The history
of mental illness has been a long and troubled one in the United States, with
reform coming slowly. There are those that tirelessly dedicate their lives to
change, many of whom have been lost to history and are little known. Their
efforts to enact reform in mental health care often stem from personal
experiences with mental illness, which has resulted in a passion and
understanding others may not possess. This passion is the fuel that these
reformers often use to the end of their lives, working up to their dying day to
help others.
Previous APHGA
blog posts have mentioned Mary Williams Howes (1823-1910), daughter of Lydia
Spaulding and Ezra Howes, granddaughter of Mary Williams and Reverend Josiah
Spaulding of Buckland, Massachusetts. In 1865 she married Peter Goddard, also
of Buckland. She went by Mrs. P.M. Goddard or Mrs. M. W. Goddard from then on.
Mary was born the year Reverend Spaulding and Mary Williams both died. Her
uncle Josiah Spaulding, who was insane and kept in a cage, had been transferred
from the home of Reverend Spaulding to Lydia’s house just prior to Mary’s birth.
Previous blog posts about the Spaulding family say that family letters did not
mention him after about 1812, when he was put in the cage. This is not the
case. After receiving more letters, the APHGA has learned that Josiah was
indeed mentioned.
Deborah
Pomeroy Trowbridge wrote to her sister-in-law, Mary Spaulding of Southampton,
Massachusetts, on November 29th, 1823, the day before Mary Howes was born. She
wanted to let Mary Spaulding know how her brother, with whom she had been very
close, was faring after being moved to Lydia’s house (punctuation added):
Your Dear Brother is in his new room,
he was put into it Saturday Last. I think he will be comfortable this winter.
Mrs. Townsley[i] says it is a warm
room. Deborah has been washing his clothes today, she says you need not be
troubled about Josiah for he will be took as good care of as if his Mother was
alive. For the same ones take care of him now as they did then.
This letter
indicates that Josiah’s other sisters, Deborah and Lydia, who had been caring
for him, would continue to now that their mother had passed. Letters between
Josiah and Mary prior to his being caged show that the two had a nice
friendship. Mary was no doubt very concerned with him, and must have felt far
away in Southampton, which was 30 miles from Buckland. In those days, it may as
well have been several states away due to the circumstances of the time period
limiting travel and communication.
Mary Williams
Howes was born the day after the above letter was written. She became a mental
health reformer as an adult, working with her husband and son to open a
therapeutic sanitarium on a mineral hot springs in Alaska for the mentally ill
in the early 1900s. The memory of her uncle’s cage most likely inspired Mary
and by extension, her family, to create a humane environment for people with
mental disorders. Readers can learn more about her in March 2012’s two-part
blog post The Descendants of Lydia
Spaulding.
At the same
time as Mary, her husband Peter and son Dr. Frederick L. Goddard were working
to create the hot springs asylum, Dr. Henry Waldo Coe, President of the
Sanitarium Co. in Portland, Oregon, was working on a rival contract. The state
of Alaska in the late 1800s to mid 1900s had no asylum for their mentally ill.
Federal funds had been allocated for the creation of an asylum, and the
Goddards were in competition with Henry Waldo Coe over who would receive them.
Henry, who
lived in a mansion at 933 Northwest 25th Avenue in Portland, was
successful and well-connected politically. He was president of the Oregon State
Medical Society, whose meetings were sometimes attended by the Mayor of
Portland. Originally from Wisconsin, the son of Dr. Samuel Buell Coe (b. 1835
in Randolph, Portage County, Ohio) and Mary Jane Cronkhite (b. 1835 in Oneonta,
Otsego County, New York), Henry Waldo Coe began his education at the University
of Michigan at Ann Arbor. His father, also a physician, was a surgeon in the
Union Army during the Civil War. Like Dr. Frederick L. Goddard, Coe went on to
graduate from the Long Island College Hospital in New York in 1880, seven years
before Frederick did. After graduating, Dr. Coe moved to the Dakota Territory
and worked as a physician in Mandan, also serving as that town’s Mayor. It was
in the Dakota Territory that he met and began a lifelong friendship with Theodore
Roosevelt. There he also met Viola Mae Boley, the daughter of Honorable Elijah
Boley and Sarah Llewellyn of Indiana. Henry and Viola were married on June 24th,
1882.
