Central State Hospital Milledgeville GA: An Abandoned Insane Asylum Full of History

Once a month, Milledgeville GA offers a tour of the Georgia State Lunatic, Idiot, and Epileptic Asylum. No, I’m not being ugly…that was the original name of Central State Hospital, established in 1837.

You won’t want to miss a tour of the Central State Hospital Milledgeville GA!

We believe this tour offers the perfect reason to day trip to the area…and here’s why!

Central State Hospital Milledgeville GA: An Abandoned Insane Asylum Full of History
The Walker Building at Central State Hospital, courtesy of Visit Milledgeville.


We learned a lot about the history of the hospital and grounds, and these stories really stood out to me. I’m going to give you the teasers, but you’ll have to take the tour yourself in order to hear the juicy deets.


Many times online you’ll read that there were once as many as 12,000 patients to 13,000 patients here, but our tour guide (who once worked at the hospital) confirmed the actual number is close to 17,000 patients.

With 17,000 patients and 200 buildings, spread over 20,000 acres, it is by far the largest mental institution in the United States (and probably the world).


This was the most shocking to me…Milledgeville State Hospital is still open, just not in the same capacity.

It is currently a maximum secure forensics facility providing psychiatric evaluation, treatment and recovery services to 384 people referred from Georgia State Corrections who do not require a hospital-level of care but are unable to reintegrate directly into the community. The current name of the maximum secure forensics facility is the Payton B. Cook Building.


Cedar Lane, the cemetery for whites, is the cemetery photo you usually see, with metal stakes lined neatly in tight-knit rows.

It turns out, those stakes do not actually mark graves. They are a memorial to the lost burial places of those interned at Cedar Lane. You’ll have to come on the tour to hear the whole chronicle. We also learned another unique side-story: While we are adamantly opposed to segregation, we discovered why African-American families of former residents can be thankful for this instance in a strange twist of fate.


Tillman Barnett is the name of the first patient admitted here in 1842. He was from Macon, but did not enjoy a 30 min drive from his hometown; he arrived via horse and buggy. However, because of his feared mental illness, he was not allowed to ride in the buggy. He was chained to it, and forced to walk the entire distance. Before a year was up, he died at Central State from the exhaustion of the trip.


There are multiple stories about poor treatment of patients, and “crazy” therapy plans like lobotomies, shock therapy and such. According to our guide, that’s not the reason the institution was shut down. Those treatments, at the time, were state-of-the-art advances in the world of behavior health and psychiatric hospitalizations.

The problem was the lack of help. With such a large number of patients, there was only one doctor for every 200-300 patients. At that rate, no matter how caring and intelligent the doctor, patients just could not get the mental health care they needed.


Geraldo Rivera is probably America’s most revered investigative reporter for his 1972 expose about Willowbrook Institution’s poor conditions and treatment of those seeking mental help. He won a Peabody Award for his effort.

Long before this revelation, though, John “Jack” Nelson won the Pulitzer Prize for reporting about Central State in 1960, in an AJC article. His coverage led to reforms at the institution and additional funding for mental health in Georgia from the state legislature. 


Dr Greene was the hospital’s superintendent during the Civil War. When Sherman and his troops came to town, Greene was able to convince Sherman to spare the hospital, and even give rations to the patients here. You’ll have to take the tour to learn his persuasion techniques.


  • The Powell building’s facades offers a unique architectural optical illusion
  • The train depot here is being transformed, and you’ll love it
  • The world’s largest kitchen has been bought and finds a new use
  • The pecan grove can be rented for events
  • The Jones Building was a filming location for a pop-culture favorite
  • …and more!


  • The trolley tour is about 90 minutes, and tickets can be purchased here for $30 per person.
  • You’ll leave from Milledgeville’s tourism building, climbing aboard the trolley for the tour. Parking in the area is generally easy to find. Just note that it is all 2-hour parking. That works out perfectly for the tour, but if you want to explore Downtown (and you should!) then you’ll need to move your car before doing so.
  • Plan for some time after the tour to go back to the Pecan Grove if you want photos. The only time you’ll exit the trolley on this tour is at Cedar Lane Cemetery. I longed to take photos of the ruins, but there is no opportunity. I recommend you take the tour first so that you understand the significance of the buildings you photograph.
  • Yes, you can enter the grounds on your own. You are not, however, permitted inside any of the buildings. In fact, the rules require that you stay on the sidewalks.


The Central State Hospital Campus Driving Tour is a self-guided driving tour that highlights the historic buildings of the campus and mentions important people from CSH past, as well as the significance of certain periods in the Hospital’s history.

To take the tour, follow the maps contained in the brochure and scan the QR codes with your phone to receive narration about each stop. Brochures are available for pick up at the Visitor’s Information Center, 200 West Hancock Street, and the Just Imagine Cottage, 95 Depot Circle Drive, on the campus grounds.


The Central State Hospital Milledgeville GA has tons of events you won’t want to miss! Here are just a couple:

April Fools Bike Ride: Take two wheels and plan a scenic pedal with Bike Walk Baldwin’s 16th annual April Fools Ride!  The annual ride kicks-off overlooking the pecan grove of the former Central State Hospital campus. Featuring a variety of routes, climbing terrain and easy-going fun, there is a great ride option for cycling enthusiasts of various levels! 

Run the Thriller 5K: Looking for an event to get your heart pounding? Join the Milledgeville Young Professionals as they host the frightfully fun 9th Annual Thriller 5K in October. The Thriller 5K loops racers through the most historic and iconic points on the Central State Hospital campus. Runners beware – for a fun Halloween twist, zombies chase the racers around the 5K loop. The event benefits Keep Milledgeville-Baldwin Beautiful & Zeta Tau Alpha – Georgia College to benefit Breast Cancer Education & Awareness. Dates and information for this event have not been announced yet.

Central State Hospital Milledgeville GA FAQ

When did Central State Hospital in Milledgeville GA close?

Central State Hospital in Milledgeville, GA, closed in some capacities in 2010, but it still serves a small number of patients today. It is still open and expanding, and a brand new facility was opened in March of 2018.

Can you go inside the Central State Hospital in Milledgeville?

The inside of the Central State Hospital buildings are closed to the public, but you can take a trolley or self-guided tour and learn more about the grounds and the buildings.

Can you spend the night at the Central State Hospital in Milledgeville?

Although you can’t spend the night at the Central State Hospital, you can spend the night on its campus. Stay in the 1920’s Bungalow situated on the corner of a large pecan grove, across from the Central State Hospital infirmary.



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Central State Hospital Milledgeville GA: An Abandoned Insane Asylum Full of History