Fulton State Hospital was not only Missouri"s first state mental asylum but also the first such institution west of the Mississippi. In tracing its founding and evolution over a century and a half, this book sheds light on both a neglected aspect of the state"s history and the development of mental health care in America. It acknowledges the noble aspirations of Fulton State Hospital - as well as its failures, throughout much of its existence, to transform those aspirations into realities. This institutional history of the hospital traces the debates surrounding its creation (as the State Lunatic Asylum) in a time when mental illness was barely understood. Although the Fulton hospital was initially conceived as a treatment facility, it quickly transformed into a primarily custodial institution. It existed as a self-sufficient establishment until the mid-twentieth century, dependent on patient labor and even producing its own food. But for the most socially disadvantaged and for the...