4 days ago
Cox calls for mental health care expansion on Utah State Hospital's 140th anniversary
Dr. Amanda Rapacz, assistant superintendent, and Dr. Paul Whitehead, medical director at Utah State Hospital during a tour of the the institution's Rampton building on July 23, 2025. (Alixel Cabrera/Utah News Dispatch)
The Utah State Hospital has come a long way since it was conceived as the Utah Territorial Insane Asylum in 1885 at a Provo location meant to be as distant as possible from the city's center. As this month marks its 140th anniversary, neighbors now use the 312-acre campus as an outdoor recreation spot, while inside, a much smaller patient population can cope and heal.
The hospital treats children, teens and adults with severe mental illness, as well as adults who need mental health treatment before they can face charges in court, a big change from how it worked during its inception, when the facility was the first stop for mental health disorders.
The campus has been in the community longer than Utah has been a state and has evolved with the times. Its staff now treats about 300 patients, only a portion of the 1,250 people the hospital housed in the 1950s. Care is more personalized and thoughtful, treatment units are smaller, and overcrowding isn't as big of an issue.
SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Gov. Spencer Cox mentioned that fact at the Wednesday celebration, highlighting the team that makes the hospital run as 'outstanding,' but also acknowledging a need for expansion.
'When I share just those numbers, 1,250 patients who were here in the 1950s with only 1,000 beds, to recognize that we just have a fraction of those 1,000 beds,' Cox said. 'Now we're not a smaller state than we were when there were 700,000 people and 1,000 beds. There are, of course, now 3.5 million of us and many fewer beds, unfortunately.'
While the hospital reduced its patient intake capacity, it has also undergone substantial changes in its mission. It's no longer the first stop for mental health patients, but the last resort. It's also joined by many institutions across the state that provide similar care.
The state is grateful for that expansion, Cox said. But, he added, 'there's a desperate need for more of it.'
Obsolete practices have been replaced by better treatment, and care has become more compassionate, Cox said. But more investment and work is needed.
'I would just also say there is nothing compassionate about allowing patients who should be here, who are not here, who are killing themselves slowly on our streets. There's nothing compassionate about that,' he said. 'And too many have believed that that's where we needed to be, that that's where we need to go. And I think we've made a grave mistake.'
The state has also faced a lawsuit in recent years over extended wait times for people charged with crimes and ordered to receive competency restoration treatment at the Utah State Hospital, but who were instead spending months in jail waiting for a bed. In 2017 the state settled the case brought by the Disability Law Center and agreed to shorten wait times.
During the Wednesday event, Brandtley Henderson, the hospital's music therapist sang happy birthday to the institution with an acoustic guitar as hundreds gathered on a big, green lawn near paths shaded by thick trees and a prime view of the Wasatch mountains.
Lt. Gov. Deidre Henderson commended the hospital for being 'a place of not just housing,' but 'a place of healing.' But it hasn't always been that way, she said.
'People, maybe like me, could have been sent to a place like this for being too opinionated, right?' she said. 'We know a lot more now about mental health and how to help and how to heal and how to provide hope, and that's what this institution is.'
Henderson is right — 1885-1910 admission records from the hospital listed financial embarrassment, poverty, jealousy, worry, unreciprocated love, excessive reading, reading novels, girl trouble and other now unthinkable reasons as supposed causes of insanity. As late as 1963, a female patient's cause was recorded as 'frustrated housewife syndrome.'
Henderson said she expects doctors to learn even more about mental health care in the coming years, but for now, the state is 'committed to maintaining this facility, to maintaining the function, the purpose, the why, and to making sure that more people have access and have the opportunity to not only experience healing here, but to experience the community that is here.'
While the campus has remained a community landmark for over a century, during the last couple of years there have been talks about the potential sale of the prime Provo real estate.
Rep. Tyler Clancy, R-Provo, proposed a bill in 2024 that, among many provisions, required the state to sell the property. However, that was scratched in an amendment and the Legislature only approved a study about issues relating to civil commitment, or a court-ordered intake of an individual with severe mental illness.
Despite that change in the bill, the idea hasn't been extinguished. Earlier this year, Utah County commissioners voted in favor of a resolution to support a relocation proposal, according to KUTV. That may involve dispersing services throughout the state.
Senate Majority Assistant Whip, Mike McKell, R-Spanish Fork, opened a bill file titled 'Utah State Hospital Amendments' during the 2025 legislative session, but ended up abandoning it.
About the relocation bills, a Department of Health and Human Services public information officer said in a prepared statement that in the department's view, what matters most is that the state continues to ensure behavioral health care needs are met.
'The Utah State Hospital has a long and proud tradition of serving Utahns with significant mental illness. We expect that tradition to continue, as there are continually growing needs for mental health treatment in our state,' the department said. 'We are committed to continually improving the services we provide. We are also committed to working with our partners, including Utah legislators, the Utah Behavioral Health Commission, and local mental health authorities to maintain or improve the services we offer.'
However, with those potential relocation plans still uncertain, business continues as usual in the Provo campus. In a tour of the Lucybeth Rampton building — named after the former Utah first lady — Dr. Amanda Rapacz, assistant superintendent, and Dr. Paul Whitehead, medical director at the hospital, showcased the many ways patients are treated and what life in the hospital looks like.
Hallways filled with art and natural light from ceiling skylights lead to gyms for physical therapy, rooms for ceramics or music therapy, conference rooms for group sessions, a K-12 school run by the Provo School District, and even a cantine that accepts 'hospital money' that patients can earn by participating in treatment or keeping their rooms clean.
Among the stars of the show are the courtyards, Rapacz and Whitehead said, where patients grow their own tomatoes to turn into salsa, and get to spend time outdoors, a rare feature among other state hospitals around the country that may be surrounded by city blocks and can't allow patients outside, or have fences that give the space a 'correctional' look.
'I've done individual therapy sessions out here, and the literature shows that green space and being outdoors is incredibly important for somebody's recovery, and I think it's one of the ways we're really blessed,' Rapacz said.
Solve the daily Crossword
