The first asylum was founded by the Quakers in 1813. The Friends Hospital, http://www.friendshospitalonline.org/ceo.htm, in Philadelphia was founded to help people who were experiencing mental or emotional health problems.
People were sent to state hospitals for various reasons in the past. In a state hospital near the city where I live, while it is now reserved for those deemed "criminally insane," it once housed people for other reasons, including dementia. It was not uncommon for men to have their wives committed. A short article describing this can be found on Bella Online at http://www.bellaonline.com/articles/art42196.asp. Women could be committed by their husbands at the husband's whim. Sometimes this may have been an excuse for them to divorce their wives and go on to marry someone else.
My first family history experience with asylums was when I ordered death certificates for two of my great-great grandparents who died during the 1940s. They were each committed in their latter years and died at a state mental hospital. In both cases it appears that they were unable to care for themselves; perhaps they had dementia and their family members were unable to do care for them. Remember, this was a time before modern day rest homes and convalescent hospitals. Few options existed for the elderly.
In some cases you might be able to learn more about the institution your ancestor lived in by looking it up on the Internet. Histories, cemetery records, and patient indexes are available for various institutions.
A history of the Dorothea Dix Hospital in Raleigh, North Carolina is available at http://www.dhhs.state.nc.us/mhddsas/DIX/history.html. This online history starts from the creation of legislation that provided for the formation of state hospitals, to the hospital's present day history.
Histories of state mental hospitals can sometimes be found by googling the name of the hospital. Make sure you type the hospital name in quotes; for example, "Patton State Hospital." By doing so, Google will return results for that phrase instead of finding any occurrence of those three words in a document. By enclosing your search term in quotes you will receive more accurate results. In some cases Wikipedia have histories of some institutions. Just make sure you verify whatever information you find because Wikipedia is a reader-contributed encyclopedia and not necessarily accurate.
If you are interested in what a state mental hospital looked like during the time your ancestor resided there, consider checking out vintage postcards. Believe it or not, these facilities were the subject of picture postcards around the turn of the century. You can find vintage postcards at antique stores, ebay, and at postage stamp shows. Some online collections of these postcards are at http://www.people.fas.harvard.edu/~wellerst/collection/, http://www.rootsweb.com/~asylums/northern_mi/postcard/, http://www.umdnj.edu/librweb/speccoll/postcards_1.html.
While it may sound odd that people would have purchased and sent postcards picturing a state mental hospital, Sarah Ann Hook, JD, AHIP, in her article entitled, "You've got mail: hospital postcards as a reflection of health care in the early twentieth century," available online at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1175805 explains that cities showed their civic pride through these postcards. Depictions of local hospitals and sanitariums provided a glimpse to others of the city's modern facilities and treatments.
Each state has different rules and regulations regarding whether you can look at patient files from a state hospital. In California, as in most other states, confidentiality of these files extends after death. So these files continue to be sealed. However, if you have a medical condition that you believe may be genetic, you can ask your physician to write for and obtain the files of a relative committed to a state hospital. In some cases these files can also be obtained by a court order.
While these files are sealed, hospitals have the right to destroy parts of the files and may do so after a number of years. So for the files of those long deceased a file may only contain very little information.
In some cases, while you may not be able to obtain a record on a patient at a state mental hospital, you can access information from their record of admission. This is usually an index with the entry, including the person's name and date of admission. These records can sometimes be obtained from state archives. One state archive that has admission record books for the state hospital is the Oregon State Archives at http://bluebook.state.or.us/state/executive/Mental_Health/mental_health_holdings.htm.
Some county courthouses will have records of those who were involuntarily committed. This is usually found in an index by year with the name of the person committed and where he or she was sent.
Occasionally, you may get lucky by checking out the modern day web site for a state mental hospital. In the case of the Central State Hospital in Georgia, http://www.centralstatehospital.org/GENEALOGY.htm, there is contact information for admission records and burial records.
The web site, Blacksheep Ancestors, Insane Asylums, has an index, by state, of links to state mental hospital records. Unfortunately, this is limited and only contains records for Colorado, Delaware, Idaho, Illinois, West Virginia, Wisconsin, and Wyoming.
Most, if not all, state hospitals include a cemetery. Unfortunately, it is not uncommon for those cemeteries to be overgrown patches of land somewhere near the hospital, with few markers. Many times they are all but forgotten resting places for those who spent time in these facilities. Although there are some exceptions, often those buried were simply buried with a marker that listed a number, not a name. In some cases the markers no longer exist.
Hospitals may in the past have had different policies regarding what happened to the bodies of those who died there. One state hospital I talked to had a policy over 40 years ago to donate the bodies of deceased patients to a local medical school, in cases where the patient's family did not come forward to claim the body for burial. The death certificate for one such patient indicated the name of the medical school in the place where the funeral home name would normally be found. A call to the medical school provided additional information about the donation of this patient's remains.
This month several mental health facilities participated in the fifth annual Remembrance Ceremony sponsored by the California Memorial Project. This was a time to honor those patients who died and were virtually forgotten by the system and in many cases their families. The California Memorial Project has a mission that includes restoring cemeteries at state institutions and recording the stories of people who lived in the state institutions. According to the web site for the California Memorial Project at http://www.californiaclients.org/projects/ca_mem_description.cfm:
Since the first institution opened in 1853, people were committed to state institutions for a variety of reasons that would be unacceptable today. Up until the 1950's approximately 10% of the hospital population died each year. For a variety of reasons, people were abandoned by their families: shame, stigma of disabilities, family hardships, time etc. As a result people were buried at the hospital grounds in unmarked cemeteries. Over time these cemeteries have fallen into total disrepair, neglected, and have been used for other purposes: land sold for condominiums, pasture for cattle grazing, hog farms, etc. . . .
Unfortunately, when state institutions closed, people were exhumed and moved to county cemeteries in unmarked graves. Many times people were placed in unmarked community graves. Part of the research involves locating were people were moved.
We want to not only restore and properly memorialize the cemeteries still on state hospital and developmental center lands, and those gravesites of people in county cemeteries, who died in institutions. Everyone deserves to have a marker with their first and last name, date of birth, date of death.
We need to change the current burial practice at state hospital or developmental center for people who are indigent and unclaimed by family members. Currently people are either cremated and placed in unmarked community graves at local pauper's fields, or at Napa buried in the pauper's field with only a numbered marker.
While it is often difficult to pinpoint the exact resting place for deceased mental hospital patients, there are some exceptions. One exception is found on the web site for the Kansas State Historical Society. They have an online database of the names of the 1157 people buried at the Topeka State Hospital cemetery, http://www.kshs.org/genealogists/vital/topekastatehospitalcemetery.htm. Through the Kansas State Historical Society you can obtain information from the file of a a deceased family member who stayed at the hospital from 1872 to the 1960s. The diagnosis won't be released but you will be given "genealogical information."
A web site with resources for Tewksbury State Hospital in Massachusetts is located at http://freepages.genealogy.rootsweb.com/~tewksburyhospital/cemeterywelcome.html, includes information about patients interred in the hospital cemetery. Pictures of the cemetery are also included.
Rootsweb, USGennet and the USGenweb are all great examples of places where you can find some transcriptions of state hospital cemetery records.