The first hospital service for mentally afflicted persons in America was established at the Pennsylvania Hospital in Philadelphia in the year 1752. (Kimmich)
Later, across the US, interest was growing in caring for the mentally ill; asylums are opened in East Coast US cities. Kamehameha V expanded his interest in medical facilities.
The 1863 law passed by the Hawaiian legislature states: “A building is to be erected for the reception of insane persons. This facility will furnish restraint till the person becomes of sane mind or is discharged.”
“There shall be in Honolulu, at such places as the superintendent of public works shall direct, a suitable building for the reception of all insane persons, to be styled an insane asylum … The board of health shall have the management and control of the insane asylum.” (1862, Revised Laws, 1915)
“It shall be the duty of (the) district magistrate or circuit judge to examine all persons brought before them on said warrants as to their sanity.”
It was difficult to obtain the funds for this purpose, however, and the hospital was not constructed until 1866. Its first location was at the corner of School and Lanakila Streets.
The hospital was completed in 1866, and the first six patients were transferred to the hospital from the jails at which the mentally ill had previously been kept. By 1867, there were 62 patients. (Cultural Surveys)
The annual report of 1867 mentions a total of 62 admissions, an average age of 40 years, and goes on to state that 17 of the 62 admissions were discharged as “recovered.” (Kimmich)
The patients, with the exception of those most violent, were allowed to wander about the extensive grounds, assisting in the care of the lawns and flowers, and in light manual labor of various kinds.
The Hawaiians have ample allowances of their much loved poi, likewise, there were large luau, held there once or twice during each year.
These were attended by many of the residents and visitors to Honolulu, who chose these occasions to satisfy their curiosities. The inmates of the Hospital are of all nationalities, the aggregate number, in proportion of the Islands, being small. (Ellsworth)
The Legislature increased the Maintenance Appropriation from $40,000.00 to $45,000.00 under the title “Insane Asylum And Infirmary” in response to the representations of the President of the Board relative to the necessity of a place of detention and care of those whose cases properly require observation before a charge of insanity should be lodged against them.
“Many of these cases are the result of indulgence in liquor and drugs and in short time their normal mental balance becomes restored.”
“We have already taken steps to erect a building that will shelter forty patients and so relieve the buildings at the entrance of the grounds: they can be turned into the Infirmary and accommodate some twenty patients.”
“A visit to the Insane Asylum will show many improvements. Nothing is more conducive to the bodily health and mental condition of the physically able insane than employment to a moderate degree.”
“During the past twelve months the inmates have quarried stone, made curbing and macadam, filled in ground where necessary and generally improved the Asylum grounds. They practically rebuilt one building for men, repaired several cottages, and have done general renovating and painting.”
“They have built quite a large addition to the woman’s building and are now completing a cottage of four special rooms with a separate lanai for each, that patients may be isolated where the case requires, or friends desire by special arrangement.” (Report of President of the Board of Health, 1907)
“All inmates, if physically able, are taken out of doors every day … .During the year the female employees and patients made a considerable amount of clothing for use in the institution.”
“The principal articles for food were bread, beef, fresh fish, salmon, codfish, beans, poi, rice, potatoes, cabbages, carrots, prunes, canned fruits, eggs, milk, ham, bacon, fresh vegetables, tea and coffee, and fresh milk.” (Report of Governor of Hawaii, 1921)
“No institution extant is better, more cleanly and more orderly kept, resources considered, than the Oahu Insane Asylum. The Asylum is regularly, professionally and officially inspected each two weeks by the two medical members of the Board of Health. The President of the Board visits the Insane Asylum at least once each week.” (Report of President of the Board of Health, 1907)
From 1903 to 1928, a new site was looked for, a final decision on the present location in Kāneʻohe being made in late 1928. (Kimmich)
In 1930, all 549 patients in the then-named Territorial Hospital were transferred to the new Territorial Hospital in Kāne‘ohe, O‘ahu.