In 1987 I moved my young family to Asheville to take a job at Highland Hospital, a psychiatric hospital affiliated with the Duke Psychiatry Department. Highland was started in 1904 by psychiatrist Robert Carroll and received referrals from all over the East Coast. Dr. Carroll gave the hospital to Duke upon his retirement. Unfortunately, the department chair at Duke decided to sell Highland to Psychiatric Institutes of America, a chain of private psychiatric hospitals, to create an endowment for his department.
PIA already managed and had an option to purchase Appalachian Hall, the other psychiatric hospital also founded by psychiatrists, Mark and William Griffin, in 1931. Between the two hospitals, Asheville had over 200 inpatient psychiatric beds to serve WNC. Under corporate management, Highland Hospital was closed in 1993 and Appalachian Hall closed by the end of 1999. Two hospitals that served the region for a combined 157 years were closed after fewer than a combined 20 years of corporate management. When profit is the primary motivator, the needs of the community take a back seat. Two hospitals that provided excellent psychiatric care for close to a century were closed because they were not profitable enough.