In 1848, the North Carolina legislature established the "Insane Hospital of North Carolina," the first institution in the state for the mentally ill. Dorothea Dix, a tireless advocate of improved mental-health care, had toured North Carolina earlier that year and made an impassioned appeal to legislators to create a facility for the mentally ill. The hospital buildings, completed in 1856, were designed by well-known architect Alexander J. Davis. Legislation in 1899 changed the name of the facility to "The State Hospital at Raleigh," and in 1959 the legislature again renamed it, this time to Dorothea Dix Hospital.

This biennial report for 1903 and 1904 gives statistics for this mental health facility. The superintendent of the hospital, Dr. James McKee, was a prominent Raleigh physician who led the State Hospital through substantial advances and was an advocate for expanded medical training at African American universities. In the report, McKee presents patient demographics, work accomplished, upcoming plans, finances, and outstanding needs that the facility had at that time. Specifically, McKee argues that an addition to the hospital was necessary. McKee then provides tabular data about finances as well as patient information, such as admissions and discharges, social status, diseases, occupation, and place of origin. The treasurer and steward report additional financial data, and the gardener, engineer, carpenter, tinner, laundress, and matron provide brief production summaries for their respective departments.

Also included at the beginning of this document is a brief report from the Joint Committee of the State Hospital at Raleigh and the State Hospital at Morganton. The State Hospital at Morganton, originally the Western North Carolina Insane Asylum and now Broughton Hospital, was established in 1875 when the legislature determined that a second hospital was needed to accommodate the state's growing mental health needs. In this brief report, the Joint Committee presents census data demonstrating the discrepancy between treatment needs and both the hospitals' current resources. The Committee asserts that care could be improved if the state would adopt a more well-defined policy on mental health issues.

Monique Prince