Viola Mae Coe
was also a physician. A graduate of the Woman’s Hospital Medical College of
Chicago, Viola began her career as a schoolteacher, and received her medical
degree after giving birth to her first child, George Clifford. George was born
in North Dakota in 1885. In 1890, Dr. Coe and Viola moved to Portland and began
work to open Morningside Hospital, an asylum for the mentally ill. The couple
had two more sons in Oregon, Wayne Walter (b. 1894) and Earle Alphonso (b.
1896). Viola was one of only five women physicians in the Portland area at the
time. She became a founding member of Portland’s first Women’s Medical Society,
and had her own private practice. Henry by this time was specializing in
nervous disorders and mental illness, and the asylum project was an extension
of this.
The asylum
was founded in 1899 and built on 47 acres of formerly agricultural land in East
Portland on 96th and 102nd avenues, and Stark and Main
streets. Originally, it was not a large asylum building, but a system of
cottages. A 1903 advertisement from the Pacific Medical Journal shows “Mt.
Tabor (Dr. Coe’s) Nervous Sanitarium”. At the time, the asylum consisted of six
buildings “situated in Portland’s most desirable suburb…and it is exclusively
for the care of NERVOUS DISEASES”. Also on
the property was Mindease Retreat, which promised treatment for “selected cases
of alcoholism, drug addiction and DISEASES OF THE MIND.” Pictures in the ad
feature pastoral scenes and stick-style cottages bordered with Art Nouveau
fences.
Around this
same time, Dr. Frederick L. Goddard had taken over the Western Washington
Hospital for the Insane at Steilacoom. His parents had moved to Washington with
him. Before his arrival in 1900, the hospital had been run by a businessman,
and had developed a reputation as being a sort of Bedlam, neglectful of
patients and not a pleasant place to be. Frederick’s management brought
sweeping changes to the institution, including the release of many patients who
had been committed for things like menstrual disorders and masturbation. Dr.
Goddard was not interested in keeping the mentally ill in chains. He patented
his own system of humane cloth and leather restraints and also thought highly
of the use of water for treatment. Many of his reforms of the Washington Asylum
centered on water, and he updated and enlarged the bathing area which he wrote
in a report had been “repulsive”. He also directed water from a local spring
for the asylum’s use to irrigate the grounds, on which vegetables and trees
were planted.
Previous APHGA
blog posts on Mary, Peter and Dr. Frederick Goddard mention their Buckland,
Massachusetts roots, but the family moved quite a bit. After meeting in
Buckland, Frederick’s parents, Mary and Peter were married in Philadelphia and
then moved to Brooklyn, where Peter worked as a cotton merchant. Frederick was
Mary’s step-son, and was born in Buckland in 1862. His mother, Climera Mallory
(1835-1864), died when he was a baby, and Mary and Peter were married soon
after her death. Mary and Peter had begun courting when Mary returned to
Buckland after teaching school in the antebellum South and working as a nurse
under famed mental health activist Dorothea Dix for the Union Army. She had
returned to Buckland because one of her last surviving family members was dying
- her stepmother, Lois Warrniner, who had been caring for Mary’s caged and
insane Uncle Josiah for decades in the family home. Josiah Spaulding had
outlived almost every one of his family members (with the exception of Deborah
Pomeroy Trowbridge, who lived to be 90), all of whom died from epidemic
disease. Mary had grown up with her caged uncle in her house. He was first
cared for by her mother, Lydia. After Lydia died in 1836 from tuberculosis, Mary’s
father married Lois, who took over Josiah’s care. When Lois died, it was up to
Mary to see that Josiah and his cage had somewhere to go. It had been many
years since Josiah’s limbs had atrophied from being caged for so long. Mary was
living in Philadelphia at the time and could not bring him with her. In what
must have been a very painful decision, Mary saw that he was transferred to the
Deerfield County Poor Farm. He would die there two years later, at age 81. He
had spent 57 years of his life in the cage. Experiencing the treatment of the mentally
ill this way must have left an indelible mark on Mary’s mind. There was no
other place that Josiah could go in the area, and there never had been. Peter,
who grew up in Buckland, also knew of Josiah (as everyone did) and was with
Mary during the difficult time of Lois’ death and Josiah’s transfer to the Poor
Farm. The fact that their son became a physician specializing in the treatment
of the mentally ill was most likely influenced by their past with Josiah, a
story Mary and Peter must have told Frederick when he was growing up.
