Lakeshore's legacy filled with success and stigma

The demolition of Lakeshore marks the end of a state mental hospital that experienced 126 years of success and stigma.

(WBIR - Knoxville) The 128-year-old administration building at Lakeshore Mental Health Institute is one of the few structures that will survive the demolition of the former state psychiatric hospital.

However, the building looks very different today than it did when the East Tennessee Hospital for the Insane opened in 1886. The original building featured sprawling wings on both sides of the structure that remains today.

Photo Timeline: History of Lakeshore property in pictures

"The administration building - it used to have big hospital wings that went a few hundred feet in each direction from the building that is there now," said Rev. Doebler, who served as chaplain for the hospital from 1972 until 1985. "It was a classic Kirkbride architecture, which was a type of design used in hospitals all over the country. Those hospital wings house around 800 patients."

Those wings were dark places that inspectors deemed fire traps, filled to the brim with the elderly whose families were no longer willing or able to care for them. The state tore down those wings a year after the highly publicized "midnight raid" in 1971 revealed critical sanitation problems, acute personnel shortages, lack of maintenance, inability to care for patients, and serious overcrowding at what was then Eastern State Hospital.

The raid shed light on deplorable conditions and care at the understaffed and underfunded hospital. The scandal was just one chapter in a long book filled with ups and downs, medical breakthroughs, and stigmas associated with upper East Tennessee's primary facility for treating mental illness for 126 years.

Name Psychology

The mental health institute's name changed several times, reflecting society's perspective on mental illness

When the hospital on the property opened for the first time in 1886, the East Tennessee Asylum for the Insane was located on 300 acres of farmland that was then outside Knoxville's city limits. In 1886, the area near the University of Tennessee's campus and Fort Sanders was considered the western end of Knoxville.

The state prison system operated the facility. Like many institutions from that era, patients were often treated like prisoners.

In 1927, the state renamed the facility from East Tennessee Hospital for the Insane to Eastern State Hospital. The state eventually changed the name to Lakeshore Mental Health Institute in 1977.

For much of its existence, the Knoxville community simply called the hospital Lyons View.

The state purchased the property with vistas overlooking the Tennessee River in the 19th century from the Lyons family. Counties throughout East Tennessee coveted the mental health facility because it would create industry, employment, and an idealistic source of pride in the treatment of mental illness.

But over time, Lyons View became synonymous with insanity and terror. Authors such as Tennessee Williams, Cormac McCarthy, and Peter Taylor have all published stories that featured a state asylum called "Lyons View" or "Lion's View." No matter how it was spelled, authors used the name to convey images of a place where people were sent away forever.

Rev. Doebler said the community outside the gates perpetuated that stigma of Eastern State as a place to be feared.

"I think the reputation with families is parents who would tell their kids, 'If you do not behave, we will take you to Eastern State.' I think the image of mental illness and the stigma attached to that was here and still is," said Doebler. "I think the image people have of psychiatric facilities was these people were all dangerous and very much out of control. But it was far from that."

From Prisoners to Patients

The facility first housed prisoners but then became an institution for the mentally ill

The prison system originally ran state hospitals that treated mental illness. In many ways, life at the East Tennessee Hospital for the Insane was analogous to a prison. The property was fenced, guarded, and many patients were restrained or caged.

The first people transferred to the East Tennessee Asylum for the Insane were 99 patients who were previously housed at the overcrowded Tennessee Lunatic Asylum in Nashville.

The transition from prisoners to patients became tangible when Tennessee created a state Department of Mental Health in 1953, which took over operation of Eastern State Hospital.

Rev. Doebler said, at the time, the facility was one of the best in the country for the treatment of mental health.

"There was a building up here called Lonas Hall that in the 1950s was mentioned in Readers Digest as one of the most modern facilities in the country to treat mental illness," said Doebler. "It had a big balcony area where patients could get out to walk around. There was a swimming pool. It's kind of ironic that it was one of the most modern, but was one of the first to be torn down before a lot of these other buildings."

Another major breakthrough in mental health treatment arrived at Eastern State in 1960. The institution created a therapeutic village where patients could function in a less institutionalized setting.

"Dr. Bedford Peterson built all of these cottages, a chapel, and the patients lived with some of the staff," said Doebler. "It was so creative. It was revolutionary in this country. He had modeled it after a mental illness treatment facility in Norway, I believe. It was only a small portion of the patients who lived in the village. Most were still in the other buildings and wards."

In the next decade, Eastern State would come under scrutiny for overcrowding in other areas of the campus where a wide variety of patients were housed together.

