The Minnesota Mental Health Reform Crusade

Through the wonders of my trusty Google Search Bots, I was made aware of a book published by a regional university press. Upon linking to the press release for this book, I realized that in another less totally “connected” world in my past lifetime, I would have never known of this literary gem. This book, as fascinating and scholarly as it is, appealing to my personal historical interests and professional psychiatric mental health reform history, likely will have an undeserved narrow readership. But in my own literary zeal, I hope to support this author’s superb scholarship efforts in this field by calling attention to her wonderful book and read.

The book I am speaking of is “The Crusade for Forgotten Souls: Reforming Minnesota’s Mental Institutions, 1946-1954,” by Susan Bartlett Foote. This book is published by the University of Minne-     otaPress, Minneapolis, MN, 20108.

The Crusade for Forgotten Souls: Reforming Minnesota's Mental Institutions, 1946–1954

There exist dozens of books in print on the history of mental health reform, state hospitals, asylums, and so on. Additionally, there are many out of print books to be had by the student of mental health reform, thanks to the incredible networked of bookshops and sellers on the Internet. I have long been a student and collector (to my wife’s everlasting anti-hoarding tendencies) of antique and historical tomes on psychiatry, mental health, and psychoanalysis. In past decades when I first had my interest kindled in this scholarly effort by two mentors. These two far-sighted supervisors and teachers cultivated the awareness in me that many surprising answers and relevant insights could be gleaned from the acquaintance of the historical efforts of predecessors in our field and any area of human endeavor and understanding for that manner. To fuel my collecting and voracious reading appetite, I relied on one publishing and book reseller business in New York City (natch, where else?) as the only source for my dogged blood hound collector impulses. That business still exists, but sadly I utilized them far less often as their range of books seems narrow to me these days. But they still “cover” the field of psychiatric writers that I can find nowhere else so my loyalty to them persist.

This book serves as a scholarly, historical prod to this reader of mental health reform history because it is a unique book. It is not dry documentation of events as some books in this arena can be. Any area of historical review and retelling for a contemporary audience runs the high risk of taking the easy route of simply cataloging events. At least some of the history textbooks of my youth were such tediously boring examples.  Like many youths of that era, I could not understand why anyone would want to study history. What saved me was experiencing the teaching of history of other countries and cultures in schools overseas. I was awakened to the rich stories of the Middle East and of the British Empire in different schools. I returned to the US at the end of my high school years and dove into America political history in the only history course before university studies that hooked me. I focused on two area, the Civil War and the formation of the American system of government in the Revolutionary period. These interests prepared me for looking at my profession of psychiatry in a historical manner that afforded me a much deeper appreciation for even the most routine daily efforts in my work with patients and systems.

One of the first lessons that are highlighted in Ms. Foote’s book is the lost refrain that mental reform is not a new current of our time. Every generation of reformers seems to suffer initially from the realization that their efforts often have been duplicated in past eras. The helpful grace of this intellect and psyche warming circumstance is that any contemporaneous effort can be buttressed by learning from the directions of past efforts and their successes and failures.

Another lesson that is more sobering is that past reforms led to acclaimed successes that were much celebrated. Politicians, reformers, and those who implemented the changes bourne out of the results of the reforms felt early on that changes they had all worked so hard to accomplish would go a long way toward solving the problems that initiated the zeal of reform.

But the efforts did not lead to lasting change. In the state mental hospital orbits, reality overtook even the best of intentions.

Ms. Foote weaves a masterful story of a period of years in the pre-deinstitutionalization era, up to the early 1950’s. This makes for a truly engaging and fascinating read. Many different tides of motivations and ideologies are described. They range from social reformers of the 1800’s such as national figures like Dorothea Dix to a more intimate portrayal of local Minnesotan figures that were unknown to me. One of the other historical tributaries for the unique critical mass reached in Minnesota in the post-WWII years, was that of the singular religious community in the state, largely not existing elsewhere in this country except for the Quaker communities who pioneered mental health reform as early as the 1700’s.

One notable feature of Ms. Foote’s book helps stories of patients’ lives to come alive as few other books I have read. The second chapter has vignette life stories of several patients all ably researched from superb sources that the author read herself in unique local venues in Minnesota.

Only one other book I have seen rivals this book as far as an unusual source of person based history which I find to be the most interesting kind…That other  book with such storytelling power is “The Lives They Left Behind: Suitcases from a State Hospital Attic,” by writer by Darby Penney, psychiatrist-photographer Peter Stastny.

