Central State Hospital was Indiana’s principal public mental hospital for decades, operating in Indianapolis from 1848 to 1994. Founded as the Indiana Hospital for the Insane, it grew from a single brick building with five patients into a vast self-contained campus with monumental wards, medical facilities, service buildings, and gardens. Its women’s ward, Seven Steeples, reflected Kirkbride-plan ideas about treatment through light, air, and order. Although later limited to central Indiana, the hospital remained overcrowded, reaching 2,500 patients by 1950. Reform efforts, criticism of patient treatment, abuse allegations, funding problems, and the move away from large institutions shaped its decline. Only a few original buildings survive.