Final Report of Progress

Central State Hospital Archives Project

King Davis, PhD, Principal Investigator, Research Professor, School of Information
The University of Texas at Austin, king.davis@austin.utexas.edu 

Patricia Galloway, Ph, Co-Principal Investigator, Professor, School of Information
The University of Texas at Austin, galloway@ischool.utexas.edu

Unmil Karadkar, PhD, Co-Principal Investigator, Assistant Professor, School of Information
The University of Texas at Austin, unmil@ischool.utexas.edu

April 11, 2019
Summary of the Project

     The Central State Hospital Archives Project started in 2009 as an unfunded project in the College
of Liberal Arts at The University of Texas at Austin. The project was initiated at the request of
Charles Davis, MD., director of Central State Hospital (2007). He was concerned that their historical documents were at risk of deterioration from being kept in a non-archival environment. Under the Virginia Records Retention Act of 1972, the Library of Virginia is the legal repository of these types of records held at CSH. However, the relationship of the Library to the hospital was limited and interpretation of the Retention Act unclear. Over the course of the project, the Library has become an active and supportive collaborator, providing access to its archival files on CSH and participating in a privacy roundtable meeting on historical psychiatric records.

     In its first six years, the project obtained operational funding ($75,000) from the National Association of State Mental Health Program Directors and the President of The University of Texas at Austin ($75,000). The project used the initial funding to locate, restore, catalog and digitize (external contract) the 800,000 paper documents and 10,000 photographs maintained at the hospital. However, micro-film copies of historical treatment records were not included in the digitalization project. Our major funding source would not provide funding for digital copying.

     In 2015, generous funding ($763,000) was obtained from the Andrew W. Mellon Foundation
enabling the archives project to address the intersection of increased access and maintenance of privacy of historical psychiatric records. The archives project sought to determine how the application of critical policy analysis, contemporary digital library technology, and archival research and preservation methods combined to assist a state mental hospital system to update their traditional approaches to competing policy issues of increasing access, maintenance of privacy standards, and retention of historically significant mental health records, documents,
photographs, and legislation. Initial work to identify, collect, preserve, catalog, copy, and analyze the contents of the archives illuminated how the multiple issues of race, slavery, segregation, unscientific predictions of the prevalence of illness, and treatment science were managed in historical literature, public policy and mental institutions. The archives project received its final year of funding from the Mellon Foundation in 2018.

     The archives project collected, copied, and analyzed patient, organizational, and policy data from Central Lunatic Asylum for Colored Insane (renamed Central State Hospital in 1885) as well as survey findings from multiple states and academic scholars to address five complementary activities supported by funding from the Mellon Foundation:

1. Analyze state and federal laws on access, privacy, and confidentiality of historical mental health records, documents, photographs, and legislation; and, compare Virginia laws with other states;

2. Develop a conceptual model for digital mental health records including policies and procedures for ingesting records, storing these in a dark archive, assessing the sensitivity of these records and migrating records for use by different stakeholders;

3. Apply digital technology to create a dark archive and digital library that serves as a proof-of-concept implementation and demonstrates the viability of this model which balances need-based access for various stakeholders with privacy of historic records and documents to house the historical mental health records, documents, photographs, legislation, and findings from surveys.

As the project advanced, we included two additional activities that are essential for
conceptualizing the interface of privacy policies and digital technology to create a dark archive
and digital library useful to a variety of stakeholders.

4. Survey and analyze the digital infrastructures within state archival agencies to determine their readiness and staffing to digitally store and manage access to restricted historical mental health records, documents, photographs, and legislation; and, determine current digital capability of each state;

5. Collect and analyze data on admissions of African Americans to Central State Hospital from 1868 to 1941; compare 15 variables routinely collected at admission;

Substantial progress or completion of each of these outcomes has been made over the three years of grant support from the Andrew W. Mellon Foundation.

