Ep. 43: History of Napa State Hospital, Part 1 (1872-1901)

Episode 43 covers the first three decades of "The Castle" at Napa Insane Asylum in Napa, California. Find out why tourists were drawn to the asylum and what they did while they were there. Learn what my connection is to Napa State Hospital and the rigorous process it took to get me there.

My primary source for this episode is Images of America: Napa State Hospital, by Patricia Prestinary. All other sources will be listed in the episode transcript.

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Transcript

Hello, hello, hello, and welcome back to Behind the Walls of the World’s Psychiatric Hospitals! I’m your host, Dr. Sarah Gallup, and after about two months of covering hospitals in Australia, we are back in the U.S. – and not only are we back in the U.S., but we’re back at a hospital that I am familiar with. So that should be extra fun. I want to give a little background information on how I arrived at this hospital, so bear with me…

If you know someone who has studied to become a doctor – a medical doctor or a psychologist like me – then you know that after their studies they go on residency or internship. And the process of getting that residency is complicated and very stressful. You don’t just apply and the program accepts you or doesn’t accept you like you would any other job. You apply to multiple sites, interview at sites that offer you an interview, and then the applicant ranks each site in order of preference and the sites rank each applicant in order of their preference. It goes through some sort of algorithm and matches applicants to a site, and you go to that site. So even though, say, you’re just dying to go to such-and-such site, you may end up getting placed somewhere else. And there’s always the chance that you may not match anywhere, which is an additional stressor. 

Going through the match process was easily the most stressful academic event of my life. One of the most challenging parts for me is that I’m from Oregon and I never intended to leave Oregon. But all of the sites were out-of-state. So an additional stressor was choosing a place where I would be happy to live for at least a year. In the span of about three weeks, I interviewed at eight state hospitals and prisons around the U.S. I tried to spend an extra day or so at each location, just to get a feel for the place, in case I ended up moving there. But I was constantly getting on an airplane, constantly packing my suitcase again, and constantly navigating the rental car situation in a new place. It was kinda fun but also very exhausting for an introvert like me. I ended up traveling to Utah; Missouri; Minnesota; California three times; and Washington, D.C. 

By the end of the three weeks, I was worn down, exhausted, and getting sick. I had one more interview to do, this time in Napa. I had actually visited Napa Valley the week before after interviewing at the prison in Vacaville and had been able to do some wine tasting in the area. Because I was so sick and had already done the tourist thing in Napa, I was really close to cancelling that final interview. It wasn’t my top site, and I was too tired to keep going. But I decided to make it a quick overnight trip, and I went anyway.

I wish I could have recorded my interview that day. I was sniffling, coughing, and I had no filter to my responses to the interview questions. But who cared? I just wanted to get home. After the interview, I giggled to myself that those poor interviewers just got the most raw and unedited version of myself. Usually, internship applicants are polished and nervous, but I must have exuded a sort of unencumbered sort of confidence that day.

Perhaps the worst part of the match process is that you have to wait two agonizing weeks after submitting your ranks before you find out which site you matched with. And the email about (a) whether or not you matched at all and (b) if so, which site you matched with arrives at 4:30 in the morning. 

My cohort of 24 people had a pre-match party, where we all got together at someone’s house and brought food, sang karaoke, played silly games, and tried to get out all of our anxious jitters. I doubt any of us got any decent sleep that night.

My body practically forced itself awake at 4:30 on the dot. I opened The Email that would decide my future for the next year. “Congratulations,” it said. “You matched.” And I just paused on that sentence, whispered “thank you,” and basked in the knowledge that whatever followed would be okay because the hard part was over. I scrolled down. “Napa State Hospital??” I grumbled at the screen. That wasn’t even in my top three! And I had that terrible interview! I called my parents to let them know (yes, they were anticipating my call that early in the morning), but I still felt disappointed.

The disappointment faded as I started to think more about the aspects of the site that I liked and, of course, the incredible location. I would be living in Napa, California, for a year! Pretty soon, I got more and more excited to go. 

By the time that I arrived in Napa in August 2019, I had practically forgotten about my other sites. I had also gotten a weekend job at a local winery, so I could actually be part of the wine industry in Napa Valley. Long story short: my year of training at Napa State Hospital was amazing, even though the COVID-19 pandemic interrupted my internship halfway through. I loved the area, loved the Napa community, and loved working at the hospital. I was sad to leave after my training year, but I’m still so thankful I got to be there.

