This is not a joke! Well — it is — but then — it is not!
Trans-Allegheny Lunatic Asylum (link) was “Designed to House 250 Souls” in West Virginia and “reached its peak in the 1950’s with 2,400 patients in overcrowded and generally poor conditions.” The above list is the actual reasons for admission between 1864-1889.
Not sure why this triggered Deliverance in my memory. That was in jawjia! Must be a bad regression algorithm! 😉