Summary of Outcomes

(1). Analysis of existing state policies and federal laws on access, privacy, and
confidentiality of mental health records, documents, photographs, and micro-film:

a. Purpose: The intent of this part of the archives project was to gather and examine as many as possible of the state and federal laws and policies that govern issues of access, privacy, confidentiality, and retention of historical mental health records, photographs, documents, and micro-film. Part of the rationale for this approach was to compare the rules and regulations across all fifty states that dictate access by families, former patients, scholars,
and media to historical mental health records retained by state mental health agencies. A
second intent was to assess the goal of increasing access to historical psychiatric records
by families, scholars, and the media in a context guided by existing law and policy.

b. Methods: Initially we used Google Scholar case law search of the 50 states and
Washington, D.C., using search terms “mental health records,” “decedent mental health
records,” “mental health records HIPAA,” and “mental health records access” from 2010
to 2016. Twenty-four states provided copies of their state laws on privacy including Texas,
Virginia, Florida, Hawaii, Alaska, Massachusetts, Utah, Montana, South Dakota, Arizona,
The District of Columbia, Nebraska, Rhode Island and others. In addition, we used Internet
and legal database search methods and extensive literature reviews of case law to obtain
copies of laws and court decisions on privacy from states that did not reply.

c. Findings: Generally, The Health Insurance Portability and Accountability Act of 1996
and the (HIPAA) Privacy Rule, 45 CFR Part 160 and Subparts A and E of Part 164, is the
applicable law and policy most often cited as governing access and privacy decisions at the
state level. However, it was also found that there were more specific state laws or policies
regarding protection of health information (including mental health records) beyond
protections established in HIPAA. Mostly, state law dictates record retention requirements
in terms of historical mental health records. For example, Texas law restricts certain
holders of mental health records beyond HIPAA rules and regulations.

Organization of the laws and policies revealed three general categories of law and policy:
1) records retention laws or policies that require mental health records to be retained by
agencies for specific time periods; 2) privacy or confidentiality laws or policies protecting
mental health records; and 3) disclosure, access and use laws or policies, indicating a
patient or former patient’s rights over the patient’s records and serving as exceptions to the
privacy or confidentiality laws or policies in limited circumstances such as law
enforcement, guardianship or research.

Some state law and policy on privacy are designed to address mental health and substance
abuse records together, while others treat the two types of records separately. This
inconsistency is also an issue at the federal level, where HIPAA focuses on health,
including mental health, records, while other federal statutes specifically address issues of
substance abuse treatment records.

Retention periods are the most fundamental and easily explained difference between the
states (five, six, seven and 10 years of retention of mental health/health records seem to be
most common), while clearly explaining the difference between laws and policies
regarding confidentiality, privacy, disclosure, access and use is much more difficult.

(2). Develop a conceptual model for digital mental health records including policies and
procedures for ingesting records, storing these in a dark archive, assessing the sensitivity of
these records and migrating records for use by different stakeholders;

a. Purpose: The purpose of this objective was to design a model that can be adopted by
projects or institutions that host similar collections–ones which are characterized by
privacy-sensitive materials and compliance requirements related to these records.
Such collections include mental health, medical or human rights collections, to name
a few. In order to make these collections available to different types of users, an
additional objective was to assess our collection and develop workflows for
classifying materials with respect to access.

b. Approach: We reviewed existing models of organization and metadata encoding that
have been adopted by various state libraries as well as well-known metadata
collections such as the Digital Public Library of America. We especially focused on
schemas that were sufficiently equipped to provided unsupervised, online access to
sensitive materials after user authentication as well as those designed for community
archives. We also studied processes followed by various institutions for determining
the degree and nature of access to various records.

c. Outcomes: We have designed a well-documented, standards-compliant schema for
recording relevant metadata for policy-guided, privacy-sensitive collections. The
schema documentation is available publicly on the UT Austin wiki at:
https://wikis.utexas.edu/display/CSHProject/Dark+Archive+Metadata+Schema . The
schema is modular and consists of several components, each of which may be
included or excluded consistent with the needs of an adopting project. The schema
includes components–called profiles–for preservation, administrative, technical, and
compliance metadata. Furthermore, we have developed a workflow that includes
input from relevant stake-holders for determining the mechanisms and protections
under which various documents and records may be made available to users.