Mary and
Peter knew firsthand what could happen when there was no place for the mentally
ill to go, and no available treatment for them. Like Dorothea Dix, the family
understood the need to create asylums in places where there were none.
Frederick left the Western Washington Hospital for the Insane in the early
1900s, moving to Alaska to speculate in Gold and work as a physician at the
Treadwell Mine. He moved to Juneau with his family: wife Mary Clunas (the
couple married in 1890 in Tacoma) and children Erwin Mallory (b.1891) and
Dorothy (b. 1899). Mary and Peter, now elderly, went with them. After moving to
Washington, Peter had become a plumber, which was fitting with his son’s
water-based ideas of mental health therapy. Peter would be involved in the
development of the mineral hot springs asylum, which Frederick and his partner,
Dr. E.J. Brooks, bought in 1905 in Sitka, Alaska. The modest asylum started out
like Dr. Coe’s Mindease retreat: it wasn’t a large hospital but the beginnings
of what the family hoped would become Alaska’s first asylum for the mentally
ill. Government contracts and support could help to make it large enough and
equipped to accommodate more people over the years. Dr. Goddard chose the spot
for its healing mineral waters, which he would incorporate into the care of his
patients. The spot had been used by local Native Alaskans for its curative
powers for thousands of years, and was considered a sacred spot.
Alaska’s
mentally ill were being shipped by this time to Dr. Henry Waldo Coe’s
Morningside Hospital, which had come to fruition in 1905 in a large building
that the doctor purchased and had moved to his land at 10008 Southeast Stark
Street. A mentally ill person in Alaska would be sent before a judge, declared
insane, arrested, and put in chains like a criminal and sent to prison before
being eventually shipped to Portland. This type of treatment of the mentally
ill was exactly what Dr. Goddard was against. In the Biennial Report of the Western Washington Hospital for the Insane,
Years 1896-7-8, Dr. Goddard wrote:
The
law however should be changed so that the trial for the commitment of an insane
person would differ from that of a criminal, and the conveying of the insane to
the hospital should be placed in hands of parties educated in the management of
the insane rather than those who are constantly dealing with the criminal. A
great saving could be made to the state if the patients were conveyed to the
hospital by qualified hospital attendants, and would be much more humane[ii].
Dr. Coe had
been awarded a contract from the U.S. Department of the Interior in 1904 to
care for mentally ill and developmentally disabled people from Alaska. This
included many members of Alaska’s Native American tribes. Dr. Frederick Goddard
and his family at this time had been petitioning the government for that same
contract, which would allow patients to go to their Hot Springs Asylum. Dr.
Coe’s wealth and political connections to then president Roosevelt, his old
friend from the Dakota Territory, most likely did not hurt his chances in getting
the contract. He even gifted the city of Portland with a statue of Theodore
Roosevelt.
Dr. Coe’s
Sanitarium Company reaped the benefits of this government contract, with
hundreds of Alaskan patients being transferred to his facility, which also
housed children. Running this facility made Dr. Coe a wealthy man. His banking
and real estate interests served to increase that wealth. Maintaining his
contract with the government was vital to his operation’s success. Dr.
Frederick Goddard had to abandon the idea of a hot springs asylum and instead
turned the site into a hotel. He continued trying to get the contract until at
least 1915, bidding in his proposal to the Department of the Interior that he
could save them money, needing only $27 per patient per month. It was the
lowest bid for the care of Alaska’s patients. Other hospitals in Washington and
Oregon had also made bids, but Dr. Coe’s Sanitarium Company and Morningside won
the contract again.[iii]
Morningside
Hospital had come under scrutiny in 1915 for never releasing patients, and for
housing them so far away from their homes, among other complaints, some from
patients. Dr. Coe refuted these charges in a letter to the government, calling them
“malicious”.[iv] Viola
Mae Coe also denied the accusations.[v]
Other complaints were levied against the institution, which compelled Dr. Coe
to put together a book entitled “The Insane of Alaska” in 1917, dedicating it
to the Governor and legislators of Alaska in response to the bad reputation the
hospital was getting. He offered as explanation: “Many of the insane believe
that they are being unlawfully detained, discharged nurses are sometimes
resentful, and there is always the local politician…seeking the establishment
of an insane asylum in [his community’s] midst.” The book featured pleasing
photographs of patients sitting comfortably outdoors on manicured lawns, engaged
in activity, and rows of clean, nicely made up beds. Dr. Coe wrote later in the
book that “As long as the insane are cared for, complaints will be made as to
such care, regardless of where the patient may be treated…probably 99 out of
every 100 complaints are the result of insane delusions…”[vi]
A government inspection also cleared the institution of any wrongdoing.
