St. Elizabeths has been a mental health hospital in Washington, D.C., since 1852, when it was established by the United States Congress as the Government Hospital for the Insane. St. Elizabeths, along with other hospitals, experienced rapid expansion in its first century, hitting a peak of almost eight thousand patients by the 1960s. Deinstitutionalization in the second half of the twentieth century emptied out the historic buildings on campus. This well-illustrated book follows an exhibition at the National Building Museum, tracing the hospital’s evolution over time, highlighting the ways that this specialized architecture and landscape served the mentally ill. It continues the story of St. Elizabeths, a National Historic Landmark, through its current redevelopment as a federal campus and mixed-use neighborhood.