A single granite monument across the street from the former Augusta Mental Health Institute in Maine bears 11,647 names. They are the patients who died inside one hospital over 164 years, an average of 71 deaths per year. The institution operated from 1840 to 2004. When Maine became a state in 1820, it had no facility for the mentally ill.
A census commissioned by Governor Jonathan Hunton in the 1830s found 562 people with mental illness living in the state, roughly one in every 300 citizens, with nowhere to house them. Families typically cared for their own, but those without support ended up in poorhouses, county jails, or on the streets, sometimes kept in chains or cages. The push for a hospital gained momentum through the work of Dorothea Dix, born in Hampden, Maine, in 1802, who had documented conditions in asylums across New England. In 1834, the legislature authorized construction of the Maine Insane Hospital with $20,000 in public funds, contingent on matching private donations within a year.
Two men stepped forward with $10,000 each. Reuel Williams of Augusta was a future U. S. senator.
Benjamin Brown of Vassalboro had offered 200 acres along the Kennebec River, but the legislature rejected that site, sold it, and purchased land in Augusta instead. The chosen location was deliberate. The building sat on the eastern bank of the Kennebec, directly across the water from the State House, ensuring legislators would see it every working day. Architect John De Lord modeled it on the Worcester State Lunatic Asylum in Massachusetts, and construction was completed in 1840 using Hallowell granite, the same stone used for the State House.
The facility was built for roughly 120 patients. The first superintendent, Dr. Cyrus Knapp, lasted less than a year. His replacement, Dr.
Isaac Ray, arrived in 1841 and was already a prominent figure. He had authored a treatise on the medical jurisprudence of insanity that shaped American court thinking for decades and was a founding member of what became the American Psychiatric Association. The hospital was designed around a theory called moral treatment. This approach held that insanity was a disease, not a curse, and that patients could recover through environment, routine, fresh air, and kindness rather than restraint.
Patients were sent to work in the fields and laundry from the first year. The trustees described this as necessary for recovery, and it also reduced operating costs. Medical practices of the era included bloodletting, cupping with heated glass cups, and a device recorded as the calming chair, in which a person was strapped until still. Medications included opium, alcohol, bromides, and conium, the poisonous hemlock plant.
A patient named Isaac Hunt was admitted in September 1844 at age 37. He later published a book describing his treatment, including a drug that threw him onto his bed with chattering teeth and an attendant who struck him and seized him by the neck. His account was never verified. A researcher who examined surviving legal records described it as factually unconfirmed and exaggerated at best.
Hunt himself admitted that on his day of arrival he was, in his own words, a completely disturbed man. Both accounts exist in the record. What is undisputed is where Hunt’s fellow patients came from. Dr.
Ray’s 1843 report to the legislature described admissions of people who had spent years in cages, arriving, in his words, stripped of every gentle human attribute. The numbers tell the story of what happened inside. Designed for about 120 patients, the facility averaged roughly 90 residents in 1850. By 1900, the average exceeded 700.
In 1901, the population reached 1,020, and the hospital also housed Maine’s only forensic unit for those the state called criminally insane. By 1931, the census reached 1,555, and by the 1940s it stood at 1,837. The peak came in 1956 with 1,840 people, fifteen times the original design capacity. The hospital expanded over the years with new wings and buildings, including Harlow Wing designed for 100 patients, men’s and women’s wards of 42 each, and Marc Arte and Darling buildings with a combined 240 beds, the latter serving as a seclusion ward.
Attic rooms meant for staff were converted, and sleeping porches were bolted onto the outside of wards. Even with these additions, the hospital operated about 30 percent over capacity throughout the 1950s, and that figure uses the expanded capacity, not the original design. The State of Maine was aware of the problem. In 1901, it opened a second hospital in Bangor and immediately transferred 145 patients from Augusta, offering temporary relief before numbers rose again.
A state legislative committee specifically formed to review overcrowding at Augusta and Bangor delivered its report in 1987, one year before the deaths that finally ended the institution. That report warned that the community care system meant to replace institutionalization had not been built yet. The most lethal event in the hospital’s history came early. In 1848, a new heating system was installed, inspired by one seen at McLean Hospital outside Boston.
A wood-burning furnace in the basement heated air that passed through a wooden chamber, then traveled through wooden pipes to rooms on the upper floors. The men’s wing got it first, and the old south wing was connected in 1849. On the night of December 4, 1850, there were 124 patients in the hospital, 79 men and 45 women. There was no night watch, only a single sleeping attendant per ward.
