06/02/2026
America's First: Eastern State Hospital, Williamsburg
Long before the United States existed as a nation, Virginia was grappling with a question that most societies preferred to ignore: what do you do with the mentally ill?
Before 1773, people suffering from mental illness in colonial Virginia were judged not by doctors but by juries and classified as criminals or lunatics. Many were locked in the Public Gaol (colonial name for jail) alongside common criminals. That changed on October 12, 1773, when the doors of the Publick Hospital for Persons of Insane and Disordered Minds swung open in Williamsburg — the first institution in America built exclusively for the care of the mentally ill.
"It is expedient I should recommend to your consideration a poor unhappy set of people who are deprived of their senses and wander about the country, terrifying the rest of their fellow creatures." — Governor Francis Fauquier, 1766
The hospital's founding was driven by Enlightenment thinking. Virginia's Royal Governor Francis Fauquier, appointed by the British, had made impassioned appeals to the House of Burgesses beginning in 1766, arguing that every civilized country should provide for its mentally ill, the colonies being no exception. While an uncommon ideology at the time, Governor Francis Fauquier's philosophy on the mentally ill had been formulated by years of experience in charity and enlightened research. Four years of debate followed before legislators finally heard Governor Franics Fauquier's pleads and authorized construction on an eight-acre site near the College of William and Mary. Two patients — Zachariah Mallory and Catherine Whaley — were among the first admitted.
The hospital's most transformative era came under Dr. John Minson Galt II, who took over as superintendent in 1841. Decades before such ideas were mainstream, Galt promoted human dignity for patients, introduced therapeutic activities, talk therapy, and calming medications — approaches that would not be widely adopted elsewhere for another century. His work made Eastern State a genuine pioneer in psychiatric care, not merely a warehouse for the unwanted.
The institution survived the Revolutionary War, the Civil War (during which Union troops occupied Williamsburg and seized the asylum), and a devastating fire in 1885 that burned the original structure to the ground. It was rebuilt, relocated to a larger campus in the 1930s, and the original 1773 building was reconstructed by the Colonial Williamsburg Foundation in 1985 and now serves as a museum. Eastern State Hospital continues to operate today as an active 300-bed psychiatric facility — more than 250 years after welcoming its first patients.
Image 1: Rebuilt 1773 Public Hospital for Persons of Insane and Disordered Minds in Colonial Williamsburg; north elevation
Image 2: Portrait of Francis Fauquier, (c.1704-68) Lieutenant Governor of Virginia in the American Colonies, c.1757
