ByMarcus O'Shea, writer at
Resident RPG nerd and SoulsBorne fanatic. Can be spotted by their floofy hair.
Marcus O'Shea

Outlast, the terrifying first-person horror game by Red Barrels Studio, is without a doubt one of the breakout indie horror hits of the last several years in . With the sequel moving the series into the countryside for some rural terror, it's time to look back at the setting that made the first game so damn scary. The sprawling halls of Mt. Massive Insane Asylum are one of the creepiest and most deadly settings around, but did you know about the real-life asylums that served as its inspiration?

The Terrifying True History Of The Asylums That Inspired 'Outlast'

There's a lot of creepy asylums out there, they seem to attract ghost stories like a corpse attracts flies. But there are some places so spooky, so filled with horrible history and so imposing that they can't help but inspire creations like .

Danvers State Hospital, The Original Arkham Asylum


Danvers State Hospital for the Criminally Insane has a long history of inspiring works of horror. The iconic, gothic design of the hospital served as the bases for the Arkham Asylum in the works of H.P. Lovecraft (which was later stolen for Batman) and was the setting of the cult horror film Session 9.

The hospital was constructed in the late 1800s, an ambitious and expensive project put together at a time when the country was still reeling from the cost of the Civil War. Despite being built on the former home of the judge of the Salem Witch Trials, the original design of the hospital was created with the noblest intentions.

Architect Nathaniel J Bradlee designed the hospital in accordance with the theories of Thomas Kirkbride, a physician and mental health advocate who believed that facilities should be devoted to the treatment of the mentally ill, rather than simply their control and imprisonment. Despite the hospital's somewhat spooky gothic exterior, it was designed to be well-lit and cheery within, with plenty of access to fresh air and few restraints on the patients.

The Road To Hell Was Paved With Good Intentions

[Credit: The asylum project]
[Credit: The asylum project]

Things took a turn for the worse in the 1920s and 30s, as funding cuts, combined with overcrowding, led to horrifying deterioration of the hospital's conditions. The hospital, which was meant to hold around 600 patients in total, was overwhelmed by the almost 2,500 daily patients that they now had to control. The staff began to resort to cruel and abusive methods to control their population, including forced lobotomies, solitary confinement, electro-shock therapy and straight jackets.

By the late 60s, several parts of the hospital were so degraded that they were practically in ruins, and were shut down. The whole hospital was closed by 1985 and in the late 2000s, the land was bought by a real estate developer. Against the wishes of the local historical preservation groups, most of the buildings on the grounds were destroyed, only the facade of the Kirkbride building remained, as well as some of the original tunnels and the cemetery. Apparently, the builders re-used much of the wood and stone from the demolished building as flooring for the new apartments. Not sure I'd like to live in them.

Trenton State Hospital, A Bloody Hall Of Horrors

[Credit: The Asylum Project]
[Credit: The Asylum Project]

Much like Danvers Hospital, the Trenton State Hospital was founded in accordance with the theories of Thomas Kirkbride. In fact, it was the very first hospital in America created with his ideas in mind. Much like Danvers though, the hospital is remembered more for its horrific stories and creepy atmosphere than its original good intentions.

The problems for Trenton State Hospital began in 1907, when a doctor named Dr. Henry Cotton was named medical director. This forward-thinking doctor seemed to be a perfect fit at first, he refused to use mechanical restraints on patients, instituted useful therapies like occupational therapy and instituted daily staff meetings to make sure the patients were well cared for.

The Madness Of A Doctor: Trenton's Dark Turn

[Credit: Dave Scaglione]
[Credit: Dave Scaglione]

However, Cotton's reign soon took a dark turn, one that transformed the pioneering hospital into a hall of horrors. After discovering that the bacteria that causes Syphilis was responsible for some of the patients's mental symptoms, Cotton began to believe that all mental illnesses were related solely to infections in the body.

To 'prove' his theory, Cotton began to perform horrifying invasive surgeries on his patients. He removed many of his patients's teeth, even if they weren't infected. Even worse, he began to remove any organs he felt were inflamed, or capable of causing his patients's 'moral corruption'. These included stomachs, gallbladders, colons, spleens and even the genitals or uteruses of unlucky patients. Cotton claimed a 'cure rate' of 85%, which probably counted the masses of people who died beneath his brutal knife as having been cured.

[Credit: Dave Scaglione]
[Credit: Dave Scaglione]

More disturbing than his methods were the fact that he didn't keep them a secret. Cotton regularly published papers and gave presentations on his disturbing practices. He was lauded by respectable members of the psychiatric community and many reports of his abuses were repressed and hidden away.

Despite Cotton retiring in the 1930s, his legacy of horror and death lived on. Staff at the facility continued his practices, pulling the teeth from patients and conducting unnecessary surgeries on the people in their care until the 1960s.

The Richardson-Olmsted Complex, The Model For Mt. Massive


The Richardson-Olmsted Complex is actually the direct model for the exterior of the Mt. Massive Insane Asylum from , and is considered a local haunted hotspot in the region.

Unlike other asylums on this list, the claims about the Richardson-Olmsted Complex are much harder to verify. The building was constructed in the late 19th century by genius architect Henry Hobson Richardson, and first served as a military hospital for wounded Civil War soldiers, before being repurposed as an asylum.

Like many mental health facilities of the time, the Richardson-Olmsted complex ran into problems with overcrowding and lack of funds. Rumors began to circulate of dangerous and unethical practices, including involuntary lobotomies, electro-shock therapy used to control patients and even the forced sterilization of patients to prevent them from passing on their so-called 'inferior' genes.

Would you stay a night in one of these terrifying asylums? Looking forward to Outlast 2? Let us know in the comments!


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