The original plan for patients was to hold alcoholics, geriatrics, drug addicts, mentally ill, and the criminally insane.

The administration section has a large clocktower and is kept in good condition to provide people with an idea of what the mental institution looked like when it was completed in 1886.

Amenities have also been added such as electricity, running water, and other buildings including infirmaries and a minimum security prison that was established in 1980.

The reasons for patient deaths were gruesome lobotomies, improper food and water, starvation and dehydration, abuse, surgeries, extreme climate, and various other forms of treatment.

The former hospital grounds are now home to the Clarinda Academy, a juvenile detention facility serving southwest Iowa and eastern Nebraska.