February 28, 2025 • 13 mins
In this episode of Mental Health Pathfinders, Erin Connors speaks with Dr. King Davis about the historical significance of Central State Hospital, the first institution in the U.S. dedicated to the care of black patients. Dr. Davis discusses the challenges faced in preserving the hospital's history, the impact of racial segregation on mental health care, and the evolving understanding of race and mental illness. He emphasizes the need for continued research and preservation efforts to better understand the intersection of race and mental health care in America.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
Hello and welcome to Mental Health Pathfinders.
I'm Erin Connors.
Our guest today, Dr.
King Davis, is a professor emeritus at the School of Information and Liberal Arts, UTAustin, and a former commissioner of behavioral health and developmental services in
Virginia.
He founded the Friends of Central State Hospital, a federally recognized nonprofitorganization to further his work.
(00:28):
Among the crowning achievements of his career as a social worker, researcher, and educatoris his preserving the records and history of Central State Hospital, a psychiatric
hospital in Petersburg, Virginia, that was the first institution in the country dedicatedsolely to the care of black patients.
Dr.
Davis, I look so forward to this conversation today.
(00:50):
Thanks for joining us.
Thank you.
I appreciate the invitation, Aaron.
So let's get right to it.
How did you become aware of Central State Hospital and its unique history?
Well, it'll seem a little strange perhaps to you, but I came to Virginia in 1972 asdirector of community mental health services.
(01:12):
Central was not part of my package.
I was only dealing with the services in the community, but I had an intern the firstsummer that I was at the department that was a student in the university that is in the
same town as Central State and her summer project turned out to be Central State Hospitaland its history.
(01:33):
And that's how I became aware of it many, many years ago.
But that's continued over time because I've spent probably 20, 25 years in Virginia.
And I've had the opportunity to visit Central at different time periods, different staff,different individuals.
So it's worked out very well.
I've just learned a lot about it since 1972.
(01:57):
It sounds like this is really important to preserve the history of Central State Hospital,you know, in the context of racial and mental health justice.
Absolutely.
No question about it.
Central being the first institution of its kind in the United States.
When you go back through the history, you really raise the question of why Virginia, whyCentral State, and what were the factors that combined to make this occur in the
(02:26):
Commonwealth of Virginia?
And I think in part, you have to put it in the context that Virginia was also the statethat opened the first mental institution in the United States in Williamsburg at Eastern
State.
They opened the second in Stanton, Virginia in 1827.
They opened Central State Hospital then in 1868.
(02:49):
So the first three very unique institutions from the mentally ill were established in thestate of Virginia.
And part of the history of looking at Central is to ask the question, why did Virginia dothese things?
And so that has moved my career along.
Yeah, that is fascinating.
Did you run into any challenges during your during your work to research and raiseawareness to the history of Central State Hospital?
(03:16):
Do you have three days for me to talk about that?
I'm teasing, of course.
Well, absolutely.
No, absolutely.
One of the most significant of all of these was that very few people, seemed, in positionsof authority in government appreciated the history of central state.
So that was the first barrier that we had.
(03:39):
The governor that I worked for, individuals in the Department of Behavioral Health, mentalhealth at the time.
They saw no real value in the artifacts or in the memorabilia of any kind at Central thatwas worth pursuing.
And when I first started raising questions about the archives, I was advised that thearchives from Central had no historical value and should in fact be shredded.
(04:08):
So yes, there are many, challenges, financial, programmatically, policy-wise.
the absence of interest in Central overall, there were numerous challenges.
But probably the biggest challenge for us was trying to figure out where we got thedollars to do anything about preserving the records at Central.
(04:28):
And that was the greatest challenge that we had.
sure.
And how did racial segregation impact the care and treatment of black patients at CentralState?
you can almost reverse that there were no areas where it did not significantly influencecentral state and to probably put that in its broadest context, you really have to go to
(04:52):
the 1840 census of population for the United States.
That was the first census that identified as much as they could.
Inaccurately, however, the extent of mental illness in various states and cities and byrace.
across the United States.
And what it identified and proposed in the census material was that African Americans whowere in northern states who had migrated from the south and from slavery to the north had
(05:26):
mental illness rates that were going to be 10 times greater than the persons who wereenslaved and remained in the south.
So that started a variety of questions and research hypotheses.
In fact, trying to explain the condition or the value or the import of race in predictingor even in considering diagnosis of persons by race.
(05:55):
And the notion was at least initially, as long as African-Americans stayed in the SouthernStates and enslaved, they were basically immune.
from the problems of mental illness.
When they went further north, if they escaped slavery, if they became free, the notion wasthat a humongous amount, large numbers of African-Americans would in fact develop very
(06:19):
severe mental illnesses.