(3). Apply digital technology to create a dark archive and digital library that serves as a
proof-of-concept implementation and demonstrates the viability of this model which
balances need-based access for various stakeholders with privacy of historic records and
documents to house the historical mental health records, documents, photographs,
legislation, and findings from surveys of state policies, scholars, archival agencies, and
patient level data.

a. Purpose: The purpose of this part of the archives project was to design a policy-
compliant digital archive for securely housing the records of the Central State Hospital. The team has access to over 700,000 digitized pages containing the records of the institution, which has operated since 1870. Approximately a third of this collection consists of handwritten cursive documents, which do not lend themselves to automated content extraction.

b. Approach: In order to make the content in these historically-significant documents available to scholars, genealogists, policymakers, and families of former patients, we have designed methods for large-scale data curation, classifying the images according to a developed CSH finding aid for Board Minutes, Patient Records, and Photographs, and hosting them in a OAIS-compliant dark archive. We developed semi-automatic techniques for accessing the textual and tabular data within these documents, since they do not respond to optical character recognition methods. While crowdsourcing is a promising approach for problems where privacy is not an issue,
our data are medical data, where others were making decisions for the patients. Hence, we have needed to develop “privacy-sensitive” crowdsourcing techniques, as well as exploring methods that might gather reliable textual feedback from crowd workers who might work with only single words.

c. Outcomes: Our team has designed a policy-compliant digital archive for securely housing the records of the Central State Hospital. The team has access to now over 700,000 digitized pages containing the records of the institution, which has operated since 1870. Approximately a third of this collection consists of handwritten cursive
documents, which do not lend themselves to automated content extraction. In order to make the content in these historically-significant documents available to scholars, genealogists, policymakers, and families of former patients, we have designed methods for large-scale data curation, classifying the images according to a developed
CSH finding aid for Board Minutes, Patient Records, and Photographs, and containing them in a dark archive. We then developed semi-automatic techniques for accessing the textual data within these documents, since they do not respond to optical character recognition methods. While page-level crowdsourcing is a promising approach for problems where privacy is not an issue, our data are medical data, where others were making decisions for the patients. Hence, we have needed to develop “privacy-aware” crowdsourcing techniques. We have developed software
that segments page images into their constituent textual units, then clusters these units by similarity, thus grouping together many occurrences of a single word. Then, a human may associate a cluster with the word image, thus transcribing multiple word occurrences simultaneously, via Zooniverse, an open source crowdsourcing engine.

The source code for our software has been released via GitHub and is available at:
https://github.com/ColoredInsaneAsylums/ (repositories labeled as
PrivacySensitiveTranscription)

Our software for processing the archival quality images for inclusion in the dark archive is also available via GitHub:
(https://github.com/ColoredInsaneAsylums/DarkArchiveWorkflow).

These scripts are also documented externally on our project wiki at:
https://wikis.utexas.edu/display/CSHProject/Dark+Archive+Script+Documentation .

These scripts process documents beginning with files stored with folders and extract or generate metadata consistent with the model described in outcome for objective 2. Using PREMIS-3 compliant preservation metadata, compliance profile based on retention and disposal schedules from three states (Virginia, Texas, and Mississippi),
administrative metadata from our finding aid, and extracted technical metadata, our scripts generated JSON metadata objects in MongoDB and then export these metadata for inclusion in a dark archive along with the images. The dark archive is currently implemented in Archivematica. Each of our repositories include lightweight, modular scripts that can potentially be used in other environments than we have constructed. This need will prove important as more and more hospitals are using Electronic Medical Record Systems—although this issue may become much like the state of state recordkeeping systems as technology companies compete for hospital business.

