St. Elizabeths Hospital



St. Elizabeths Hospital, located in Washington, D.C., was the first large-scale, federally-run psychiatric hospital in the United States.

Housing several thousand patients at its peak, St. Elizabeths has since fallen into disrepair and is mostly abandoned, though it is still operational. The Department of Homeland Security announced in March 2007 plans to relocate its headquarters, along with most of its Washington, D.C.-area facilities, to the abandoned western campus of St. Elizabeths beginning in 2010.

History
The hospital was founded by Congress in 1852, largely as the result of the efforts of Dorothea Dix, a pioneering advocate for people living with mental illnesses. It opened in 1855 as the Government Hospital for the Insane, and rose to prominence during the Civil War as it was converted temporarily into a hospital for wounded soldiers. In 1916, its name was officially changed to St. Elizabeths, the colonial-era name for the tract of land on which the hospital was built. The hospital had been casually known by this name since the time of the Civil War, when&mdash;in their letters home to loved ones&mdash;patients of army hospitals temporarily located on the grounds were reluctant to refer to the institution by its full title.

Several important therapeutic techniques were pioneered at St. Elizabeths, and it served as a model for later institutions. Carl Jung, for example, studied African-American patients at St. Elizabeths to examine the concept of race in mental health. Well-known patients of St. Elizabeths include would-be presidential assassins Richard Lawrence and John Hinckley, Jr., successful assassin Charles J. Guiteau (until his execution), as well as Mary Fuller, Ezra Pound, and William Chester Minor.

It is speculated that St. Elizabeths has treated over 125,000 patients, though an exact number is not known due to poor recordkeeping. Additionally, thousands of patients are believed to be buried in unmarked graves across the campus, but, again, records for the individuals buried in the graves have been lost. More than 15,000 known autopsies were performed at St. Elizabeths between 1884 and 1982, and a collection of over 1,400 brains preserved in formaldehyde, 5,000 photographs of brains, and 100,000 slides of brain tissue was maintained by the hospital until it was transferred to a museum in 1986. In addition to the mental health patients buried on the campus, several hundred Civil War soldiers are interred there as well.

Decline
At its peak, the St. Elizabeths campus housed 7,000 patients and employed 4,000 people. Beginning in the 1950s, however, large institutions such as St. Elizabeths were being criticized for hindering the treatment of patients. Community-based healthcare, which included local outpatient facilities and drug therapy, was seen as a more effective means of allowing patients to live near-normal lives. The patient population of St. Elizabeths steadily declined.

By 1996, only 850 patients remained at the hospital, and years of neglect had become apparent; equipment and medicine shortages occurred frequently, and the heating system was broken for weeks at a time. By 2002, all remaining patients on the western campus were transferred to other facilities. Although it continues to operate, it does so on a far smaller scale than it once did.

Campus
The campus of St. Elizabeths sits on bluffs overlooking the confluence of the Potomac and Anacostia Rivers in the southeast quadrant of Washington, D.C. It is divided by Martin Luther King, Jr. Avenue between the 118 acre east campus (owned by the D.C. Government) and the 182 acre west campus (owned by the Federal Government). It has many important buildings, foremost among them the Center Building, designed according to the principles of the Kirkbride Plan by Thomas U. Walter (1804-1887), who is perhaps better known as the primary architect of the expansion of the U.S. Capitol that was begun in 1851.

Much of St. Elizabeths' campus has now fallen into disuse and is in serious disrepair. It has been named one of the nation's 11 Most Endangered Places in 2002 by the National Trust for Historic Preservation. Access to many areas of the campus, including the abandoned western campus (which houses the Center Building) is restricted.

Revitalization plans
After several decades in decline, the large campus could not be maintained. In 1987, hospital functions on the eastern campus were transferred from the United States Department of Health and Human Services to the District of Columbia government, with the federal government retaining ownership of the western campus. Several commercial redevelopment opportunities were proposed by the D.C. government and consultants, including relocating the University of the District of Columbia to the campus or developing office and retail space. However, the tremendous cost of bringing the facilities up to code (estimated at $50-$100 million) kept developers away.

With little interest in developing the site privately, the Federal Government stepped in. Control of the western campus&mdash;home of the oldest building on the campus, the Center Building&mdash;was transferred to the General Services Administration in 2004. The GSA improved security around the campus, shored up roofs, and covered the windows with plywood to try to preserve the campus until a tenant could be found.

After three years of searching for an occupant, the Department of Homeland Security (DHS) announced on March 20, 2007 that it would spend approximately $4.1 billion to move its headquarters and most of its Washington-based offices to a new 4.5 million ft2 facility on the site, beginning with the United States Coast Guard in 2010. DHS, whose operations are scattered around dozens of buildings in the Washington, D.C. area, hopes to consolidate at least 60 of its facilities at St. Elizabeths and to save $64 million per year in rental costs. DHS also hopes to improve employee morale and unity by having a central location to operate from.

The plans to locate DHS to St. Elizabeths have been met with criticism, however. Historic preservationists argue that the move will destroy dozens of historic buildings located on the campus and that other alternatives should be considered. Community activists have also expressed concern that the planned high-security facility will not be interactive with the community, and will do little to revitalize the economically depressed area.

In media
Part of the campus was featured as the outside of the Judge Advocate General's building in the movie A Few Good Men.