Eastern State Hospital

Medical / Kentucky

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


It was decided circa 1816 to construct a mental hospital to serve Fayette County, Virginia. 3 Previously, such patients had to be transported to Eastern State Hospital in Williamsburg, Virginia. The Main Building for the new Fayette Hospital was dedicated by Henry Clay and other dignitaries on June 30, 1817, but the entire facility was never fully completed or occupied and was forced to close during the economic Panic of 1819. 4

Fayette Hospital was re-established by an act of the Virginia legislature as the Eastern State Lunatic Asylum on December 7, 1822, and on May 1, 1824, it admitted its first patient. 3 4 The first of two new wings were added to the Main Building in 1825 at the cost of $5,735, and the second wing was finished in 1826 at the cost of $4,405. Between 1829-30, two extensions were added onto the previous two wings, followed by a new building in 1832 that was finished at the cost of $5,480. 3 To resolve overcrowding concerns, additional wards were erected in 1836 and 1840, followed by a new two-story structure to the rear of the Main Building in 1844 and a library was in 1845.

In 1850, a fire destroyed the wood-framed horse stables and ice house, which were quickly replaced with fireproof buildings. 3 A new ward, with each floor including a veranda, a bathroom, a dressing room, and two dayrooms, was added in 1851.

Overcrowding conditions forced Eastern State to only admit residents from Kentucky by 1860. 3 The institution began a capital improvement campaign to increase the hospital capacity to 520 patients, which led to the completion of several new buildings in 1868, including new wards for females, a ward for African-Americans, and a new two-level laundry and boiler house. But by 1870, Eastern State was again overcrowded and the superintendent at the time, Dr. John W. Whitney, M.D., refused to admit an additional 150 patients and resigned in protest in 1872.

Eastern State Lunatic Asylum was renamed to Eastern Kentucky Lunatic Asylum in 1876. 4

A new three-story structure was constructed to fill the gap between the male and female wards in 1885, followed up with a new building to house African-Americans in 1889. 3 A new administration building, with sleeping apartments for physicians, was added in 1894, followed by a new residence for the superintendent and family. By the end of the century, Eastern State had the capacity of 861 patients.

Source: Clay Lancaster.

The start of the 20th century saw a flurry of new construction projects and upgrades. A bowling alley was built for patient use in 1905, followed by a new laundry in 1906, and a dairy barn and slaughterhouse in 1911. 3 A 36-bed apartment building for nurses opened on April 25, 1928.

Reflecting changes in the treatment of the mentally ill, Eastern Kentucky Lunatic Asylum became Eastern State Hospital on January 2, 1912. 3 4

This did little to stem the overcrowding of the institution, which was 200 over its stated capacity by the mid-1910s. 3 By the 1930s, Eastern State, with a capacity of 920 patients, was overwhelmed with 1,756 patients.

By the mid-1910s, the institution was overcrowded once again, boasting a census of 1,431 patients with a capacity of 1,200. 3 This sharply increased to 1,996 patients in 1945 1 before marginally declining to 1,725 patients by 1957 and a little over 1,000 patients by 1967. 4


By the mid-1940s, 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 added, followed by the renovation of the administrative building employee quarters into offices in 1954. 3 In 1956, Eastern State sold 300 acres of its farmland to International Business Machines (IBM) for a new research park and manufacturing plant, and all farming at the hospital ceased a year later. The Allen Building opened in 1957 with 160 beds for the acutely ill.

Deinstitutionalization, the process of replacing long-term psychiatric hospitals with community mental health services, began in the 1960s. The movement towards deinstitutionalization was born out of a socio-political movement for community-based services and open hospitals and the advent of psychotropic drugs and financial rationales. 10

Eastern State’s resident population was gradually reduced by releasing stabilized patients, shortening inpatient stays and reducing admission and readmission rates. Programs were implemented to mitigate the reinforcement of dependency, hopelessness, and other maladaptive behaviors.

The hospital’s census decreased to 999 by June 24, 1967, marking the first time since the 1890s that Eastern State had a patient count under 1,000. 1 3 This declined further to 639 patients by 1970 1 3 and just 150 inpatients by 2007. 1 5

In 1984 the city of Lexington discovered the remains of patients buried in unmarked graves while constructing Loudon Avenue through the property, resulting in the re-burial of over 4,000 bodies behind the Hope Center.

In 1993, the non-profit Bluegrass Regional Mental Health-Mental Retardation Board (Bluegrass Regional) 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 was part of broad cost-cutting efforts that left few inpatient options remaining. As a result, Bluegrass Regional began discussions with the Commonwealth in taking over day-to-day operations of Eastern State. In September 1995, Bluegrass Regional took over management of Eastern State under a contract with the Commonwealth, 1 5 initially receiving $31.7 million in state funds annually to operate the facility. 6

Of the more than one-dozen structures that once housed patients, only three remained in use by the 2000s which featured asbestos, lead paint, exposed wiring, and poor fire protection systems. 1


In 2004, Bluegrass Regional approached the state in regards to the construction of a new $130 million psychiatric hospital either between Louisville and Lexington or at the Veterans Administration Hospital on Leestown Road. 5 On June 14, 2005, it was decided to relocate Eastern State Hospital to University of Kentucky-owned Coldstream Research Park on Newtown Pike, which would include space for specialized mental health programs for veterans and those with substance abuse. 6 With a projected cost of $86 million, the state would lease the hospital from the city until the construction bonds were paid off. 1 2 6

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

Under a land swap deal announced on February 28, 2008, Bluegrass Community & Technical College would relocate from its main campus on Cooper Drive and its two satellite campuses on Leestown and Regency roads to the soon-to-be-vacated Eastern State Hospital property. 7 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 Transylvania University.

The new $129 million Eastern State Hospital opened at the Coldstream Research Park on September 10, 2013, and has been managed in a partnership with the University of Kentucky’s UK HealthCare through a contract with the Kentucky Department of Behavioral Health, Developmental & Intellectual Disabilities. By December, most of the buildings on the original Eastern State campus were demolished; the administration and laundry structures were the only structures to be spared.

The long-term facility at Eastern State, with just 14 patients, closed in mid-2018. 11 The patients were transferred to either the Western State Nursing Facility and Glasgow State Nursing Facility, saving the state $2 million in operational costs.




  1. Musgrave, Beth. “A new Eastern State is planned: Legislative OK needed for psychiatric facility.” Herald-Leader (Lexington), 22 Aug. 2007. 20 March 2008.
  2. Musgrave, Beth. “Research park considered as site for new psychiatric hospital.” Herald-Leader (Lexington), 22 Aug. 2007. 20 March 2008.
  3. Shoemaker, Shane. “Eastern State Hospital Timeline.”
  4. Shoemaker, Shane. “History of Eastern State Hospital.”
  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.
  8. Hatton, Mary and Jerry Taylor. “The Eastern State Hospital Project.” 20 March 2008.
  9. Brammer, Jack and Art Jester. “Eastern State deal surviving talks.” Herald-Leader (Lexington) 30 Mar. 2008.
  10. The Rockland Campus Plan. New York State Office of Mental Health, 1989.
  11. Stunson, Mike and Morgan Eads. “14 under long-term care face transfer as Eastern State Hospital ends service.” Herald-Leader [Lexington], 22 May 2018.