The iron stakes were stamped with numbers, not names. No dates. Nothing to tell a visitor who lay beneath the grass. At least 10,000 of them were pulled from the ground in the late 1960s and thrown into the woods, according to the Atlanta Journal-Constitution.
The remains they marked are still there, but the only identifiers the state ever gave those dead were discarded to make mowing easier. This was the burial ground of the Georgia Lunatic Asylum, later known as Central State Hospital, in Milledgeville. Over more than a century, roughly 25,000 patients were buried on its grounds, many identified only by a number stamped into a small iron stake. The place was built with a humane vision and became something else entirely, shaped by poverty, politics, and neglect.
The land itself was acquired from the Muscogee Creek through the Treaty of Fort Wilkinson in 1802. Georgia quickly carved out Baldwin County, founded the town of Milledgeville, and made it the state capital in 1804. It was a planter’s capital, where enslaved people were auctioned in the market square beside a church. In 1834, Governor Wilson Lumpkin asked the legislature to act on behalf of the “lunatics, idiots, and epileptics.
” In 1837, the state created the asylum. A 40-acre plot south of town was chosen, and the institution opened its doors on November 1, 1842. The founding philosophy had a name: the institution as family. Superintendent Thomas Green, who ran the asylum from 1845 to 1879, ate with patients and staff daily and abolished chains and ropes.
The design of the new main building was specific about care, with ventilation planned for each patient room and dormitories connected to an attendant’s room. The first patient arrived on December 15, 1842. Tilman Barnett, a 30-year-old farmer from Bibb County, was brought in chained to a horse-drawn wagon, described as violent and destructive. He died about six months later of “maniacal exhaustion.
” No one has found where he was buried. He is the first entry in a burial count that would continue for more than a century. The new building, designed by Schaul and Fay of Savannah, was completed and occupied in the summer of 1858. It was 486 feet across, with a central block behind an Ionic portico and a dome.
Each patient room was 12 by 12 feet. The plan was one person per room. The hospital expanded to 200 buildings on 2,000 acres at its height. But even early on, the numbers pointed in two directions.
Of the first 50 patients admitted, eight were pronounced cured, but 29 died without ever leaving. By 1872, the asylum had 112 patients for every physician, a ratio that would not improve for almost a century. The patient population was not produced by diagnosis alone. Admissions were recorded for “incontinence,” “religious excitement,” “domestic unhappiness,” and “ill health and jealousy.
” After 1866, the asylum began accepting Black patients. Communities began sending their unwanted residents, including many freed people judged unfit for independent living under the scientific racism of the day. The population grew steadily, and in 1898, the state renamed it the Georgia State Sanitarium. Superintendent Theophilus Powell, who served from 1879 to 1907, attributed rising insanity and tuberculosis among Black Georgians to emancipation.
Hospital reports show the thinking in practice: in 1893, white women patients were issued writing pens, envelopes, spectacles, and toothbrushes. Black women patients were issued irons. The population kept climbing, driven by a budget that made real treatment impossible. In 1910, the total daily operating cost per patient was 34 1/2 cents, covering salaries, meals, and supplies.
That figure left little room for care. Around that time, pellagra overtook tuberculosis as the hospital’s leading killer. Dr. Joseph Goldberger came to investigate and found that staff fed themselves first and kept the milk from patients.
He changed only the food on two wards of pellagra sufferers. Within a year, he had cured them all. As the patient load grew beyond the staff’s capacity, the hospital turned to tools that sounded like progress. Insulin shock and electroconvulsive therapy became common.
Georgia became the last state, in 1937, to pass a eugenic sterilization law. Over the following decades, more than 3,200 people were sterilized. The man who chaired the state’s board of eugenics was the hospital’s own superintendent, Dr. Thomas Peacock.
Patients were also buried in numbered graves. The hospital had its own mortuary and carpenters who built coffins. At the grave, a small iron stake stamped with a number was driven into the ground. The number matched a file in an office.
No name, no dates. The hospital cemetery for Black patients, in use from 1911 to 1937, holds roughly 1,200 to 1,500 graves. When the state built a tuberculosis building that opened in 1940, about 2,000 bodies were dug up in 1938 and 1939 and reburied in trench graves at a new cemetery on South Camp Creek. The identities of those buried were eventually lost.
Sources disagree on who pulled the stakes: patients working as groundskeepers, prison inmates, a maintenance crew, or a lawn-mowing service. The motive was the same in every version: the stakes were in the way of the mower. Within the patient records, some names survive. Samuel Henderson was a 47-year-old farmer from Cobb County whose admission register said religious study had driven him insane.
