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During the Victorian era, enormous buildings sprang up across the UK, Europe, and North America as authorities scrambled to tackle the rising 'epidemic' of mental illness that seemed to increase alongside the rapid industrialization of the Western world. The accepted solution was to create large institutions, heavily regulated and isolated from society at large.
As cities expanded, many of these historic asylums were eventually engulfed by urban sprawl. By the 1960s, it was decided that these institutions should be phased out and their residents integrated back into society—whether or not suitable housing and care had been arranged for them.
Though the well-being of patients was often overlooked, the buildings themselves rarely received consideration for repurposing. Consequently, numerous sturdy, often stunning, and historically significant structures were left to deteriorate, with demolition looming on the horizon. Here are a few examples of those that survived to serve a different purpose.
10. Royal Bethlem, London
Bethlehem Priory was initially established in Bishopsgate in 1247 and began housing individuals considered 'mad' as early as 1377. A newer facility, by then referred to as 'Bedlam,' was constructed at Moorfields in 1676, designed by the distinguished scientist and architect Robert Hooke (1635–1703), who was also a major rival of Sir Isaac Newton.
The third incarnation, called 'Royal Bethlem,' opened in Southwark in 1815 and became the largest of the three, accommodating up to 425 patients at a time. Initially, it was also responsible for all of Britain’s 'criminal lunatics.' Bedlam, notorious throughout history for its cruelty and suffering, began catering only to middle-class, fee-paying patients by the 1860s.
Today: After closing its doors in 1930, the former 'lunatic palace' now houses the Imperial War Museum in London. In a twist of irony, this museum chronicles the history of warfare and conflict, reflecting humanity’s most extreme and destructive forms of madness.
9. Claybury, Essex
Claybury, built as the Fourth London County Asylum in Woodford, Essex, was the largest British asylum in terms of overall size, housing up to 2,740 patients at its peak.
Designed by George T. Hine (1842–1916), the architect responsible for constructing more asylums than any other, Claybury was one of fifteen asylums attributed to him, with five others receiving extensions or additions during his career.
Today: After closing in 1997, this enormous building, once surrounded by secure railings to keep its pauper patients contained, has been transformed into a gated community. The wards have been converted into homes, the chapel turned into a swimming pool, and the lavish recreation hall is now a gym. Located on the outskirts of London, it has become one of the most desirable areas, though access is restricted to the public, with the former paupers now kept out of its grounds instead.
8. Traverse City, Michigan
Michigan's third asylum opened in 1885 and quickly became the city's largest employer, expanding to over 1,400,000 square feet (130,064 square meters) of floor space. By 1959, it was home to around 3,000 patients.
The first medical superintendent, Dr. James Munson (1848–1902), ran the asylum for its first 39 years before retiring at 76. He believed that having patients surrounded by beauty and providing them with ample activities was essential for their well-being and recovery. Munson also abolished the use of straitjackets and other restrictive measures.
Today: Sadly, the asylum’s magnificent Italianate central block, the most striking section of the building, fell into disrepair and was demolished in 1963. The rest of the facility closed in 1989. A $60,000,000 redevelopment project began in 2000, renovating the remaining 1880s structures and vast grounds into a mix of residential areas, shops, restaurants, hotels, and conference facilities.
7. The Lawn, Lincoln
The Lincoln Lunatic Asylum, later known as The Lawn, was a charitable public institution that opened in 1820 at the heart of the ancient town, next to its grand castle and beneath the towering cathedral. When the church’s main tower was completed in 1311, it stood as the tallest structure in the world, surpassing even the Great Pyramid of Giza.
The Lawn took patients on a charitable basis, meaning most did not have to pay at all. It had a good reputation, inspired by its first visiting medical physician, Dr. Edward Parker Charlesworth (1783–1853). Charlesworth insisted that mechanical restraints (bindings, cuffs, straitjackets, etc.) were abolished and that violence and physical coercion should never be used upon the patients, which was then a controversial approach.
Today: The Lawn closed in 1982 and was later used by the local council. It is now a conference center and coffee shop, with its grounds open as a public park.
6. Mapperley, Nottingham
Nottingham was progressive during Georgian times when medicine for the poor was usually left to unqualified quacks and questionable herbal remedies. It built its general public hospital as early as 1781 and opened the very first of Britain’s “county asylums” at Sneinton in 1812.
As its first asylum became grossly overcrowded, middle-class patients were moved to new accommodations at The Coppice in 1859. However, as Nottingham continued to grow into a large industrial city, Sneinton again became overcrowded, with the much larger Mapperley Asylum eventually built in 1880. This, too, was full by the end of its first year and soon expanded.
In the 1950s, Dr. Duncan MacMillan, the superintendent at Mapperley, redefined the status of long-term patients by categorizing them as 'voluntary.' Rather than viewing their rehabilitation as an unattainable goal, a common belief in many asylums at the time, he fostered a sense of self-assurance and worked to reintegrate them into society. No new patients were confined to the grim, old chronic wards, and over time, the doors to all wards were progressively left unlocked.
Today: After its closure in 1994, half of the former buildings have been transformed into upscale housing, while the northern section continues to serve the NHS as the University of Nottingham Medical School. Additionally, a substantial medium-security forensic unit was established within the grounds.
