Editing Bolivar State Hospital

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| alt =  
 
| alt =  
 
| caption =  
 
| caption =  
| established = 1885
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| established =
| construction_began =  
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| construction_began = 1885
 
| construction_ended =
 
| construction_ended =
| opened = 1889
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| opened =  
 
| closed =
 
| closed =
 
| demolished =
 
| demolished =
 
| current_status = [[Active Institution|Active]]
 
| current_status = [[Active Institution|Active]]
 
| building_style = [[Kirkbride Planned Institutions|Kirkbride Plan]]
 
| building_style = [[Kirkbride Planned Institutions|Kirkbride Plan]]
| architect(s) = Harry P. MacDonald/Adolphus Heiman
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| architect(s) =
| location = Bolivar, TN
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| location =  
| architecture_style = Gothic Revival
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| architecture_style =  
 
| peak_patient_population = 2,300 in 1961
 
| peak_patient_population = 2,300 in 1961
 
| alternate_names =<br>
 
| alternate_names =<br>
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==History==
 
==History==
Opened to receive patients on November 22, 1889, the then denoted "West Tennessee Hospital for the Insane" was designed by architect Harry P. MacDonald of Louisville, Kentucky, and Memphis, Tennessee. The MacDonald firm was responsible for many fine, large public buildings in the South, such as the Sevier County Courthouse in Sevierville, Tennessee
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Western State Mental Hospital, located near Bolivar, was the last state mental hospital to be constructed and habitually the one least funded. In December 1885 the site commissioners chose the farm of Paul T. Jones as the location for the proposed facility.
(1896). The institution was intended not only to meet the mental health needs of the Western Section of the State, but also to complete Tennessee's first efforts at implementing a social policy initiated before the Civil War. Tennessee initiated its public policy regarding the institutionalization of the mentally-ill in the 1840s. The "lunatic asylum" in Nashville soon proved inadequate and architect Adolphus Heiman produced a Gothic Revival design following the advice of Thomas S. Kirkbride.  
 
  
By 1892, 319 patients were living in the mental hospital. Entertainment, work, diet, and discipline were still considered the main types of therapy. In 1900 the hospital was overcrowded with 594 patients. It was continually being modernized and around 1910 a new wing was built. When weather allowed, the unfinished wing was used as sleeping quarters for several patients. Other additions to the facility were constructed in the 1920s. These included a tubercular hospital or ward and a congregate dining room. In 1927 the two story brick Doctors' Apartment Building was constructed, while an adjacent frame cottage was built by the family of a former patient. These structures emphasize the growth of professional medical staff as well as changes in therapies in treating the mentally ill.
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The institution's patient population grew from a few hundred in the 1890s to over 2,000 in the 1960s as patients remained hospitalized for decades. Many were crowded into large dormitories and had little privacy. With a limited number of doctors and attendants and a large patient population, many were simply "warehoused."
  
Therapy in the 1920s and 1930s "tended to be highly eclectic." This was true at Western as well, under the administration of Dr. Edwin W. Cocke. "He was author of the 1919 Tennessee State Law which dealt with the legal aspects of psychiatric patients' treatment, and he was co-producer of the first diathermy to produce artificial fever in the treatment of syphilis of the brain and allied diseases." These new treatments included fever therapy, prefrontal lobotomy, metrazol and insulin shock, while occupational therapy was also still relied upon. Dr.Cocke was likewise a pioneer in the use of the then novel insulin shock therapy devised by Viennese physician Manfred Sakel. Sakel had observed mental changes in diabetic drug addicts who were treated with insulin. "The injection of a sufficiently large dose of insulin drastically lowered the sugar content of the blood and ... induced a hypoglycemic state. In this state of 'shock,' the patient went into a deep coma which could be relieved by. ..sugar. After the process was over the patient's mental condition appeared to improve." Dr. Sakel's visits to the United States in the 1930s helped popularize this therapy, although it was abandoned by most American mental institutions in the 1950s. Along with insulin shock therapy, metrazol therapy swept across the country from 1937 to 1940.
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Patients at Western received the treatments available in their period of institutionalization. These treatments ranged from hydrotherapy and insulin shock therapy to lobotomies and electric shock therapy. With the severe staff limitations, however, patients were fortunate to receive ten minutes per week with a psychiatrist.
 
 
The institution's patient population grew from a few hundred in the 1890s to over 2,000 in the 1960s as patients remained hospitalized for decades. Many were crowded into large dormitories and had little privacy. With a limited number of doctors and attendants and a large patient population, many were simply "warehoused." Patients at Western received the treatments available in their period of institutionalization. These treatments ranged from hydrotherapy and insulin shock therapy to lobotomies and electric shock therapy. With the severe staff limitations, however, patients were fortunate to receive ten minutes per week with a psychiatrist.
 
  
 
The system for securing financing for patient care limited the operating budget. In Tennessee, there were three classes of patients: the state-pay patients, the county-pay patients, and the private-pay patients. State agencies agreed to pay for one patient out of a population of one thousand. Once this portion of the payment had been satisfied, the county was responsible for additional costs. The county payments consistently lagged behind, and superintendents had to engage in deficit spending to keep the hospital operating. The two most influential superintendents, Dr. Edwin Cocke and Dr. Edwin Levy, often faced political pressure from state officials, but both managed to make some improvements in the care offered at Western.
 
The system for securing financing for patient care limited the operating budget. In Tennessee, there were three classes of patients: the state-pay patients, the county-pay patients, and the private-pay patients. State agencies agreed to pay for one patient out of a population of one thousand. Once this portion of the payment had been satisfied, the county was responsible for additional costs. The county payments consistently lagged behind, and superintendents had to engage in deficit spending to keep the hospital operating. The two most influential superintendents, Dr. Edwin Cocke and Dr. Edwin Levy, often faced political pressure from state officials, but both managed to make some improvements in the care offered at Western.

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