So that’s some of my own history about how I ended up at this site. Now, onto the history. Throughout this episode I borrow pretty heavily from the Images of America book on Napa State Hospital, written by Patricia Prestinary.

So, come on in, get comfortable, and grab a glass of your finest Cabernet, as we go behind the walls of Napa State Hospital…

Today when most people think of Napa, they think of the world-class Bordeaux blends that are made there. When people mention “the Castle” today, most people think of the Castello di Amoroso winery in Calistoga on the north end of the Valley. But before Napa was known for its wine, it was known for its asylum, called “the Castle.”

To put this in an historical context, the first wine grapes were planted in Napa in 1839 by George Calvert Yount (“History of Wine”). Over 20 years later, in 1861, Charles Krug established the first commercial winery, which still bears his name.

Around this time, on the East Coast of the United States, asylums were being built to relieve local jails from housing the mentally ill. In California, the Gold Rush boomed in 1849, and people flooded out west. As we learned in the series on Aradale and the Victorian gold rush, the sudden influx of immigrants and the insatiable quest for gold brought out madness in many people. Since the west coast was slow to catch up to the east coast, the mentally ill were being warehoused in a ship anchored in San Francisco Bay off San Quentin Point (Prestinary 11). Not ideal conditions, by any means, and then there was only so much space to hold people.

Talk soon began about building an asylum. Several possible locations were discussed: Benicia, Martinez, and Stockton (Gilbert). If you’re unfamiliar with California geography, all three of these cities are NE of the San Francisco Bay area, with Stockton being the farthest east.

 Stockton was eventually selected as the new site and by 1853, the Stockton Insane Asylum was constructed. Not only was it the first asylum in California, it was the first asylum west of the Mississippi River (Gilbert). Detainees from the ship in San Quentin Bay were transferred to Stockton, but before long, it too became overcrowded.

It was clear that another asylum would need to be built in northern California to accommodate the growing number of “insane inmates.” In her book on Napa State Hospital, librarian Patricia Prestinary writes: 

Using Stockton as a basis for comparison, Dr. Edmund T. Wilkins visited 149 institutions as part of a six-month survey of U.S. and European facilities and treatments. He had been commissioned by Gov. Raymond Haight to develop a plan and find a site for a new facility…He chose the Kirkbride Plan and selected Napa because there were over 100 acres of arable land, in the country and yet close to a town, with a water supply and nearby wharf. (11)

In previous episodes, we’ve discussed the importance of the environment surrounding the hospital in order to maximize the therapeutic benefits of an asylum. This was one of the primary tenets of Thomas Kirkbride’s vision for asylums, as well as an important aspect of moral therapy. The land around the asylum must be aesthetically pleasing, preferably on a hill, with trees and lush gardens for patients and staff alike to enjoy.

The land for the new asylum was purchased on August 2, 1872, and was originally part of Rancho Tulocay. It offered 209 acres of space and was purchased for $11,506 (Prestinary 9). A board of directors was formed in the following month in September 1872 to discuss the potential design of the new asylum, given their budget of $600,000. Now, amazingly compared to today, they quickly settled on a design and construction began in October 1872. I cannot imagine that happening today (for better and for worse): property purchased in August and construction beginning in October (Prestinary 9). 

But, just like today, construction was tedious and slow and stopped several times due to lack of funds and arguments with the state legislature in Sacramento. The main battle focused on the extravagance of the building and its cost. What was originally slated to have a $600,000 dollar budget ended up costing the state $1.75 million dollars (Prestinary 9). Oddly enough, the building they ended up with, called “The Castle,” was touted as the “finest building in the State” (qtd. in Prestinary 9) – nice enough to house millionaires but intended for the indigent and insane (Prestinary 21).

