Riddled with rumors of ghosts and neglect, Broughton Hospital has often been criticized for not providing adequate care for its patients. Despite a large part of it being abandoned, this late 1800’s hospital still functions today, serving 4000 patients from 37 counties in western North Carolina, as part of the state’s system of care and treatment of persons with mental illness. In its early years, it was known as The Western North Carolina Insane Asylum and was later changed to The State Hospital at Morganton in 1890. In 1959, it was changed to Broughton Hospital after then Governor J. Melville Broughton. Today, it’s known as one of the most beautiful hospitals in the United States.
I first became acquainted with this place as a 17 year old when I was ordered to complete 40 hours of community service there as punishment (that’s a different story for a different day). I was tasked with mopping floors and wiping down bed rails in the men’s area. I got cussed, yelled at, and grabbed while walking between tightly packed hospital beds that lined all four walls of a giant room. Even though their wild behavior was a bit unnerving, I felt bad for them. Overlapping grumblings of old men in a room where voices echoed loudly would be enough to make anyone go mad. I completed my community service and swore I’d never step foot on those grounds again. The memory of the old men in the old buildings stayed with me well into adulthood. So when I learned parts of it were now abandoned, I couldn’t wait to go back.
One of my family members that completed her internship there said, “That place is still so creepy. I did clinical work there in the summer of 2009 and they still use big skeleton keys to open all the doors and we all had to carry one around in our scrubs. I saw a huge notebook in one of their libraries that talked about what some of the first patients were admitted for things like jealousy and being in debt.”
In 1875, an estimated 700 North Carolinians were classified as “insane”and not receiving proper care. There was only one hospital to treat the State’s mentally ill, so theGeneral Assembly voted to provide $75,000 to establish a second state hospital. Four western North Carolina cities, Statesville, Hickory, Asheville, and Morganton, competed to become the home for the institution that was to be known as the Western North Carolina Insane Asylum.
Morganton, NC was selected as the city to break ground. 263 acres were acquired by the State in 1875 and work began almost immediately. To keep costs down, 50 convicts were released for the purpose of making bricks for the hospital’s first building. After being transported to Morganton, the brick contractor was responsible for the feeding, safekeeping, and returning the convicts. Realizing that the building under construction would not provide adequate space and due to insufficient funding to expand its size, the General Assembly appropriated an additional $60,000 in 1877 for another wing. Five years later, in December 1882, the Avery Building and its south wing were completed. Dr. Patrick Livingston Murphy was hired as the first superintendent, a position in which he served for 25 years
On March 29, 1883, the first patient was admitted to the Morganton facility. Not long after, around 100 patients were transferred by rail from the crowded hospital in Raleigh. Then another 152 patients were received. In an 1884 report, Dr. Murphy said, “There are some insane persons in our district who ought to be in the asylum but cannot be cared for.” Hearing a need for more space, the General Assembly authorized the funds to build a north wing, providing space for 150 additional patients.
During the early years, male patients worked on the hospital’s roads and grounds, and a road was built to the hospital from the town of Morganton. Additional land was purchased, and by 1893, the campus had 331 acres. The eastern dividing line for the Western District was changed in 1899, and more buildings were added, including an airing court, a summer house for women, a bowling alley and billiard room, a bake house and dairy, a greenhouse, and a new stable and farm house. In 1900, land was purchased at the Hunting Creek Bridge, and a golf course was built near the Farm Colony.
In the early 1900s, the colony treatment approach was adopted, leading to the establishment of detached residential units where patients could live in smaller groups in a less institutional environment. These colony houses were designed to resemble typical western North Carolina farmhouses, surrounded by gardens, vineyards, and orchards. Patients were involved in farming operations, with three colony groups housing about 350 patients.
In 1901, the hospital faced an influenza and pneumonia outbreak. By 1903, the Harper Building opened, and in 1906, a new laundry facility was constructed. Plans were made for an amusement hall in front of the Scroggs Building, which is now the location of the Geropsychiatry parking lot and Watkin’s Garden. In 1908, buildings for female tuberculosis patients and a Nurses’ Home were completed. A new kitchen, bakeshop, and a building for male tuberculosis patients were added in 1909. In 1910, plumbing in the Avery Building was replaced, wooden beds were replaced with iron beds, and the front steps were changed from granite to marble.
In the aftermath of World War I, public attitudes towards mental health patients began to shift. A state-level hospital commission was formed to inspect and supervise hospitals, ensuring that each patient received thorough treatment planning. Daily staff meetings were held to review patients’ cases and improve their care.
However, the mental health hospitals were soon forgotten and management became more concerned with saving money than providing quality care. Despite this, new buildings and facilities were constructed: a receiving ward for men, a dorm for men, a staff apartment building, a central power plant, a cold storage plant, and an elevator for the Avery Building.
Staffing during this time was inadequate, with one physician for every 355 patients and one attendant for every 13 patients. Nurses worked long hours, with only one afternoon off per week and one evening off per month. Unit attendants even slept on the wards with patients.
In the 1930s, the situation worsened, with one physician for every 500 patients and one nurse for every 21 patients. Despite the poor conditions, new therapies like occupational, industrial, and recreational therapy were introduced. Affiliations with medical and nursing schools were also established.
In 1963, the Community Mental Health Act was passed, and President John F. Kennedy called for the creation of 2,000 community mental health centers. Today, Broughton Hospital is the largest of the three psychiatric hospitals operated by the State of North Carolina within the Department of Health and Human Services under the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.