(4). Survey and analysis of state archive agencies and their readiness to manage mental
health records, documents, photographs, and legislation where questions of privacy and
confidentiality and stigma are pronounced:

a. Purpose: The intent of this part of the archives project was to obtain two sets of information from state archive agencies to help insure a goodness of fit between the prospective model being developed in the project and state archive agencies. First, it was important to identify, compare, and contrast the digital environments in as many states as possible to establish a baseline. The second objective was to determine what procedures (redaction vs restriction) the state archives were going to implement to maintain privacy of historical psychiatric records. These two issues would determine whether and under what broad provisions sensitive records could be made available to scholars, media, and the general public.

b. Approach: The project team developed a 21-item qualitative survey designed to obtain information online about existing policies on access and privacy, software already being used, progress towards developing digital systems, staffing levels, and interest in participation as a field-testing site. Names and contact information for all state archives
were obtained through the Council of State Archivists (CoSA). Questionnaires were delivered via the Internet using Qualtrics and responses were obtained from archive agencies in 21 states with data from three additional states obtained through Internet searches.

c. Outcomes: State archivists who responded to the survey consider that medical records should in many situations be considered sensitive, such that they were interested in our work with redaction of identities going back into history from the Central State Hospital. We found, however, that there is still no single system used for digital or digitized
records among states thanks to the uniqueness of state laws (already revealed in our review of state laws). States that have received the most funding from grants, as well as academic assistance, have developed their own systems, but even they have not yet adopted standard metadata elements and ontologies. States coming late to the task of
dealing with digital recordkeeping at all have acquired commercial systems, especially Preservica. There has also been a significant adoption of Archivematica and ArchivesSpace., which should also be useful as providing workflow.
Here in Austin, we are in discussions with the Hogg Foundation for Mental Health and the Dell Medical School to assess, catalog, digitize, and analyze the archival records held in the Austin State Hospital. We will submit a proposal to the Foundation in June 2019.

(5). Collect and analyze data on admissions of African Americans to Central State Hospital
from 1868 to 1941 (State retention act prevents data analysis beyond 1941):

a. Purpose: This part of the archive project was designed to collect and convert extensive amounts of raw historical data into a more digestible form to allow for detailed qualitative and quantitative analyses.

b. Approach: Identifying data were gathered from patients, families, and from involuntary commitment orders from courts. The names of patients admitted were included in the extensive raw historical data and subject to disclosure under existing law and policy. The archive project chose to redact all names and any data that could lead to disclosure of a patient’s identity from our analysis and publications. Categorical data included basic
demographic information: name, age, race, gender, place of birth and residence, occupation, and marital status. Clinical information such as type of admission, date of admission, diagnosis, cause of illness, length of stay, condition at discharge, mortality, and cause of mortality were also included in the data collected.

Data on patients were transferred from multiple patient registers and counter-checked to insure accuracy. Raw data were transferred to excel spread-sheets and visually analyzed to consider how to organize the 15 categories of demographic and clinical material. For example, there were over 222 different words used for diagnoses making analysis unwieldy. An outside psychiatric consultant reduced the 222 diagnoses to 9 consistent with the current Diagnostic and Statistical Manual (DSM V). A similar process was used to categorize hundreds of causes of illness and mortality. Data were subjected to mixed statistical methods to determine whether there were significant relationships between variables. For example, the project staff were interested in determining whether there was
a correlation with the risk of admission to the hospital and such variables as diagnosis, age, gender, residence, or occupation.

Outcomes: Slightly over 54% of the persons admitted from 1840-1940 were male significantly exceeding the percentage of females 46.5%). Admissions of males exceeded those of women in every decade except the 1860s (admitted to Eastern Hospital). Slightly over 80% of all admissions were of individuals between the ages of 18-54 with 13% over the age of 55 and less than 5% under age 18. Geographically, most admissions came from cities and counties in proximity to the hospital with large black populations. The largest number of admissions came from the larger cities of Richmond, Petersburg, and Norfolk and from Charlotte, Pittsylvania, Henry, Patrick, and Carroll counties. The farther a city or county was from the hospital the smaller the number of admissions. Less than 20
persons were admitted from outside of Virginia from Kentucky and Washington DC. Almost all the persons admitted through 1940 were laborers with some in semi-skilled to skilled positions as carpenters, plumbers, and shoe-makers. Of the 17,023 persons admitted less than 50 held professional positions as teachers, preachers, or lawyers.

