Community Histories Workshop
The Asylum in the Archive

The Asylum in the Archive

Color photograph of Emma Stout and Nate Nihart at the State Archives of NC. They are looking at an image on a laptop. A large ledger book is on the table next to them.
CHW Staff at the State Archives

Since 2017 the Community Histories Workshop has committed to a long-term, open-ended initiative whose goal is to use archival records (in the broadest sense) to illuminate the historical experience of “madness” and the public insane asylum in the American South. Working with colleagues across UNC Chapel Hill, we are connecting the ascendance of the asylum and of psychiatry as the first American medical specialty in the nineteenth century with contemporary understandings of mental illness. Through our collaborations, we hope to facilitate and stimulate the use of archival asylum records in interdisciplinary research, graduate training, clinical practice, and professional development. 

Our work has been inspired by the American Psychiatric Association’s “Apology to Black, Indigenous and People of Color for Its Support of Structural Racism in Psychiatry,”  published in January 2021. It acknowledges a legacy of “prejudicial actions” and “racist practices” in the treatment of Black, Indigenous, and People of Color that reaches back to the formation of psychiatry in the 1840s and to the practices of the first generation of American psychiatrists: the superintendents of dozens of public and private insane asylums created between the 1820s and the 1850s. This legacy includes not only individual “abhorrent actions,” but also institutional silences and systematic exclusions.    

We believe that the long history of mental illness and mental health treatment in North Carolina cannot be responsibly represented except in the context of race, and that the history of race in North Carolina encompasses Black, Indigenous, and People of Color. 

Through our work to date, we have demonstrated that every archival record is a window onto the social, economic, political, and medical conditions under which North Carolinians lived. Although the archival records are identified and organized in relation to a single individual, the very act of transformation from citizen to inmate connects the asylum with families, communities, and networks of other therapeutic, carceral, and custodial institutions. A holistic approach to the asylum leads us to a wide range of disciplines and perspectives: from database-driven quantitative analysis of thousands of records to the granularity of the individual case study. 

Color photo of the cemetery in Dix Park, Raleigh. It is a large green space. The photo features an upside down gray stone that reads
Photo by Diana Graham

Across our work we are always cognizant of the fact that subjects of archival records such as these are not merely data but past lives. Although all of the records we work with are available to the public without restriction, we have an ethical and professional responsibility to respect the lives we uncover. 

Our commitment is sustained by a sense of institutional responsibility: the histories of UNC and Dix Hospital have been intertwined for more than a century. Generations of UNC-based psychiatrists, psychologists, psychiatric nurses and social workers trained at Dix, with many going on to work there. Recovering the asylum from the archive promises to inform how the next generation of health professionals could come to a better understanding of the history of their theories and practices.

Our work interweaves several strands:

We are recording and transcribing more than 10,000 admissions records for the period from 1856 to 1921, as well as other associated records such as intake forms.

The transcribed and digitized admissions ledgers and general case books now represent more than 500,000 data points for more than 7,000 patient admissions. We are creating a relational database, which will facilitate management of the data and greatly expand the range and complexity of questions we can pose, as well as the ways in which the data can be visualized. This, so far as we are aware, will be the first comprehensive relational database of historical patient records for a nineteenth-century American insane asylum.

From manuscript holdings in UNC’s Southern Historical Collection, we have uncovered, transcribed, and published more than 100 letters to, from, and about the first female patient at what became Dix Hospital. Anna Cameron was a member of the most affluent family of nineteenth-century North Carolina—niece of Duncan Cameron, who, at the time of her admission, owned 900 human beings.  She remained at the asylum for 33 years.

We are integrating the initiative into project-based graduate education and professional training at UNC through interdisciplinary graduate research seminars, offered every semester since 2018. The seminar has been taken by graduate and professional students from Nursing, Medicine, Public Health, Health Humanities, Folklore, Geography, American Studies, Religious Studies, Literature, and History.

Our research has established that fewer than 50 African Americans were admitted to Dix Hospital between 1856 and the institution’s “integration” in the 1960s. Inspired by the American Psychiatric Association’s 2021 apology for the profession’s historical legacy of systemic racism, we work to uncover the racist theories behind asylum practices, recover the lives of Black patients, and access as yet unexamined archival collections that illuminate the role of race in the history of mental health in North Carolina.

Since January 2020, we have offered presentations on our Asylum in the Archives initiative to more than 100 psychiatric clinicians and professionals in training.

The history of race in North Carolina cannot be understood apart from its post-settlement tri-racial character. Our work asks how American Indians have been placed and displaced in relation to North Carolina’s asylums since 1856, and how this relationship has been obscured in the archive and in historical accounts. We are taking first steps toward documenting this complex and dynamic relationship, evidence for which lies largely outside available asylum admissions records.

(Best viewed on a laptop/monitor or Android device.)

Dix Projects

To learn more about each project in this initiative, click on the project icon or title.


Our undergraduate and graduate research fellows have worked and continue to work to transcribe historic records from Dix Hospital—primarily the admissions ledgers and general case book forms.


From our digitization and transcription of Dix Hospital records, we have produced four datasets that are available for request through UNC Dataverse. We are also working to analyze subsets of our data and to create a relational database.

Anna Cameron Kirkland

The third patient admitted to Dix was also the first female patient: "Annie M. Kirkland." Because she was a member of the slave-owning Cameron family, her history has been preserved in several different archival collections.

Graduate Research & Practicum

For the past 2 years, CHW co-director and professor Bobby Allen has lead a seminar of interdisciplinary graduate students, immersing them in Dix Hospital records and exploring the history of modern psychiatry with them.

Race & Indigeneity

Through deep and prolonged engagement with Dix Hospital records, CHW staff, students, and fellows have worked to uncover the lives of Black and indigenous patients and to examine how race was constructed at the asylum.

Professional Training & Practice

We provide engaging presentations, based on the Dix archival materials, for mental health providers and practitioners. Our goal is to help them understand the history of and biases within the profession of psychiatry.