Asylum

[Dark Dwarf]

I am trying an asylum adventure and looking for a villain to use for inside. Here some ideals I have been given.
1: inmate a insane vampire unknown to anyone
2. Evil wizard experiments on inmates.
3. Evil necromancer cleric or wizard making flesh golems from dead.
4. Drunken administrator unaware of his assistant is evil person doing things to the inmates.
5. Other creature killing the inmates
Please leave your ideals on one of these or others ideals you may have

[Today is a good day to... halp]

Carrion Hill and Strange Aeons part 1: In Search of Sanity has encounters in an asylum, if you be seeking out inspiration...

[Mark Hoover 330]

What if you flip the script? The bad guys aren't the staff of the asylum at all. Perhaps an inmate is a cultist of an evil deity that grants the Madness deity and they're keeping the other patients from recovery, causing the staff to behave in a cruel or erratic behavior, and in the process working to convert everyone in the asylum to their religion for some dark ritual?

You could also pick one of the occult classes for an inmate. Perhaps a Wis based Psychic who is perpetually casting suggestions or compulsions into the minds of their fellow patients. Maybe a Medium who is a conduit for even darker, more crazed spirits?

Even darker still, there are monsters that could be causing all of this simply by their presence. What if the asylum really was just an ordinary home for convalescence but a Gibbering Mouther slithered into the basement, or perhaps a young patient died in an isolation chamber and became an Attic Whisperer? Depending on the level of the PCs in the game, you might say that either a Cerebric Fungus (CR3) or a Vespergaunt (CR 12) has rooted itself somewhere in the building and is manipulating inmates and staff to keep it fed and happy. However, just the creature's mere presence is slowly spiraling everyone in the asylum into total insanity.