07/10/2026
Forensic Treatment Center History: 1900 - 1948
The period from 1900 to 1948 at the St. Louis City Insane Asylum was marked by significant overcrowding and budgetary limitations. In 1901, there were 631 patients living on the grounds, mostly in the Dome Building, though a few were living in poorly maintained cottages nearby.
After decades of avoiding the issue, the City of St. Louis finally approved the construction of two large wings for the Dome Building in 1905; the wings were completed by 1911 and the facility’s name was changed to the St. Louis City Sanitarium. Even with the space for an addition 1800 beds, the facility was almost instantly back over capacity when over one thousand patients, who had been transferred out to other facilities before the wings were built, were all transferred back to the Dome Building’s new wings.
The Employee’s Home, later known as the Employees’ Building, was built where the Main Building is now in 1925. This building provided separate living quarters for employees who previously lived within the Dome Building. It also freed up space within the Dome Building for additional patient beds and also provided the employees with improved living conditions. By the 1940s, most employees no longer lived on the campus, commuting from neighborhoods across the city. The Employees’ Building was eventually repurposed to house students in the nursing program.
Treatments for mental illness through the first half of the twentieth century continued to ineffective at best, and dangerous at worst. Some treatments were continued from the earlier days at the asylum, including hydrotherapy, work, leisure activities and a limited number of medications, mostly sedatives or dangerous compounds. By the 1930s, the facility was using insulin shock treatments or Metrazol to induce seizures, which were thought to cure mental illnesses. Lobotomies, also known as “psychosurgery” began at the facility in 1941 and would continue to increase in use until the mid-1950s. The census continued to grow and by the late 1940s, there were around 3500 patients living on the campus.
Beginning in the 1920s with a new Residents in Training Program and accelerating through the 1930s with the Nursing Education Program, the facility began focusing on training staff and providing education programs to increase the number of qualified healthcare professionals on staff. Though they did not know it at the time, a new age of mental health treatments and approaches was just about to begin.
