Established largely through the efforts of Dorothea Dix, the leading mental health reformer of the 19th century, it was chartered by Congress in 1852 as the Government Hospital for the Insane, with the mission to provide “the most humane care and enlightened curative treatment” for patients from the Army, Navy, and District of Columbia. The hospital opened in 1855, and shortly after the outbreak of the Civil War was impressed into service as a general hospital for sick and wounded combatants. It was these wartime patients who originated the use of the name Saint Elizabeths, after the property’s 17th century land patent, out reluctance to use the hospital’s formal name. Congress officially renamed the institution in 1916.
As was customary and considered healthful, the hospital grounds were established outside the city limits, on what was the Barry Farm overlooking the Anacostia River. The first structure, the innovative four-story Center Building (1853-55), was designed by superintendent Charles Nichols and architect Thomas U. Walter in a castellated Gothic style. The building was an early example of the “linear plan” for mental hospital wards developed by reformer Thomas Kirkbride. Several more buildings were constructed to treat veterans after the Civil War, and by the 1890s the institution grew into a complex of residential and treatment buildings as well as a central kitchen, boiler house, ice plant, bakery, dairy, firehouse, gatehouses, and barns. A major expansion occurred at the turn of the century, with Italianate classical buildings designed by Boston architects Shepley, Rutan & Coolidge; further expansion occurred through the 1950s. The campus is also notable for its designed picturesque landscapes. Gardening became part of patient therapy, as did work on the hospital farm, which lasted into the twentieth century.
St. Elizabeths served as a model for later institutions, both as a pioneer of humane treatment of the mentally ill and for its advancement of innovative therapeutic and diagnostic techniques. Over 150 years, the hospital treated perhaps 125,000 patients, and at its mid-20th century peak, housed 7,000 patients with a staff of 4,000. Well-known patients have included presidential assassin Charles Guiteau and poet Ezra Pound. Thousands of former patients are believed to be buried in unmarked graves across the campus, and several hundred Civil War soldiers are interred in two small cemeteries.
Center Building (Built 1853-55)
West Lodge (1856)
Boundary Wall (1858‑1869)
East Lodge (1861)
Civil War Cemetery (1864‑66)
Patient's Circulating Library (1883); moved and enlarged 1904, renovated 1928‑29
Dining Hall for Detached Buildings (1885‑86)
Fire Engine House (1889‑91, moved 1905)
Burroughs Cottage (1891)
Administration Building and 11 Lettered Buildings (built 1903; Shepley, Rutan & Coolidge, architects)
Nichols, White, and Eldridge Buildings (1930s)
Continuous Treatment Buildings (9 buildings; built 1940s)
NR listing April 26, 1979
NHL designation December 14, 1990
DC designation May 26, 2005