So yes, it's been a factor throughout our history, from 1840 at least, 1860, and with theend of the Civil War, the notion was
A separate institution for African Americans needed to be developed because of theprediction that of the 500,000 African Americans who were subsequently free, a significant
(06:46):
number of those would develop serious problems of mental illness.
That's how we got central.
So yes, it's been a factor throughout our history.
yeah, it sounds like the hospital played like a really big role in discussions about race,healthcare inequality and public policy along the way.
Absolutely.
And you can probably think about, and I did for example, in raising the question of whywas this done in Virginia?
(07:13):
Why wasn't it done in Alabama or North Carolina or South Carolina?
Why did the first mental institution in the U S get started here in Virginia?
Was it related to the fact that Virginians opened the very first institution and thesecond mental hospital or asylum?
Well, it really reflects
a dispute that was being held between the director of Eastern State, the first hospital,and the director of Western State Hospital, Francis, not Francis Jury, but another
(07:45):
physician who believed and wanted to have his hospital at Stanton, Virginia be thehospital that basically only invited whites as staff or as patients.
And because he felt
that if there were black patients or black staff that would influence the willingness ofwealthier whites to come to his hospital, he petitioned state government to identify a
(08:13):
separate place for black patients as opposed to utilizing the two state hospitals thatactually existed.
There were black patients at Eastern State Hospital almost from the beginning, but not atWestern.
And they didn't have black patients at Western until after
teaching in 1970.
So very significant in terms of history.
(08:38):
Absolutely.
So in what ways can sharing the stories of black patients and staff at Central StateHospital contribute to a more complete understanding of the intersection of race and
mental health care in America?
I think initially it did not.
And the reason for that in part is that very little attention was paid to AfricanAmericans at that time period in part because of the presence of what I call the immunity
(09:07):
hypothesis.
The notion that as long as African Americans stayed somewhere in the South, hopefully inbondage, that they would be immune from problems of mental illness.
After the end of slavery,
and after the end certainly of the Civil War, the hypothesis changed.
And the new hypothesis was African Americans couldn't deal with freedom.
(09:30):
So the possibility then existed that thousands and thousands and thousands would in factflood cities with severe problems of mental illness.
So services had to be provided.
And that continued to be the case for almost 100 years.
1868, 1869 to 1964, when the Civil Rights Act of 1964 required a very differentorientation about race and mental illness.
(10:02):
What you probably recall as well is that it wasn't until 2002 was the Surgeon General'sreport written that raised these very significant questions about is there a relationship
between race
and the risk or the probability of mental illness.
So throughout the hundred years, we really didn't have a very good understanding or even avery good approach to looking at the relationship, if any, between race and mental
(10:33):
illness.
sounds difficult, it really is true that that's the way we approached it.
Go ahead, I'm sorry.
You know, no, that's okay.
This has really been a great discussion and I'd love to know if there's anything elseyou'd like our listeners to know about the research you've conducted over the years.
Well, there has been a lot more research and there are a lot more questions being raisedabout the relationship between race and mental illness.
(11:01):
I was in Austin just this past week.
There are more States that are beginning to look at the historical records that they have.
The hog foundation for mental health in Austin, Texas, for example, they've recentlygotten a library grant to engage almost all of the Southern States.
and seeing whether or not there can be a united effort on the part of all of these statesto take a look at their historical records and to preserve them.
(11:32):
There's an archivist at the Hogg Foundation, Elizabeth Stauber.
You might want to interview at some point because she's doing this new project that'staking an effort and making an effort to really integrate the information that we have
about the relationship between race and mental illness.
I think it would be great.
to look even more broadly at how the other states are dealing with the issue that Virginiahas started to deal with now.
(11:58):
Our next effort in Virginia is to take all of the records that we've accumulated, all800,000 of them, and to provide a space where family members, researchers, scholars of
various kinds, administrators from other states as well, can gain insight on
(12:19):
the probability of dealing with these issues that African-Americans have in a much morescientific way than what we've done.
And by that part of what we've learned in our study of the Virginia examples, about 70 %of all the African-Americans that have been in the hospital, and that's close to 54,000
(12:40):
people, all had the exact same diagnosis.
Well, that's almost impossible.
The work that we've done and the work that others have done, Lonnie Snowden, for example,in California, Bill Lawson in Washington, D.C., and many others should help to really
change the approach that we've used, one, to diagnose, and secondly, to treat the personsof color.
(13:07):
Aaron, any more questions or comments you want to raise?
No, doctor, doctor, thank you so much for joining us today.
This has really been a fascinating discussion.
really do appreciate you being here today.
My pleasure.
