old for modern equipment. Its operations moved to the newer Culver-Kidd building and the Jones building decayed.”
The Green Building (information on Green Building from Remembering Central State Hospital, including an interview of Walter Reynolds)
“Walter Reynolds says the place runs in his DNA. ‘I’m actually the fourth generation of my family to work on this campus,’ Reynolds said. ‘My great-grandfather worked in the steam plant, both of my grandmothers were nurses, my great-uncle was the photographer for the campus, and both of my parents worked with the Department of Corrections.’
“He says the Green Building is just one piece of the hospital’s history. It was actually one of the first buildings completed immediately following the Second World War. This would’ve been open around 1946 and it served as a patient dormitory. It was named after the hospital’s second superintendent, Dr. Thomas Green.
“They really put an emphasis on making sure the people weren’t unnecessarily restrained or otherwise limited in their ability. They really wanted people to act as normal as possible and really enjoy a quality of life here. For around 12,000 patients on campus, there were large dorms, bunk beds, showers, and activity spaces. For patients to come and go with relative freedom. However, between the 1960s and the 90s, there was a move towards deinstitutionalization.”
the Walker Building
From the previous sign, if the building could have been redeveloped, it had 40,000 square feet and was in an E-shape for easier construction. The building could be separated at the front corridor so the front wouldn’t be damaged. It had 300,000 bricks available for recycling.
The Walker building is the last one of three buildings set to be torn down by the state, according to the executive order Governor Brian Kemp signed in July.
In an article about a Milledgeville woman remembering the Walker Building, Caroline McClain gave her experience with the hospital.
“It was the site of medical experimentations, strange and even cruel treatment of its patients. However, she says despite its history, it still deserves to be saved. In fact, her great-grandfather, Herbert Walter Williams, was a patient there. ‘We found out that Papa was at the Walker building. He was admitted in late August of 1907,’ McClain said.
“She says two years before her great-grandpa was admitted, he had just lost two children, his wife to childbirth, and had been swindled by a business partner. ‘He was violent, drinking– he was of ill health,’ McClain said.
“So, McClain said the family admitted him because there was no one who could take care of him. It was easy to do at the time. ‘Back then a husband could have his wife admitted just because he wanted to,’ she said.
“The Walker building opened in 1884 known as the ‘white male convalescent’ building. ‘Back in the day, they would call it an insane building,’ McClain said. She said they had spaces for therapy, medication, and treatments. ‘Everybody was together whether you had epilepsy, or alcohol addiction, or some type of mental illness,’ McClain said.
“‘She says some treatments patients experienced in the Walker building were a lot to handle, like hydrotherapy. Putting a person in ice cold water, and then taking them out and putting them in hot water,’ she said. ‘They also gave nauseants to make people throw up. They thought that would help them, and laxatives. I just can’t imagine that.’
“Then treatments started to evolve. ‘In 1928, they added sterilization, 30s and 40s they started lobotomies, and in the 40s they started doing electroconvulsive therapy,’ McClain said. She says it was like torture. ‘At the time that they used these procedures, they were state of the art,’ she said. ‘That’s not something we would do today. They would say that’s abuse.’
“In the 1950s, McClain says the Walker building hired its first psychologist, Dr. Peter Cranford, who wrote a book in 1981 called ‘But For the Grace of God: The Inside Story of the World’s Largest Insane Asylum’ recounting the hospital’s medical history.
“McClain says by the time she had started working on the campus as a behavioral specialist in 1997, the treatment of patients had gotten better. ‘Yes, bad things did happen, but when you look at it overall, you see a development of how to minister to people with mental illness,’ she said.
“The Walker building closed in 1974 and is now set to be demolished by the state. However, McClain says it should be saved. ‘It was horrible, but it was the best they had,’ McClain said. ‘If you don’t learn from history, you’re going to repeat it. That means the good history and the bad history. That’s how the development of specialties have been created.’
“She says without Central State Hospital she doesn’t know what would have happened to her Papa.”
The land between the buildings for the men and the women housed lovely pecan trees. I wonder if the patients were able to enjoy this open area.
While we’ve been able to show you some of the buildings, what we didn’t take pictures of were all of the outbuildings where workers did what was necessary to support the hospital; some of these buildings are still in use. The man we met in the next post told us his wife had worked at the hospital as a nurse and it had been the largest employer in the county. Its closing affected many, not just the patients.
So we wonder what the best thing is to do for the mentally ill and those who don’t have family able to care for them. With all the people living on the streets, many on drugs and creating problems for others, are hospitals the best way to go? But finding staff to lovingly care for them with the best treatments available is difficult.
This has been a challenging post to learn about and write. I bet it’s been challenging for you to read about too.
Now on to lighter topics of the Georgia Military School and College and the Old Governor’s Mansion .
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