An Underfunded Community

Isolation both a blessing and a curse for the mental health facility

The isolated nature of psychiatric hospitals was both a blessing and a curse for Lakeshore, according to Rev. Doebler.

"It was a community unto itself," said Doebler. "People here worked, there was a farm, there were cafeterias, a chapel, and a whole society inside the gates."

Because the hospital was tucked away behind bars, the facility was out of sight and out of mind for the community. Doebler said isolation created apathy within the region about the hospital's role.

"There were several reasons someone would be sent here. We had patients with schizophrenia, delusional, hearing voices, seeing things. People that were just extremely depressed and suicidal," said Doebler. "We didn't do a good job of communicating what we were helping the community do. So funding for mental health facilities was never adequate. People criticized it for these terrible conditions and said it was overcrowded. Well, yeah, it was overcrowded because they wouldn't build any more buildings because they didn't see the need for that."

Up until the 1970s, judges and families throughout the region used Eastern State as a dumping ground for all types of undesirable people.

"Some patients were brought by their families because they couldn't control them. Other patients were referred by their physicians. People who had difficulty with alcohol were brought by the police. There were elderly people sent here who did not have mental illness. Some people were sent here due to mental retardation, which is a word we don't use anymore. But those persons would come here and often be transferred to another facility. Then there were mentally disturbed children here in the adolescent program," said Doebler. "It was cheap housing and people were sent here from more than 20 counties in East Tennessee."

The very diverse population often intermingled.

"For a long time in mental hospitals around the country, adolescents were not admitted separately from adults," said Doebler.

1971 Midnight Raid

The scandal placed a spotlight on the hospital's deplorable conditions and care

In 1971, state Rep. Richard Krieg visited the hospital during the day and decided to shed light on the deplorable conditions in the dark of night.

"The staff here referred to it as the 'midnight raid.' Krieg was here a couple of days before, but then showed up unannounced at midnight with the media," said Doebler.

The images captured by the media, including WBIR, showed extremely overcrowded conditions in the old wings of the administration building. Many beds for the elderly spilled into dark hallways. Large rooms were filled with so many patients that all of the beds touched each other.

WBIR also captured video of roaches crawling up many of the crumbling walls as rats scurried through the hallways. Large water leaks and rusty pipes created a dank environment.

As a result of the raid, the state held formal hearings and many administrators were fired or resigned. The state hired Dr. John Marshall as the new superintendent, who persuaded Doebler to move to Knoxville.

"We had worked together at the federal hospital treating the mentally ill in Washington, D.C. and Dr. Marshall asked me if I would be willing to come to Knoxville and replicate what we had done before," said Doebler. "The whole attitude in the 1970s was the beginning of trying to get people more aware of who the mentally ill were. And the people who were here, the whole goal was to get them out."

After the Raid

The institution underwent lots of changes following the fallout

WBIR followed up a year after the raid with a series of lengthy interviews to show what changes had been made at Eastern State and what improvements were still needed.

The wings of the administration building were demolished in 1972. One of the physicians interviewed said these wings were extremely dangerous.

"We had about 800 elderly people housed in these buildings that I was personally afraid to go in because they were such fire traps. We now have those people moved out and in much better conditions."

After the raid, the state admitted minors in entirely separate facilities than adults. In WBIR archive film, the head of the adolescent program explained some of the changes that made previous conditions seem despicable.

"During the old adolescent program, children were required to prepare their own meals," he said. "Now we have a dietary group prepare the meals and the food is brought in to the children. There's also no longer any use of withholding meals from children as punishment for any kind of behavior."

The 1972 footage also included an interview with George Doebler as the newly-hired chaplain. In the video, Doebler explained the importance of combining clinical psychiatric training with theology. His job was, in part, to educate people who were "losing their religion" that their mental torment was not an act of God.

"People here in East Tennessee have a very strong religious element. Sickness is often expressed in religious ideation," said Doebler in 1972. "The patients speak of their problem as being possessed by the devil, being possessed by the Holy Spirit. They talk about feeling the devil push on part of their mind. And if that is something that can be utilized in a helpful way to see that is not religion, but something that's going on within them, they can become more free of that and a healthier person for it."

Doebler went on to explain what he thought about the hospital as a new employee with experience at other facilities across the country. His perspective on facility was much different than local opinion.

"Eastern State, in spite of the criticism that many have had about the facilities, has the best location and facilities of any hospitals in our state. And it's really a beautiful place."

