This paper is an attempt to redress the limited rendering of institutional workers through the narratives of individuals who worked as psychiatric attendants at Southwestern Virginia Mental Health Institute (SWVMHI). Despite a wealth of literature on the history of mental illness and the establishment of asylums, descriptions of the work and lives of psychiatric attendants are rare. In this paper, oral histories among former psychiatric attendants at SWVMHI reveal the dynamics of an overlooked occupational culture that speaks to the perception and management of mental illness in a rural Appalachian community. This offers the dual function of eliciting information about mental illness and stigma in Appalachia, as well as using an Appalachian case study to contribute to the larger dialogue on the history of mental illness, particularly with regard to the roles and experiences of institutional workers.

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