 This book resulted from the NY State mental health commission finding a treasure trove of patients’ suitcases after their admissions to one of the closed state hospitals. The authors wrote a book on the actual lives of the patients whose belongings they found. The authors found descendants living in venues in NY state and interviewed them learning more of their lives, filling in the details accordingly, making for an incredible read.
Advertisements

Were State Psychiatric Hospitals Better 100 Years Ago?

A fundamental intellectual tenet of mine is that to have a comprehensive and ‘honest with oneself’ grasp of historical and social long term processes, history of the subject being studied should be included. George Santayana’ famous quote that those who ignore history are ‘doomed’ to repeat, seems to hold more and more power of truth the older I become.

The history modern mental health care began in almshouses, shelters for the developmentally disabled and intellectually disabled, earliest perhaps by the Quakers of the early 1700’s in Pennsylvania. Theirs was an extraordinary (and still is) ethos of charity, helping those in need and one of the original origins of the philosophy of “non-violence,” embodied in conscientious objects in our wars and taking on the needs of the shunned, ‘repugnant,’ disabled persons who frightened the average person. It is no new concept that state hospitals were built intentionally out of the ‘boondocks,’ the countryside, away from towns so delicate sensibilities of citizens were not disturbed by the sight of unpredictable persons, that in reality before the era of modern treatment in the middle half of the 1900’s NO ONE really understood beyond crude empirical approaches, i.e., “we do not know how but this medicine works on hallucinations so let’s give it for that.”

There are many, many articles, books, some films from the earliest days of the then miraculous, wondrous Brownie 8 movie camera, that record the abysmal conditions of many state psychiatric hospitals in the Western world and the US, Latin America, Scandinavia, Europe and a few other regions and countries where modest efforts at housing the chronically mentally ill occurred. For instance, it is not well known that the famous country singer, Johnny Cash, established and supported an orphanage for children in Jamaica and did so very quietly as a true philanthropist.

If it were not for Google’s miraculous search bots, I would never have come across or read the article to which I wish wholeheartedly to refer the reader. It is from this week’s edition of the English newspaper, The Daily Mail. In the usual British brutal journalistic tradition it has simply ghastly title: “EXCLUSIVE: Chained to their beds with no heat or water, and left to lie in their own excrement: How the 19th century mentally ill were sent to hide away in grisly insane asylums and categorized as ‘idiots’, ‘imbeciles’ or ‘lunatics,’

This article itself is based on what appears to be a singularly striking book with lots of old pictures of life and patients in state psychiatric hospitals in Scotland and England, entitled, ” Lunatics, Imbeciles, and Idiots: A History of Insanity in Nineteenth Century Britain & Ireland, by Kathryn Burtinshaw and Dr. John Burt.

Continue reading “Were State Psychiatric Hospitals Better 100 Years Ago?”

Millidgeville State Hospital, History & Pictures

I had a residency classmate at my training program some 40 years ago who eventually served as medical director of this huge old state hospital. I visited it once long after he had worked there for a stint and was overwhelmed by its size and vastness of its campuses. I had never seen such a massive mental hospital facility and was not prepared for its size.

It had its share, or more than its share of scandals and periodic tales of abuse for decades and did many such state hospitals especially early in their histories before the era of modern treatment with advent of effective medications, movement beyond just ECT, or electroshock therapy for out of control mania and truly treatment resistant long-standing depressions and the addition of all the behavioral and cognitive therapy, art therapy (and that really is valuable stuff speaking as someone who in my younger stupider days, thought it was not very relevant [I was a dummy young Turk type then to some extent], music therapy, DBT [Dialictal Behavioral Therapy which is wonderful stuff], psychodrama [which is sadly not practiced in enough hospitals] and so on.

What I am leading up to in my habitual meandering style is pointing the reader(s) to a post I somehow discovered one night recently, on a sort of mixed text and wonderful pictorial history of Milledgeville State Hospital [latter called Central State Hospital in recent modern days before it closed in 2016] that is so well done I had to do this post and highlight/publicize it by offering its URL so readers could read it and marvel at this institution, its history and dilapidated kind of grandeur. I know there are those that would rankle at having the term ‘grandeur’ applied to state hospital that personally represented horrors to them or their extended families, and I understand and completely accept that sentiment as all state hospitals had their sins, tragedies, and horrors to say the least and were in ways certainly ignoble chapters in our nation’s history.

But anyway, here is the URL to the extremely well-done website that shows an enormous amount of artistic photographic effort and historical research that I think many will enjoy and as I said above, marvel at. URL: Milledgeville State Hospital in Georgia.