Training, Music, Humor, and Healing

Hard work and dedication brings about positive change

Doebler said the negative perception of Eastern State overshadowed the benefits it had on the community. For one, it was a priceless site for grooming generations of healthcare professionals.

"Many of the people who work in mental healthcare today were students at UT who were able to get training by working at Eastern State. They experiences they got here, we do not have that anymore. Many of the people trained here are still in the community treating mental illness," said Doebler.

Despite many positive changes, Doebler said it was nearly impossible to overcome stigma of previous scandals.

"People talk about the mistreatment of these people and the horrible things that would go on. The story that isn't told is what these facilities meant to the community," said Doebler. "The people who worked here were very committed to try to help these people. The public thought of mental institutions as terrible prisons. Those of us who worked in these places struggled with that."

One similarity Eastern State Hospital shared with some prisons around the country is that it hosted a Johnny Cash concert. In 1972, the country music legend performed a free concert for the patients, staff, and visitors. The concert featured Johnny's wife, June Carter, and several members of the Carter Family. Other performers included Carl Pekins, Glen Shirley, and the Statler Brothers. A photo from the McClung Historical Collection shows Tennessee governor Winfield Dunn presenting Johnny Cash the "Governor's Award for Distinguished Mental Health Service" after the show.

Doebler said music was also a big part of patients' everyday life.

"When we would have chapel, there were a number of musicians in Knoxville that wanted to come down and meet patients to learn mountain songs," said Doebler. "We had people here with tremendous talent who knew all types of music."

Doebler said music wasn't the only aspect of chapel patients appreciated.

"Before I came here, they served grape juice for communion. I'm Lutheran, so we started serving wine for communion. Our attendance tripled," laughed Doebler. "And the patients would take communion and get back in line again. I said, 'These people are mentally ill, but they are not dumb.' And that's one of the things about mental illness. The mentally ill are very bright."

While the public may have viewed Eastern State/Lakeshore as a place full of criminally insane people, those types of individuals were rarely housed at the hospital. The state typically sent the criminally insane to Nashville. However, some would be sent to Eastern State/Lakeshore for short evaluations to determine if they were mentally capable to stand trial for their crimes.

Doebler said he felt the hospital was safe enough to let patients interact with his daughters.

"I had my two girls and they were both younger than 5 years old. Every Sunday, I would bring the girls to chapel with me and the patients would take care of them. Seldom did the patients get to see little kids. They absolutely loved taking care of these two little girls. It made them so happy," said Doebler.

Potentially dangerous patients were usually physically restrained within a hospital setting.

"People who got hurt here were frequently the staff trying to help a patient who was out of control. It usually was not that the person was trying to hurt someone. They were just thrashing, kicking, and biting because they were disturbed with whatever was going on in their mind," said Doebler. "Before we had psychotropic drugs, it was especially difficult in state hospitals to get people under control where they would not be a danger to themselves or others."

Privatization and Parks

Downsize leads to the closure of Lakeshore Mental Health Institute

The amount of staff and patients dwindled from the 1960s to the 1990s. Throughout that time, the state frequently discussed outsourcing control of Lakeshore to private healthcare providers. However, the hospital remained in state control and continuously faced cuts in staff, and subsequently, patients.

"Any facility, it takes a lot of money to keep them going and those resources were not available," said Doebler.

Doebler left Lakeshore Mental Health Institute in 1985 and joined the staff at UT Medical Center where he still serves as the chaplain emeritus.

As the staff at Lakeshore continued to shrink, the state announced plans in the early 1990s to consolidate Lakeshore and Chattanooga's Moccasin Bend.

In 1994, the state passed ownership of part of the Lakeshore property to the city of Knoxville. The official ribbon cutting took place March 4, 1995, which celebrated Lakeshore Park becoming a reality with a 2.2 mile greenway trail and five baseball fields.

Today the term "Lakeshore" likely conjures up images of a popular park where children play softball, baseball and even sled after a snowfall. But the beautiful property's abandoned buildings have also fueled ghost stories. Busted windows, crumbling walls, and scattered trash provide the perfect setting for haunting tales.

As the city demolishes those abandoned buildings, wiping nearly all of Lakeshore Mental Health Institute off the map, Doebler said he hopes the hospital can become more than a so-called haunted place.

"This was a place full of people. One of the great joys in my life is I still get to see some of the people who were here as patients. We visit and talk about life," said Doebler. "This is sad. What has happened to this place [Lakeshore] is sad to me. The people who worked here were very committed to try to help these people."


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