Thank you very much for calling.
And to our listeners, you can join us for a new episode of Mental Health Pathfinders eachmonth at psychiatry.org slash podcasts, or on your favorite podcasting platform.
(13:35):
Thanks, Aaron.
Hello and welcome to Mental Health Pathfinders.
I'm Erin Connors.
Our guest today, Dr.
King Davis, is a professor emeritus at the School of Information and Liberal Arts, UTAustin, and a former commissioner of behavioral health and developmental services in
Virginia.
He founded the Friends of Central State Hospital, a federally recognized nonprofitorganization to further his work.
(00:28):
Among the crowning achievements of his career as a social worker, researcher, and educatoris his preserving the records and history of Central State Hospital, a psychiatric
hospital in Petersburg, Virginia, that was the first institution in the country dedicatedsolely to the care of black patients.
Dr.
Davis, I look so forward to this conversation today.
(00:50):
Thanks for joining us.
Thank you.
I appreciate the invitation, Aaron.
So let's get right to it.
How did you become aware of Central State Hospital and its unique history?
Well, it'll seem a little strange perhaps to you, but I came to Virginia in 1972 asdirector of community mental health services.
(01:12):
Central was not part of my package.
I was only dealing with the services in the community, but I had an intern the firstsummer that I was at the department that was a student in the university that is in the
same town as Central State and her summer project turned out to be Central State Hospitaland its history.
(01:33):
And that's how I became aware of it many, many years ago.
But that's continued over time because I've spent probably 20, 25 years in Virginia.
And I've had the opportunity to visit Central at different time periods, different staff,different individuals.
So it's worked out very well.
I've just learned a lot about it since 1972.
(01:57):
It sounds like this is really important to preserve the history of Central State Hospital,you know, in the context of racial and mental health justice.
Absolutely.
No question about it.
Central being the first institution of its kind in the United States.
When you go back through the history, you really raise the question of why Virginia, whyCentral State, and what were the factors that combined to make this occur in the
(02:26):
Commonwealth of Virginia?
And I think in part, you have to put it in the context that Virginia was also the statethat opened the first mental institution in the United States in Williamsburg at Eastern
State.
They opened the second in Stanton, Virginia in 1827.
They opened Central State Hospital then in 1868.
(02:49):
So the first three very unique institutions from the mentally ill were established in thestate of Virginia.
And part of the history of looking at Central is to ask the question, why did Virginia dothese things?
And so that has moved my career along.
Yeah, that is fascinating.
Did you run into any challenges during your during your work to research and raiseawareness to the history of Central State Hospital?
(03:16):
Do you have three days for me to talk about that?
I'm teasing, of course.
Well, absolutely.
No, absolutely.
One of the most significant of all of these was that very few people, seemed, in positionsof authority in government appreciated the history of central state.
So that was the first barrier that we had.
(03:39):
The governor that I worked for, individuals in the Department of Behavioral Health, mentalhealth at the time.
They saw no real value in the artifacts or in the memorabilia of any kind at Central thatwas worth pursuing.
And when I first started raising questions about the archives, I was advised that thearchives from Central had no historical value and should in fact be shredded.
(04:08):
So yes, there are many, challenges, financial, programmatically, policy-wise.
the absence of interest in Central overall, there were numerous challenges.
But probably the biggest challenge for us was trying to figure out where we got thedollars to do anything about preserving the records at Central.
(04:28):
And that was the greatest challenge that we had.
sure.
And how did racial segregation impact the care and treatment of black patients at CentralState?
you can almost reverse that there were no areas where it did not significantly influencecentral state and to probably put that in its broadest context, you really have to go to
(04:52):
the 1840 census of population for the United States.
That was the first census that identified as much as they could.
Inaccurately, however, the extent of mental illness in various states and cities and byrace.
across the United States.
And what it identified and proposed in the census material was that African Americans whowere in northern states who had migrated from the south and from slavery to the north had
(05:26):
mental illness rates that were going to be 10 times greater than the persons who wereenslaved and remained in the south.
So that started a variety of questions and research hypotheses.
In fact, trying to explain the condition or the value or the import of race in predictingor even in considering diagnosis of persons by race.
(05:55):
And the notion was at least initially, as long as African-Americans stayed in the SouthernStates and enslaved, they were basically immune.
from the problems of mental illness.
When they went further north, if they escaped slavery, if they became free, the notion wasthat a humongous amount, large numbers of African-Americans would in fact develop very
(06:19):
severe mental illnesses.
So yes, it's been a factor throughout our history, from 1840 at least, 1860, and with theend of the Civil War, the notion was
A separate institution for African Americans needed to be developed because of theprediction that of the 500,000 African Americans who were subsequently free, a significant
(06:46):
number of those would develop serious problems of mental illness.