Around 3 a. m. , a firefighter named James B. Vickery saw smoke rising from the hot-air pipes in the old south wing.
He went to the basement and found the wooden air chamber burning, along with the beams above it. He tried to extinguish the fire and could not. Some patients smelled smoke and called for help. No one came.
The patients called out every night, and the staff had stopped listening long ago. Patients were locked behind doors that closed from the corridor, with barred windows set in granite. The smoke rose through the floor and vents, reaching every room at once because that is what the pipes were designed to do. The alarm bell was rung.
There was not enough water and no plan. The building was a mile from town, so help arrived slowly. Attendants walked the corridors opening doors by hand. Some halls filled with smoke faster than anyone could enter.
Some patients refused to leave their rooms. Some ran back toward the fire. Outside, ladders were placed against the granite, and men tore iron bars from window frames so people could climb down. The rescue worked, but slowly, window by window, and the floors collapsed before they finished.
An attendant named H. D. Jones said he would save as many patients as he could or die trying. He suffocated inside the building, the only employee killed.
Twenty-seven patients died, 28 people in all. It remains the deadliest fire in Maine history. The cause was never officially determined. The hospital’s annual report said the fire originated in the hot-air chamber under the old south wing, perhaps due to some defect in the smoke pipe connected to the heating apparatus.
The word perhaps appears in the report. A coroner’s jury in the civil trial that followed found the deaths were accidental. Survivors were housed at the Augusta House hotel and in private homes, while the most violent patients were held at the county jail. The hospital did not close.
Not after the fire, not after the peak population of 1,840 in a building designed for 120, not even after deinstitutionalization emptied the wards and left the building standing for another 30 years. What finally closed it was a heat wave. One summer, one granite building, and a set of deaths the state of Maine still cannot agree on in number. The state’s own accounts conflict.
Patients died at the Augusta Mental Health Institute during a heat wave inside one of the granite buildings. The governor’s office, state newspapers, and mental health advocates say the number was 10 people. A timeline produced by the Journal of the Maine State Legislature reference indicates five deaths. A public report by the National Alliance on Mental Illness of Maine attributes 10 deaths to the summer of 1989.
Sources differ on both the count and the year. The cause is undisputed because the state stated it itself. Overcrowding, deficiencies in the community mental health system, and poor conditions in the facility contributed to the deaths. The event reshaped Maine’s mental health law.
Legislative hearings followed, voluntary admissions were suspended, and a class-action lawsuit was filed on behalf of nearly 300 patients under the name Bates v. Glover & Ives. On August 2, 1990, the state signed a consent decree of 99 pages and 350 paragraphs, requiring the patient population to drop from 295 to 70. It had the force of law, but it never mandated any funding.
Fourteen years of noncompliance followed. In 1994, a court found Maine in contempt on eight separate counts. In 1996, it found the state in contempt again. In 2002, after a 17-day trial, Judge Nancy Mills ruled the state had proved compliance with only 23 of 197 disputed paragraphs, found it had acted in bad faith, and placed the hospital under judicial control.
She wrote that this was not a funding failure but a management failure to get the job done. No one was ever charged with anything, and the names of the people who died in that heat were never publicly released. The hospital closed in June 2004. The consent decree outlived it by 20 years, finally dissolved in December 2024 after 34 years, five governors, and seven attorneys general.
The state now has offices in the campus off Independence Drive, and the building where patients lived has been empty since 2004. The stone building, six connected structures totaling 262,000 square feet of Hallowell granite, has deteriorated. A section of roof collapsed, exterior walls moved, panel joints and mortar failed, and windows shattered. Water has leaked in for two decades.
The current work includes full asbestos removal, lead paint abatement, and animal waste cleanup. When the work finishes, expected in spring 2027, the state plans to put between 700 and 1,000 employees inside. The fates of other facilities varied. The Worcester hospital in Massachusetts, the model for this building, was demolished.
Bangor’s main hospital, built in 1901, still operates today under the name Dorothea Dix, reduced to 51 beds, with its dead buried at Mount Hope Cemetery in records as incomplete as Augusta’s. Central State Hospital in Milledgeville, Georgia, buried more than 25,000 people in unmarked graves, then removed the metal markers to make mowing easier. Augusta received none of those endings. It was repurposed.
In 2015, a granite marker was finally placed in Cony Cemetery across the street, costing about $20,000 raised from private donations, including $10,000 from a single foundation. It bears the number 11,647. But it cannot mark locations because no one knows them. In the poor section of the cemetery, a hand-drawn undated map shows about 40 graves.
