With their vast campuses, patient populations numbering in the thousands, and towns-worth of employees, “asylums for the insane” and schools “for the feeble minded” were among the largest public investments in the United States from 1850-1950. Despite their broad cultural impact, there is no authoritative guidance for how best to preserve asylums (now state hospitals) and state schools.

“State School and Hospital Preservation: A Survey of the Field” is the culmination of an academic year’s worth of research into the status of state hospital preservation work nationwide. With data on 372 historic state-operated mental health facilities and nearly 500 state hospital preservation projects, this report summarizes national trends in this complex field by identifying common strategies, frequent challenges, and potential gaps in state hospital preservation work.