Fulton State Hospital in Fulton, Missouri, with the original 1851 campus being advertised as the oldest public mental hospital west of the Mississippi, is an example of a hospital that continued to be used for its original purpose well past deinstitutionalization and provides an understanding of the types of issues that arise when doing so. Following deinstitutionalization, the hospital faced a number of problems that arose when its patient population began to sharply decrease, most notably being a number of buildings on campus being abandoned, the pharmacy and dairy programs on site being shut down due to financial issues, and public safety concerns after two women were attacked by former patients that led to public criticism of both the hospital and the lack of care available to those outside of the hospital.2 The reputation of the hospital continued to decline in the 1980s as local news outlets reported on scandals involving alleged sexual abuse and an attempted suicide of a patient that staff were accused of failing to deal with properly and a group of hospital staff in 1987 went to the government to report that they feared for their lives due to instances of violence between patients and staff.3 However, as the hospital began to implement new innovative programs and its reputation began to improve in the 1990s and early 2000s, the primary problem facing the hospital became that it continued to operate from its original historic location.
Like many other historic asylums, Fulton State Hospital in the early twenty-first century began to struggle with outdated equipment, a layout inconducive to modern methods of care, and a decaying building that was too difficult and expensive to keep up. The plight of staff and patients is illustrated clearly in a 2013 Missouri Times article written by journalist Collin Reischman following a tour of the facilities, particularly the Briggs Forensics Center, with Chief Operating Officer of Fulton Marty Martin-Forman. Both Reischman and Martin-Forman expressed concerns that what Reischman described as a prison-like environment was simply not conducive to healing or to the treatment the hospital was supposed to be providing. Another staff member, Tammy Smiley, who ran one of the wards at Briggs, described the treatment of patients as “inhumane” due to the lack of privacy and prison-like environment. Furthermore, the staff overall expressed fears that they lacked the ability to respond to safety concerns because the structure of the building made it impossible to monitor sufficiently or easily navigate around the facility, putting staff and patients alike in dangerous situations. Reischman repeatedly throughout the article described how uneasy he felt moving around the hospital as well and it is clear that this was also felt by patients and staff alike. The tour of the facilities continued to the dietary building, which was a source of major concern due to its poor conditions; Martin-Forman noted that she expected the kitchen to become unusable within the next few years, and even at the time it was barely functioning. The conditions working there were poor due to a lack of air conditioning that caused temperatures to constantly be extremely high, and the kitchens were equipped with old equipment that came from a decommissioned Korean War battleship, all of which was too old to be repaired and some of which had already broken but was too expensive to remove. This was a problem that came up regularly; for some additional examples, the gymnasium was no longer accessible due to asbestos that was too expensive to be removed and all of the elevators in the facility were no longer able to be used as they were too old to be repaired. This, understandably, along with extremely low wages, made it difficult for the hospital to find and retain employees. This article is particularly impactful due to the inclusion of interactions between Reischman and the staff; it is clear that the employees at Fulton were aware of the issues and wanted better for their patients, but the issues with the buildings themselves made the desired improvements impossible.4
It was these issues that ultimately led to the hospital being relocated to a new, modern building. Jay Nixon, the governor of Missouri for whom the new facility was named, sufficiently summarized the emotion behind the transition by describing the old campus as “basically prison” and the new location as “the finest mental hospital in the US.” Many of the characteristics of the new site are described in direct opposition to those of the original location: the new site has natural lighting while the old was dark, the new site has sound proofing to create a therapeutic environment while the former was loud, and the old building was dangerous and dreary while the new one is safer and “life changing.”6 There is some sense of loss in the discussion of the transition, a sense that Missouri has lost something that once brought it pride by moving out of what was the oldest building of its type in that area, but that is hardly the focus when discussing the change. For an institution such as Fulton that continued and and wished to continue to provide mental health care, the focus is much less on the historical significance of the building it occupied or once occupied and more on practical concerns such as whether or not they are conducive to continuing to provide modern mental health care.
- “Biggs Forensic Center, seen in this February 2013 photo, was part of the Fulton State Hospital campus in Fulton, Mo,” (image), “Fulton State Hospital: “Do you think you could get better here?,'” News Tribune, February 10, 2014, accessed October 29, 2023. https://www.newstribune.com/news/2013/feb/10/fulton-state-hospital-challenges-shortcomings-grow/ ↩︎
- Richard L. Lael, Barbara Brazos, and Margot Ford McMillen, Evolution of a Missouri Asylum : Fulton State Hospital, 1851-2006, (Columbia: University of Missouri Press, 2007), 212-214, https://ebookcentral.proquest.com/lib/umw/reader.action?docID=3570934&ppg=260 ↩︎
- Lael, Brazos, and McMillen, Evolution of a Missouri Asylum, 213-215. ↩︎
- Collin Reischman, “In-depth: Inside of the deteriorating Fulton State Hospital,” The Missouri Times, August 26, 2013, accessed September 11, 2023, https://themissouritimes.com/depth-inside-deteriorating-fulton-state-hospital/. ↩︎
- Missouri DMH, “Fulton State Hospital,” Youtube Video, 4:10, January 24, 2014, https://www.youtube.com/watch?v=2rct_-VCxOk. ↩︎
- Alisa Nelson, “‘Finest Mental Hospital in U.S.’ Unveiled in Missouri,” Missourinet, May 23, 2019, accessed September 11, 2023, https://www.missourinet.com/2019/05/23/finest-mental-hospital-in-u-s-unveiled-in-missouri/ ↩︎
- Nelson, “‘Finest Mental Hospital in U.S.’” (image). ↩︎