By the end of 1879, close to 500 black patients had been admitted. Although the annual average was only 50 new admissions, the decennial total was six times more than admitted soon after Emancipation. The rapid growth in excess admissions, greater than the black proportion of the population, heralded a pattern that would extend throughout the 19th and well into the 20th century. For example, in the 1880s, admissions of black psychiatric patients swelled to 1248 from 493 in the previous decade and continued climbing to 1570 from 1890 to 1899. The average number of admissions increased from 58 per annum to 181 by the 1890s. Admission of black men increased by 220 exceeding the increase of 102 black women during the 1890s.

The 1920s and 1930s were the decades of major increases in overall admissions to Central State Hospital. Following major declines (644, 631) in the first two decades of the 20th century, admissions swelled to over 10,000 in the 1920s and 1930s. De-identified admissions data from 1940-1945 show that admissions increased to their largest annual
totals during the first five years of the decade.

Table 1. Total Admissions by Gender and Facility, 1840-1940

Recent Evaluations, Publications, News Articles, and other Materials Related to the Grant

(1). Efforts continue to transfer historical paper documents from Central State Hospital to the National Museum of African American History and Culture.

(2). The May 2019 edition of the American Psychiatric News will carry a brief article on the Central State Archives Project that focuses on admissions data. The May 2018 edition also carried an article on the project that focused on the immunity hypothesis.

(3). The American Psychiatric Association has reached an agreement with Central State Hospital to acquire copies of key documents uncovered by the archives project. Arrangements are being made to transfer these documents to the APA Museum in a public event covered by media.

(4). Central State Hospital 150th Anniversary Planning Committee – Archive project members continue to participate in the planning. Recently, we completed a letter of intent to the Cameron Foundation in Virginia to obtain support for the 150th anniversary recognition. In addition, the project team has helped facilitate a collaborative relationship between the hospital and the Dinwiddie Historical Society to help increase community engagement.

(5). Workshops – 2018-2019
Methods used to create and analyze the archives at Central Lunatic Asylum and Implications for other state mental health systems. King Davis, Society for the Study of Psychiatry and Culture. University of San Diego: April 21, 2018.

Introduction to the Central State Archive Project. King Davis, African American Studies Faculty, Virginia Commonwealth University: September 17, 2018

(6). Presentations by Project Staff

Final Update on Findings from Central State Archives Project, King Davis, Central State Hospital Staff, Petersburg, Virginia: February 27, 2019

Access, Privacy, & Utility of Historic Psychiatric Records, King Davis, The Benjamin Rush Lecture, American Psychiatric Association 175th Annual Conference, San Francisco: May 2019

Genealogical Implications of the Central State Hospital Archives. King Davis, Middle Peninsula African American Genealogical Society, Tappahannock, Virginia: March 10, 2018

The First Mental Hospital in the US for African Americans. Keynote Presentation. King Davis, Virginia Commonwealth University Conference, Cabell Library: March 14, 2018.

Three Culturally-Based Hypotheses Linking Blackness, Madness, and Dangerousness. Panel Presentation, King Davis, Society for the Study of Psychiatry and Culture. University of San Diego: April 21, 2018.

Implications of the Central State Hospital Data Base for Scholars. Keynote Presentation, King Davis, Black Social Workers of Virginia, Virginia State University: April 26, 2018

The Central Lunatic Asylum for Colored Insane: Mental Illness, Race, and Privacy in the Digital Age. Keynote Presentation. King Davis, Texas Conference on Digital Libraries, University of Texas at Austin: May 15, 2018

Issues of Access and Privacy, College of Behavioral Health Leadership, Annual Conference, King Davis, Virginia Union University, Richmond, Virginia: September 25, 2018

Research Findings from the Central Lunatic Asylum, King Davis, Psychology Seminar, Virginia Commonwealth University, Richmond: Virginia, October 10, 2018

