Dorothea Dix Hospital is a monument to the constant efforts of Dorothea Dix, who worked to accommodate the needs of the mentally ill within American society. Dix’s proposal for a mental asylum in North Carolina took root after her success in establishing hospitals in other states, including Tennessee. By 1848, North Carolina and Delaware were the only two states of the original thirteen with no institutions for the mentally ill. Dix personally studied the state’s jailhouses and poorhouses over the course of three months and, in the fall of 1848, approached the legislature with her proposal. She was turned down by lawmakers who preferred to invest in the railroad being constructed in the western part of the state. During her presentation, Dix asked for a $100,000 grant to erect the facility, which was over half of the annual state budget.
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Dix then asked John W. Ellis of Rowan County to introduce the bill to the legislature and, in December 1848, the bill again was defeated. Dix soon after befriended the sick wife of a member of the House of Commons, James C. Dobbin of Cumberland County. His wife’s dying wish was for him to help Dix get the bill passed. Dobbin kept his promise to his wife and, on December 21, 1848, reopened the debate, bringing his colleagues to tears with his proposal. The bill passed by a wide margin.
The next priority was selecting a location for the new institution. Dix preferred an area that was vast, removed from the city, clear of noise and smoke, and with available clean spring water. Six commissioners chose a 182-acre site for the “Insane Hospital of North Carolina” in southwest Raleigh featuring a grove of oaks and a small hill. In 1853, Dr. Edmund Strudwick of Hillsborough became the first physician and superintendent of the facility. Construction was not completed until 1856. Two wings, designed by New York architect Alexander T. Davis, accommodated 274 patients. The hospital was renamed “Dix Hill” after Dorothea Dix’s grandfather, Dr. Elijah Dix, because Dix refused to accept the honor.
The first patient arrived at Dix Hill on February 22, 1856, and was diagnosed with “suicidal mania.” By the beginning of the Civil War in 1861, Dix Hill had 193 patients on the premises. In April 1865, Union troops en masse camped upon the grounds. By the early 1900’s the public had begun to acknowledge and accept mental illness as a disease and pressured the state legislature to increase the capacity of all hospitals within the state, which by that time included what would come to be known as Broughton Hospital in Morganton and Cherry Hospital in Goldsboro.
A school of nursing opened in 1902 and, by 1918, specialists in other areas had followed the nursing school model, teaching dentistry and social work. In 1926, a fire destroyed the main building but with no lives lost. By the 1930s there were over 2,000 patients. The nursing school closed in 1949. On the one-hundredth anniversary of the asylum in 1956, the General Assembly changed the name to Dorothea Dix Hospital. Today the hospital accommodates 682 patients and a staff of 1,300. Major change is in store for the property with the pending relocation of the primary state mental health facility to Granville County and alternate use of the tract.
Marjorie O'Rorke, Haven on the Hill: The History of North Carolina's Dorothea Dix Hospital (2009)
David Gollaher, Voice for the Mad: The Life of Dorothea Dix (1995)
Helen E. Marshall, Dorothea Dix: Forgotten Samaritan (1937)
Elizabeth Reid Murray, Wake: Capital County of North Carolina (1983)
North Carolina Division of Mental Health, Development Disabilities, and Substance Abuse, “History of Dorothea Dix Hospital”: