Hospital History

Organized by Congress in 1855 as the Government Hospital for the Insane, the institution that would become a nationally recognized symbol of healthcare and medical breakthroughs became known as St Elizabeths during the Civil War.  Wounded soldiers treated here were reluctant to admit that they were housed in an insane asylum, and instead referred to their location as “St Elizabeths.”

St Elizabeths had been the name given to the original 600-acre tract of land by a 17th century owner, John Charman IV.  The curious absence of an apostrophe in “Elizabeths” dates to a time when the use of such punctuation was inconsistent at best.  Congress officially changed the name to St Elizabeths Hospital in 1916.

The hospital’s early mission, as defined by the famed social reformer Dorothea Lynde Dix, was to provide the “most humane care and enlightened curative treatment of the insane of the Army, Navy, and District of Columbia.”  Dix, a devoted advocate for the mentally ill, and Dr. Charles Henry Nichols, a physician who specialized in the treatment of mental illness, persuaded Congress to purchase the original 189 acres and fund the hospital.

St Elizabeths Hospital purchased the East Campus in 1869 to expand the agricultural activities that were considered essential to both the mission and the economy of the renowned institution.  Until the 20th century, the barns, stables, henneries, and piggeries that contributed to the hospital’s food production were jumbled with staff cottages throughout the pasture land. After the end of the 19th century, the East Campus was gradually converted from farm to facilities for an increasingly larger patient and staff population.

St Elizabeths was a prominent example of the mid-19th century movement advocating moral treatment of the mentally ill through a therapeutic combination of architecture and the natural environment. Perhaps the most famous institution of its kind in the U.S., St Elizabeths Hospital was one of the first hospitals to care for injured African American soldiers during the Civil War. It was home to one of the country’s earliest psychiatric facilities (Howard Hall, 1887), built specifically to care for and treat the criminal insane and mentally ill offenders.  And it pioneered the use of hydrotherapy, psychodrama, and pets as a part of therapy.

By the 1940s, the first and only federal mental facility with a national scope housed 7,000 patients and sprawled across more than 350 acres on both the west and east sides of Nichols Avenue (formerly Asylum Avenue and now Martin Luther King Jr. Avenue SE).  Setting the stage for the contemporary vision for St Elizabeths East, the East Campus became the hospital’s center of scientific research and medical services in the 1920s.

Coinciding with the federal deregulation of mental healthcare, the 183-acre St Elizabeths East campus was transferred to the District in 1987 .  In subsequent years, mental health facilities were concentrated in buildings on the eastern end of the campus, and in April 2010, a new hospital opened to continue to serve local patients and federally assigned inmates with mental health concerns.

St Elizabeths was designated a National Historic Landmark in 1990. The East Campus is also a designated historic district in the District of Columbia Inventory of Historic Sites (2006).