The Castle was built using stones quarried from the property – about 10 million bricks were used in its construction (Prestinary 20). It was a massive structure, built in the Romantic Gothic style, a mile in circumference, and 3-5 storeys high, with seven fireproof towers (16-17). On the 175-foot central tower was embedded a $16,000 clock (20). On each main entryway were four statues that represented the four basic cardinal virtues of ancient Greek philosophy: fortitude, justice, prudence, and temperance (21). The forward-facing entry central arch read, “Faith, hope, and charity divine be thine beyond compare.” The left arch read, “In Temperance learn thou to live.” And the right arch read, “Let Prudence still thy footstep guide with Justice steadfast by her side.” (21)

As with other Kirkbride hospitals, there was a large central administration building that housed visiting rooms, officers’ quarters, and residential apartments for the director and assistant physician. It also included a chapel and a library, main kitchen, bakery, laundry, and boiler room (Prestinary 19).

Like other Kirkbride buildings, there were two identical, “L”-shaped wings on either side of the central administration building – one for men and one for women. They had single sleeping rooms, a dining room, and a central “living room” with a glass-enclosed fireplace to make it feel more homey (Prestinary 19). Both the men’s side of the hospital and the women’s side of the hospital had large courtyards where they could exercise and get fresh air.

The driving mission of the asylum was ambitious. It hoped to “cure mental illness and prepare patients for the rigors of daily life” (Prestinary 11). Remember that at this point of the 19th century, the medical field was overly optimistic about its ability to manage mental illness. It was something they believed could be cured with the right treatment and atmosphere and, to a certain extent, at least, that can help, although it cannot entirely cure someone of their disorder.

The first superintendent of Napa Insane Asylum was Dr. Edwin Bentley of San Francisco. He was appointed on October 18, 1874, a little over a year before patients would arrive there. He would end up staying until after the Stockton patients transferred. His successor, Dr. E.T. Wilkins, arrived in March 1876. Dr. Wilkins was one of two physicians to consult with the board of directors prior to the construction of the Castle, so he had been familiar with the project since its beginning (Prestinary 9). Dr. Wilkins would end up serving as superintendent for 15 years until 1891 (12). He was a widely-respected administrator and physician (9) and was instrumental for establishing a system of lakes and reservoirs for adequate water supply, development of farmland, encouraging positive community relationships, and beautifying the grounds (12).

The first inmate arrived at Napa Insane Asylum on Monday, November 15, 1875. All we know about this person is that they were an alcoholic from San Francisco (Prestinary 11). In fact, many of the first inmates at Napa struggled with alcoholism or were otherwise unhoused. In January 1876, about 60 patients were transferred from the Stockton Insane Asylum to Napa in order to alleviate some of their overcrowding. The Castle in Napa was built to accommodate 640 inmates as they were known (Prestinary 17), although they would quickly exceed their capacity.

Only a few years later, in 1880, the number of patients housed at the asylum had grown so significantly that Dr. Wilkins requested funds from the state to convert the attic areas into patient wards (Prestinary 24). You know there’s a problem when you outgrow your facilities only five years after opening. And, of course, the problem would only continue to escalate. By 1891, 16 years after opening, the patient population was 1,373 – over double the original maximum capacity (24). 

Many of the patients during this time were admitted from nearby San Francisco County, but in total, 26 California counties had transferred inmates to the Napa Asylum. Common reasons for admission included business troubles, childbirth, use of opium, typhoid fever, sunstroke, spiritualism, paralysis, overwork, jealousy, heredity, grief, epilepsy, domestic trouble, disappointment in love, loss in mining stocks, masturbation, sensational reading, syphilis, and excessive study (Prestinary 31). Now, obviously, this is a problematic list. Some of these so-called reasons for admission are quite normal stressors or medical conditions that many of us have experienced. I got to turn my excessive study habit into a doctoral degree, whereas 150 years ago, I may have been institutionalized for it. It’s an interesting thought.

Now, during this time, there was a lot that the asylum was doing well: they had a number of recreational and vocational opportunities that patients could participate in to help manage their symptoms and work toward recovery. There was a farm and vegetable garden where patients worked and cultivated produce and dairy products. According to Patricia Prestinary:

By 1883, patient labor produced 116,000 pounds of cabbage, 25,000 gallons of milk, 17,000 pounds of port, 7,000 pounds of potatoes, 1, 670 pounds of horseradish, 12,000 pounds of lettuce, 20,000 pounds of grapes, 33,000 pounds of turnips, and 18,000 pounds of beets. Surplus fruit and vegetables were canned on-site and sent out to other state hospitals. (34)

As I’ve mentioned in previous episodes when we’ve discussed patient labor, all this work was done under the auspice of “treatment,” so patients were not compensated for their work.

