[11] An appointed Board of Directors was tasked with the purchase of a pre-approved parcel of land near the West Fork River, which at the time was still considered the state of Virginia.

Patients were admitted into the asylum for a variety of reasons including asthma, laziness, egotism, domestic troubles, and even greediness.

A series of reports by The Charleston Gazette in 1949 found poor sanitation and insufficient furniture, lighting, and heating in much of the complex, while one wing, which had been rebuilt using Works Progress Administration funds following a 1935 fire started by a patient, was comparatively luxurious.

This was an effort by the state of West Virginia and Walter Freeman to use lobotomy to reduce the number of patients in asylums because there was severe overcrowding.

In February 1986, then-Governor Arch Moore announced plans to build a new psychiatric facility elsewhere in the state and convert the Weston hospital to a prison.

The closure came by court order due in part to a class action lawsuit filed by family members of patients.

[5] In 1999, all four floors of the interior of the building were damaged by several off duty city, county and state police officers playing paintball,[20] three of whom were dismissed over the incident.

[15][19] A non-profit 501(c)3 organization, the Weston Hospital Revitalization Committee, was formed in 2000 for the purpose of aiding the preservation of the building and finding appropriate tenants.

[21][19] Three small museums devoted to military history, toys, and mental health were opened on the first floor of the main hospital building in 2004, but were soon forced to close due to fire code violations.

There are paintings, poems, and drawings made by patients in the art therapy programs, a room dedicated to the different medical treatments and restraints used in the past, and artifacts such as a straitjacket and hydrotherapy tub.

[18] The Trans-Allegheny Lunatic Asylum is featured in the Pulitzer-winning novel Night Watch by West Virginia author Jayne Anne Phillips.

This Civil War era story is set in the Asylum and explores daily life in the early days of its operation.