he Athens Lunatic Asylum, currently known as The Ridges, permeates the history of Athens, Ohio. Opened in 1874, it greatly impacted the local economy, served as a social recreation site for the community and influenced politics at every level. More than a century of psychiatric care is reflected in the architecture, landscape, and local lore of the facilities. The stories and experiences have become interwoven with the history of Southeastern Ohio and its approach to treating mental illness.
According to the National Alliance on Mental Illness, one in five Americans currently lives with a mental health condition. Though the original institution closed its doors in 1993 and moved across the river to a more modern location, people in the region continue to be impacted by mental illness. Strong mental health support remains a necessity in the Athens area. Though the people and place have changed, the story continues to be written.
The video below is a poetic adaptation of an anonymously written letter by a former patient of the Athens State Hospital. The letter is believed to be written by a female after 1950.
wo institutions made Athens a landmark town at the turn of the century: its university (the oldest in the state) and its asylum. Two decades after the establishment of the public mental health facility, the population of Athens almost doubled from 1,696 people to 3,066 people. At one point, it became the town’s largest employer. It brought life back to the town after many of its inhabitants were killed during the American Civil War. The steady influx of university students and asylum patients made Athens a booming town in the 1900s. Athens became a city in 1912 following the 1910 census showing the population had passed 5,000 residents.
The Athens Lunatic Asylum was built according to the highest standards of the time on a peaceful hill a mile south of the town center. The floor plan and architectural features of the building followed the radical Kirkbride plan designed by Thomas Story Kirkbride. It had distinctive long corridors that were open to sunlight and air ventilation to provide a naturally curative and restful environment.
Patients admitted during the height of its operations were local farmers and laborers, women suffering from postpartum and hormonal-related issues as well as Civil War veterans struggling with post-war stress. Epilepsy treatment was not widely understood in the late 1800s, and some early patients were admitted to the hospital with this condition. According to early intake papers, some male patients were admitted to the facility due to “masturbation,” which was reflective of the conservative conscience of the day and its understanding of mental health.
As the stigma and nuances attached to mental illnesses changed, so did the facility’s name. It was changed ten times during the 119 years it was in operation. The names weren’t the only changes present at the hospital. As the study of psychiatric health advanced, it also saw the introduction of new modes of treatment. For a period of time a common treatment was the lobotomy, a radical and invasive physical therapy originating in Europe in the early 20th century that surgically disconnects several of the nerve pathways between parts of the brain. The procedure’s practice at the asylum helped seal its reputation as one of the most haunted places on the planet.
The implementation of Community the Mental Health Act of 1963 pushed for deinstitutionalization and more community-based care. The once booming asylum (then Athens Mental Health Center) saw a dramatic drop in admittance, from 1800 patients in 1966 to 200 in 1985. The remaining patients were moved nearby to a new facility in 1993, and the building officially closed its doors as a hospital. The property, now known as the Ridges, was later transferred to Ohio University, uniting the two institutions that put Athens, Ohio on the map.
or the most part, Adam Nilson wants to avoid the stigma that comes with being a United States military veteran living with post-traumatic stress disorder and deployment-related injuries. “You feel like no one understands you; you don’t feel close to anybody, and then there are all these misconceptions about what you are and what you aren’t,” says Adam. “So, I really don’t talk about military service to people.”
In 2010, three years after joining the Ohio National Guard, Adam was officially deployed with an Operational Mentor and Liaison Team, also known as an OMLT. It was a North Atlantic Treaty Organization-run mission that worked with the Partnership for Peace, and teamed up with European militia. While in Afghanistan, their mission was to mentor Afghan soldiers by observing operations during combat missions and then improving their skills.
Although Adam has been home from Afghanistan for over seven years, he mentally returns overseas daily and doesn’t think he’ll ever feel like a civilian again. “Once you go through that, there’s no going back,” he says. “Once you’ve been in combat, for good or bad it changes you.” Adam makes comments about the complicated experience of being a soldier in Afghanistan. He says one paradox was the beautiful mountainous landscape in the desert of a war-torn country. Another is the feeling of combat. “Combat is one of those things that you love and hate at the same time,” he explains. “In one aspect, it’s kind of a rush, but it’s absolutely terrifying in another aspect… then you get these weird feelings of, I shouldn’t enjoy this. This is war and people are getting killed. But I do, strangely, enjoy this. And you’ll never feel that alive again, ever, no matter what you do. I’ll never let go of that excitement. I’ll probably never let go of the guilt of being excited by it.”
During Adam’s first combat experience, the Taliban ambushed his unit. They killed all of the aggressors in less than a minute. “That was my introduction to Afghanistan,” Adam recalls. “That first one was really exciting. The first time you get shot at and survive, you’re just on cloud nine. It’s a huge adrenaline rush.” He explains that the second ambush wasn’t as exhilarating, but felt more real. “They told me before I got there that you’re going to know where every rock is,” Adam remembers. “I was like, ‘That’s stupid. We’re in the mountains, there are rocks all over the place.’ But it’s true. You learned on the road you traveled where all the boulders and rocks were and if something was out of place it was probably because an IED was under it or nearby. It was amazing just how detail-oriented you could become.”