5. Matteawan State Hospital, Beacon, NY
Nestled between the Hudson River and the Fishkill Mountains, Matteawan opened its doors in 1892, providing care for a wide array of mental health conditions. A notable portion of its population included those classified as 'criminally insane' at the time.
One of the most infamous patients in this category was George Metesky, also known as the 'Mad Bomber.' From the 1940s until his capture in 1957, he instilled fear in New York by planting homemade explosives in public places. Remarkably, he was released in 1973, just 16 years after his conviction.
Today: Matteawan’s function has transformed since the 1970s into the Fishkill Correctional Facility. The facility continues to house both high- and medium-security psychiatric patients in the original asylum buildings. Additionally, it runs a minimum-security work-release program for those in rehabilitation.
4. Royal Albert Idiot Asylum, Lancaster
The first 'idiot asylum' was established in Surrey by John Langdon Down (1828–1896), who was the first to identify the syndrome that now bears his name. At that time, the condition was referred to as 'idiocy.' Langdon Down created an institution aimed at housing, educating, and enabling individuals with learning differences to lead meaningful lives outside its walls.
Other similar institutions emerged across the West, East, and Midlands of England. Royal Albert, originally known as the Northern Counties Idiot Asylum, was designed in a grand Flemish style in 1870. The facility was meant to accommodate 500 children, aged six to fifteen, each for up to seven years, after which they would be deemed ready to apply their newfound skills in the outside world.
However, these lofty ideals gradually faded over time. By 1948, the asylum’s population had grown to over 800, with 35% of residents being over the age of thirty-five and classified as long-term cases.
Today: The building closed in 1996 and was transformed into the Jamea Al Kauthar Islamic College, a private Islamic boarding school for girls aged eleven to eighteen.
Gheel, Belgium, is a village with deep historical roots, particularly known for its association with Saint Dymphna and her remarkable influence on mental health care.
Dymphna, born in 7th-century Ireland to a prosperous family, fell into profound grief after the death of her mother. Her father, sharing the sorrow, was urged by his advisors to remarry to heal his heart. He dispatched emissaries across Europe, only to return with the shocking notion that no one was more suitable than... his own daughter, Dymphna.
Appalled and horrified, Dymphna fled to the European continent, accompanied by a priest, a court jester, and his wife. They reached Antwerp, present-day Belgium, and found refuge in the small village of Gheel. Her father pursued her relentlessly, killing the priest who tried to protect her and, in the end, murdered Dymphna, his own 15-year-old daughter. She was martyred and was later canonized as Saint Dymphna around AD 650.
Legends speak of miraculous cures for those with mental health challenges who visited Gheel, prompting Saint Dymphna to become the patron saint of the mentally ill. As a result, more and more people were brought to Gheel by friends and relatives. Initially, patients were housed in a small asylum connected to the church built in her honor. However, eventually, they were welcomed into the homes of Gheel's ordinary families.
Today, the practice in Gheel remains remarkably unchanged, even though the original structures have disappeared. Unlike most Western countries, including the rest of Belgium, which adopted large, distant mental institutions, Gheel continues to have local families provide care for those with mental health conditions. This practice, passed down through generations, has become an integral part of family tradition in Gheel, as natural and accepted as any other family legacy.
Glenside, located in Somerset, has a rich history, having transitioned from a psychiatric facility to a war hospital and finally into a modern educational space.
Glenside was established in 1861 as the Bristol City Lunatic Asylum, designed with the corridor-pavilion layout typical of psychiatric hospitals of the time.
During World War I, Glenside temporarily ceased its psychiatric functions and became the Beaufort War Hospital. It treated 29,434 wounded soldiers, while all its psychiatric patients were either sent home or transferred to other asylums. Upon reopening in 1919, one of the patients was Elsie Leach, the mother of Hollywood legend Cary Grant.
In the present day, Glenside’s historic buildings have been repurposed into residence halls and training facilities for the UWE Faculty of Health and Social Care. The grand recreation hall has been transformed into a cafeteria, and the former chapel now serves as a museum showcasing the long history of Glenside, both as an asylum and a war hospital. This repurposing stands as a rare and thoughtful example of preserving a building's history while adapting it for a new use.
Buffalo State Hospital, NY
Buffalo State Hospital, which opened its doors in 1880, was designed by Henry Hobson Richardson (1838–1886), a man celebrated as the first American architect to gain global fame. The building's design adhered to the Kirkbride plan, where the ward blocks stretch out from a central administrative block, creating a formation that evokes the wings of a bird in flight.
Buffalo's asylum was perhaps the most striking of its kind in America, with its massive gothic towers towering over the enormous central block, resembling something straight out of a dark fairy tale.
Today: Even though it was added to the State and National Registers of Historic Places in 1973 and designated a National Historic Landmark in 1986—one of only seven such landmarks in Western New York—the building remained abandoned and neglected for many years. A legal battle eventually forced state authorities to take action and begin its restoration. The central third of the structure became the Hotel Henry, named in honor of its architect, but it closed in 2021 and was later revived as The Richardson Hotel. Tours are now available of the remaining abandoned sections, with future plans to transform them into apartments and office spaces.
