Joel M Nadler Photography

St Elizabeth’s hospital

St. Elizabeths hospital, located in Washington D.C., Southeast was built in 1852 and opened in 1855. The campus sits on a hill overlooking the Potomac and Anacostia rivers.

 St. Elizabeth’s hospital, located in Washington D.C., was built in 1852 and opened in 1855. The campus overlooks the Potomac and Anacostia rivers in the southeastern section of the city. “Dr. Charles Henry Nichols, a physician who specialized in the treatment of mental illness,”[1] was a physician who worked at Bloomingdale Asylum in New York. Nichols goal and hope was that St. Elizabeths would be a landmark in D.C. As superintendent of the institution, Nichols’ made many important strides. He built new buildings on the campus, he advocated for the change of the hospitals name to St. Elizabeths, and was involved in the setting of the hospital. [2]

In the 1850’s, there were only a small number of private and public mental hospitals but the conditions in them were horrible. St. Elizabeths was an attempt to make an institution that would treat patients in humane ways and that would rehabilitate the patients. This would also be the first federal insane asylum ever built. St. Elizabeths was planned to be the model institution for the time.[3]  Dorthea Dix, a, teacher and reformer of the time, was a major figure behind the building of St. Elizabeths. The hospital was a result of her lobbying efforts. [4] She was a strong advocate for the improvement of conditions for patients and inmates in institutions. She made great changes in the world of mental institutions, creating and promoting ideals that these places should run by. [5]

The hospital was originally called the Government Hospital for the Insane. The name St. Elizabeth’s came along only during the Civil War. The hospital did experience overcrowding during the Civil War which led to the expansion of the campus.

The hospital had its own farm where it would produce its own food as possible. Dr. Nichols wanted St. Elizabeths to be a model institution, so having a model farm was essential to his plan. Dix believed that the farm setting would improve the mentally ill patients’ condition.[10]

Tens of thousands of patients were housed at the institution. The hospital kept patients segregated by sex and by race as well as the severity of their illness. [11] Other than being a source of work and way to sustain the institution, the farm was a piece that added liveliness to the hospital. Animals roamed around, farmhands and patients maintained the farm animals and the facilities. It was seen as a great value to the patients in their care and treatment.


The hospital’s goal originally was to provide the “most humane care and enlightened curative treatment of the insane of the Army, Navy, and District of Columbia.” [13] The hospital focused on the moral treatment of patients, which meant providing patients with a pleasant environment, treating them kindly, giving them attention and other positive means of care. This method was introduced by Quaker asylum director William Tuke at the end of the 1700s. [14]  Moral treatment was also a result of the enlightenment of the late eighteenth century.[15] Advocates for this treatment believed there would be more chance of recovery if a patient were treated as a child as opposed to animals.

Through the late 1800s and into the early 1900s, methods of treatment included psychotherapy, lobotomy, occupational therapy, ergo therapy, and recreation.[16] The staff was well trained and kept patients comfortable and in healthy living conditions. Towards the later part of St. Elizabeths history, in the 1850s, the hospital became overcrowded and lacked the necessary personnel it needed. Fortunately, the institution could function and maintain its facilities at that time.

Nurses kept the patients well and in order, and in the wards they provided patients with medications, took the patients on walks, encouraged them to participate in exercise and work on the campus. [17] The hospital at one time had an incredible farm which the patients worked. This was earlier in St Elizabeths history and was part of rehabilitation of the patients[18]

In an oral interview with Anne Reese, a former psychiatric social worker at St. Elizabeths during the 1970’s, recalled “there really wasn’t much of any treatment other than medications, which practically every patient was given”.[19] During this period of time, most institutions had moved to medication rather than therapy and other forms of treatment. There was psychotherapy, which Ms. Reese believed was beneficial to the patients but there was not much else that they did with patients other than talk to them and give them meds. As this use of new medication started, institutions began to lose funding, so care for the mentally ill changed significantly. Soon the institutions would close with the lack of funding given by the government leaving patients no place to go in the community.

Preservation issues related to the fate the institution

S.t Elizabeths was designated a National Historic Landmark in 1990. The hospital holds local and national significance because it was the first and only government hospital for the insane. Its recognized because of it’s beautiful architecture, its importance in treatment of the mentally ill and because of the figures who founded it.[21] At that time, there were 70 buildings on the West Campus and 52 will be reused. [22] The East Campus is also a designated historic district in the District of Columbia Inventory of Historic Sites (2006).[23]

The hospital moved all its patients out by 2010 and the hospital was closed. The new hospital sits right next to the old campus but operates on a much smaller scale. The old campus was left abandoned after it closed.

Today, the old St Elizabeths campus is being redeveloped. The western half of the campus is being used by the Department of Homeland Security, where they are consolidating the headquarters. The DHS headquarters today are “spread among 40 buildings in Washington D.C.”[24] The goal of moving to the St. Elizabeths campus is to provide a more secure campus and bring all its pieces together in a single unit.

The eastern half of the campus will be turned into affordable housing, townhomes, and office space. [25] 



[3] Otto, Thomas. St. Elizabeths Hospital: A History. United States General Services Administration, 2013. (6)



[6] Otto, Thomas. St. Elizabeths Hospital: A History. United States General Services Administration, 2013. 


[8] Yanni (71)



[11] Thomas(15)

[12] Department of Health, Education, and Welfare. St. Elizabeth’s Hospital. 4/11/1953-8/9/1967- 5664540




[16] St. Elizabeths Hospital (1946) 1946 Annual Reports for the Clinical Psychiatry Department, Washington D.C. : National Archives

[17] Instructions to the staff, collection 418, entry number 42, folder 2/2:D.C. National Archives

[18] Video Interview, Anne Reese, Former Social Worker St. Elizabeths

[19] Video Interview, Anne Reese, Former Social Worker St. Elizabeths

[20] Photo taken by Joel Nadler






© 2024 Joel M Nadler Photography

Helped by Józsa Attila Gergő