Shortly before Christmas in 2010, Adam and his unit returned to the United States. He says that’s when his PTSD really started to manifest. He was jumpy; his sleep was filled with nightmares and he had a heightened startle response. Adam assumed that this was normal and that eventually he would readjust to civilian life. However, he is still living with PTSD and is experiencing more severe issues. “I think I must have had some of the symptoms the whole time I was there and didn’t notice it,” says Adam. “But we were just always on edge. Even back where we were kind of safe, we weren’t really safe, so you’re just always alert.”
His time in war also started affecting his relationships with his friends and family. Adam withdrew from loved ones almost as soon as he returned to Ohio. He found it easier to spend days alone with his dogs or reaching out to other veterans. He found comfort in a Combat Veterans Motorcycle Association group where he feels safe in shared humor and understanding. It was during a conversation with two Vietnam veterans from his veteran motorcycle group, Cool Hand and Boze, that Adam divulged his feelings and experiences since returning from deployment.
Adam says the two “wizened warriors” shared a quiet, knowing look and said, “Wolfman, we love you brother, but you’re fucked up. Don’t wait 40 years like we did. Go see somebody.” Wolfman is Adam’s military nickname, which he attributes to his ability to grow a beard overnight and his overall hairiness. With his friends’ encouragement, Adam began seeking help from the U.S. Department of Veterans Affairs. According to the VA, between 11 and 20 out of every 100 veterans that served in Operation Enduring Freedom, like Adam, are living with PTSD.
As early as the American Civil War, soldiers returning from combat displayed PTSD symptoms. The Victorian era thinking often attributed the bizarre behavior to the physical rigors of combat, rather than the mental strain. The Athens Lunatic Asylum was originally built in part to accommodate the high number of soldiers returning from war with “acute mania.” However, for soldiers like Adam, there may not be a place like the old Asylum for them to seek proper treatment.
Although the VA recognizes that PTSD is a mental health problem that many veterans face after combat, Adam has had an incredibly tumultuous relationship with their health care system. “It was an eye-opener that once you’re hurt in the service, they really don’t care about you anymore,” Adam says about his experience with them. From the moment he first sought help, he came across issues and obstacles that he never expected from an organization designed to assist veterans.
Adam feels that mental illness has a negative connotation and that PTSD is misunderstood. He explains that it can come in many forms, such as nightmares, but that doesn’t mean it would make someone lose control. With the negative connotation, Adam explains that he’s had trouble getting some jobs and knows friends that have gone through similar situations because of the negative stigmas. Although society views PTSD as a mental illness, Adam finds this label inaccurate. “For me, it’s a normal reaction to an extraordinary circumstance,” Adam says. “I don’t feel sick, I don’t feel ill. I just went through some bad times, and I’m having trouble readjusting.”
“Combat is one of those things that you love and hate at the same time,” says Adam. “In one aspect, it’s kind of a rush, but it’s absolutely terrifying in another aspect...then you get these weird feelings of, I shouldn’t enjoy this, this is war and people are getting killed, but I do, strangely, enjoy this. The biggest satisfaction comes at the end when you’re alive and your buddies are alive...And you’ll never feel that alive again, ever, no matter what you do. I’ll never let go of that excitement. I’ll probably never let go of the guilt of being excited by it.”
Adam finds that there is no dialogue between the military and civilians and the information that is available, as well as the media bias, depict a horribly inaccurate picture of PTSD and military service. Adam created art as a personal way to create understanding about the military, PTSD and his own experiences with the healthcare provided after his service.
hristi Hysell grew up in Meigs County, Ohio. Her home sat on the side of a sloping ridge between the gravel road that ran to the highway and a hilltop where she would sit under her favorite tree to read. She had her ears pierced like other girls, but she was more interested in playing with Tonka Trucks than with dolls and only wore skirts when it was a part of her Girl Scout uniform.
Christi didn’t have any friends her age in her neighborhood and liked playing with her younger brother’s friends when they came around. At the age of 12 Christi says she was raped by a neighborhood boy. “That was the price I had to pay to play with the guys,” Christi said, “Something was taken from me.” Christi felt like she had to choose between isolation and giving up a piece of herself to be accepted.
According to Christi, the neighbor continued to rape her until his family moved away two years later. She assumed this would be the end of her assaults –but she was wrong. Christi recalls that it was at this time that someone close to her began sneaking into her room at night to molest her. The abuse would continue for another five years. No one was ever charged.
At this point, Christi no longer wanted to display the feminine side of herself. She quit wearing skirts and dresses all together and opted for pants. She decided to take out her earrings and let the holes close up. “I didn’t want any part of being a female anymore,” Christi said. She hid herself as a woman to avoid the attention of her assaulter and any other man.
For years Christi was prone to extreme mood swings and self-mutilation by picking at her fingernails whenever she was reminded of the abuse. She also experienced suicidal thoughts.