The wooden markers have long since disappeared. Only seven headstones remain readable, including one for William Ray, born in Scotland in 1829, who died at the hospital in 1860; Angie Jackson, 18 when she died there in 1888; and Elmer Bradbury, who died at the hospital in 1889, buried beside his wife Mary, who had died 12 years earlier. What happened to Elmer during those 12 years is not recorded anywhere. Isaac Hunt, the patient who published his account, was released in 1847 after what he calculated as two years, eight months, and ten days.
From 1848 to 1854, he campaigned against the state, and the state archives still hold 16 pages of his filings. He demanded more than $3,000 for his unlawful imprisonment and $100,000 for what he called brutal, inhuman, and cruel treatment. In 1851, he published the book himself, 84 pages printed in Skowhegan under the title “Startling Disclosures. Three Years in a Lunatic Asylum, by a Victim, Written by Himself.
” The cover shows him restrained by three guards while one pours medicine into his mouth through a funnel. A Senate committee listened to him, interrogated him, and rejected the petition. He appealed again in 1854 with the same result. Near the end of his book, Hunt wrote that a man confined one day in a lunatic asylum would never afterward be accepted as a proper and reliable witness in a court of law.
He used the word stigma decades before it became common. Isaac Ray never publicly responded, but in May 1852, at the annual meeting of the country’s asylum superintendents, he read a paper complaining about the gross misconceptions and scandalous gossip surrounding institutions like his. Twenty-one years later, he was still telling the story of a partially recovered patient who lectured against him and circulated a pamphlet with Ray’s picture on the cover. The hospital’s finances were never commercial.
No one ever hired these patients. There were no products, no buyers, no contractor taking a margin. What existed was a state deciding each year the value of a life inside that building. It started with $20,000 in public money in 1834, followed by $20,000 from two private men.
After that, the hospital was expected to cover its own costs, and the tool was the farm. Patients worked it, and the trustees stated clearly that income from selling what patients grew helped cover operating costs. The farm expanded as the population grew, with a hay barn and cow barn in 1895, a pig barn and silo in 1896, and a horse barn in 1903. By 1920, the land and buildings were valued at $1,894,000, with another $22,000 in furniture and equipment, on 600 acres, 450 of them under cultivation.
Patients were never paid for any of it. That did not end until a consent decree in the 1970s finally eliminated unpaid patient labor. The claim widely repeated is that 11,647 patients lie in unmarked graves on an 800-acre campus in Augusta. That is not what the records show.
The National Register nomination puts the hospital’s maximum extent at about 566 acres. And no cemetery was ever identified on the campus. No burial record was kept, and there is no evidence such a record existed. Some of the dead were returned home and buried in family plots in their own towns.
The only documented burials are those 40 graves on the hand-drawn map across the street. There is no mass grave here. There is an absence of records, which is worse, because a mass grave at least tells you where to stand. The building was placed where the state could not overlook it.
The dead were placed where no one could find them. Still, the real number is devastating. Nearly 45,000 people were admitted here between 1840 and 2004, and nearly a quarter of them died inside the institution. The list also includes people who were not psychiatric patients but were admitted for epilepsy or Alzheimer’s disease as late as the twentieth century.
We know all this because of one woman. Karen Evans was 17 when she was diagnosed with schizophrenia in the early 1960s and admitted here for about a year. Her parents were told she would remain institutionalized for the rest of her life. While inside, a girl she knew only as Margaret told her she was thinking of suicide.
Evans warned the staff. The next day, Margaret was found in her room with her head between the window bars. The glass shattered. Evans said they took her away.
She never learned what happened to her. About 50 years later, Evans began asking where they had all gone. Twelve years of work with a Portland agency called Amistad produced a list of 11,647 names extracted from patient records and funeral records. The legislature had to pass special legislation before anyone could access them.
But Evans never learned what happened to Margaret. When the state governor proposed moving state offices to the old campus in 2015, the Augusta city manager warned the city would lose a million dollars a year in leased space. In 2000, the legislature allocated $33 million to build the replacement hospital. In 2026, the state allocated $20.
4 million to repair the roof and masonry of the building where patients actually lived. And in the death record of one patient at the new hospital, the total the state paid for a burial plot, a headstone, and a funeral home came to $3,400. Twenty point four million dollars for walls, and $3,400 for a person. Most of the people who enter the campus each morning now work on paperwork.
The stone building has been empty since 2004, waiting on a completion date. The granite still stands, as do the seven readable headstones across the road. The question remains: how does a state lose 11,647 of its citizens inside a building it could see from its own windows?