The Central Lunatic Asylum for Colored Insane: Archives, King Davis, Virginia Commonwealth University Firehouse Theater, Richmond, Virginia: October 25, 2018

The Central Lunatic Asylum for Colored Insane: Origins, admissions, and treatment. King Davis, Gateway Homes Annual Staff Conference, Richmond, Virginia: November 8, 2018

The Central State Hospital Archives, The Virginia History Forum (March 2-3, 2017). King Davis, African American History and Genealogical Society National Conference, Marriott Hotel, Richmond, Virginia.

Central State Hospital Digital Archives Project, Central Texas African American Family Support Conference (February 2017). King Davis, Palmer Event Center, Austin, Texas

Overview of the Central State Hospital Archives Project (January 4, 2016). King Davis, Virginia Joint Legislative MLK Commission, Capitol Office Building, Richmond, Virginia.

Central Lunatic Asylum for Colored Insane Archives: Balancing Access and Privacy of Mental Health Records (February 11, 2016). King Davis, Yale University Archives and Library Staff Development, Yale University, New Haven, Connecticut.

The Central Lunatic Asylum for Colored Insane Archives (February 12, 2016). Black Solidarity Conference, King Davis, Yale University and the Steve Foundation, New Haven Connecticut.

Data Practices: Harnessing Cultural Heritage Data to Support Scholarly Practices (March 17, 2016). Unmil Karadkar, Digital Curation Institute, School of Information, University of Toronto, Canada.

Update of the Central State Hospital Archives Project, Central State Hospital Retiree Association (February 2016), King Davis, Petersburg, Virginia.

Understanding Public Policy, The Jack Otis Lecture, School of Social Work (April 6, 2016), King Davis, The University of Texas at Austin. Austin, Texas

The Central Lunatic Asylum for Colored Insane, Kwaanza Festival and Conference (December 30, 2016), The Marriott Hotel, Richmond, Virginia

Analysis of the First 5000 Admissions to Central Lunatic Asylum (October 8, 2016). King Davis, Association for the Study of African American Life and History Annual Meeting and Conference, The Marriott Hotel, Richmond, Virginia.

Central Lunatic Asylum Findings, Poster Session, (October 7-9, 2016). King Davis, Association for the Study of African American Life and History Annual Meeting and Conference, The Marriott Hotel, Richmond, Virginia.

Genealogical Implications of the Central State Hospital Archives (March 28, 2015). King Davis, Richmond African American History and Genealogical Society, Richmond Public Library, Richmond, Virginia.

Using the Central State Hospital Archives for Genealogy Research (October 14, 2015). King Davis, African American History and Genealogical Society National Conference, Marriott Hotel, Richmond, Virginia.

Updating the Central State Hospital Archives Project (December 4, 2015). King Davis, Central State Hospital Staff Development Meeting, Building 32, Petersburg, Virginia.

Central State Hospital Digital Archives Project (December 6, 2015). King Davis, Dinwiddie County Board of Supervisors Meeting, Dinwiddie, Virginia.

(7). Publications and News Articles on Hospital and Project

Colvin, Leonard (2018, March 1). Project on Central State is the Topic, The New Norfolk Journal and Guide

Gonaver, W. (2019). The peculiar institution and the making of modern psychiatry, 1840-1880. University of North Carolina Press.

Dang, Bryan Uyvu. Handwriting Transcription using Word Spotting with Humans in the Loop. Master’s Report, University of Texas at Austin, 2018.

Davis, King (2018, May). Blacks are immune from Mental Illness. Psychiatric News. Washington, DC. American Psychiatric Association. Vol. 53, No. 9., 25-44.

Davis, King (2019, May), Admissions to Central State Hospital by Race, 1840-1940. Psychiatric News. Washington, DC. American Psychiatric Association. Accepted for Publication

Dong, L., Ilieva, P., & Mendeiros, A. (2018). Data dreams: Planning for the future of historical medical documents. History Matters. Journal of the Medical Library Association, 104(4), 547-551. doi: 10.5195/jmla.2018.444.