“I was in pain, so much confusion that I didn’t know what to do, and I thought if I wasn’t here that pain wouldn’t be here either,” Christi said. “I know it was a coward’s way out, but what else was I supposed to do?” She worked through her suicidal thoughts through her faith, but still tries to hide some of her medications from herself as a last line of defense when those thoughts return.
In 2005, Christi was diagnosed with Borderline Personality Disorder and Post-Traumatic Stress Disorder, possibly resulting from her childhood abuse. After years of bouncing between jobs, homes, and small cities around Southeastern Ohio, her diagnosis came as a relief. “When I got diagnosed it was like, ‘Yes, finally I know what's going on’ and I’m just really thankful that I got that diagnosis,” Christi recalled.
It felt like a weight had fallen from her shoulders and she understood what was wrong with her. After the diagnosis, she was able to recognize that she had been living with these illnesses since she was a teenager. She had been sick for close to half her life; now she could be treated.
Christi now has a combination of art therapy and medicines that help her to manage her symptoms, but she is still afraid she could lose this stability. Her greatest fear is to be admitted to a state hospital for long term treatment. That fear is reinforced by the presence of what used to be the Athens Lunatic Asylum that sits on a high hill across from Hopewell Health Center where Christi currently receives treatment.
“Having a mental illness is a very lonely thing,” Christi said. “People come up here (The Ridges) and they're pretty much left alone… You're going to have to hogtie me to get me in there (The State Hospital), because that's how scared I am of it.”
This year she turns 50 and is still coming to terms with her femininity. “At forty-nine and a half, I’m learning what it’s like to be a lady,” Christi said. She describes a time when a friend asked her what part of herself she would change if she could, and she told them her female parts that defined her as a woman. “For us girls, when something that’s so special has been taken from you, it doesn’t serve a purpose anymore,” Christi explained.
Borderline Personality Disorder is also characterized by a poor self-image that has fed Christi’s lack of confidence over the years. Now she is working to change that. Two or three years ago she pierced her ears again. She frequently hides herself under a cowboy hat or a baseball cap but takes the time to do her hair for special occasions. Her wardrobe was once dominated by jeans, pants, and flannel shirts.
Now Christi occasionally mixes in a dress or skirt inherited from her late grandmother whom was a “fashionista in her time”, Christi said. Her pain and her symptoms still persist, but today she finds the patience to endure.
he act of deinstitutionalization “simply just switched the post office address from the mental hospital to the local jail prisons and jails,” according to Tom Walker, an Ohio affiliate member of the National Alliance of Mental Illness. Over the past three decades, the number of individuals with severe mental illness in prisons and jails now exceeds the number in state psychiatric hospitals exponentially. In the 1970s, state hospitals began to close, shuffling patients into the community with little to no resources. The idea was that the mentally ill would do better with community-based mental health care rather than institutionalized care. But adequate funding and organization did not follow this change, and the lack of resources and commitment to a community-based system of care continues to be detrimental to a large portion of communities today.
The Ridges began the process of deinstitutionalization in 1993, closing their doors permanently and creating a population surge in Ohio correctional facilities. According to a national survey completed by The Treatment of Persons with Mental Illness in Prisons and Jails, the majority of state prisons and jails in Ohio each house more mentally ill inmates than does the largest remaining state hospital.
Click on each person to hear their perspective.
“We don't have the facilities. We have to have the resources to help care for people with mental health and we have to learn how to do it right.”
“It's unfortunate but the largest institution for housing people with mental illness is corrections. It's not hospitals, it's not nursing homes. It's not adult care facilities and the other things; it's prisons and jails.”
“I think we need to be careful about labeling people with a mental illness as criminals. I think we need to provide more services in the jails and in the communities where people live and try a preventative measure rather than a reactive one.”
“Jail is never the best option for somebody in a mental health crisis. But with the way that things are with criminal justice and mental health, that sometimes is the only available option.”
“Typically, someone with a mental illness that needs hospitalization now has to almost be incarcerated prior to getting the help that they need.”
“What's happened is we've changed one institution to another. Probably no less than 40 percent of everybody in our jails and prisons today are there because of an undiagnosed or untreated mental illness.”
When examining the history of a place like The Ridges it’s easy to see the mistakes that were made. However, lobotomies and shock treatments weren’t performed by cruel sadists hoping to cause pain to another person or remove their humanity. They saw a sick person and thought that they knew the cure. Thanks to pharmaceutical advancements there are now more treatment options. People who are mentally ill, once locked away, can live within a community. According to the National Alliance on Mental Illness, between 70 and 90 percent of individuals who seek treatment see a significant reduction of symptoms and improved quality of life.
Much like the Kirkbride moral treatment approach during the inception of the Athens Lunatic Asylum, many experts in the mental health field see a strong need for community support and engagement for the mentally ill. Today people with mental illnesses aren’t isolated by the walls of the asylum, but by the stigma that society has attributed to them. In order to increase understanding, break down those stereotypes, and keep people with mental illness in the community, mental health promotion needs the long overdue attention that it deserves. Only then can the mental health gap begin to be closed.