"A cemetery is a history of people—a perpetual record of yesterday and sanctuary of peace and quiet today. A cemetery exists because every life is worth loving and remembering—always."

After working on my own family tree I began sixteen years ago to research those buried in asylum cemeteries. I am a psychiatrist who has worked over thirty years in state hospitals.

I know the kind of people who dedicate their lives to working with the mentally ill in state hospitals. I have for years heard the disparaging, ill-informed comments made by those who see asylums as nothing more than places of torture, torment and abuse and now as places haunted by "ghosts" of those "mistreated" by caregivers. You may be among those who choose to believe such tales instead of learning the true history of America's state psychiatric hospitals.

In the 1800s states and territories relied on county poorhouses to tend to their poor and insane. Some churches stepped up to staff them with nuns. Some physicians provided services. In the larger counties there were enough insane people to warrant an entire asylum as well as a poor house and/or county hospital.

And then as populations swelled the numbers of symptomatic people grew and the demand for the states and territories to take these people off the counties' hands grew. States funded asylums. Some had one, like Montana. Most had several. And, of course, there were private asylums. Even the state asylums had private rooms set aside for paying customers. Because they were beautiful, state-of-the-art facilities. They were the crown jewels in every state that built them. Just look at them. They were enormous, beautiful buildings and towns vied for them to be built near them, in them, because they brought jobs to their citizens. Railroad tracks ran directly past them. The asylums were self-sustaining institutions with farms, dairies, abattoirs, chicken houses, bakeries, shoe shops, laundries, carpentry shops, florists, conservatories, ice houses, beautiful lawns and drives. The physicians were not just specialists in psychiatry but were also general practitioners and surgeons. Many of the asylums ran nursing schools. And every asylum boasted in its earliest years of operation of minimizing the use of physical restraints.

People in care in the asylums were encouraged to work, not made to work, encouraged to work because it was therapeutic to do something constructive rather than sit about. And they were compensated, usually with tobacco. But there were commissaries where they could buy things. Women usually worked indoors, knitting, crocheting, working in the laundry, mending, quilting. Men usually worked outdoors. But both could also help out with ward work, sweeping, emptying ash cans, trash cans, etc. The goal was to be engaged, productive.

And there were, from the very beginning, entertainments. Formal dances, plays, bands came. Musical instruments were available. They could go outside on walks, in carriage rides. To fish in the pond. Some had their own garden plots or chickens or turkeys. Some sold books or jewelry. Some were tasked with running errands on the asylum campus or with delivering mail on campus.

The trouble came as the asylums grew and grew and grew. WWI happened. Then the Great Depression. Pellagra plagued this nation. Pellagra and its horrible effects on the mind and body. And then WWII. PTSD had been with us, of course, after the Civil War. It's well-documented. It's in the records of the asylums. Add to that the effects of WWI and WWII. Then the poverty of the Great Depression. And, of course, all along there was syphilis, untreatable until penicillin was available in the mid-1940s. So, the asylums MUSHROOMED in size.

And all along, since very soon after they were built, there was the ever-familiar battle between liberals and conservatives over whether tax dollars should be paying for the care of the mentally ill or whether private concerns could better handle the demand. Those massively oversized asylums were gradually drained of funding and steadily understaffed with inadequately trained people. And abuses became almost inevitable. And they became the stick with which conservatives finally won the battle and downsized the state hospitals, closing most of them, yelling all the while, "I told you so." Well, of course, state hospitals couldn't do the job if they were chronically undersized, understaffed and underpaid. And the plug was finally pulled on one of the greatest endeavors the United States had ever made in the care of the mentally ill.

And here we are. Back where we started.

Our mentally ill are in homeless shelters or sitting in Emergency Rooms for weeks at a time waiting for a bed in a psychiatric unit somewhere or they are in jails.

Those funds that were taken from the state hospitals with the promise being made decades ago that they would be used to set up group homes and apartments and clinics? Yea. Good luck finding a group home. Patients who are ready to leave the state hospital and go to an apartment or group home wait for MONTHS because there is no place to go, no funding available. And those appointments? WEEKS out. WEEKS.

It was a lie. Private entities didn't step up. Because psychiatric patients don't have funds. The State Hospital system in America was dismantled and jails and homeless shelters and emergency rooms were left in its place along with myths about how horrible the asylums were instead of the truth about how they were slowly bled of funds.

A person who needs help now, if insured, will get spit out of a psychiatric unit as soon as the insurance runs out. If uninsured, he or she will wait sometimes weeks, even months to get into a state hospital bed, IF your state is fortunate enough to still have one. But he or she waits in line behind the dozens of forensic patients waiting in jails for those same beds in the state hospital. Forensic patients are stuck in years-long cycles because they've been deemed incapable of proceeding to trial, whether on minor charges or murder charges, and they wait for the chance to get into a state hospital for Capacity Restoration and treatment with medications that often are not provided in jails and prisons. The process often takes YEARS. Our system is BROKEN.

It is also the case that we are often mistaken in assuming that those buried in asylum cemeteries were "forgotten" or "abandoned" by their loved ones. There is no reason to think most were forgotten by their families. There were lots of reasons for people being buried on asylum grounds. Sometimes it was due to the weather presenting challenges in getting someone's remains all the way home by train or wagon or it was the expense of transporting the remains, something a family may not have been able to afford. Often there was no family left at home to accept the remains. Sometimes a family didn't send their loved one to the asylum for care until the last parent at home had become feeble or had died and after years at the asylum there may have been no one left back home to accept the remains or to even answer the telegram or the letter or the call from the hospital about what to do with the remains. Sometimes the person had been in the asylum so long they considered it home and the family decided to have them buried here. The first hospital superintendent at the WNCIA (State Hospital at Morganton) refused to donate any of the bodies to the medical schools for dissection, saying that if family or friends couldn't provide a burial place for them back home they would be buried in the asylum cemetery.

Some asylums posted notices in the newspapers when people in their care died, seeking family members or friends who might be interested in attending to their remains and promising to give them a Christian burial in the asylum cemetery if no such person was available. Such a newspaper notice can be seen attached to the FAG memorial of Earl Sayer who died at the Warm Springs asylum in Montana in 1925.

So it wasn't often a matter of "abandonment" or of being "forgotten". The asylums have for too long been misrepresented as places of torment and abandonment. There were, of course, always examples of abuse - just as there were in the homes of the mentally ill. But for many the asylums were a place of refuge and of kind and effective care.