Galloway, P. (2019). Providing Restricted Access to Mental Health Archives within Government Archives: The Subject Stakeholder. American Archivist, Submitted for Publication.

Smith, Tammie (2018, August 17). Born to a Mother Once Institutionalized at Central State Hospital. The Richmond Times Dispatch. https://www.richmond.com/born-to-a-mother-once-institutionalized-at-central-state-and/article_66f49e5a-0428-5da1-95d2-7580b99a8381.html

Coffee, V. (2019). Benjamin Rush Awarded to Central State Hospital Project. Hogg Foundation for Mental Health News.

University of Texas (April 8, 2015). Information researchers to create digital archives from Central Lunatic Asylum for Colored Insane, University of Texas Press Release.

Crowley Company Blog (April 15, 2015). Saving Black History: Digitizing Records of the Central Lunatic Asylum for Colored Insane, Crowley Conversions, Fredericksburg, Maryland.

Smith, T. (Oct. 18, 2015). Archiving project aims to preserve historic treasure at Central State. Richmond Times Dispatch, p. 1.

Brooks, Adia A. (2014). The politics of race and mental illness: Central Lunatic Asylum for the Colored Insane in historical perspective. Master’s Thesis, African and African Diaspora Department, The University of Texas at Austin, Austin, TX.

Dong, Lorraine. (2015). Taking the long view of medical records preservation and archives. Journal of Documentation, 71(2), 387-400. doi: 10.1108/JD-11-2013-0141.

Dong, Lorraine A. (2015). The institutional and archival social ecologies of a state mental hospital’s records, 1870 to present. Doctoral Dissertation, School of Information, The University of Texas at Austin, Austin, TX.

Dong, Lorraine A. (May/June 2016). Exploring the Reaches of Privacy and Technology: The First Year of the Central State Hospital Digital Archives Project, Archival Outlook (Accepted for publication).

Foltz, Caitlin D. (2015). Race and mental illness at a Virginia hospital: A case study of Central Lunatic Asylum for the Colored Insane, 1869-1885. Masters’ Thesis, Department of History, Virginia Commonwealth University, Richmond, VA. (King Davis served on the committee).

Smith, Dustin. (2014). Steganoscription: Exploring Techniques for Privacy-preserving Crowdsourced Transcription of Handwritten Documents. Masters’ Thesis, School of Information, The University of Texas at Austin, Austin, TX.

Smith, Dustin; Karadkar, Unmil; Galloway, Patricia; & Davis, King. (2014). Reading between the lines: Image to segment relations and analysis. DH 2014: Digital Humanities Conference Abstracts 533-534. http://discovery.ucl.ac.uk/1447248.

(8). Awards –

The American Psychiatric Association provided the project with the Benjamin Rush Award. established in 1967. It recognizes an individual and/or project renowned for outstanding contributions to the history of psychiatry. The Award includes a lecture given at the annual program meeting of the American Psychiatric Association. This lecture will take place in San Francisco in May 2019.

(9) Project Associates

Lorraine Dong, PhD, Post-Doctoral Fellow
Victor Obaseki, JD, Law and Policy Associate
Ronald Forbes, MD, Central State Hospital Medical Director (Ret.)
David Chu, MSW, Administrator, Central State Hospital (Ret.)
Kamar Nassor, MS, Fiscal Administrator
Chunhui Ren, PhD, Statistician
Celeste Henery, PhD, Anthropology & African American Studies
Nitin Verma, MSIS, IT Design Graduate Student
Caitlin Foltz, MA, Data Entry, Virginia Commonwealth University
Malind Saddhanti, MSIS, IT Design Graduate Student
Keisha L. Brown, MSIS, Web Design Graduate Student
Sherri Reid, MSIS, Virginia State University, Data Collection
Halima N. Davis, MSIS, Document Identification and Labelling
Gary Geisler, PhD, Consultant in Digital Library Development, Stanford University