By Wade H. Dorsey, Supervisor, Reference Services

The South Carolina State Hospital, now the Department of Mental Health, was born as the state Lunatic Asylum and created by an act of the General Assembly in 1821.  It took many years of struggle before the doors actually opened and the first patient arrived in December 1828.  Prior to this time, the insane of the state were generally cared for at home or might find themselves in a district jail or poorhouse.  Needless to say, treatment was not a part of that system.  The Asylum was conceived as a place of refuge and treatment for the mentally ill. While it did not always live up to its founders’ hopes, it was the state’s first foray into charitable institutions. 

Most of the older records of the Department of Mental Health were transferred to the Archives in the 1980’s where many are available for use and research.  It is important to note that state law seals mental health records for seventy-five years.  It should be pointed out that there are no compiled patient files, but records of individuals may be scattered through five or six record series.  Each type of record would need to be researched separately to try to obtain all the entries for a particular patient. Many of these records are not indexed and require careful reading to find an individual.  They can be a rich source of information for historians, medical researchers, and genealogists.  I hope to offer some tips to assist the researcher trying to navigate these useful, but sometimes daunting, records. 

The records of the State Hospital from 1828 through Reconstruction are challenging to use.  Many are arranged somewhat haphazardly and others only by date.  Few are indexed.  The key to finding a patient is the date that the person entered the Asylum.  If you are searching for a person in this period, the SOUTH CAROLINA MAGAZINE OF ANCESTRAL RESEARCH contains a real treasure.  In Volumes XXVII-XXXIII one may find abstracts of the Admissions Books (S190025) from 1828-75.  These admissions books will give the date of admission, the district/county of residence, age, description of malady, and in many cases cures, removals, or deaths.  After determining the date of admission, one can move on to the Patient Treatment Records, 1828-80 (S190019).  This consists of four volumes.  The first two are arranged by a rough chronology and may take a bit of page-turning to find a patient.  Volumes three and four are arranged by admission date.  These records will generally give a history of the patient’s symptoms and background, as well as treatments given.  They became less extensive as time passed by.  Related to these is the Physicians’ Record Book, 1860-74 (S190020).  This book contains much of the same information recorded in the Patient Treatment Records, but rarely does the same patient appear in both. One should check both series to be sure.  In this era, records of death are scattered.  They may appear in each of the above series, and for 1851-61 there is a recorded list of Patients Cured, Removed, and Dead (S190029).  This list is not indexed and requires reading through in hopes of finding a patient. 

After Reconstruction, the records become a little more user friendly.  The key to finding patient information in this era is the patient number.  Each patient was assigned a number upon admission and most records will be findable using this number.  If a patient was admitted more than once, each admission will have a different number and must be researched separately.  There are several different methods one may use in order to find the patient number.  If you know a general time period in which a person was in the hospital, you should first consult (S190027) List of Admissions (also known as County and Alphabetical Books).  These volumes begin in 1876 and end in 1950 (open through 1945).  Divided into sections by race and sex, one can follow the progress of a patient through time.  This will provide the patient number, the date of admission as well as the date of death, discharge, or parole.  In the back of the volumes are lists by county of persons admitted to the hospital.  Now that you have the patient number, you can begin searching the pertinent records.  You may wish to start with the Commitment Files (S190024).  These begin around 1872 and are the single most useful record that you are likely to find on a patient.  Signed by a judge in the county of residence, these papers often include parents’ names, indications of other family members who may have been committed, as well as history of the disease afflicting the patient.  Unfortunately, these records have large gaps and many are missing.  A duplicate copy was filed in the home county’s probate court, giving another possibility of finding a missing file.

Next you may wish to try the Admissions Books (S190025).  These are arranged by date and by patient number.  Again there are some volumes missing, so you may have to substitute Admissions and Discharge Books (S190026).  These are arranged by month and by category, and are basically abstracts of the Admissions Books.  If the patient was admitted between 1875 and 1915, he should have an entry in the Case Histories Books (S190021).  These volumes are set up by patient number.  Beginning in 1893, they are divided by male and female departments.  They contain medical information about the patient, as well as dates of death or discharge.  Not all volumes have survived.  The Case Histories end in 1915 and are replaced, in part, by the Staff Books (S190022).  Staff Books are notes on patients taken pursuant to evaluations by the hospital’s medical staff.  This may include short interviews with the patient and diagnoses by the physicians.  These entries usually show up shortly after commitment and may appear periodically in succeeding years.  These books generally have an internal index to point the researcher to pertinent pages.

If you have discovered that a patient was discharged, either in the Case Histories or the List of Admissions, you may then check the Discharge Books (S190034) dated 1893-1950.  These are arranged strictly by date of discharge.  Likewise, if you have discovered that a patient died in the hospital you may check the Record of Deaths (S190038). These cover the period 1893-1979 (open after seventy-five years) and are arranged by the date of death.  The Record of Death books will give the patient’s name, age, race, and date and cause of death.  They will indicate whether the body was buried at the Asylum or shipped home.  We also have in our Reference Library three volumes of records from the McCormick Funeral Home, the undertakers who served the State Hospital for many years.  Published by the Chicora Foundation, these books can give details on the dates of death and burial of deceased patients. 

I have often found that beginning from the date of death can be an effective research strategy.  Records of burials and tombstones can give death dates.  You might wish to consult www.findagrave.com to find a death date.  For patients who died after January 1, 1915, South Carolina Death Certificates will give date of death and place of burial.  They will also give an approximate date of admission to the hospital.  Since death certificates are closed for only fifty years, you may find information about a patient whose mental health records are still closed, particularly the dates of admission and death. If the death has been at least seventy-five years in the past, you can consult the Record of Death books to obtain the patient number and move on to the other records from there. 

The records of the State Hospital are voluminous and somewhat frustrating to use, but the information contained is often priceless.  There are records that were not mentioned in this guide because they are not as commonly used, but that does not mean they would not be useful for a particular researcher. For a complete list of our holdings for the Department of Mental Health follow this link: http://www.archivesindex.sc.gov/guide/StateRecords/rg0190.htm.