Hope, Healing and Ghosts

A sunset drive around the 540-acre campus of Petersburg’s Central State Hospital seems serene, if lonely. Around the periphery of campus there are green spaces and woods rich in wildlife. On this evening, a flock of turkeys wanders behind the campus, wary but undaunted by a passing car.

But the campus is quiet. The only signs of life are parked cars here and there, scattered around the handful of buildings still in use. Those structures are mixed in with eerie old buildings that date from the early 1900s. Some have been abandoned so long that shrubs, even trees, grow from their ledges, roofs or doorways. Long shadows darken these structures in the evening, making them seem both formidable and forlorn.

One of three public mental health hospitals serving Virginia — the others are Eastern State in Williamsburg and Western State in Staunton — Central State has a forensic unit on its campus that serves the entire state for patients with mental health conditions who have been accused of crimes. Its other patients are drawn from the Richmond area and Central Virginia.

About half the buildings here are abandoned, and many of those still in use probably should be. There’s no air conditioning in the kitchen or in the laundry, where summer temperatures can soar above the century mark. Plumbing and electrical systems could fail at any time, the cost of maintenance continues to rise, and a catastrophic infrastructure failure could render a building unusable.

“There’s imminent risk in terms of physical structures,” says Rebecca Vauter, director and CEO of the facility.

Physically, the facility is outmoded, outdated and potentially unsafe for staff and patients. The abandoned structures, such as those near the maximum security unit, send the wrong message to Central State’s workers and those in its care, Vauter says. “They show disrespect to the people there for treatment, how little they are thought of.”

That is set to change.

A new facility was approved earlier in 2019 by the state, which has targeted $315 million for construction of a five-story, 252-bed facility to be built over five years on the campus across from the Hiram Davis Medical Center. Meetings with potential vendors began in August, and the timetable calls for contracts to be approved late this year with groundbreaking in 2020, according to Daniel Herr, deputy commissioner of facility services for the Virginia Department of Behavioral Health and Developmental Services.

Next year is significant for the hospital for another reason: It will be the facility’s 150th anniversary. The sesquicentennial (csh150th.com) will be marked with activities that include community events, history symposiums, and efforts to locate and acknowledge the many patients who died while at the facility and were buried in unmarked graves. Central State’s history is atypical of many similar institutions across the nation in that it was set up in the Jim Crow South as a place solely for black residents of Virginia. It was not integrated until the federal government enacted the Civil Rights Act of 1964.

Del. Lashrecse Aird (D-63rd District) says a new Central State facility has been a priority since she first ran for office in 2015. “To finally bring this to fruition is a huge deal,” she says.

Aird also says that she will likely introduce a resolution in the General Assembly to mark the importance of Central State and its 150th anniversary. “Prior to this, I didn’t realize the historical significance,” she says. “It is important to me that we are preserving this.”

Ghosts

Her name is Maria Armistead, a house servant. About 70 years of age, with no property of her own, she is African American and blind, having lost her sight in the summer of 1873. Now it’s Jan. 16, 1874, and officials in York County are deciding her fate. She is “suspected of lunacy.”

W.L. Henley, who is listed as a farmer and is probably her employer, is one of two witnesses at the hearing. He says he’s known her for 20 years, “and she has always been insane.”

It’s eight years after the Civil War, and Armistead likely was once enslaved. She has a child, but there is no one here to advocate for her. It’s just Henley and one Betsy Baird, a 32-year-old cook in the house. Henley says Armistead has a “disposition to wander off,” and that she has done so more frequently since she lost her sight. Another indicator of her mental illness? “She imagines she is the owner of the property on which she lives.”

It runs in the family, Henley tells the magistrate: A brother was insane, an inmate at the asylum in Williamsburg, the magistrate writes in the commitment record.

A fire is described by Baird, who tells the magistrate that Armistead burned up her bedclothes, scattered the fire over the floor, and then attempted to get out through the chimney, lighting her own clothing afire.

The magistrate rules that Armistead will be committed by reason of insanity. She is to be sent to Central Lunatic Asylum in Richmond, located then at what is now Mechanicsville Turnpike at Fairmount Avenue. This is the forerunner of Central State; at this time it was known by its previous name, Howard’s Grove, which had been a Confederate hospital during the Civil War. After the war, it transitioned into an asylum exclusively for blacks through the federal Freedmen’s Bureau.

It was initially used to treat physical ailments and injuries and to provide a home for people who had no other place to go. But in 1870, the state deemed it a place to treat the mentally ill.

