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38 dead now near Moscow. Older folks in the Quad Cities recall 37 died in a psych hospital fire in Davenport, IA in 1950. The story is often retold in the Quad Cities media. I believe it's the worst mass death in area history. All the dead were women, and all but one were patients. The three men there all managed to escape as did 23 women. It was intentionally started by a female patient, who survived. Building was 60 years old, not fireproofed, without sprinklers and with most windows and doors barred.

Sadly I agree chronic institutionalization remains the best option for at least some psychiatric patients, although certainly not the majority. Currently the only PC way to do that is in prison, which requires letting them do something(s) really bad first. MSM refuses to consider that cost. Hopefully research resulting in improved treatment will some day really produce Star Trek's vision of all the remaining hopelessly insane fitting in one small institution, with one of the nuttiest residents oddly resembling Batgirl.

If non-penal psych hospitals were to be restored, granting the genuine lunacy of their residents, and that most probably would be smokers, very stringent building and fire codes and regular inspections should be required. Alas the public never wants to spend much on, nor think much about, such facilities so tragedies would likely continue to occur.