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This paper explores the similarities and 

differences of Midwestern American small 

town ghost stories, as well as the haunt-

ed asylums of the Midwest and their own 

ghost stories. The essay explores asylum 

histories and shows what makes up the 

American Midwest cultural haunting and 

why those fears are pushed onto asylums 

and their ghosts.

Adam Ladner, Ball State University

The American 
Midwest Haunting: 
The Asylum Lives On

Ghost stories, while seeming unique 

and individual to many cities, towns, and 

states, often fit into a practiced formula 

and outline that isn’t always apparent. 

In the Midwestern region of the United 

States, there are countless stories of wom-

en in white, hitchhikers who disappear 

halfway through the car ride, wailing and 

screaming coming from woods and aban-

doned sites, figures wandering lighthous-

es and the lakeshores, and haunted houses at the ends of streets—just to name a few. 

Stories like these all have common themes and structures, the most prominent being 

the idea and painful realization of a permanent and unbreakable isolation. Upon closer 

examination, these stories show that women in white are always left to wander the area 

where they died alone, hitchhikers never reach their destination and often vanish half-

way through the car ride, and ghostly lighthouse keepers stay locked in their lighthouses. 

Unbreakable isolation is common theme scattered in many American Midwestern ghost 

stories, but its origin lies in the residual hauntings of the reformatories and asylums scat-

tered throughout the solitary and empty midlands of America.  

 The haunted insane asylum is a prevalent story in the American Midwest. Only In 

Your State, a website dedicated to investigating every state in America in search for local 

attractions and the best tourist stops, has a section detailing each state’s haunted loca-

 1 13



Digital Literature Review 2
 114

tions and ghost stories. At least one asylum pops up in their lists for all but one of the 

twelve of the states that make up the American Midwest—the Dakotas, Nebraska, Minne-

sota, Iowa, Missouri, Wisconsin, Illinois, Kansas, Michigan, Indiana and Ohio—with South 

Dakota as the only exception. Towns adjacent to these abandoned asylums overflow with 

stories of ghosts haunting the buildings and property grounds (Only In Your State). Many 

residents of these neighboring towns express fear of these stories and ghosts, despite the 

fact that the alleged ghosts never seem to leave their haunting grounds. Asylums were 

scattered throughout the midwestern region because of the large open plots of land, the 

ability to keep and maintain a functioning farm near the asylum, and the condensed sites 

of the region’s population. These asylums were typically located far enough away from 

cities to avoid causing disturbances, and some asylums even provided neighboring towns 

with food and other farm-fresh products as well as working opportunities for asylum pa-

tients. Yet haunted asylums are still among the first ghost stories haunting the American 

Midwest. Asylums housed patients grappling with both psychical and mental illnesses, 

and patients were the marginalized, unwanted members of society. Illness, in any capac-

ity, awakens feelings of uncanniness and frightens many, and so the fear of asylums was 

already deeply rooted in American culture before people began filling the halls of these 

buildings. It was the aftermath of these institutions and society’s own fears of what they 

meant for the people within that truly brought about the ghosts and hauntings of the 

American midwestern asylum.  

 Across the country, asylums were constructed using different architectural systems, 

the most common of which was the Kirkbride system, which was popular in the latter half 

of the 19th and early 20th centuries. Devised by psychiatrist Thomas Kirkbride, this design 

featured a “bat wing” shaped floor plan and an emphasis on air circulation and natural 

light. According to the Trans-Allegheny Lunatic Asylum’s history website, which weaves 

the history of the Kirkbride system with their own, about 300 of these Kirkbride asylums 

were built. The asylums were only made to house only 250 people and focused on the 

idea of “building as cure,” which placed the brunt of patient treatments on the environ-

ment they were in. These asylums, however, very quickly became overcrowded and, in 

a combined total of asylum patients nationwide, housed nearly half a million patients 



Digital Literature Review 3
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during the late 1950s and mid 1960s, right before the mass shutdown of many of these 

asylums. Tuberculosis hospitals started cropping up at the same time as many of these 

Kirkbride asylums, and the tuberculosis hospitals drew their own building plans and treat-

ment tactics from the Kirkbride system. As tuberculosis came and went, these hospitals 

changed from sheltering tuberculosis patients to mental patients and some, like Waverly 

Hills Sanitorium, even housed elderly patients with mental illnesses along with their tu-

berculosis patients. 