This is where Armistead ends up. She’s far from alone. Here’s a sampling of other commitments that year, from the archives at the Library of Virginia:

• Henrietta Baughman is admitted to Howard’s Grove on Dec. 4, 1874. There is no one who can make bond for her. She is 28 years old, married, with no children. She, too, is a house servant, with no property of her own. She is angry, “raving all the time,” says the person seeking her admittance, who adds that she threatened someone with a butcher knife.
• Petersburg resident James Casey, 39, a married factory hand, is a rarity, a patient who “has a piece of property.” He’s admitted because he was “acting and talking strangely.”
• Warren County resident Walton Campbell, a 36-year-old servant, is admitted in July 1874, after he became “terrified after religious excitement.”
• Sixty-two-year-old George Burton of Pittsylvania County is committed in September 1874: “He imagined that every tree in the woods was a man and every limb a gun pointing at him.”
• Thirty-two-year-old William Brooks of Elizabeth City County was confined in August 1874 for “talking of strange things.” He was married, with two children, a laborer with no property. As with the others, there is no record of friends or family speaking on his behalf.

What’s striking in a quick look through these early commitment papers is the lack of an advocate for these people. There are no friends or family members present at the hearings, just their employers, doctors, lawmen and magistrates.

“They were all people who were sentenced to the hospital by the courts after being considered mentally ill or vagrants,” says Kirby Ann Randolph, an assistant professor of bioethics in the College of Medicine at Kansas City University and an assistant professor in the Department of History and Philosophy of Medicine at the University of Kansas. Randolph’s 2003 doctoral dissertation is “Central Lunatic Asylum for the Colored Insane: A History of African Americans With Mental Disabilities, 1844-1885.”

For many, the families just weren’t there. Randolph notes that prior to emancipation, slaves took care of one another. After emancipation, the priority for many was to reunify their families. There were too few alms houses, and there was no one left to care for people facing commitment. “They found themselves alone, with no money,” Randolph says.

They also were part of a growing number of African Americans who were committed from across the state. Central State continued to grow, from 373 patients when the move was made to Petersburg, to 849 by 1897, to a population of 1,703 in 1915. It had morphed into a small city, or maybe more of a plantation.

A Reflection of Its Time

Historically, blacks were thought to be immune to mental illness and some other diseases, too, says King Davis, a former behavioral health commissioner for Virginia and current director of the Institute for Urban Policy Research & Analysis at the University of Texas at Austin. The hypothesis held that blackness and landlessness offered immunity to mental illness, and it was proposed that they needed no mental health services.

But that changed with the belief that freedmen were even more susceptible to mental health ailments, a hypothesis that held some sway well into the 20th century, as late as 1968, says Davis, who is leading an effort to save and digitize Central State’s records, including a trove of historic photographs. That view is reflected in blacks being admitted to state hospitals at a greater rate than people of other races.

Virginia had “astronomically high numbers of people categorized as insane,” Randolph says.

Davis says about 70% of the people admitted to Central State were diagnosed with severe mental disorders, schizophrenia or bipolar disorders, a frequency far higher than has been found in other populations.

What was going on here? Why were extreme diagnoses given to blacks? Why did Virginia dedicate so much money to this facility? African Americans had initially been treated at Eastern State in Williamsburg, which housed them in a segregated wing in a basement.

Randolph says that the hospital administrator in Staunton was opposed to having black people at his facility because it would discourage wealthy, whites from going there.

The attitude of those in charge at the time is reflected in the writings of William Drewry, a longtime superintendent of Central State, who contended in 1908 that “It has frequently been observed that prior to the war there were very few insane Negroes, yet since then there has been a constant increase in their numbers.” He hypothesizes that “the Negro is today an easier prey to constitutional diseases than the whites, succumbs more readily to strain, stress and disease.”

The men running Central State and the other asylums were mostly former Confederates — all of them white Southerners — most of whom believed that the natural state for blacks was to be slaves.

Some therapy and medications were administered, but labor was considered a crucial component to treatment. Central State was self-sustaining, with farmland and everything that went with it. This wasn’t just the situation at Central State; similar facilities across the nation also relied on farms, Davis says. “[Farms] were considered essential to feed the patients and lower the cost of running the institution,” he says.

Randolph says it was a re-creation of sorts of the Old South and its plantations, with Central State residents supplying much of the labor. “It was essentially a farm, and they [also] rented out patients to nearby farms and quarries, and that was essentially the treatment — that you are to do this work,” she says. Those who worked could get meat and vegetables for dinner. Those who didn’t were served bread and water. There was a Catch-22 in place: If being healthy is defined as being able to work, why not allow the residents to be returned to live with family?

