Constant Struggle For Space Eastern State Hospital Began Suffering From A Space Shortage Almost As Soon As It Was Opened In 1891. Since Then, Schools Of Thought And Methods Of Treatment Have Come And Gone, But Overcrowding Has Remained.

Overcrowding at Eastern State Hospital is as old as the hospital itself. In 1891, the year it opened, more patients than expected were sent from Western State Hospital in Steilacoom. The first two-year budget was immediately in the red.

Eastern, perched on a pine-flecked hill above Medical Lake, was then called an asylum. Causes of mental illness were believed to be “age, tobacco, constipation, whiskey and morphia,” according to hospital records. Treatment meant iron shackles and leather restraints.

By 1954, 2,274 patients lived in a space built for 1,500. Many lived their entire adult lives in the institution.

The invention of anti-psychotic drugs in the 1950s and the deinstitutionalization movement in the 1960s prompted downsizing. The patient population shrank to 1,109 in 1965, to 410 in 1976, and to 302 today.

This brief history of Eastern is based on records from the hospital, the Spokane Public Library, the state archives at Eastern Washington University and The SpokesmanReview. Costs of care are adjusted to year 2000 dollars:

1888

Sen. Stanley Hallet of Medical Lake sponsors a bill to create Eastern Washington Hospital for the Insane on an 833-acre parcel west of town. The hospital opens three years later with 122 patients. Cost of care: $12.40 a day.

1894

The hospital struggles with a $30,000 deficit on a two-year, $105,000 budget. A new wing opens to ease overcrowding.

1901

56 staffers treat 300 patients. More than half the patients work the hospital’s 400 acres of farmland, with 61 cows, 500 pigs and 1,000 hens.

1921

1,200 patients warehoused by 100 staffers and two doctors. Rest and restraint are primary methods of treatment.

1935

The eight-hour day and 48-hour workweek are instituted, but staffers continue working 12-hour days. More than 1,600 patients are held. Cost of care: $7.50 a day.

1941

80 percent of patients work oncampus to support the war effort. Moral and religious counseling is used to treat “demented” patients.

1944

165 staffers treat 2,000 patients. Electroshock therapy begins; by the early 1950s, half of the patients would get the treatments. Cost of care: $15.34 a day.

1948

2,100 patients live in wards built for 1,500; on the criminal ward, 80 men share one bathroom. A report to the Legislature recommends increasing bed capacity to 2,500.

1951

Lobotomies, which began decades earlier, are discontinued.

1954

Patient census peaks at 2,274 just as anti-psychotic medications emerge. Large numbers of patients begin to be discharged for the first time. Concerns about community safety rise.

1957

Maximum security building for the criminally insane opens; a six-year string of escapes from the building begins. Fifteen patients hold 36 guards hostage in October to demand more treatment. Superintendent complains funding is sufficient only “to lock up patients and forget them.”

1960

$10,000 worth of wrist, waist and leg restraints are removed from service.

1962

Community fears peak over escapes from criminal wards; 129 have escaped between 1958 and 1962. The Legislature orders a study.

1963

Maximum security building is closed. Treatment at clinics in Spokane opens. Stays in the hospital average 2.3 months, but one-fourth stay 20 years or more. Patient census falls to 1,300. Cost of care: $79 a day.

1973

Modern civil commitment laws passed, requiring court orders to involuntary hospitalize patients. Census is 450, with 460 staffers.

1987

Two patients hang themselves within seven months on understaffed criminal ward. The first part of a five-phase project begins to modernize wards.

1988

Staffing shortages are acute, forcing the hospital to temporarily withdraw its application for federal funding. Union goes to court to force more staffing on criminal wards.

1990

Legislature funds new system of outpatient treatment to keep patients out of hospital. Cost of care: $294.11 a day.

1995

30-patient ward is closed by budget cuts; hospital census is 302, the smallest since 1901.

1996

The federal Health Care Financing Administration threatens to pull $17 million unless patient therapy and medical care is improved.

Superintendent resigns in July under fire for misuse of state property.

1999

Hospital declares in September that an overcrowding crisis may again endanger federal funds. Voluntary admissions are banned.

2000

Continuing overcrowding prompts further restrictions on admissions. Census is 302, pending opening of enlarged criminal ward. Cost of care: $355 a day.