Sometimes patients took it upon themselves to come up with ways to occupy their time. One patient, John Donovan, wrote and printed a hospital newsletter called the Asylum Appeal. It included poetry, letters from patients to the editor, articles of the goings-on of the asylum, various observances and jokes, weather reports, and local advertisements. It was said to provide “more reading matter for the patients than ever before known” (qtd. In Prestinary 30). I’m not entirely sure, but it sounds like they didn’t have other reading material available at the hospital before this newsletter. If that’s the case, then John Donovan did a favor for his peers. But, as Patricia Prestinary points out, John Donovan reportedly disappeared into the hills for a few months before returning to the asylum (30). I would be curious to know more about that little adventure…

One of Dr. Wilkins’ contributions to the property around the asylum was the introduction of a system of reservoirs. These lakes were used as irrigation for the farm, watering livestock, and for their natural aesthetics (Prestinary 14) – they were quite beautiful, especially with the backdrop of the castle behind them.

The first lake was called Lake Camilla, named for Dr. Wilkins’ wife. Next came Lake Louise and Lake Como (Prestinary 14-15). Lake Camille is still part of Skyline Park, adjacent to the current state hospital site today. There are a couple of smaller reservoirs on the far side of the hospital property today, but they’re more like catchments.

I want to go back to the aesthetic beauty of the lakes and the property surrounding the hospital. Around the turn of the century, the asylum became a tourist attraction site. Visitors came from all over to see the magnificent castle and the lush, landscaped grounds. People would come and have picnics next to the lake. Patients who were working on the farm or in the gardens would come out and greet visitors (Prestinary 43). For a while, there was even a gift shop on site, where they sold postcards and engraved spoons – and all proceeds went toward hospital maintenance (65). Clearly, they also sold other goods at these shops, since the sign out front reads, “Candy, fruit, cigars, & tobacco.” It’s really strange and sad to think of how often people would come to asylums out of amusement and curiosity, like going to the zoo. Imagine being that person who got sunstroke or was disappointed in love and institutionalized. Then suddenly people are looking at you like a freak show at the circus. It would be awful.

Early on, around 1890, you may be wondering how people got to the asylum. Well, there would be quite a trek. Visitors would often travel by ferry and then walk or ride a horse or take a wagon three miles north to reach the asylum (Prestinary 23). And if they had their picnic basket in tow, they would have their hands full. Still, this didn’t seem to deter visitors.

By 1891, as I mentioned earlier, the asylum had reached 1,373 patients – over twice the original maximum capacity (Prestinary 24). Dr. A.M Gardner replaced Dr. Wilkins as superintendent of the asylum. His tenure was marked by growth and expansion. By 1898, several large cottages were constructed along Magnolia Drive, the entrance to the asylum. The intent was to build these residences outside the asylum itself and convert the original staff residences into patient wards to accommodate the overcrowding.  

An architect from Napa, Luther Turton, designed the 18-room Queen Anne residence that would become the superintendent’s living quarters (Prestinary 38). Each superintendent lived in that residence until 1920. Afterward, it became a residence for professional staff. The large residences are still on the property today – they were used for various departments until a 6.0 earthquake in 2017 caused significant damage. It was still roped off when I was there in 2019, but by 2020, renovations had started on the old buildings again.

Staffing at the asylum was a challenge. Patricia Prestinary points out that “The staff was composed of 88 employees, including one resident physician, two assistant physicians, one secretary, one steward, one male and one female supervisor, one matron, one dispenser, four cooks,…one laundryman, three laundresses, one needlewoman, and 40 male and 30 female attendants” (24). This information absolutely boggles my mind. Even if we very conservatively estimated the number of patients to be 640 (the original max capacity), that would be one staff member for every 7 patients, and not all of those staff members that I just listed would have direct contact with patients every day. And if we looked at that population number from 1891 of 1,373, that would be one staff member for every 15-16 patients. 

So, just to give a perspective of the difference today, the state hospitals where I’ve worked operate with an approximate ratio of about 1.5 to 2 staff members per 1 patient. Now, again, not everyone has direct contact with patients – most of those staff members are administration and support, but they are also essential to having the hospital run effectively.

