A Guide to the Records of Southwestern State Hospital, 1887-1948 Southwestern State Hospital, Records of, 1887-1948 23890 and 24773

A Guide to the Records of Southwestern State Hospital, 1887-1948

A Collection in
the Library of Virginia
Accession Numbers 23890 and 24773


Library of Virginia

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© 2009 By The Library of Virginia. All Rights Reserved.

Processed by: Jessie R. Robinson

The Library of Virginia
Accession Numbers
23890 and 24773
Records of Southwestern State Hospital, 1887-1948
57 volumes
Southwestern State Hospital

Administrative Information

Access Restrictions

As of September 11, 2019, medical records will be open 125 years after the date of creation or after date closed, whichever is later. The Health Insurance Portability and Accountability Act (HIPAA) requires that individually identifiable health information of a decedent be protected for 50 years following the date of death of the individual (45 CFR 164.502(f)).

Protected health information (PHI) as defined under the Privacy Regulations issued under the Health Insurance Portability and Accountability Act (HIPAA) includes, but is not limited to, personally identifiable information such as names, addresses, and social security numbers. Restricted material may include, but is not limited to: patient lists, patient admission registers, treatment registers and medical record files. Please contact Archives Research Services for further information.

Use Restrictions

All researchers must sign a research agreement to use archival material. This agreement specifies that confidential or personally identifiable health information (PHI) less than 125 years of age that may be encountered during research will not be recorded, published, publicized, or re-disclosed to any other party for any purpose. Improper use and/or re-disclosure of privacy protected information is a breach of confidentiality which could result in the loss of access to the archival collections housed and maintained by The Library of Virginia, and could result in legal penalties (Code of Virginia, 18.2-186.3). Please see the "Use Restrictions" section of the finding aid for additional restriction information.

Preferred Citation

Records of Southwestern State Hospital, 1887-1948. [Cite specific accession], State records collection, The Library of Virginia, Richmond, Virginia.

Acquisition Information

Accession 23890 transferred by Southwestern State Hospital, Marion, Virginia, 29 October 1952.

Accession 24773 transferred by P.R. Cox, Administrative Services Director, Southwestern State Hospital, Marion, Virginia, 20 May 1958.

Historical Information

In March 1884 the Virginia General Assembly appointed a board of commissioners to select a site for a new lunatic asylum for white citizens to be built west of New River. The board selected a 208-acre site in Smyth County and in August 1884 the General Assembly gave the board the power to purchase the land for thirty thousand dollars and granted the county the right to issue bonds as well. In November 1884 the General Assembly formally established the Southwestern Lunatic Asylum, near Marion, Virginia. Dr. Harvey Black, J. Hoge Tyler, Thomas J. Boyd, D.D. Hull, Dr. John S. Apperson, N.L. Look and F.B. Hurt were appointed to the building committee which was tasked with overseeing the construction of the hospital.

Dr. Harvey Black became the first superintendent of Southwestern Lunatic Asylum when it opened in May 1887. Dr. Robert J. Preston and Dr. John S. Apperson served as assistant physicians, and Mr. C.W. White was appointed as steward to oversee the day-to-day business operations of the hospital. The patient population grew steadily and over time several buildings were added to the hospital's campus including a tuberculosis treatment building, a building for the criminally insane, the Davis Clinic, and the Harmon Building. For much of its early history, the hospital was mostly self-sufficient through the utilization of its own farm for meat, milk, and vegetables. Other early hospital superintendents include Dr. Robert J. Preston (1888-1906), Dr. Daniel Trigg (1906-1908), Dr. J.C. King (1908-1915), Dr. E.H. Henderson (1915-1927), and Dr. George A. Wright (1927-1937).

One of the hospital's most influential superintendents, Dr. Joseph R. Blalock, served from 1938 to 1971 and was the force behind many changes in treatment including the use of psycho-surgery, drug therapy, and vocational rehabilitation. By the mid-1970s, deinstitutionalization had greatly diminished the patient population as mental health treatment became more community-focused. In 1981, the Virginia Department of Corrections took over the care and treatment of adjudicated criminally insane patients at the hospital. This institution is adjacent to the hospital and is known as the Marion Correctional Treatment Center. In 1986, the General Assembly passed legislation providing for the demolition and reconstruction of much of Southwestern State Hospital. The new Bagley Building was constructed to house 177 patients in an integrated care design with living and treatment areas in one place. All adult patients were moved to the new complex in March 1990.

