From the newspaper archives of Staunton, Virginia:
A.H. McGehee, a patient at Western State Hospital in 1910, fell in love with Alice Lillie, a beautiful female attendant, and she reciprocated. In December, McGehee and Lillie met in Staunton and obtained a marriage license from the city clerk.
"As the clerk does not know a lunatic from anybody else," noted the Staunton Daily Leader, "he issued the license. They hunted up Dr. O.F. Gregory, the obliging pastor of the Baptist Church, who is just as innocent when he sees a lunatic."
The pair were married, but their happiness short-lived. Officials at the hospital quickly found McGehee and hurried him back into custody, ending the romance, while Lillie was summarily discharged from her job. [Link]