But the point is that I don’t know how these old asylums even survived day to day. When I think about the vast number of patients, as well as the range of reasons that brought them to the asylum (some psychiatric, some medical, some…nonsense), the limited staffing, and no psychiatric medications yet, I am simultaneously impressed and horrified. It’s no wonder there was rampant neglect and abuse at these facilities. I don’t doubt that many staff members wanted to give good patient care, but I can’t imagine the circumstances allowed them to be as effective as they wanted to be. 

But I digress…I found it interesting that the Napa State Hospital book examined the reasons why people were drawn to this job. And that was something I hadn’t yet considered over the course of this podcast. If you think about it, these asylums were relatively new and treating mental illness was still relatively new. There was so much that was unknown and probably frightening, so what types of people ended up working there? Patricia Prestinary says:

Women who were drawn to asylum work were usually young, single, or widowed and “thrown upon their own resources.” Asylum work offered an opportunity for women with limited education, knowledge of “domestic concerns,” and a positive disposition. Young men who were not interested in farming or manual labor were also drawn to the relative security of working in an asylum. (25)

We don’t usually think of working with the severely mentally ill as a “relatively secure” job, but perhaps contrasted with the back-breaking work of farming and manual labor, I can sorta see that.

Staff generally lived on the same units as their patients, usually two to a room (Prestinary 25), and to that I say a very firm, “No, thank you.” Not only do I want some space away from work to clear my mind, but I also dislike the thought of being woken up at night by someone’s screaming or a fight down the hall. Or, maybe even worst of all, waking up on the weekend and hoping to lounge around in my bathrobe for a bit, only to have a patient knock-knock-knock on my door, “Dr. Gallup! Can I get some towels, please?” No, thank you.

The hours that ward attendants worked by the turn of the century were – how shall I say? – completely absurd. The original working day started at 6:00 AM and ended at 9:00 PM, with a half day off each week and one full day off per month (Prestinary 26). That’s a 15-hour day, each day, with a half day off per week. That’s about a 98 hour work week. Again I say, no, thank you.

And what did attendants earn for their 98 hour work week? Men earned $30 per month for the first six months, $35 for the following year, and $40 until promoted. Women, of course, earned less for the same work: $25 per month for the first six months, $30 the following year, and then $35 until promoted (Prestinary 26). So, for just under $400 per year (if you were a man), you too could have had the joy of living in a castle and being chronically overworked. I wonder how long it took before someone said, “We really need to start a union. This is madness.”

Somewhere along the way, while the asylum was growing and developing, it earned itself a nickname: Imola. There are a couple theories about how this informal name began. Some people say it comes from an indigenous word. The more popular theory is that a local, Italian postal clerk said it reminded him of Imola, Italy, which also had an asylum (Prestinary 122). For years, Napa Insane Asylum was informally known as Imola Asylum. Even today, you can tell a true Napa local because they sometimes refer to it as Imola State Hospital. The name has stuck permanently as the name of one of the major crossroads near the hospital.

And that’s where I’m going to start Part 1 of this series on Napa State Hospital. I’ll be off this upcoming week and back in two weeks to tell you more about the infamous Castle and what has happened in the years since.

As always, thank you so much for listening! If you’re tuning in for the first time, welcome! Please rate and review the show wherever you are listening, but especially if you’re listening on Apple Podcasts. If you’d like to support the show, you can check out my Beacons page: beacons.ai/behindthewallspodcast.

Be sure to join the Facebook group page (Behind the Walls Podcast) or follow me on Instagram at behindthewallspod.

But, most importantly, remember the words of Maya Angelou: “Do the best you can until you know better. Then, when you know better, do better.” Until next time… 

Gilbert, Lori. “Hospital Legacy Shrouded in Mystery, Controversy.” Record Net, 26 Oct. 2010. https://www.recordnet.com/story/lifestyle/columns/2010/10/26/hospital-legacy-shrouded-in-mystery/51425784007/

“History of Wine in the Napa Valley.” Napa Vintners. https://napavintners.com/napa_valley/history.asp#:~:text=Wild%20grapes%20certainly%20grew%20in,Napa%20Valley%20grapes%20in%201839

Prestinary, Patricia. Napa State Hospital. Charleston, SC: Arcadia Publishing, 2014.