Mental institutions have a bad stigma around their name and this is mostly due to the history of these institutions, which were originally established to house not only the mentally unstable but the social outcasts within the society. Some common treatments, such as lobotomies and electroshock therapy, typically turned temporary patients into permanent ones due to the unethical harshness and ineffectiveness of the treatments. The eastern United States fueled this stigma as it housed many of these institutions such as South Carolina, Danvers, and North Carolina State Hospitals, Searcy Hospital for the Colored Insane, and even the largest - at the time of operation- in the world, Central State Hospital. Each of these hospitals held its own unique story and added their own encounters to the history of horror stories. These conditions within these institutions would not start to change until reformers, such as Dorthea Dix and Thomas Kirkbride, stepped in to change these notions around them. Endless cases, such as O'Connor v. Donaldson, were brought onto the stand for years until rules and regulations began to change. Even after rules had been in place, current institutions still fight against the stigma that was given to them historically by their predecessors.