That's how we got central.
So yes, it's been a factor throughout our history.
yeah, it sounds like the hospital played like a really big role in discussions about race,healthcare inequality and public policy along the way.
Absolutely.
And you can probably think about, and I did for example, in raising the question of whywas this done in Virginia?
(07:13):
Why wasn't it done in Alabama or North Carolina or South Carolina?
Why did the first mental institution in the U S get started here in Virginia?
Was it related to the fact that Virginians opened the very first institution and thesecond mental hospital or asylum?
Well, it really reflects
a dispute that was being held between the director of Eastern State, the first hospital,and the director of Western State Hospital, Francis, not Francis Jury, but another
(07:45):
physician who believed and wanted to have his hospital at Stanton, Virginia be thehospital that basically only invited whites as staff or as patients.
And because he felt
that if there were black patients or black staff that would influence the willingness ofwealthier whites to come to his hospital, he petitioned state government to identify a
(08:13):
separate place for black patients as opposed to utilizing the two state hospitals thatactually existed.
There were black patients at Eastern State Hospital almost from the beginning, but not atWestern.
And they didn't have black patients at Western until after
teaching in 1970.
So very significant in terms of history.
(08:38):
Absolutely.
So in what ways can sharing the stories of black patients and staff at Central StateHospital contribute to a more complete understanding of the intersection of race and
mental health care in America?
I think initially it did not.
And the reason for that in part is that very little attention was paid to AfricanAmericans at that time period in part because of the presence of what I call the immunity
(09:07):
hypothesis.
The notion that as long as African Americans stayed somewhere in the South, hopefully inbondage, that they would be immune from problems of mental illness.
After the end of slavery,
and after the end certainly of the Civil War, the hypothesis changed.
And the new hypothesis was African Americans couldn't deal with freedom.
(09:30):
So the possibility then existed that thousands and thousands and thousands would in factflood cities with severe problems of mental illness.
So services had to be provided.
And that continued to be the case for almost 100 years.
1868, 1869 to 1964, when the Civil Rights Act of 1964 required a very differentorientation about race and mental illness.
(10:02):
What you probably recall as well is that it wasn't until 2002 was the Surgeon General'sreport written that raised these very significant questions about is there a relationship
between race
and the risk or the probability of mental illness.
So throughout the hundred years, we really didn't have a very good understanding or even avery good approach to looking at the relationship, if any, between race and mental
(10:33):
illness.
sounds difficult, it really is true that that's the way we approached it.
Go ahead, I'm sorry.
You know, no, that's okay.
This has really been a great discussion and I'd love to know if there's anything elseyou'd like our listeners to know about the research you've conducted over the years.
Well, there has been a lot more research and there are a lot more questions being raisedabout the relationship between race and mental illness.
(11:01):
I was in Austin just this past week.
There are more States that are beginning to look at the historical records that they have.
The hog foundation for mental health in Austin, Texas, for example, they've recentlygotten a library grant to engage almost all of the Southern States.
and seeing whether or not there can be a united effort on the part of all of these statesto take a look at their historical records and to preserve them.
(11:32):
There's an archivist at the Hogg Foundation, Elizabeth Stauber.
You might want to interview at some point because she's doing this new project that'staking an effort and making an effort to really integrate the information that we have
about the relationship between race and mental illness.
I think it would be great.
to look even more broadly at how the other states are dealing with the issue that Virginiahas started to deal with now.
(11:58):
Our next effort in Virginia is to take all of the records that we've accumulated, all800,000 of them, and to provide a space where family members, researchers, scholars of
various kinds, administrators from other states as well, can gain insight on
(12:19):
the probability of dealing with these issues that African-Americans have in a much morescientific way than what we've done.
And by that part of what we've learned in our study of the Virginia examples, about 70 %of all the African-Americans that have been in the hospital, and that's close to 54,000
(12:40):
people, all had the exact same diagnosis.
Well, that's almost impossible.
The work that we've done and the work that others have done, Lonnie Snowden, for example,in California, Bill Lawson in Washington, D.C., and many others should help to really
change the approach that we've used, one, to diagnose, and secondly, to treat the personsof color.
(13:07):
Aaron, any more questions or comments you want to raise?
No, doctor, doctor, thank you so much for joining us today.
This has really been a fascinating discussion.
really do appreciate you being here today.
My pleasure.
Thank you very much for calling.
And to our listeners, you can join us for a new episode of Mental Health Pathfinders eachmonth at psychiatry.org slash podcasts, or on your favorite podcasting platform.
(13:35):
Thanks, Aaron.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!