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Includes records pertaining to the transfer of ownership to Duke University, as well as the day-to-day operation and expansion of the hospital. Records include agreements, annual reports, architectural plans, appraisals, audits, brochures, budgets, clippings, correspondence, data on lawsuits resulting from fire and accidents, deeds, fiscal reports, historical essays, insurance papers, maps, minutes, monthly statements, newsletters, photographs, programs, publications, reports, as well as sale and lease papers. The files, among other things, include a glimpse of the perception of mental disorders and approaches to psychiatric treatment in mid-twentieth century America and the trials of running a small, ever expanding hospital. The records do not contain information on particular patients unless they died at the hospital and that information does not include patient records or notes. Topics include the 1948 fire, staffing issues, local real estate, mid-century modern furniture, and institutional kitchens. The record dates range from 1906-1978. The majority of the records are from 1939-1957.

Includes Mabel Harris' nursing notebooks. Notebooks contain Harris' handwritten notes from class lectures she attended on the following topics: mental nursing, hygiene and practical nursing, urinalysis, histology and pathology, chemistry, massage, and stretching. There are 4 notebooks, and 3 of the notebooks have a label that reads Highland Hospital Asheville North Carolina". The 4th notebook is untitled and is presumably from the same series of lectures; it contains information about massage and stretching. Materials date from 1918 to 1920.

Includes evidence of hospital complex layout, plant improvements, plans for building construction, land deals, and evidence of expansion by way of comparison. Records date from 1938 to 1979.