“Rows upon rows of numbered, small, rusted markers as far as you can see. No names, just numbers. It must be the most gruesome sight in Georgia. Unknown humans, shunned when living, deprived of their very names in death—and known only to God.”
—the late Joe Ingram
Ingram was describing the graves of some 25,000 patients buried at Central State Hospital in Milledgeville, Georgia, where he worked for 50 years. These and hundreds of thousands of shunned “unknown humans” interred nationwide, however, finally are receiving some of the respect they deserve. Across the country, advocates are working to restore grave sites at state hospitals, and fund-raising for a national consumer memorial in Washington, D.C., has begun.
Under the proposed design, peaceful gardens, reflective of the moral treatment model brought to the United States by English Quakers in the 1800s, will be the focus of the national memorial, which will be at Saint Elizabeths Hospital in Washington, D.C. The site will be easily accessible from a subway station near the memorial's entrance gate.
“You'll wind through gardens with rock markers from all 50 states listing numbers buried and at which institutions,” says Dr. Pat Deegan, technical advisor to the national memorial, “and then exit through the gate back into the community, with a takeaway message of ‘a life in the community for all.’”
District of Columbia Department of Mental Health Director Stephen T. Baron and his staff have led the efforts to identify land for the memorial and secure a local engineering firm to donate an architectural rendering of the memorial. The initial design, expected this fall, will help determine the projected cost, now anticipated to exceed $1 million. A three-year formal fund-raising drive is being planned, although donations already are being received.
“It is fitting that this memorial be located at Saint Elizabeths, given its history as a leader in moral treatment,” says Baron. “We are excited to participate in this national project and are committed to moving it ahead as quickly as possible.”
Opened in 1855, Saint Elizabeths was the first and only federally funded asylum and originally was called the National Asylum for the Veterans of the Army and Navy and Residents of the District of Columbia. Overlooking the Anacostia and Potomac Rivers, Saint Elizabeths was designed to be a model moral treatment asylum with peaceful gardens. It was a pet project of reformer Dorothea Dix, who had experienced a “breakdown” as a young woman.
Dix's recovery benefited by spending more than a year in Liverpool, England, resting in the home of the grandson of William Tuke. Tuke, a Quaker merchant and doctor from York, England, founded a retreat asylum in 1792, modeling it after a simple family farm. Tuke's asylum rejected harsh “treatments” such as mechanical restraints (e.g., chains and straightjackets). Believing patients were inherently good regardless of their behavior, Tuke focused on emotional and spiritual recovery—being “moral—rather than on restraints and punishment. The Quakers practiced gentleness and respect attuned to the needs of the ill, offering an inclusive, homelike setting that included garden walks, nourishing food, recreation, reading, and sewing.
The original goal of moral treatment asylums was humane treatment, but by the late 1800s medically focused state institutions began to replace Quaker asylums in the United States. Moral treatment practices gradually were eroded as state institutions became overcrowded.
The Georgia State Lunatic Asylum, opened in 1842 in Milledgeville, originally promoted moral treatment. The institution went from a place where the superintendent and his family shared meals with patients to a small city of 3,000 acres and a patient population that swelled to more than 12,000 in the late 1950s and early 1960s. In fact, it was once known as the “world's largest insane asylum.”
Many people sent to the Milledgeville institution after the moral treatment era were subject to abuse and neglect, forced lobotomies, dangerous experimentation without consent, electric shock treatment used as punishment, and overmedication. Most never returned home, and up to 25,000 died there and were buried in graves marked only with numbers on the grounds. It's reputed that no other state facility in the nation has more patient graves.
Across the country, Eva York's remains aren't even buried, but rather are in a corroding canister on a pine shelf in the 122-year-old Oregon State Hospital in Salem (where One Flew Over the Cuckoo's Nest was filmed). Her urn is one of 5,000 in the hospital's “Cremains Room.” In 1896, York died in a bathtub at the hospital, then known as the Oregon Asylum for the Insane. An inquest absolved the hospital staff, but no one claimed her corpse. She was buried in the asylum cemetery but exhumed and cremated 18 years later. York's story finally was told in a series of Pulitzer prize winning editorials in The Oregonian.
Motivated by these tragic stories, advocates are working to restore grave sites and create better conditions for current patients. For example, in 1997 advocates began restoring the Georgia Central State Hospital cemetery to honor the 25,000 patients buried there. In the process, they found thousands of displaced markers, which during the late 1960s and early '70s had been removed or pushed into the ground to make mowing the grass easier. Those markers became the part of the memorial shown in the figure.