RISING 200 FEET OUT OF the hills of rural West Virginia, a clock tower looms over a vast and empty collection of buildings that once housed thousands of people diagnosed with mental illness. After being shuttered for more than 20 years, since 2007 the Weston State Hospital has been open for business again under its original name—the Trans-Allegheny Lunatic Asylum—and caters to tourists interested in some combination of history and the paranormal. Some buildings are off-limits and most of the site is without electricity, but a considerable portion of it awaits the curious and the brave. As I pulled in to the vast, park-like grounds, the imposing, cut-stone main building leered in the late afternoon sun. The architecture is Gothic-inspired, and the windows dark—like it was made to evoke a sense of dread and mystery. But this is precisely not what the builders wanted to inspire.

I’m an academic historian of American culture at Southern Connecticut State University, and my trip to the Trans-Allegheny began years earlier, when I saw it featured late one night on a ghost-hunter television show. What was it that made this place so scary? Was it always that way? (According to the Travel Channel, the hospital is one of the 10 most haunted spots in the country.) I spent the next five years tracking the dark narrative of mental hospitals through fiction, memoir, film, media, and art. I watched hundreds of movies, read scores of novels, and pored over heaps of periodicals. Ultimately, I came to the conclusion that Americans have always been deeply invested in what goes on within the walls of these institutions, and I began to understand why. The term “asylum” itself, which has negative connotations today, was originally used to evoke confidence, safety, and security. How and why this changed is part of this longer story of stigma, fear, and horror. A “ghost tour” through the Trans-Allegheny is the logical end of the story. Or perhaps, more precisely, the opening of another chapter.

THE TRANS-ALLEGHENY WAS ONCE AMONG the most expensive buildings in the United States. Ground broke on this massive collection of sandstone buildings in 1858, with the forced work of incarcerated African-American laborers, and continued on and off through the 1950s. Situated on over 300 acres, it was designed to evoke optimism and the spirit of reform that gave birth to similar mental hospitals around the country, beginning in the 1830s.

These public works were sold as monuments to healing, mansion-like and airy, with cutting-edge medical treatments and scientific architecture. Inside, a person committed there was said to encounter occupational therapy, medication, hydrotherapy, even hypnotherapy. Superintendents boasted that the older methods—chaining up the “mad” in basements—had been abolished. Straitjackets and strong rooms, it was said, would be used only sparingly. Clean air, baths, simple food, and healthful activities were considered cures for disorders of the mind, and the reported “cure” rates were—at least at first—terrific.