Several large sections of the Provo City Cemetery appear vacant. No headstones. No flowers. No memorials to mark the final resting places of nearly 500 early Utah settlers.

Those buried here were far from being blessed, honored pioneers. Oh, they braved danger, blazed trails and broke ground, but it wasn’t for the sake of future generations. And, in most cases it was entirely against their will.

Those sections of the cemetery that appear unused are the burial grounds for patients — though some were inmates — of Provo’s Utah State Hospital, once known as the “state insane asylum.”

Nearly 40 years after the arrival of the Mormon pioneers, the territorial Legislature decided something “official” needed to be done for the unfortunates besides putting them in jail, chaining them to trees or locking them in outbuildings.

All of that was for their own good, of course. I’m guessing that, given the understanding of mental illness back then, it was considered advanced medicine to no longer just stone or burn them as witches.

The hospital, or “asylum,” opened in 1885. Business boomed as judges and magistrates now had a place for these impaired individuals.

But even back then, you couldn’t just drop someone off at the asylum in the middle of the night, ring the doorbell and run. Patients had to be diagnosed by doctors before being committed.

Unfortunately, what doctors understood about mental illness then was little more than guess work based on observation. Just about anything could send someone over the edge and, from there, to Provo.

Actual doctor’s notes (which I completely made up): “Patient weeps on floor, piteously calling the name of imaginary woman. Berates same for running off with racetrack man. Diagnosis: ‘Unreciprocated love.’”

And away to the mental hospital with the poor wretch. Incidentally, “unreciprocated love” is, in fact, listed as an official cause of insanity based on the hospital’s own admission records from 1885 to 1910.

Additional causes of insanity during that time include disappointment, girl trouble, reading novels, masturbation, financial embarrassment, sheep herder, blow on head, sedentary life, cigarettes, domestic fever, syphilis, studying prize fighting, solar heat exposure and religious excitement.

Absent medication and more reliable means of diagnosis, treatment in the early days amounted to exercise, work, rest and restraint. Lots of restraint.

(Courtesy Kelly Clark) Some Utah State Hospital patients required restraints, particularly during the early days before medications. The use was limited and then only per doctor’s orders. On the left is the “Oregon boot,” a device also used on prison inmates when being transported outside of the prison.

The Oregon boot was an early form of ankle monitor, intended to keep a patient from wandering off. A 20-pound weight was clamped to one ankle, making walking difficult.

This didn’t make escape impossible, though, as one patient managed to get all the way from Provo to Magna while dragging an Oregon boot.

(Courtesy: Kelly Clark) Utah State Hospital Museum curator Janina Chilton explains the operation of the Utica Crib, an old-time device intended to calm restless patients and prevent nocturnal roaming of the hospital.

The Utica Crib essentially was an adult-size bed with bars and a lid. And no asylum would be complete without restraint jackets, in this case manufactured at the hospital by the very people who sometimes had to wear them.

The stories of the nameless and forgotten patients are sometimes heartbreaking. They might spend 50 years waiting for a family that had essentially abandoned them. Some were already without anyone else in the world when confined.

The forgotten graves in Provo’s cemetery are filled with the victims of early and sometimes-barbaric attempts to deal with “insanity.”

The youngest patient to die in the hospital was 18-month-old Phyllis Joan, who was abandoned when her adopted family discovered she was severely disabled.

A 19-year-old Ogden man spent the rest of his life in the asylum after being lobotomized because he was gay. And “Charlie Chinaman,” so called because he lived out his days never learning to speak English, is buried in the lawn of forgotten souls.

These are just some of the sad stories of those who pioneered Utah’s early efforts to cope with mental illness. They died unremarked and unremembered.

They would remain so but for the efforts of the Utah State Hospital Forgotten Patients Cemetery Project. By raising $120,000, the project hopes to build a memorial in the cemetery and name all 474 of the patients buried there.

If you’re interested in donating to this tax-deductible effort, contact the Utah State Hospital Museum curator Janina Chilton at 801-344-4635.