The people who ran the place did have some compassion, though, Randolph says. The physical facility was top-notch, and those in charge did seem to care about the patients, but it was a peculiar sort of concern. The superintendents were products of their times, Randolph says. They could be opposed to civil rights and voting rights for blacks, but in the name of medicine, they were seeking to help their charges. A similar relationship had also existed in slavery, as with Thomas Jefferson and James Madison, two Virginians who were crucial to this nation’s founding and dedicated to liberty, but who also relied on slaves for labor at their businesses and homes.

It was a time when mental illness was not always treated with compassion and empathy. A railroad went to the campus, and it brought people out to look at the residents as if they were entertainment, Randolph says. That was not just at Central State, she notes; it was a common practice at other asylums of the time, too.

A Crumbling Campus

Central State was once a small city. Look at the campus map, and you’ll find a laundry and power plant; pump houses, two active, one vacant; a carpentry shop and a pipe shop; an amphitheater with projection booth; and a kitchen. It had reached an average patient population in the 4,000s in the mid-20th century.

Now Central State receives five to eight admissions a day. Two-thirds of those patients are discharged within 30 days; most of the rest are released within six months. The patient census, which changes daily, stood at 274 on Sept. 17. There are about 821 full-time equivalent positions at the current facility, and that number should remain about the same for the new Central State.

There are 13 buildings in use across the 540-acre campus. In a modern unit, each room has its own bathroom; not here. Bathroom visits and movement around the facility are the most dangerous times in a facility such as this.

A tour of one patient building shows a dormitory-size room that’s serving as the bedroom for four people who are sleeping on plastic platforms holding mattresses, with minimal plastic storage cubicles for their gear and clothing. The beds are within arm’s length of one another; there’s no way to have a sense of personal space. “Our setting is not therapeutic at all,” Vauter says.

There is no central dining area: Meals and food are prepared in one place, then trucked to the various units. Patients have to take a bus ride for treatment, then another back to their residence. Staff are isolated in the various buildings, making it hard to build a sense of community. “It’s an incredibly inefficient way to do business,” Vauter says.

A modern facility also needs multiple recreational and quiet areas, as well as more than one area with a television, which means fewer potential conflicts over what to watch. “It seems pretty minor, but it’s a safety issue,” Vauter says.

It’s also hard to entice and retain qualified staff at a rundown, outmoded facility. The state currently has 100 open positions at Central State.

Vauter says the building is a relic of another time, one with a very different understanding of mental illness and how to treat and heal people who are in crisis, “and we’re done with that,” she says.

What’s coming is a state-of-the-art building that will incorporate many of the features of the Western State Hospital in Staunton, where a new facility opened in 2013, costing $150 million. That is substantially less than the tab for the new Central State, with the higher price tag stemming from the higher security needs for the forensic unit that houses people who have been charged with crimes and are also diagnosed with a mental illness. The current forensic facility was built in 1950 and has 111 maximum-security beds.

Among the improvements are better lines of sight, which will enhance the safety of staff and patients; an electronic badging system, which will enable freer movement of patients within the facility; and a well-lighted, more attractive environment overall.

Electronic records will be introduced, an impossibility in the current environment, given that some areas of the current facility do not receive Wi-Fi signals.

The new facility will have areas for a range of activities, including space and equipment for teaching everyday skills such as cooking and cleaning.

Individual patients will have the maximum amount of freedom they are eligible for, so they can move about without a staff escort. It will be a campus that will infuse a sense of much-needed renewal into the facility, “a place where it feels possible to get well,” says Vauter.

There are no plans on what to do with the remainder of campus and the existing structures. Herr notes that state-owned property may be declared surplus and put to alternative uses. It could be repurposed, sold off or just sit there. For example, the Southside Virginia Training Center campus was sold in 2017, and Dominion Energy is constructing an administration facility on the 50-acre site in Dinwiddie County off West Washington Street at the Petersburg city limits.

Remembering Their Names

There’s a cemetery on campus that has numerous unmarked and invisible graves. The state honored those unnamed souls in 1991 with the dedication of a tombstone-like marker that notes in remembrance of “those persons who were served and buried here in the campus cemetery during the early years and are known only to God.”

Central State wants to have a study done in preparation for the new construction and for the 150th anniversary commemoration to locate graves that may lie hidden and unmarked on campus.

Davis is trying to give a voice to these patients.

There are 30,000 names in the database of Central State patients that Davis is helping to build. He was called in after Central State had looked at its old records in 2009. At the time, they had misinterpreted a state program, believing that they had to destroy all the old records. Instead, Davis was called in to sort out the mess of unarchived documents that were scattered and kept in a too-hot environment.

He got a team together and obtained grant funding through the University of Texas at Austin and the National Society of State Mental Health Providers. It took 10 years, and the task was daunting, with 800,000 items to catalog, including 36,000 photos, negatives and images.