The hospital has gone through two name changes in its history. In 1894 the General Assembly passed legislation changing the name from Southwestern Lunatic Asylum to Southwestern State Hospital. In 1988, the name was changed to Southwestern Virginia Mental Health Institute.

Scope and Content

Contains a variety of records that document many of the day-to-day operations of Southwestern State Hospital. The records date from the year the hospital opened (1887) and include architectural drawings, financial records, supply and inventory ledgers, letter books, Executive Committee and Special Board of Directors' meeting minutes, and patient case books. The case books provide the most information on patient life at the hospital and also document mental health treatment during the late 1800s and early 1900s.


This collection is arranged into the following series:

Series I. Administrative Records, 1887-1944 Series II. Architectural Drawings and Site Plans, undated Series III. Finance and Supply Records, 1887-1948 Series IV. Letter Books and Correspondence Records, 1901-1915 Series V. Meeting Minutes, 1887-1936 Series VI. Patient Records, 1887-1918

Contents List

Series I. Administrative Records , 1887-1944 .
Extent: 5 volumes.

Contains a variety of registers that document several administrative functions of Southwestern State Hospital. Included here are a book of signed employee contracts, a visitor's register, and a ward property report book featuring periodic inventories of items on Ward 8 of the hospital. Also included are two morning report books that contain statistical information regarding the number of employees and number of patients present each day. The first morning report book also contains a list of officers and employees on furlough in 1888.

Arranged alphabetically by type or title of record.

  • Employee Contracts, 1906-1909 .
  • Morning Report Book, 1887-1891 .
  • Morning Report Book, 1892-1906 .
  • Visitor's Register, 1896-1903 .
  • Ward Property Report Book (Ward 8), 1936-1944 .
Series II. Architectural Drawings and Site Plans , undated .
Extent: 1 volume.

Contains one volume of architectural drawings and site plans for Southwestern State Hospital. The drawings include "present" and "future" buildings, so it is likely that the plans were drawn several years after the original buildings were built. Included are drawings of the annex to the main building, patient wards, the tubercular building, and an addition to the criminal insane building. The architectural firm responsible for the drawings is unknown.

  • Architectural drawings and site plans, undated .
Series III. Finance and Supply Records , 1887-1948 .
Extent: 23 volumes.

Restricted: Finance and supply records containing patient names and identifying information that are less than 125 years old. Due to the presence of restricted patient information, these records may require review by an archivist and/or redaction (if it is possible) before they are served. Contains a variety of financial account books and inventory ledgers, many of which were maintained by the hospital steward. The volumes cover daily expenses, receipts, disbursements, sales, pay patients, the contingent fund, supply inventories, as well as farm and auditing records. The volumes also contain budget information and document the ordering of food and other supplies for the hospital. The second Auditing Book also contains list of bills for each month for 1904-1905 and Ward Night Reports for 1913.

Arranged alphabetically by type or title of record.

  • Account Book (possibly patient funds), 1941-1942 .
  • Account Book (possibly patient funds), 1942 .
  • Auditing Book, 1887-1899 .
  • Auditing Book, 1899-1904 .
  • Beef and Vegetables Received from Farm and Garden, 1894 .
  • Classified Account of Issues, 1887-1889 .
  • Contingent Fund Ledger, 1903-1931 .
  • Day Book, 1887-1889 .
  • Day Book, 1894-1900 .
  • Journal, 1892-1900 .
  • Journal, 1900-1917 .
  • Journal, 1946-1948 .
  • Journal (rough?), 1887 .
  • Journal (rough?), 1887-1889 .
  • Journal (rough?), 1893-1896 .
  • Ledger, 1887-1896 .
  • Pay Patients Ledger, 1887-1929 .
  • Receipt and Issue Book, 1894-1895 .
  • Receipts and Disbursements, 1887-1889 .
  • Receipts and Disbursements, 1938-1941 .
  • Sales Book, 1887-1899 .
  • Sales Book, 1907-1930 .
  • Supply Inventory Journal, 1887-1889 .
Series IV. Letter Books and Correspondence Records , 1901-1915 .
Extent: 8 volumes.

