'Architecture Of An Asylum' Profiles St. Elizabeths Hospital, From State Of The Art To Notorious : Shots - Health News Founded in 1855, St. Elizabeths Hospital in Washington, D.C., grew from 250 patients to 8,000. A new exhibit at the National Building Museum explores the links between architecture and mental health.

'Architecture Of An Asylum' Tracks History Of U.S. Treatment Of Mental Illness

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Ezra Pound, a major American poet, and John Hinckley Jr., the man who shot President Reagan - both men had something in common - St. Elizabeths Hospital, where those with mental illness were housed. NPR special correspondent Susan Stamberg says a new exhibit at the National Building Museum explores the links between architecture and mental health.

SUSAN STAMBERG, BYLINE: When I moved to Washington in 1962, St. Elizabeths was notorious. A federal facility opened with idealism and hope in 1855, had ballooned from 250 patients to 8,000. Its vast, rolling patch of farmland had become the poorest neighborhood in the capital. Dorothea Dix, the 19th-century reformer, who fought for the hospital, would have rolled over in her grave.

SARAH LEAVITT: She had observed the treatment of the mentally ill in jails and other kinds of alms houses, poor houses all over the country...

STAMBERG: Sarah Leavitt is curator of the St. Elizabeths exhibit.

LEAVITT: ...And was really appalled by the treatment that they were getting. And she made it her life's work to change that story.

STAMBERG: She crusaded state legislators and the Congress and got them to create what was then called the Government Hospital for the Insane. She handpicked land on which it was to be built. And at her small, wooden desk - it's in the exhibition - Dorothea Dix outlined her vision.

LEAVITT: She really believed that architecture and landscape architecture would really have a role in curing people.

STAMBERG: R. Denise Everson, an architect who specializes in design and health, says certain elements are vital.

R. DENISE EVERSON: ...Natural light, views of the outdoors so you don't feel hemmed in, so that you know that you are part of a larger society.

STAMBERG: Dix insisted on these elements for the Government Hospital for the Insane. Curator Leavitt says the dark cells, the bars, the cold she'd seen in jails fueled Dix's thinking.

LEAVITT: There was this idea that they mentally ill wouldn't notice extreme cold or heat. And she was really disgusted by that and really viscerally angry.

STAMBERG: Dix made sure the hospital that became St. Elizabeths in 1916 had heat and tall, arched windows so light could stream in and screened sleeping porches, where patients could catch summer breezes. Photos, floor plans and models in the exhibit show handsome brick buildings with towers, high ceilings, open space and river views available in the 1850s only to certain patients.

LEAVITT: The African-American patients were in these two little buildings here, behind the building. They did not have those views.

STAMBERG: Women and men, white or black, were separated, too. But a hundred years before mood drugs, everyone got the same treatment. St. Elizabeths gave mentally ill patients hydrotherapy.

LEAVITT: There was the hot water, which would calm more manic patients, and then the cold water to stimulate patients that were quieter or needed to get awake.

STAMBERG: Photos show them after the baths, lying wrapped like mummies in wet blankets. Another picture from the 1920s shows a man sitting at an electroshock machine. A lamp-like device is suspended over his head.

LEAVITT: And then it would come down onto his head. And the shocks would come through the machine. You can see it's connected by a wire.

STAMBERG: A few lobotomies were also performed at St. E's, a portion of the brain removed.

LEAVITT: The idea was that it would calm the patient, which probably it did - but at what cost to the patient?

STAMBERG: Far less chilling, a photo from the 1960s of dance therapist Marian Chase, moving around a room with patients.

LEAVITT: She really believed that would help open up their minds and help them come to peace with their day or with their existence, with everything. And I think that's a really beautiful image. Just the look on her face of kind of pure joy and dance is something I really appreciate.

STAMBERG: Over decades, the sun-filled, airy rooms of St. Elizabeths got overcrowded, understaffed and eventually, emptied out. There are still 300 patients there. But 75 buildings stand idle. New drug therapies, less federal and state support and deinstitutionalization, which started with President Kennedy and increased under Reagan, put many of today's mentally ill into homeless shelters or on the streets or in jail.

The graceful St. Elizabeths campus will eventually house condos and the Department of Homeland Security. But Dorothea Dix's dream of architecture as a path toward helping the mentally ill lives on in the hearts of many, including building and health architect R. Denise Everson.

EVERSON: I don't know about cure. Some things cannot be cured. But I think humane treatment, I think creative treatment, is where we should go as a community, as a nation and as a world.

STAMBERG: "Architecture Of An Asylum: St. Elizabeths" is at the National Building Museum until January. In Washington, I'm Susan Stamberg.

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