Eastern State Hospital, the second oldest psychiatric facility in the United States, and the first west of the Allegheny Mountains, is located along Newtown Pike in Lexington, Kentucky.

The founding of Eastern State dates to 1816-1817 when a hospital was constructed to serve the poor, disabled and “lunatic” residents of the region. Previously, such patients had to be transported to Eastern State Hospital in Williamsburg, Virginia. A main building was constructed to house Fayette Hospital, and was dedicated on June 30, 1817 by Henry Clay and other dignitaries.3 The hospital, however, was never fully completed or occupied, and was forced to close two years later during the Panic of 1819.4

The hospital was reestablished by an Act of Legislature as the Lunatic Asylum on December 7, 1822, and on May 1, 1824, the hospital admitted its first patient.3 4 The first of two new wings was added to the main building a year later at a cost of $5,735.74, and the second was finished in 1826 at a cost of $4,405.39.

Between 1829-1830, two new structures were constructed onto the previous two wings, followed by a new building in 1832 that was completed at a cost of $5,480.06.3 Additional buildings were constructed in 1836 and 1840, followed by a new two-story structure added to the rear of the central building in 1844. A library was established in the following year.

Two years after opening, Eastern State housed 54 patients, nearly doubling by 1830.3 By 1845, the mental population had increased to 153 before sharply increasing to 271 three years later. The hospital only had 180 rooms, and overcrowding became an issue.

In 1850, a new brick stable, granary, corn-house and ice-house was constructed on Eastern State’s 40-acre lot.3 The all-brick buildings were built after a fire a few months prior destroyed the previous wooden stables and ice-house. A new ward was constructed a year later that featured two day rooms, a veranda, bathrooms and dressing rooms on each floor, and a promenade of nearly 300 feet. Each ward had its own dining room and was serviced by a central kitchen.

On February 14, 1852, a fire swept through portions of the hospital, killing two out of 200 patients, day rooms, three halls, 70 lodges and three latticed verandas.3

By 1860, overcrowding conditions forced the hospital to admit only residents from Kentucky although numerous applications from abroad were received.3 Eastern State began a capital improvement campaign shortly after that led to the construction of several new structures in 1868. The first constructed was a new building for females, with a central wing that was four-stories high with a full basement and wings that were three-stories tall. A new three-story building for African-Americans soon followed, as did a new two-level laundry and boiler house. By the end of the decade, the facility accommodated 320 with room for up to 520 on 238 acres.

Maximum patient capacity was reached by 1870, though. The Superintendent at the time, Dr. John W. Whitney, M.D., refused to admit an additional 150 patients and resigned in 1872.3

In 1876, the hospital was renamed the Eastern Kentucky Lunatic Asylum.4

A new three-story structure was constructed to fill the gap between the male and female wards in 1885. The first story housed offices, while the remainder was used for patient housing.3 This was followed up with an addition to the building housing the African-Americans in 1889. S new administration building, with sleeping apartments for physicians, was constructed five years later, followed by a new residence for the superintendent and family.3 By the end of the century, Eastern State housed 861 patients.

The start of the 20th century saw a new construction projects and upgrades, the first of which was a new bowling alley that was built for the patients in 1905. A new laundry facility was completed a year later, followed by a dairy barn and slaughter house in 1911-1913. A nurse’s home and living quarters containing 36 beds was opened on April 25, 1928.

The asylum was renamed on January 2, 1912 to Eastern State Hospital and comprised of 400 acres, most of it farm land.3 4

By the mid-1910’s, the hospital had a census of 1,431 with a capacity of 1,200, but the start of the third decade saw an overwhelming number of patients admitted to the hospital, increasing the census to 1,756 in a facility designed to hold only 920.3 It increased further to 1,996 in 1945.1 The population only marginally declined to 1,725 by 1957 and to a little over 1,000 in 1967.4

By the mid 1940’s, new therapies designed to treat mentally unstable patients were put into use, including electro- and Metrozol-shock treatments, and Malarial fever therapy.3 Insulin therapy began in May 1952, although it declined in use after 1954 when tranquilizing drugs were introduced for use.4

In 1951, the Wendell building was constructed, followed by the renovation of the administrative building employee quarters into offices three years after.3 In 1956, Eastern State sold 300 acres to International Business Machines (IBM) for a new research park and manufacturing plant, and all farming at the institution ceased a year after. The Allen Building opened in 1957 with 160 beds for the acutely ill.3

Eastern State’s census decreased to 999 by June 24, 1967, the first time under 1,000 since the 1890s, and declined further to 639 by 1970.1 3 Advancements in treatments first introduced in the 1940s led to a sharp increase in outpatient treatments versus in house care.3 In-house populations also declined due to an increase in mental treatment centers throughout the state.4 By 2007, the number of mentally-ill residents had fallen to just 150.1 5

In 1984 the city of Lexington discovered the remains of patients buried in unmarked graves while working on the Loudon Avenue extension project, resulting in the re-burial of over 4,000 bodies behind the Hope Center. In 2005, the remains of 11 more patients were found while digging for a new waterline. The graves of many more are believed to be scattered around the current and former grounds of the hospital.

