Designed by Robert Mills, this building is the original hospital structure of the South Carolina State Hospital for the mentally ill. An act of the South Carolina General Assembly established and authorized its construction on December 21, 1821 and the cornerstone was laid, with Masonic ceremonies, on July 22, 1822; the building was completed December 18, 1827.
In the early nineteenth century, the concept of care for the mentally ill was far from humane. Many believed that the only solution was to "put away" these people in institutions similar to prisons. Robert Mills did not share this belief, and his State Hospital design reflects reforms that were far ahead of his day; i.e., the rooms were planned with a southern exposure to provide patients with fresh air and sunlight, and the avoidance of a prison appearance by hiding hinges and locks. The fireproofing of buildings was also a practice quite uncommon for the early nineteenth century and one in which Mills was a leader. In 1852 and 1859, Dorothea Dix, national leader in improving conditions for the mentally ill, visited the South Carolina State Hospital, meeting with officials there to discuss innovative methods of care and treatment.