The work on the archive project was recognized in May by the American Psychiatric Association, when Davis received its Benjamin Rush Award, named for a founder of American psychiatry.

Copies of the hard drive containing the resulting database will be given to Central State, the state department of mental health and the Library of Virginia.

Amoung the historic images is a photo of Louis Armstrong on campus, and Davis says that other celebrities who visited the site include Lena Horne and Ella Fitzgerald. It’s not the stars who stand out, however, it’s the faces of the patients, so many unknown and unhonored.

The database is the largest of its kind for African Americans with a hospital admission, providing information including names, ages, places of residence, and marital and occupation status. It also includes notes on diagnosis, cause of illness, onset of symptoms, admission and release dates, or date of death and cause of death. Davis’ study has lacked funding to review the full treatment records, but if money becomes available, he wants to conduct a blind review of the full records to learn more about how people became patients there and how they were treated.

Since the second year of the work, Davis and his helpers have communicated with relatives of onetime patients, via letters and emails, by phone, and in person. They want to know the basics: What was the diagnosis? How were they treated? When did they die? Where are they buried?

One woman who reached out for information had been born at Central State while her mother was a patient there. She was adopted by a relative, but she had a fraternal twin, and what happened to her twin is a mystery; there is no record of him so far.

“There are literally hundreds of similar inquiries from families,” Davis says.

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Central State Timeline

1774: A woman of mixed race is admitted to what is now Eastern State Hospital in Williamsburg. Treatment at the time is open to all, regardless of race.

1841: The state determines that Eastern State will treat slaves, with the provision that slaveholders pay for the treatment. These patients are relegated to a separate ward in a basement until a 40-bed building opens.

James Stribling, superintendent of Western State Hospital in Staunton, writes that there are more insane free blacks in the North than there are in the South, and infers in turn that slavery must have a positive mental effect on the race.

1868: Howard’s Grove Freeman Hospital is established in a former Confederate Hospital in Richmond in what is now the Fairmount Historic District around Fairmount Avenue. It is initially a general hospital to treat a variety of health conditions.

1870: The state of Virginia, which assumed control of Howard’s Grove in December 1869, begins to use the facility as the one place for mental health treatment for African Americans in the commonwealth. African American patients at Williamsburg’s Eastern Lunatic Asylum are moved to Richmond, as are African Americans from across the state who have been jailed as “lunatics.”

1882: A 300-acre site for a new asylum, the Mayfield Farm in Dinwiddie County, is purchased by the city of Petersburg for $15,000 and given to the state. The state provides $100,000 for the construction of the facility, with $2,000 for plans. Buildings, equipment and farmland are valued at $200,000.

1885: The new facility, known as Central Lunatic Asylum, opens, with 373 patients transferred from Howard’s Grove. The population stands at 436 the following year, with a waiting list of 100.

1894: The facility receives a new name, Central State Hospital. The state’s other mental health facilities are also renamed “to inspire a more positive public image of mental illness and its treatment facilities.”

1896-early 1900s: William Francis Drewry is named superintendent and presides as the facility expands and the patient population grows, from 849 in 1897 to 1,703 in 1915. The campus is expanded with buildings designed to accommodate patients by their diagnosis and conditions. Additions include a pavilion for women with epilepsy, a chapel, a building for African American employees, an industrial shop and cottages for quarantines.

1915: An additional 200 acres is added to the campus for its farm, an outlet for employment of patients and considered, with recreational activities, as part of the treatment. Male patients worked the farm or in workshops; women made clothing.

1926: The campus has more than 80 buildings, from dormitories to a carpentry shop and a blacksmith shop.

1938: The state opens a facility for its black residents with intellectual disabilities ages 8 to 21, the Petersburg State Colony for the Negro Insane, on the campus of what is now Richard Bland College. It was moved to the Central State campus in 1960 and renamed the Petersburg Training School. Other changes followed, and by 1975, it had evolved into the Southside Virginia Training Center for the Mentally Retarded. That facility was shuttered in 2014.

1940s-60s: Overcrowding is an issue, with an average population of 4,000 in 1948. One ward in 1950 is reported to house more than 300 people in one large room. Several buildings are added in the 1950s and early 1960s to ease the crowding. Additions in the 1950s include a geriatric treatment center and a maximum security forensic unit. Desegregation is mandated following the federal Civil Rights Act of 1964, and the hospital in 1967 begins to accept patients of all races from across Central Virginia.

1990s: The patient population is listed as 49.8% white, 49.2% black and 1% other.

2020: Central State marks its sesquicentennial, with several commemorative events in the works. Also in 2020, ground will be broken on a $315 million, five-story, 250-bed facility to consolidate services and replace most of the dilapidated, outmoded facilities on campus. Construction is set to take place over five years.