HOPKINSVILLE — In 150 years, the treatment of mental illness has seen a lot of changes, and so has Western State Hospital.
When Western State Hospital opened in 1854, it was a "lunatic asylum" and many of its patients were the undesirables of society, according to the hospital's community services coordinator Tony Winfield.
Pharmaceutical drugs in the 1950s aided treatment and helped decrease the hospital population from more than 2,500 to just a couple dozen.
"What hasn't changed is our mission," said Steve Wiggins, Western State Hospital director. "We're still here taking care of folks and doing it with people who want to do so."
He said the perception of mental illness is one of the big changes in 150 years, but there is still a long way to go in educating society.
"From day one, it always has been a psychiatric hospital," Winfield said. "It's one of the oldest in the entire country."
The hospital is listed on the National Register of Historic Places.
Plans for Western State Hospital began in February 1848 with an act of the Kentucky General Assembly to meet a need in the state (according to a census) for a second hospital to care for the mentally ill. Eastern State Hospital in Lexington
The original tract of land, "Spring Hill," was composed of 386 acres and was purchased for $1,971.50 — $5.14 per acre. Citizens of Hopkinsville raised money for the land, according to the hospital's history.
Building began at the site in 1849. Construction was complete in 1852 at a cost of $202,000.
A historical presentation on the hospital describes the main building as "large and well-proportioned with a magnificent portico, with six lofty columns ascended by a flight of stone steps."
The front of the building was 370 feet wide with two wings, 190 feet long, extending back at right angles. It was four stories high, with a basement and was built to accommodate 350 patients.
The Western Lunatic Asylum was opened Sept. 18, 1854, with 29 patients, mostly chronic mental cases sent from the Eastern Lunatic Asylum. In its first year of operation, the asylum admitted 113 patients. Thirty-two were discharged; 19 died.
The early years
The first superintendent, Dr. A.S. Annan, campaigned for a separate institution for the "feeble-minded patients" (mentally retarded), according to hospital historical accounts.
He practiced performing autopsies and kept records on size and conformity of patients' brains for research, Winfield said.
In its first years of operation, most employees lived on the hospital grounds and were required to sign in and out. Salaries ranged from $125 per month for the superintendent to $10 per month for an attendant.
Cost for boarding one patient was $100 per year, which in the end was too low to cover expenses.
The hospital took the form of a small community within itself, with a laundry and sewing department and a farm, which provided the dairy products and food used at the hospital.
"A 10-foot high wooden fence was constructed to enclose the grounds so patients had an opportunity to roam the grounds," Winfield said.
Underground tunnels were used to transport patients. Many have caved in or were sealed because they were too dangerous.
On Nov. 30, 1860, sparks from a chimney ignited the wooden roof and fire spread through the building. It was a dry, windy day and it was impossible to extinguish the blaze, according to historical accounts. Only one of the 210 patients died. He had barricaded himself in his room. Several ran away.
"It pretty much gutted the facility," Winfield said.
At first, patients were housed in the courthouse after the fire. Paying male patients stayed in the Brooks House and females were taken to the Rittors Hotel. Indigent females stayed in the boarding house of Bethel College and indigent males were returned to the hospital engine room.
"It had to be a very trying time for patients and staff alike," Winfield said.
Eventually, a large house was purchased for $4,500 to house the females. Twenty-three log huts were built to house male patients and attendants.
While the hospital was in a state of repair, the nation was engaged in Civil War.
Employees traveling back and forth the two miles between patient sites with supplies were captured to serve in the Confederate and Union armies. Workers repairing the hospital were harassed and supplies captured, according to the hospital's history.
Dr. James Rodman agreed to bury the dead and care for the wounded after a battle, at the request of Col. James Q. Chenweth of the Confederate Army.
In 1867, rebuilding was complete.
Two wings enlarged the building. Separate departments were created for males and females and for tuberculosis patients.
The hospital census grew to 1,500 patients.
The Kentucky General Assembly changed the name of the hospital to Western State Hospital in 1919.
Investigations by state officials and the Welfare Committee in the late 1930s resulted in renovations and higher standards.
In 1950, 2,200 patients were admitted as "incompetent" with loss of rights.
Tranquilizers came into use in 1955. By the late 1950s, several psychotropic medications were being marketed and there was a deinstitutionalization effort to weed out patients that did not need to be at the facility, Winfield said.
"Those with mental retardation and physical problems could get out of the hospital setting and back home," Winfield said.
Western State Hospital is a 222-bed psychiatric hospital serving individuals 18 or older from a 34-county area in western Kentucky. It provides acute psychiatric care for mentally ill patients, psychiatric rehabilitation for chronic mental illness and provides acute psychiatric care for geriatric patients.
The facility is accredited by JCAHO (Joint Commission on Accreditation of Healthcare Organizations).
Its other two buildings include Western State Nursing Facility — a 144-bed treatment facility for mentally disabled geriatric residents that provides care for adults with severe and persistent mental illness who require nursing-facility level of care. Patients can only be admitted as transfers from state psychiatric facilities within Kentucky.
The third separate facility is The Volta Program (Volunteer Treatment for Alcoholism and Substance Abuse) — a non-medical state facility, 28-day program with 30 beds. Volta provides a recovery process to enable people to return to society as productive, sober individuals.
Currently, Kentucky has five psychiatric hospitals — Western State, Central State in Louisville, Eastern State in Lexington, Appalachian Regional Psychiatric in Hazard, and Kentucky Correctional Psychiatric in LaGrange. Each serves a particular region of the state.
Western State employs 650 in its three facilities in Hopkinsville.
The hospital has compiled its history utilizing articles from The Kentucky New Era, former staff members and community members, but Winfield said there is a lot more history they would like to know.
A celebration is being planned for the hospital's 150th anniversary Sept. 18.
KAREN BIGHAM can be reached by telephone at 887-3262 or by e-mail at firstname.lastname@example.org.