[4] The initial steps towards establishing an asylum for the mentally ill in Kansas can be traced back to the territorial legislature's act of 1855.

On October 17, 1863, commissioners announced they had selected a site north of Osawatomie township in Miami County near the Marais des Cygnes River, which was donated by local minister Samuel L.

Dr. Charles O. Gause, a proponent of rehabilitation and "moral treatment", assumed the role of the first superintendent, with his wife, Levisa, serving as the matron.

This architectural style, known as the Kirkbride Plan, emphasized improved living conditions and better access to natural light and ventilation for patients.

[1][2] On March 8, 1880, a fire originating in the attic of the executive building caused significant damage, although the west and east wings of the hospital were able to be saved.

While moral treatment approaches gained traction initially, economic factors and a rise in the patient population led to a shift towards more custodial care models.

[1][2] The need for additional space continued, and the Adair Building was constructed in 1895 to house chronically ill female patients.