These buildings were isolated, and with that isolation came a growing fear of un-

canny loneliness and the othering of asylum inhabitants. Often, when someone went to 

one of these hospitals, they rarely came back. In a research article on early tuberculous 

treatment, Jean-Antonie Villemin and Robert Koch found that nearly 450 Americans were 

dying per day because of tuberculous, with the largest death tolls in patients ranging 

from the ages of 15 to 44. At this same time period in mental asylums, however, Dr. Her-

man Josephy found that most patients who were dying were between 40 and 60 years 

of age, and the leading cause of their death was simply exhaustion from their own men-

tal illness. In Chicago’s State Hospital, out of the 2,477 patient deaths between 1935 and 

1937, 1,297 patients were between the ages of 40 and 69, and most had died from either 

exhaustion or age. Violent and unexpected deaths, however, weren’t all that common in 

asylums, despite what popularized ghost stories indicate.

 The idea of mentally ill patients practicing unrestricted violence against doctors 

and patients alike is another popular fear spread throughout the American Midwest, even 

though that level of violence is almost unheard of in asylum histories. A 2014 study con-

ducted by four members of the mental health field found that societal fears and stigmas 

about asylums persist in the general public, and even the mental health community, 

today (Stuber et al.). The researchers asked members of the general public and members 

of their own field various questions ranging from their belief in the violence level of those 

with a mental illness to how close of a proximity they were willing to be near them. They 

described their results as revealing “negative” attitudes towards those with mental illness, 

and that many participants wanted a “social distance” between themselves and those 

struggling with mental illness, written on the first page of the study (Stuber et al.). This 



Digital Literature Review 4
 116

study was done almost 50 years after the height of asylums in the 1960s, and yet the same 

attitudes of isolation and othering towards the mentally ill continues haunting our soci-

ety.

There is no denying the widespread neglect in these asylums, as many were over-

crowded and did not have adequate staffing to properly care for their patients, but pur-

poseful violence toward patients or staff was practically nonexistent. Most of the more 

severe treatments that had been used in previous centuries, like water dunking, beatings, 

and restraints, had been abolished with the implementation and widespread use of the 

Kirkbride system in the 1900s, as the system itself didn’t use them. Outside of the acts 

of few violent patients, who were typically isolated from other asylum residents to avoid 

injury and assault, the only real example of horrendous and planned violence comes from 

Pennhurst Asylum, in Pennsylvania, and even then, it wasn’t the patients who were vio-

lent. 

Pennhurst was one of the first asylums to house patients on a massive scale. In her 

article detailing Pennhurst’s history of patient neglect and abuse, Elisabeth Tilstra notes 

that almost 3,000 people filled its halls—a building that could only accommodate a lit-

tle less than half of that number. Patient neglect occurred because of how understaffed 

and overcrowded Pennhurst was, and that neglect swiftly and violently morphed into a 

purposeful mistreatment of these patients. Patients were beaten and punished for “in-

correct” behavior, forced into ice-water baths and injected with chemicals. Pennhurst 

staff also resorted to previously eradicated methods, such as tying patients to their beds. 

Doctors even encouraged violence among the residents, and readily admitted to doing so 

when the public finally demanded answers. Pennhurst opened in 1903, and it took near-

ly 60 years for all of this to be exposed. A documentary called Suffer the Little Children 

aired in 1968 on the NBC network, exposing all of Pennhurst’s misconduct in the most 

public way possible. During interviews conducted for Suffer the Little Children, many of 

these doctors and nurses weren’t apologetic for their actions; this lack of remorse sent 

the public into a horrified outcry about the treatment of the people at Pennhurst—many 

of whom weren’t even mentally ill, as was discussed in the documentary (Suffer the Little 

Children). Pennhurst left a lasting impression of rampant violence in asylums, trickling 



Digital Literature Review 5
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down to midwestern America, which—like most of America in the 1960s—was full of its 

own quickly deteriorating asylums. According to a timeline put together by a capstone 

class at the University of Maryland’s College of Journalism, asylums were swiftly closing 

around the time of the documentary’s release.

