In 1913, the Eastern Oregon State Hospital (EOSH) was opened in Pendleton after a long legislative battle over a new facility to ease patient crowding at OSIA. That same year, the state formed the Board of Control which took over administration of OSIA and renamed it the Oregon State Hospital (OSH). The patient population at OSH peaked in 1958 at 3,545 patients. Additional facilities were opened in The Dalles (Columbia Park Hospital, 1959-1973), Wilsonville (F.H. Dammasch State Hospital, 1961-1995) and in Portland (Holladay Park Medical Center, 1995-present).
In 2008, amidst planning for replacement of the outdated buildings on the Salem campus, the hospital and grounds were listed on the National Historic Register. While construction of a new facility on the Salem campus is underway, plans include the preservation of the oldest portion of the original 1883 building and the creation of a new museum.

Postcard depicting the Oregon State Insane Asylum (T2009.006.005). Postcard is postmarked 1917.