Juliana Mayor, a 23-year-old from Savannah, was listed as a lunatic and epileptic, the register blaming “disappointed affection. ” Daniel Ashmore, 30, from Liberty County, was admitted for too much study. The hospital also held people who made headlines. Jet Lyles, a restaurant owner from Milledgeville, was convicted of poisoning and sentenced to death, then diagnosed with paranoid schizophrenia.
Her sentence was commuted to commitment at the hospital, where she died in 1977. The turning point came not from a doctor but from a reporter. In 1959, Jack Nelson of the Atlanta Constitution investigated the hospital. He found a staff of 48 doctors serving thousands of patients, not one of them a psychiatrist.
A nurse had performed major surgery without a doctor supervising. A physician moonlighting for a drug company gave patients experimental drugs without consent. A quarter of the doctors had histories of alcohol or drug abuse, and some had been hired straight off the hospital’s own wards after being treated there. Nelson won the 1960 Pulitzer Prize for local reporting.
Governor Vandiver ordered a commission to investigate. Superintendent Peacock attacked the series as the work of communist-sympathizing journalists. A historian named Mab Segrest found the story of a woman she calls Mary Roberts, a pseudonym. Before her commitment, the record shows she had been pregnant 11 times and lost nine children.
In 1911, she was committed to the Georgia State Sanitarium for “crying, praying, singing, and dancing. ” Inside, doctors could not decide between schizophrenia and manic depression. Segrest argues they mistook the woman’s spiritual practices for symptoms of trauma. When doctors asked her to deny that the voices she heard were her dead brothers and sisters, she would not.
Her answer survives: “They are not living but they are real. ” She stayed on the ward until, presumably, she died there. The hospital’s population reached nearly 12,000 in the 1960s, some sources say as many as 13,000. The campus had its own post office, police and fire stations, churches, a beauty shop, and an auditorium that booked musical acts and professional wrestling.
A newspaper photograph from the 1940s shows men in suits looking at a small boy locked inside a metal cage. In June 1965, the hospital reported it was fully desegregated. In 1967, it was renamed Central State Hospital. In 1968, the population fell below 10,000 for the first time in two decades.
That same year, the hospital closed its farm, and the land was parceled out to other state agencies, including the Department of Corrections. Several brick buildings were turned into prisons. The final emptying came after another newspaper investigation. In January 2007, the Atlanta Journal-Constitution began a series called “A Hidden Shame.
” The Justice Department opened an investigation. In 2009, Georgia signed an agreement to fix the hospitals. When the state moved too slowly, the Justice Department filed a 700-page complaint. In October 2010, Georgia signed a settlement promising $77 million in new spending.
By the start of 2010, only 30 patients remained. The hospital stopped accepting new patients that year. In 1997, members of the Georgia Consumer Council found the hospital cemeteries neglected and pledged to restore them. A hospital employee named Byron “Bud” Merritt found another burial ground while hiking in the woods on hospital land.
On October 7, 2001, a bronze angel was raised at the asylum’s first cemetery. In 2003, the cemetery was named Cedar Lane. In 2005, the cemeteries were placed on the National Register of Historic Places. The marker itself states that the restoration set off a movement to memorialize patients buried at state psychiatric hospitals across the country.
At the end of that chain sits a field of 2,000 recovered iron markers arranged as a memorial. The numbers came back. The people they belonged to did not. In 2023, Governor Brian Kemp signed an executive order authorizing demolition of the Green, Jones, and Walker buildings.
Preservation groups asked for a delay, noting the state’s study of alternatives came down to a single undocumented phone call. On October 21, 2025, a developer called Ambryo Design Group bought the Jones, Green, and Walker buildings with 8 acres of land for about $45,000, planning $40 million in work to turn them into a hotel and housing. The legacy continues in other forms. Under the settlement, Georgia was still discharging psychiatric patients to extended-stay motels and homeless shelters after closing other state hospitals, and some went to jail.
In September 2022, a 35-year-old man named LaShawn Thompson died in a bedbug-infested cell in the psychiatric wing of the Fulton County Jail in Atlanta. An independent autopsy found he died of severe neglect. The county medical examiner ruled the cause undetermined. He was one of four Black men with serious mental illness to die in that unit in under a year.
In November 2024, the Justice Department announced conditions in the jail were unconstitutional. The old women’s convalescent building, built in 1883, still carries a cornerstone with the hospital’s first name, Georgia Lunatic Asylum, cut into stone. The roof can go, the rooms can go, the stone stays.