  Violence like what occurred at Pennhurst, however, is common in deteriorating 

urban areas and crowded rural spaces, which present a similar social and geographical 

set up to the asylum. According to a study published in 2003 by sociologist Matthew Lee, 

who has studied violence and criminal acts, the upped violence in areas like this comes 

from the social isolation that these places suffer. This social isolation often occurs in mi-

nority groups, like disabled people, people of color, and people living below the poverty 

line—the people who most often ended up in these asylums. The perception that violence 

is more common among these gives communities an excuse to justify the fear of this 

violence being acted upon the middle and upper classes. Similar to the violence of Penn-

hurst, the Stanford Prison Experiment of 1971 demonstrated how abuse of power leads 

to the mistreatment of those without power. The exposé of Pennhurst’s abuses was only 

four years earlier, and still fresh in everyone’s mind. Perhaps the idea of the association fal-

lacy was at play as well. Both Pennhurst and the Stanford Prison Experiment suggest that 

violence and abuse have a higher chance of occurring in small, confined spaces. Because 

of this correlation, people assume that the mentally ill had to be violent as well because of 

the association fallacy. 

The American Midwest is a geographical oddity. According to the American Cen-

sus Reporter, the population per square mileage is only 91 people. The next closest is the 

American Southern region, ringing in at 143.6 people per square mile. The Midwest has 

an overall population of 68,308,749 people, the second lowest population by region in 

the United States. Most of America’s farmland is located in the Midwestern region, and 

the largest city by population is Chicago, coming in at 2,714,017 people. The next closest 

city in terms of population is Indianapolis at 846,674 people. A stark difference, to say the 

least. Most Midwestern counties have fewer than a million people living in them—in fact, 

only seven counties have a population of a million or more. The American Midwest only 

holds roughly 20% of the total American population, even though it makes up about a 



Digital Literature Review 6
 118

third of the country’s land. The set up of the American Midwest mirrors the set-up of the 

asylum—a large plot of surrounding farmland and small and dense rural centers of pop-

ulation. Urban areas often experience higher rates of violence, and most of the Midwest 

is comprised of rural and small urban areas. That fear of violence that we face is pushed 

onto the asylum, an outlet that already has a violent stigma attached to it, that still mir-

rors the setup of the American Midwest, because that violence was seen in an asylum al-

ready. Take Michigan’s Traverse City State Hospital as an example. According to an article 

published by L.S. Stuhler, most Kirkbride hospitals strayed from the intended “building as 

cure” treatment and became far too overcrowded to properly treat patients, but Traverse 

City State Hospital was one of the few hospitals that took care to follow the Kirkbride plan 

as well as they could. The Traverse City State Hospital had its own self-sustaining farm 

that sent a lot of its produce and harvest to the Traverse City area. It had multiple build-

ings and functioned as its own little town, with patients performing jobs and tasks on the 

farm as well as helping run the asylum itself (not unlike the setup of a small rural town). 

The hospital was the furthest thing away from the violence of Pennhurst, yet the ghost 

stories and haunting tales came nonetheless. Stories of murder, of violent deaths and sui-

cides, as well as a portal to Hell residing on the grounds of this peaceful hospital filled the 

ghost stories that eventually overshadowed the actual history of asylums.

 This fear of violence that has been pushed onto these asylums trickles down to 

their ghosts, which is why hauntings such as those associated with Indiana’s Central State 

Hospital and the Ohio State Reformatory emerge. Joy Neighbors has collected reports 

and stories of the Central State Hospital ghosts and spirits being hostile towards visitors 

and workers. These hauntings manifest through feelings of being watched, breezes go-

ing past, and harsh screaming and yelling. Bair, an author for Mysterious Heartland, a 

site dedicated to reporting ghost stories around the United States, has written one report 

from the Central State Hospital of a maintenance worker being choked by these ghosts. 

