Background and Conceptualization

Historically, concepts of race and mental illness have been intimately linked in American psychiatry and state policies. In the 1700s, it was hypothesized that enslaved Africans were immune from the risk of mental illness because they did not own property or engage in commerce. Prior to the end of slavery only a few free blacks were allowed access to services from the Public Hospital at Williamsburg, Virginia; however, slaves were not allowed access to these services until 1845 although it was known that they suffered from rates of mental illness similar to that of other populations. A mentally ill slave could be punished, abandoned, sold, jailed, or killed if their ability to work was compromised because of illness. As the Civil War drew to a close, a second hypothesis proposed that rates of mental illness in the newly freed population would increase exponentially resulting in a high demand for and increased governmental costs to establish inpatient hospital care. The increased risk of mental illness in this population was associated with false assumptions that former slaves lacked the ability to manage freedom, had no marketable skills, or the capacity to manage the stress of migrating to northern cities and states. Two prominent Virginia psychiatrists, who directed the two existing state mental hospitals, proposed construction of a racially separate hospital based on their
assumptions that blacks and whites could not be provided mental health care in the same hospital. The Virginia legislature adopted this proposal and passed legislation(Virginia General Assembly, 1870) to create a separate hospital.

Central State Hospital in Petersburg Virginia opened in 1870 as the first mental hospital exclusively for people of African descent in the United States. The hospital was created by the Virginia legislature in response to the ending of the Civil War, the abolishment of slavery, and pressure from the Freedman’s Bureau to create health care facilities for this population. The legislation also reflected recommendations from psychiatrists for separation by race in admissions to and treatment in state mental hospitals. The first location of Central State Hospital was in Henrico County, Virginia and later at the site of Howard’s Grove Hospital, a large confederate medical facility. The hospital was renamed Central Lunatic Asylum for Colored Insane in 1870 when its ownership was transferred to the Commonwealth. In 1882, the Mayfield
Farm in Dinwiddie County was purchased by the City of Petersburg for the sum of $15,000 and the property given to the Commonwealth for development of a new mental hospital for African Americans. Development of the mental hospital was not universally welcomed in the affluent black community of Petersburg where a college or general hospital was favored. Central Lunatic Asylum was a state-owned mental hospital parallel to those opened earlier at Williamsburg (1765), Staunton (1827), and Marion (1867) and brought jobs, contracts, and new resources to the city and county. The census of Central Lunatic Asylum was 373 patients by 1885. However, the census doubled in size almost every decade, reaching a total of 5000 patients in 1950. The rate of hospitalization was twice that of the black proportion of the state’s population. This disparate ratio in admissions by race was also found in 2013 (Davis, Lewis, Zhang, & Thompkins, 2011). Currently (2014), the census is less than 450 patients with an average length of stay of less than 45 days – vastly different from lifetime commitments in prior decades.

From 1870 to 1968, Central State Hospital remained segregated by race and was the only hospital in the Commonwealth of Virginia that accepted African American mental patients from throughout the state regardless of socio-economic status. This extensive history of segregated care produced the most extensive set of mental health records, history, and policies in the United States. Thousands of black families in Virginia had relatives admitted to Central State Hospital from 1870 to 1970, as shown in a review of the archival records that have been collected. The majority of these were involuntary commitments, requiring court involvement.

Problem Statement

Minimal research attention has been focused on the evolution of mental health policies and services in America that focus specifically on African Americans with severe and persistent mental illness (Metzl, 2009). Because such policies and services were first created in Virginia, efforts to study and understand their origins, impacts, and changes are viewed as important to an understanding of current discrepancies between the prevalence and incidence of mental illness in this population and the causal links between race and utilization of services. In addition to the gap in policy studies, there has not been a concerted effort to gather, maintain, and study the vast number of important historical artifacts, public policies, admission and discharge records, and related written documents from this period.
This project is expected to stimulate long term scholarly and lay interest in these critical source materials and documents on the evolution of African American mental health.

Significance of the Project

The significance of this project is the opportunity to increase our national understanding of the complex relationship between societal beliefs about race, mental illness and public policy – historically and currently. This important relationship is captured in the records of the Central Lunatic Asylum for Colored Insane. These records reveal the development and functioning of the first mental hospital that served the total population of African Americans in Virginia during 100 years of segregated admissions. For over a century these historical records have been unavailable for public review, scrutiny, family search, or scholarly analysis. Study of these records should yield new directions in efforts to design and
implement mental health services to relieve the long-term disparities by race.

The project has previously received funding support for planning from the National
Association of State Mental Health Program Directors and the Substance Abuse and Mental Health Services Administration. Additional funding from The University of Texas at Austin supported the cost of digitizing the records. The Andrew W. Mellon provided $800,000 in 2015 to support completion of the project.

