St. Elizabeths is now the subject of an exhibition at the National Building Museum; Architecture of an Asylum explores the links between architecture and mental health.

Dorothea Dix, the 19th-century reformer who fought for the facility, would have rolled over in her grave to see what St. Elizabeths had become by the 1960s.

"She had observed the treatment of the mentally ill in jails and other kinds of alms houses [and] poor houses all over the country," explains exhibit curator Sarah Leavitt. Dix "was really appalled by the treatment that they were getting, and she made it her life's work to change that story."


But, over decades, the sun-filled, airy rooms of St. Elizabeths got overcrowded, understaffed and eventually emptied out. New psychiatric drug therapies, decreased federal and state support, and the de-institutionalization of many patients — which started with President John F. Kennedy and increased under Ronald Reagan — led to a societal shift toward community-based treatment. It's an approach that has helped some but left others struggling with their condition in homeless shelters, on the streets or in jails.

There are still 300 patients at St. Elizabeths, but 75 buildings stand idle. The graceful St. Elizabeths campus will eventually house condos and the Department of Homeland Security.

Still, Dix's dream of architecture as a path to healing lives on.