The Ohio State Reformatory, while finishing its last days as a high security prison, be-

gan as a hospital for mentally ill criminals, and has its own fair share of stories of violent 

ghosts. Mysterious Heartland has reports of people being pushed down the stairs of the 

guard towers, violent breezes, and angry screams that match the stories of Central State 



Digital Literature Review 7
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Hospital’s ghosts almost perfectly. Stories like this are scattered throughout many 

American Midwestern asylums, but it’s not just in these asylums where violent ghosts 

linger. A small town in Michigan tells the story of the Ada Witch, named so because of the 

town she resides in. The story is a fairly common one and keeps rather close to the classic 

woman in white formula. A husband caught his wife and her lover one night and killed 

them both in a jealous rage. The husband also died in the struggle, and couples and hunt-

ers who have been to the area report seeing the crime continue to play out, and some 

have even reported almost being dragged into the ghostly reenactment themselves. Mike 

Kroll, who told the story of his own encounter with the Ada Witch to Gary Eberle in his 

book Haunted Houses of Grand Rapids, said that he didn’t truly feel afraid of the ghost 

that he saw until he saw what he believed to be a knife in her hand. It was not the ghost 

that truly frightened him, but rather the fear of his own injury or death that prompted 

him to return to his car and leave. The fear of violence, despite its best efforts, has left the 

asylum and integrated itself in the small-town rural ghost stories. 

 But it is not just the fear of violence that the asylum has left behind. The fear of iso-

lation frightens us just as much as violence. In his book The Sacred Canopy, Peter Berger 

speaks to this idea of a “nomos” and “atomy.” He uses these terms in regard to religion, 

but the concept remains the same. The nomos is the idea of a structured and meaning-

fully ordered society. Atomy is the idea of a complete and radical separation from society, 

and Berger even calls it a “powerful threat to the individual” (21). It’s the idea of a disrup-

tion of everyday life, of a “loss of status of the entire social group to which the individu-

al belongs” (21). Berger lists one of the reasons of this loss as a physical separation from 

society. According to Berger, to be placed in the “ultimate ‘insanity’ of such anomic hor-

ror” was the most feared thing to an individual, that to be placed in that isolation would 

ultimately destroy someone, which was what the asylum was (22). People were removed 

from the society they knew and placed in chaotic isolation, which they very rarely came 

back from. The asylum is a picture-perfect place of what that isolation would look like in 

regard to the already integrated fear of the stereotyped sickness and violence in asylums. 

Residents’ families and loved ones didn’t want them to leave the isolation, because it was 

easier to just leave them there. These patients were being taken care of, after all, both 



Digital Literature Review 8
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in life and death. Family rarely came to claim the bodies and take their loved ones back 

home once they passed, either too ashamed of the mentally-ill family member, or unwill-

ing to make the effort for a dead person. It was because of these attitudes that many of 

these asylums had graveyards to bury the dead, chock full of unmarked and numbered 

graves. According to an article by Peter Dockrill, the Mississippi State Hospital has 7,000 

unmarked and newly discovered graves, and these numbers are not unique to Mississippi. 

 Ohio’s Athens Asylum had three graveyards on its grounds, and up until 1943, not 

a single one of the headstones bore a name. They only contained numbers, with the pa-

tients’ names recorded in ledgers that have since been long forgotten. One of these led-

gers was found in the Ohio University archives, after the school took over several of the 

buildings; this discovery revealed the names of about 1,700 of the over 2,000 souls that 

had been buried on these grounds. Asylum patients, however, are not the only residents 

of these graveyards. According to Haunted Athens Ohio, the official site to set up tours 

through the buildings and graveyards, the Athens Asylum was open and running during 

the American Civil War, and it functioned as a military hospital at the time as well as car-

rying out its usual duties of caring for the mentally ill. The hospital staff buried the dead 

soldiers that came to them and the ones that died in their care just like they buried their 

own patients, in graves marked only by numbers. These graveyards are full of ghostly 

sightings and visible hauntings from both the students attending the campus and the 

surrounding town, but there is no one specific story or ghost to point to. There can’t be, 

because no one even knows who was buried here, so how can anyone know who haunts 

them? Graveyard stories like this are not specific to asylums, but the fear of being forgot-

ten lies most prominently with them, and the Athens asylum cemeteries show this cul-

tural fear with a shocking clarity. Not only was a body left behind, but so was the name. It 

was the ultimate separation from society—the ultimate atomy. 

