Dix Hill Asylum/Dorothea Dix Hospital, Raleigh, North Carolina

In the Autumn of 1848 the champion of the cause, Dorothea Lynde Dix, made North Carolina the focus of her efforts. In North Carolina Dix followed her established pattern of gathering information about local conditions which she then incorporated into a “memorial” for the General Assembly, but in spite of appeals to state pride and humanitarian feeling, the bill failed. However, Dix had been staying in the Mansion House Hotel in Raleigh during the debate where she went to the aid of a fellow guest, Mrs. James Dobbins, the wife of a leading Democrat in the House of Commons, and nursed her through her final illness, and her dying request of her husband was to support Dix's bill. James Dobbins returned to the House and made an impassioned speech calling for the reconsideration vote and on the 29^th day of January, 1849, the bill became law.

Dorothea Dix refused to allow the hospital to be named after herself, but did permit the hill on which it overlooked Raleigh to be named Dix Hill in honor of her grandfather. But, one hundred years after the first patient was admitted the General Assembly voted to change the name of Dix Hill Asylum to Dorothea Dix Hospital.

The original building was started in 1851, and began admitting patients in 1856. It was a large Romanesque structure designed by prominent NY architect Andrew Jackson Davis. A second building containing a kitchen and apartments for staff was soon added. The site of the hospital on a hill over looking Raleigh offers remarkably pleasing vistas, reflecting the treatment ideology behind the hospital's founding: to provide clean air, advantageous views, and plenty of sunshine to help restore patients to good health. The acreage surrounding the hospital also provided therapeutic farming and gardening to feed the patients and staff. Movies were loaned free by local merchants, and annual barbecues, tennis courts and a ballpark added to the lives of the patients.

It's original intent was to provide humane treatment for the mentally ill. The original building accommodated 274 patients. As a result of the Civil Rights Act of 1964 requiring designation of public facilities, Dorothea Dix Hospital no longer served the eastern counties of NC for the white and indian mentally ill, they now accepted the mentally ill of all races in 22 counties in South Central North Carolina.

Daily life at Dix Hill was structured around the “moral treatment” philosophy designed around the belief that fixed schedules, development of routine habits, calm and pleasant surroundings, proper diet, some medications, physical and mental activities carried out in a kindly manner with a minimum of physical restraints, would cure the patients. Ornamental gardens and landscaped grounds with walks were developed. Work in the gardens and on the farm was also considered beneficial to the over all wellness of the patients. Vocational work was also available to the patients. Females made baskets, clothing, rugs, artificial flowers, and linens. Male patients made mattresses and brooms as well as assisted on carpentry projects. Some cleaned wards, or worked in the kitchen or sewing room. Recreational activities included tennis, croquet, reading, dancing and concerts. Patients, attendants and nurses assembled twice a week to enjoy dancing. Dancing lessons were given to attendants and nurses so they could give them to the patients. The hospital superintendent stated in his report that “all of them thoroughly enjoy the music, the effect is so apparent that music should be credited as one of the most potential remedies for the insane.” In 1858 a wooden chapel was built. The four ministers of Raleigh took turns leading services weekly, and editors of the state newspapers furnished their papers to the hospital. Movies were loaned free by local merchants, and annual barbecues, tennis courts and a ballpark added to the lives of the patients.

During the Civil War troops occupied the land around the hospital. They used the wooden fences for firewood, helped themselves to the grains and livestock, and socialized with the patients by attending their dances on Saturday night.

After the war, admissions continued to mount with the public's confidence in the asylum and the increased understanding of mental illness as a disease. Additional diagnoses were added to the asylum admissions such as those persons with mental retardation. In the 1870's mentally ill criminals were transferred from Central Prison to the asylum. However, when the state hospitals began admitting alcoholics, drug users and epileptics as patients, the legislature mandated the transfer of the insane criminals back to the central penitentiaries in the 1890's. Then, the Insane Law of 1899 revised the code for admission of the mentally ill to hospitals and for the first time there was voluntary admission, so in the early 1900's citizen pressure forced the NC legislature to increase capacity at all state hospitals. An epileptic colony was established to the rear of the hospital on 1,550 acres of land. The colony was known as Spring Hill Farm and Oregon Farm. By 1911 a training school for the retarded in Kinston, NC removed these patients from the hospital. Over the decades, the hospital grew with many buildings added through the late nineteenth and early twentieth centuries and various new therapies became available to patients. By 1974 the complex had grown to 282 buildings on 2,354 acres, plus 1,300 acres of farmland, patient capacity was 2,756. However, demand for long-term hospitalization of the mentally ill declined as out-patient care was emphasized. In addition, other state hospitals and private institutions offered mental health services that were closer and more convenient for many citizens. By the early 2000s Dix hospital had 120 buildings and accommodated a maximum of 682 patients.

In 2012, the last patient was transferred to another state facility, and Doroty Dix hospital was closed due to lack of funding.

There is a cemetary located on three acres containing 958 graves which serves as the final resting place for the many impoverished patients who were laid to rest on the grounds of the facility which treated them. Marble posts with a chain along the line of graves were erected, and a tag with the name of each person over his or her grave with the date of death. The hospital carpenter made the coffins until 1945.

I was unable to find out how many people lived, worked, and died at the Dorothea Dix Asylum, or if there were any reports of bad conditions over its 156 years of service.