In 1993, the non-profit organization, Bluegrass Regional Mental Health-Mental Retardation Board Inc. became concerned when rumors circulated that Eastern State Hospital was to close its doors to inpatient care.4 The rapid closure of mental institutions nationwide, as part of cost-cutting efforts by state agencies, left few inpatient options and limited options for care to many. As a result, Bluegrass Regional began discussions with the state in taking over day-to-day operations of Eastern State. In September of 1995, Bluegrass Regional MH-MR took over management of Eastern State under a contact with the Commonwealth of Kentucky, however, the buildings were still property of the state.1 5 Bluegrass Regional received $31.7 million in state funds annually to operate the facility.6

Of the more than one-dozen structures that housed patients, only three are in use and several are abandoned. As the population declined, many of the buildings were closed and the ones that remained in use were minimally upgraded or renovated. A lack of state funding and antiquated facilities led to an increasing number of safety and health violations. In July 2007, a Herald-Leader investigation found asbestos, lead paint, exposed wiring and poor fire protection systems in buildings that were still be used.1 A temperamental heating and cooling system led to a wild degree of temperatures in many of the buildings.

Shortly after Bluegrass Regional took control of Eastern State, Joseph Toy, the executive director and CEO of Bluegrass Regional, stated that the complex feet more as an institution and not a hospital, adding that the facilities were woefully outdated in form and function.5 In 2004, Toy approached James Holsinger, then secretary for the Cabinet for Health and Family Services, in regards to finding a way to fund for a new psychiatric hospital. Holsinger agreed that the facilities were outdated.5 The estimated cost for a new facility was $130 million, with annual payments by the state to pay off the debt would be approximately $8 million per year.

Various proposals came about soon after for the new facility, including locating a new psychiatric hospital between Louisville and Lexington that would combine Eastern State with Central State Hospital in Louisville.5 Another proposal involved relocating Eastern State to the Veterans Administration complex on Leestown Road.

Plans were unveiled by Bluegrass Regional on June 14, 2005 that outlined the goal of a model mental institution with additional capacity and functionality built on 30 acres along Newtown Pike at Coldstream Research Park.6 New, specialized programs for veterans, those with substance abuse and mental illness would be introduced. Initial costs to construct the hospital decreased from $130 million to $86 million, although only preliminary architectural plans were completed.1 6 The state would lease the hospital from the city until the bonds are paid off. Bluegrass Regional had been in discussions with the University of Kentucky, who manages the park, in constructing a new facility on the grounds.2 6

On August 21, 2007, the Bluegrass Regional and the Cabinet for Health and Family Services signed an agreement giving Bluegrass Regional $1 million and the authority to move ahead with plans for a new mental health care facility.1 The money would be used towards employing an architect to finalize designs and obtain cost estimates on construction.

Governor Beshear announced a land swap proposal for Eastern State on February 28, 2008.7 Under the proposal, spearheaded by state Representative Jimmie Lee, Eastern State Hospital would relocate to a state-of-the-art facility at Coldstream, while the Bluegrass Community and Technical College would relocate its primary campus on Cooper Drive and two satellite campuses on Leestown and Regency roads to the hospital property. The college would have the option to occupy all 68 acres of the old hospital property. The plan would give the University of Kentucky further room to expand its campus and would allow the community college to be located adjacent to downtown and near Transylvania University.

In late-March, the Kentucky House and Senate clashed over who should operate the new Eastern State. The Senate budget bill guarantees a contract to build and operate the mental hospital to Bluegrass Regional, the current operator, while the House budget bill states that the construction and operational contract would be open to competition.9 Under a House-Senate agreement, Bluegrass Regional would be allowed to receive the first bid at proposing a plan for operating the new hospital. It would receive the contract if its plan met the state’s minimum standards. If it would somehow not meet the minimum standards, the operation of the facility would be open to competitive bid.

[stag_toggle style=”normal” title=”Sources” state=”closed”]
  1. Musgrave, Beth. “A new Eastern State is planned: Legislative OK needed for psychiatric facility.” Herald-Leader (Lexington), 22 Aug. 2007. 20 March 2008 Article.
  2. Musgrave, Beth. “Research park considered as site for new psychiatric hospital.” Herald-Leader (Lexington), 22 Aug. 2007. 20 March 2008 Article.
  3. Shoemaker, Shane. “Eastern State Hospital Timeline.” Article.
  4. Shoemaker, Shane. “History of Eastern State Hospital.” Article.
  5. Musgrave, Beth. “Bluegrass Regional proposes new $130 million facility.” Herald-Leader (Lexington) 8 July 2007. 20 March 2008.
  6. Isaacs, Barbara. “Plans for new mental hospital are unveiled.” Herald-Leader (Lexington) 15 June 2005. 20 March 2008.
  7. Vos, Sarah. “3-way deal proposed.” Herald-Leader (Lexington) 29 Feb. 2008. 20 March 2008 Article.
  8. Hatton, Mary and Jerry Taylor. “The Eastern State Hospital Project.” 20 March 2008 Article.
  9. Brammer, Jack and Art Jester. “Eastern State deal surviving talks.” Herald-Leader (Lexington) 30 Mar. 2008. 1 April 2008 Article.