The Peoria Sate Hospital in Illinois has the story of Mr. Bookbinder. According to 

Mysterious Heartland, who has the story in its archives, he was a patient at the asylum, 

and he was given the job of helping to bury other patients in the hospital graveyard. He’s 

known for mourning every patient that passed, and when he too passed, the story goes 

that at his own funeral, his ghost came back to mourn his own passing. Dr. Zeller, who 



Digital Literature Review 9
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was assigned to Mr. Bookbinder as his main doctor, writes in his personal journal that over 

400 people saw this phenomenon and that they opened his coffin to confirm his death. 

It’s an eerie story, not just because of Mr. Bookbinder’s appearance at his own funeral, but 

because, having no loved one to mourn him, he did it himself. The story of the ghostly ap-

pearance echoes the sentiment of Mr. Bookbinder’s ghost, in both his own mourning and 

his ability to not leave the graveyard that he worked at in life. Illinois also tells the story 

of Resurrection Mary, a young woman who died in a car crash along Archer Avenue near 

Chicago in the early 1930s. As Michael Keen tells it, she does not have one specific physical 

appearance outside of a white dress, but she always asks for a ride back to Resurrection 

Cemetery. One account of her story even has her telling the man who drove her back to 

the cemetery ,“where I’m going you cannot follow.” Mary, unlike Mr. Bookbinder, is able 

to leave the graveyard for a time, but she always has to return. It’s isolation at the most 

painful—able to leave for a time, but always returning. The fear of death already frightens 

the Midwest, but the thought of having to return, as shown with both Mary and Mr. Book-

binder, is a self-imposed “atomy,” the feeling that, according to Berger, is feared the most. 

Patients are not the only ones still tied to the asylum walls. Countless stories of doc-

tors and nurses haunting these buildings are just as common as the stories of patients. 

Manteno State hospital in Illinois reports stories of its former doctors and nurses roaming 

the long since abandoned halls, and some have even heard voices over the broken inter-

com going through what would have been the daily routine. Independent State hospital 

in Iowa is full of accounts of sightings of doctors and nurses, and every other aforemen-

tioned asylum has at least one account of an apparition of a doctor or nurse—both Mys-

terious Heartland and Only In Your State, websites featuring firsthand accounts of ghost 

stories, present ghostly sightings of doctors and nurses at the mental asylums they list. 

These people may not have all died within asylum walls, but it’s not strange to think of 

them coming back. Like Resurrection Mary, they may feel a sense of obligation to return, 

to see out the care of the ghostly patients that still remain. It may go back to the idea of 

atomy—they have already been secluded from society, and are not welcomed back, or 

cannot merge back into the normalcy of everyday life. Society, due to the association falla-

cy, would have rejected them. These doctors have spent time among the so-called 



Digital Literature Review 10
122

“insane,” and so they must be too. 

  Asylums carry with them a stain on the history of mental treatment and the bur-

den of the Midwestern haunting and fears of unspeakable violence and being isolated 

and forgotten. Asylums were places where people were sent to die. Even in death the 

patients couldn’t escape, buried in unmarked and numbered graves. Even doctors and 

nurses rarely left, rejected from a society who othered them along with the patients, stay-

ing behind to care for patients no longer there. Asylums are beacons of the Midwestern 

haunting—a safe place to project these fears on an environment similar to the region of 

the American Midwest without a seemingly direct correlation. Yet these fears still trickle 

down, tainting the ghost stories we tell and projecting the fear of the Midwestern cultural 

haunting back onto the culture itself. 



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