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St. Elizabeths was established by Congress in 1855 as the Government Hospital for the Insane. In addition to providing mental health facilities for the Army, Navy, and District of Columbia, the facility also served as a hospital for Civil War soldiers. In 1916, Congress officially changed the name of the facility to St. Elizabeths Hospital.
St. Elizabeths is divided into two campuses. The West Campus is owned by the federal government and is under the custody and control of the U.S. General Services Administration (GSA). It is located in the Anacostia community in southeast Washington on a hill overlooking the Anacostia River with panoramic views of Washington and Virginia. The East Campus, owned by the District of Columbia, is located across Martin Luther King, Jr. Avenue from the West Campus and is still in use as a mental health facility.