The long-term intent of this project is to identify, index, restore, preserve, utilize and increase levels of access by families and scholars to the content of these valuable records. To date, approximately 95% of the 800,000 pages of archival materials have been digitized and stored on servers maintained at the University of Texas at Austin.

Objectives/Goals

There are 5 primary goals/objectives that form the basis of the project.

1. Archival Preservation
Objective: Digitization of the entire existing collection of organizational level data, hospital records, photographs, and news articles that cover the period 1868-1970 to insure their preservation; where needed, the project will restore materials and develop a plan with key groups for their long-
term preservation:

Central State Hospital has maintained a complete set of its original admission and
discharge records, patient treatment records, morbidity and mortality data, annual
reports, vintage psychiatry books, board minutes, photographs and fiscal documents
dating back to its 1870 origins. Although digital copies of most materials have been
made, the original historical materials are in jeopardy. They have never been kept in an archival environment; and, many of the materials are fading and deteriorating as a result of long-term exposure to humidity, heat, handling, infestation, normal aging of paper, and sunlight. The majority of the historic admission materials are housed openly in the medical records department, while others are maintained in the medical library where they have been kept for decades. Unless protected in an archival environment these historic materials will be illegible and beyond restoration or usage. As a result of these combined risks, the project staff have instituted procedures to protect these valuable historical records from further deterioration. The short term solution is to reproduce copies of the most historically important documents until longer term plans can be made. Digital duplication of all of these materials and storage through an internet web site would insure the long term protection of their content and access to scholars. We estimate that there are close to 800,000 pages of materials covering the period 1870 to 1970 that should be digitized to provide protection. The hospital has recently identified 500,000
3×5 cards that hold admission data; and, the State Library of Virginia has approximately 150,000 involuntary admission certificates that should be copied. Once copied, the digital files would need to be updated periodically to be congruent with changes in computer technology. Federal and state regulations on privacy of patient records will be maintained throughout the project.

2. Digital Library
Objective: Design and development of a robust digital library with specific
interface and open-source access that corresponds to the needs of diverse
users while maintaining privacy of sensitive records and identities:

A significant portion of the historic materials that are digitized will be made publicly available on a website developed and maintained by the project. The site would house a portion of the 1 million pages of material and photographs that chronicle the history of Central Lunatic Asylum for Colored Insane. The public portion of these materials would be open-sourced and accessible to anyone with access via the internet. However, where federal or state law prohibits the display of particular
materials [treatment, personal identification] such access would be restricted to
hospital personnel, the state mental health authority, and families. The project will
examine each of the physical items in the collection to develop a controlled
vocabulary. The controlled vocabulary will be used to index every item and allow
scholars, families, policy makers, and the general public to easily search and retrieve
relevant documents from the digital library once developed. The project will also
determine additional characteristics (metadata) that will contextualize each digital
item in relationship to other items and to the collection as a whole. Development of a CSH archival website will require up to 2 years of active work by project staff and doctoral students in both Texas and Virginia. Project staff has developed software models to accommodate the materials. These models were part of doctoral level courses in the Information School at The University of Texas at Austin. A detailed work-plan for this phase of the project will be provided.

3. Permanent Repository
Objective: Develop and implement a long-term plan to house the original
collection and maintenance of the master electronic files:

Digitizing the existing historical records is the short term solution to maintaining
the historical records that document the history of this first mental hospital for
African Americans with mental illness. However, there is a need for a permanent
repository or physical space where the original records can be housed in an
archival environment. An agreement has been reached with Central State
Hospital and the State Library of Virginia (SLV) to transfer all original materials
to the Library at the conclusion of the digital work. State of Virginia law gives
the SLV the authority to maintain archival materials from all state agencies.
However, the project director will continue discussion with the legislature as well
as other state, city, and county officials to explore multiple options and multiple
sites for holding, maintaining, and displaying the original documents. These
discussions will also focus on obtaining and maintaining a permanent server for
all of the digitized images. Currently, all of the digitized records are maintained
on external hard drives that have a high rate of failure.

4. Increased Public Interest

Conduct an end-of-project seminar and exhibit of the collection that will inform,
increase interest, and attract potential users of the data. The project will create a
database that can be populated during the first phase and potentially used for
similar digitization projects in other states that have inquired. The history of Central Lunatic Asylum has remained obscure for over a century. There has been minimal documentation of its history, with the exception of one dissertation (Randolph, 2003) and two masters’ theses. Relatively few published articles have been identified in the literature; and, only two reports on the broader area of racially segregated mental hospitals have been published (Davis, 1998; Jackson, 1998). A goal of this project is to disseminate the products from this research as broadly as possible.