Contains letter books made up of onion skin copies of letters written by the hospital steward (1903-1915) and the superintendent (1901). The steward's letters include information on supplies bought and received, as well as the other day-to-day business and operational functions of the hospital. The superintendent's letter book contains letters written to patients' families and are more personal in nature. Also included here is a book that contains the names and addresses of the superintendent's correspondents. Most correspondents are friends or family members of hospital patients, so the correspondent's relation to a particular patient is also noted. Researchers should note that the letter books are extrememly fragile and sometimes hard to read due to the poor condition of the paper.

Arranged alphabetically by type or title of record.

  • Correspondence Book, undated .
  • Steward's Letter Book, 1901-1903 .
  • Steward's Letter Book, 1903-1905 .
  • Steward's Letter Book, 1905-1906 .
  • Steward's Letter Book, 1906-1908 .
  • Steward's Letter Book, 1908-1910 .
  • Steward's Letter Book, 1910-1915 .
  • Superintendent's Letter Book, 1901 .
Series V. Meeting Minutes , 1887-1936 .
Extent: 2 volumes.

Restricted: Meeting minutes that are less than 125 years old. Due to the presence of restricted patient information, these records may require review by an archivist and/or redaction (if it is possible) before they are served. Contains one volume of meeting minutes of Southwestern State Hospital's Executive Committee and one volume of meeting minutes of the hospital's Special Board of Directors. The Executive Committee was composed of a small number of members of the Southwestern State Board of Directors. The committee met on a monthly basis and was responsible for reviewing the superintendent's reports, auditing the steward's monthly expense accounts, and overseeing other matters that arose between Board meetings. In 1903, the original Board of Directors for each state hospital was replaced by a three-person group called the Special Board of Directors. The duties of the Special Board of Directors were very similiar to those of the Executive Committee. The Special Board of Directors answered to the newly-created General Board of Directors, which was composed of all the members of each hospital's Special Board. The General Board connected all of the state-run hospitals for the first time. In 1937, the individual Special Boards were abolished and the General Board was renamed the State Hospital Board.

Arranged alphabetically by administrative body, and then chronologically within each volume.

  • Executive Committee, 1887-1900 .
  • Special Board of Directors, 1924-1936 .
Series VI. Patient Records , 1887-1918 .
Extent: 18 volumes.

Contains case books and other records associated with patients at Southwestern State Hospital. The case books are divided by sex and contain indices. The case books feature references to the patient's health, medications and activities. The accounts sometimes include admission information and medical history as well. The case books each start during a particular year and were added to at sporadic intervals until the book became full and another volume was started. The date spans given to the volumes are general date ranges. There are instances when an entry was added that was outside the official date span of the volume, usually only by a year or two. In some cases, the doctor ran out of room and continued a patient's account in the next volume, usually with a note as to page number. Most of the case books contain a standardized form for recording certain patient health information as well as room for doctor's notes. Additionally, in some of the case books small photographs of each patient are attached to his or her record. The most recent volumes are referred to as "clinical records," but contain the same type of information as the case books. Also included here is one volume of annual lists of patients at the hospital (1887-1904) and an account of clothing and valuables received from patients when they were admitted (1903-1917).

Arranged alphabetically by type or title of record. Case books are arranged according to patient sex and then in numerical order.

  • Annual List of Patients, 1887-1904 .
  • Case Book, Female (Number 1), 1887-1890 .
  • Case Book, Female (Number 2), 1889-1890 .
  • Case Book, Female (Number 3), 1892-1896 .
  • Case Book, Female (Number 4), 1895-1902 .
  • Case Book, Female (Number 5), 1899-1914 .
  • Case Book, Female (Number 6), 1902-1915 .
  • Clinical Record, Female (Number 7), 1904-1915 .
  • Clinical Record, Female (Number 8), 1907-1915 .
  • Case Book, Male (Number 1), 1887-1889 .
  • Case Book, Male (Number 2), 1889-1892 .
  • Case Book, Male (Number 3), 1891-1897 .
  • Case Book, Male (Number 4), 1896-1904 .
  • Case Book, Male (Number 5), 1900-1906 .
  • Clinical Record, Male (Number 6), 1904-1920 .
  • Clinical Record, Male (Number 7), 1906-1917 .
  • Case Book, Transfers, Male (Number 8), 1904-1918 .
  • Record of Clothing and Valuables Received from Patients, 1903-1917 .