Lima State Hospital

Lima State Hospital occupies a pivotal place in Billy Milligan’s story as both a feared destination and the setting of an involuntary transfer that sharply restricted his freedom. Initially, his lawyers sought to prevent his commitment there while the courts considered whether he could assist in his defense. Later, after he was sent to Lima, disputes over his diagnosis, treatment, and transfer procedures continued through hospital reviews and court proceedings. The institution’s significance lies not only in its maximum-security restrictions, but in the way placement there became inseparable from competing judgments about risk, care, and legal process.

A feared destination in the pretrial dispute

When Judy Stevenson and Gary Schweickart were building a case that Milligan could not stand trial, they faced a separate question from the question of guilt: where he would be evaluated and treated. They feared that if Judge Jay C. Flowers accepted the report from the Southwest Community Mental Health Center, Milligan would have to be sent to a state institution. Lima was their particular concern. They knew its reputation from former clients and believed he would not survive a placement there. Their objection was therefore not simply to hospitalization; it was to a specific institution they regarded as dangerous for their client.

The concern became sharper when Schweickart raised the possibility that a commitment to Lima might provoke a violent response from Ragen. He recalled that Milligan had heard accounts of the hospital while in prison and connected those stories to Ragen’s earlier threats concerning the children. Stevenson insisted that they would have to find an alternative, even though Southwest’s recommendation was that Lima was the only suitable place for treatment before trial. The discussion exposed a conflict between a clinical recommendation and the defense team’s assessment of what Milligan could endure in that setting.

The legal wording offered a possible route around Lima. The provision under discussion allowed commitment to a hospital for the mentally ill within the court’s jurisdiction, with Lima named as a placement if the court considered it advisable. Schweickart emphasized that the statute did not make Lima the only option. That distinction mattered: the question was not merely whether Milligan required evaluation, but whether the law permitted the court to choose another institution. The location thus entered the case before Milligan ever arrived there, as the concrete point where clinical authority, statutory language, and defense strategy collided.

Transfer and confinement

The feared transfer eventually took place. After hearing evidence from Chief Cremeans, Judge Roger J. Jones granted the attorney general’s motion to send Milligan to Lima. On October 4, 1979, at two in the afternoon, Milligan was handcuffed and belt-shackled and driven 180 miles to the hospital. He had no time to say goodbye to anyone except Dr. David Caul. The hurried departure gave the transfer a personal consequence beyond the court’s order: a move between institutions became an abrupt severing from the people and treatment relationships he had known in Athens.

Lima’s security was also apparent to visitors. At a later visit, Daniel Keyes and Alan Goldsberry passed through metal detectors, had their briefcases searched, went through two sets of barred doors, and were escorted to the visitors’ room. A guard then brought Milligan in. The account places the meeting inside a tightly controlled institution, where contact with the outside world depended on searches, barriers, and staff supervision. Milligan remained in the Teacher identity during the visit and described both the events in Athens that preceded the investigation of an alleged rape and his transfer to Lima.

A review hearing followed at the Allen County Courthouse on November 30. The hearing was closed to the public and media, although television cameras waited outside. The state’s first witness was psychiatrist Frederick Milkie. Before the luncheon recess, Goldsberry placed Dr. Caul’s deposition in evidence and prepared to call Dr. George Harding Jr., Dr. Stella Karolin, and psychologist Dorothy Turner. These details show that Milligan’s placement was being contested through expert testimony as well as through the conditions of confinement themselves.

Diagnosis, treatment, and reported harm

At the hearing, the court’s findings described Milligan as mentally ill, with substantial disruption affecting thought, mood, perception, orientation, and memory, and identified risks to himself and others. The order committed him to Lima for treatment consistent with a diagnosis of multiple personality. The order therefore named the diagnosis that was to guide his care, rather than treating institutional commitment as a substitute for a treatment plan.

