In 1850, influential mental health activist Dorothea Dix petitioned the North Carolina General Assembly to support and build a psychiatric hospital to treat the insane.

Within 25 years the General Assembly determined that one hospital was insufficient to care for the population of people afflicted with mental illness.

Built in Morganton on 283 acres (115 ha) of land, Western Carolina Insane Asylum, opened on March 29, 1883.

Using the colony system, a farm area was established with a dairy, vineyard and greenhouses, all staffed by patients of varying degrees of functionality.

Additional expansions and land holdings would take place until just after World War I when public attitudes about mental health patients changed dramatically.

The hospital, like many others of this time period, was neglected and suffered during the state and national financial problems of the Great Depression.

The 1960s brought many changes to Broughton: educational programs were established, religious services were incorporated, and the hospital continued to expand (including through affiliated local community health centers).

Broughton completed a new facility in 2017 that houses the hospital departments and patient divisions under one roof, on the existing grounds.

There were times that weather precluded transport of a person's remains home and burial took place in the asylum cemetery.