5. Future Projects
Objective: Pursue funding to implement a number of related projects:

There is sufficient material gathered on this hospital to complete a documentary that
chronicles its 100 year history. A second future project would be an exhibit in a major
venue that displays several of the artifacts and written documents that were developed by the hospital. A number of doctoral dissertations, articles, monographs, books, and policy briefs on various aspects and findings from the project should be published.

Central State Archival Project National Advisory Board

Dr. Thomas Battle, Howard University (Retired)

Mr. David Chu, MSW, Former Administrator, CSH

Dr. Lucious Edwards, Virginia State University

Dr. Ronald O. Forbes, Former Medical Director, CSH

Dr. Olivia Garland, Board Chair, Former Director, CSH

Dr. Kirby Randolph, University of Kansas

Dr. Martin Summers, Boston University

Terri Williams, MSW, Publicist, New York

Dr. King Davis, Project Director/PI

Staffing

The project will be managed by King Davis, Ph.D., former commissioner of the Virginia Department of Mental Health, with staffing support from David Chu, hospital administrator and external technology consultation from Meghan Wyatt of the Crowley Company. Dr. Davis has over 30 years of experience in the field of mental health and has conducted archival research projects and published his findings during this time. Other staff include Pat Galloway, PhD, an anthropologist and archivist faculty member in the Information School at The University of Texas at Austin; Unmil Karadkar, PhD, a computer scientist and faculty member in the Information School; Celeste Henery, PhD., a post-doc in anthropologist; Gary
Geisler, PhD, a former faculty member in the Information School with an extensive background at Stanford University in developing digital libraries; Lorrie Dong, a post-
doctoral scholar in Information Science; Victor Obaseki, JD., an attorney in the African Diaspora Studies Department; and Nitin Verma, a first year graduate student in Information Science at The University of Texas at Austin.

Appendix A. Chapter 126, 1870

Appendix B. Brief Bio

     King Davis, Ph.D.

     King Davis was the inaugural director of the Institute for Urban Policy Research & Analysis and holder of the Mike Hogg Endowed Chair in urban affairs at the University of Texas at Austin for four years. Prior to this post, he served as Executive Director of the Hogg Foundation for Mental Health from 2003-2008. He held the Robert Lee Sutherland Endowed Chair in Mental Health and Social Policy at the University of Texas at Austin, School of Social Work from 2000 to 2008. He received the Excellence in Teaching Award from the University of Texas at Austin in February 2001. King was a professor of Public Mental Health Policy and Planning at the Virginia Commonwealth University, Richmond Virginia, from 1984-2000. From 1998-1999, he was the holder of the William and Camille Cosby Chair at Howard University, Washington D.C. Also in 1998, King was appointed to the Libra Chair in the School of Business and Public Policy at the University of Maine, and was a Distinguished Visiting Professor at Washington University in St. Louis in 1999. He taught at Norfolk State University School of Social Work from 1974 to 1984.

     King was awarded the Ph.D. from the Florence G. Heller School for Social Policy and Management at Brandeis University in 1971. His doctoral work focused on the linkages between fund raising, non-profit organizations, and communities of color. He holds the masters’ and bachelor’s degrees in social work (concentration in mental health) from California State University in Fresno California.

     King’s professional background and experiences are varied. He is a former Commissioner of the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services. King was appointed Commissioner by L. Douglas Wilder, Governor of Virginia, and served from 1990 to 1994. As Commissioner he held responsibility for executive leadership and management of a statewide behavioral
health care system, comprised of 17 hospital facilities and 40 community service agencies.

     King has served on a number of local, state, and national boards and commissions. He has written and published numerous articles, and reports on mental health, managed health care, fund raising, and social justice. His book on The Color of Social Policy was published early in 2004. He currently serves on the National Advisory Committee for the Center for Mental Health Services. His research focuses on redesigning urban mental health services and capturing the historical data on mental health services for African Americans in 18th, 19th, and 20th century Virginia.

Reference List

Davis, K. (1998). Slaves Don’t Get Stress: The evolution of mental health policies and services for African Americans: Implications for Current and Future Public Policy Rockville, MD: Center for Mental Health Services.

Davis, K., Lewis, A. N., Zhang, J., & Thompkins, A. L. (2011). Race and The Policy of Involuntary Admissions to Psychiatric Hospitals. In J.H.Schiele (Ed.), Social Welfare Policy: Regulation and Resistance Among People of Color (pp. 63-91). New York: Sage.

Jackson, V. (1998). Separate and Unequal: Legacy of Racially Segregated Psychiatric Hospitals Atlanta: Healing Circles.

Metzl, J. (2009). The Protest Psychosis: When Schizophrenia Became a Black Disease. Boston: Beacon Press.

Randolph, K. (2003). Central Lunatic Asylum 1870-1900. University of Pennsylvania.
Virginia General Assembly. (6-7-1870). An Act to establish the Central Lunatic Asylum. Chapter 146, p. 189.
Ref Type: Bill/Resolution