The hospital’s subsequent conduct became a source of conflict. At a courthouse appearance a week after the transfer, Milligan appeared in handcuffs; he was the Teacher and smiled sheepishly. In his account of the week at Lima, clinical director Lewis Lindner had diagnosed him as a pseudo-psychopathic schizophrenic and prescribed Stelazine. Keyes noted that the medication belonged to the same family as Thorazine, which had made the splitting worse. The contrast between the court’s direction to treat Milligan as a multiple personality and the diagnosis and medication reported from Lima sharpened the disagreement about whether the hospital was following the order.

On December 18, Milligan called Keyes from the hospital’s male infirmary and reported that an employee had badly beaten him. A Lima attorney appointed as guardian ad litem had taken Polaroid photographs documenting his injuries. The following day, after a visit by attorney Steve Thompson, the administration issued a statement confirming that Milligan had been severely injured. The FBI and the Ohio State Highway Patrol were called to investigate for possible submission to a grand jury. The reported assault transformed concerns about Lima from predictions made by the defense into an allegation about what had happened after confinement there, although the evidence presented here does not establish the outcome of those investigations.

Goldsberry and Thompson also challenged the hospital for failing to follow Judge David R. Kinworthy’s order to treat Milligan as a multiple personality. They filed a contempt motion against Lima officials and the Ohio Department of Mental Health and pressed for a transfer to a less restrictive hospital. Meanwhile, confined in the strong ward, Milligan borrowed a pencil from an attendant and began writing letters to Keyes. The letters made writing one of the few documented means by which he could communicate with someone outside the ward and describe conditions from within it.

Reviews and transfer disputes

The institutional review process did not quickly resolve the dispute. On April 14, 1980, Judge David R. Kinworthy dismissed the contempt charges brought against Superintendent Ronald Hubbard and clinical director Lewis Lindner and ordered that Milligan remain at Lima. The ruling left the hospital as his placement despite the defense’s effort to enforce the earlier treatment direction through contempt proceedings.

In October 1980, the state announced that Lima would be phased out as a hospital for the criminally insane and converted into a prison under the Department of Correction. State mental-health officials then informed Prosecutor Jim O’Grady that Milligan would be sent instead to the new Dayton Forensic Center, a maximum-security facility whose fencing and security system were described as more stringent than those of most prisons. The prosecutors’ office dropped its demand for a hearing after the state disclosed that plan. The proposed destination changed, but the underlying pattern persisted: decisions about Milligan’s care were being made through negotiations among state officials, prosecutors, and the courts, while movement to a less restrictive setting remained unsettled.

At Dayton, Milligan read, wrote, and sketched, though painting was not allowed. He was well behaved and looked forward to a 180-day hearing, hoping Judge Flowers would decide he did not need a maximum-security institution and would return him to Athens, where Dr. Caul could treat him. His hope connected placement directly to the possibility of renewed treatment and the return of the Teacher after Billy-U had been asleep. Lima therefore remained a reference point even after he had left it: the question of whether a maximum-security hospital was necessary continued to shape his expectations and legal status.

Legal reversal and lasting significance

On April 21, 1981, the Fourth District Court of Appeals of Ohio ruled on the judgment that had sent Milligan to Lima. It found that removing him from a less restrictive setting to the maximum-security hospital without notice to him or his family, without his presence, and without an opportunity to consult counsel, call witnesses, or participate in a full hearing violated his rights and required reversal of the transfer order. The ruling made procedure central to the story of the institution: whatever the authorities believed about risk or treatment, the court held that a transfer of this kind could not lawfully bypass a hearing.

The placement question nevertheless remained active. On May 20, after a 180-day hearing, Judge Flowers found persuasive evidence that Milligan lacked accepted moral restraints, showed familiarity with criminal subculture, and disregarded human life. He also considered Dr. Caul’s stated unwillingness to accept court-imposed limitations and concluded that the Athens Mental Health Center was inadequate. The decision illustrates the continuing tension between the appellate court’s insistence on procedural protections and the trial court’s assessment of risk and available treatment. Lima’s role in the narrative is consequently larger than that of a single hospital stay: it represents the point where confinement, psychiatric classification, institutional power, and the right to contest one’s placement converged.