However, patients in this era often were institutionalized for no real reason,
and were not allowed to leave the hospital. Their presence meant money for the
institution and their free labor on the grounds and in the buildings often
helped a place run at less expense. The hospital had an incentive to keep
patients committed. People would often be committed for normal life stresses
and kept in institutions until they died. But according to Dr. Coe, any
complaint should not be entertained, as it was an “insane” person making it.
Dr. Coe also stressed that Oregon was a much better climate for the mentally
ill than Alaska, failing to recognize the more temperate parts of the state
such as Sitka, which is closer to Washington.
After losing
the contract yet again, Dr. Frederick Goddard resorted to having a private
practice, as he had done in Juneau. He owned a house in Sitka, where the whole
family lived. Mary Williams Howes wrote to her Alma Matter, Mount Holyoke
Female Seminary in South Hadley, Massachusetts, to have books shipped to Sitka
for the grandchildren, working to almost her dying day to keep the family
educated. She would die in 1910. Her husband Peter passed in 1912. Dr.
Frederick would die in 1932 of a cerebral hemorrhage. Erwin Mallory,
Frederick’s son, went on to be mayor of Sitka.
Morningside
Asylum continued to transfer patients from Alaska, admitting almost 5,000 up to
the hospital’s close in 1968. Dr. Henry Waldo Coe’s son, Wayne, took over the
institution after his father’s death in 1927. Dr. Coe was a well-loved man
around Portland and his memorial in an Oregon paper said of him, “His was a
life lived in the fullest-beautiful in all its acts; carrying in his heart, as
a guiding star, the thought of making the world better for having lived in it.
He was thoughtful, considerate and courageous; kind towards all fellowmen, the
widow and the orphan, the great and the small…courageous to the last.”[vii]
During the
1940s an inspection of Morningside found that most of its patients had no
official diagnosis and were receiving little to no psychiatric treatment. In
1956 the U.S. General Accounting Office investigated the hospital and
discovered that it was taking in excessive profits from inflating expenses. The
Daily Alaska Dispatch on April 4th, 1950 published an article
decrying the horrific conditions the mentally ill were being kept in while
waiting in Alaska’s prisons for transport to Morningside:
Anchorage's
Federal jail was criticized as a "fabulous obscenity" by an Interior
department investigation committee report in commenting on the conditions under
which insane persons must be held while awaiting transportation to the State…Dr.
Fred Goddard, late owner of Goddard Hot Springs and an experienced
psychiatrist, seeing the need for a mental hospital in Alaska established such
an institution at the springs a number of years ago. He believed the therapeutic
value of the waters was such that a great number of the mentally disturbed
could be relieved. His venture was unsuccessful because of the archaic laws
dealing with the insane in the territory.[viii]
Sadly, the
conditions Dr. Goddard spent his adult life fighting to eliminate were still
the case twenty years after his death. These conditions were also the ones
Dorothea Dix saw in the 1840s when she visited a prison where mentally ill
people were kept. Over 100 years later, not much had changed. The conditions
were indeed archaic. The investigation into the Federal Jail in Alaska
thankfully led to legislation being changed. The Alaskan Mental Health Enabling
Act was passed in 1956, which ended the transferal of patients to Portland.
Alaska developed its own mental health system in the 1960s.
The insane
asylum as a repository for federal money was a new era in American asylums, and
not a more humane one by any means. Dr. Coe’s hospital was not designed to treat
patients as much as it was to house them. Psychotropic drugs replaced locked
wards into the 1940s, keeping patients in a heavy stupor. If Dr. Goddard’s
reforms at Steilcoom were any indication, he was not interested in profit, but
in treatment and care, going so far as to design an asylum that was
revolutionary for its day.
Today, over
500,000 mentally ill people are housed in America’s prisons, which PBS recently
called “The New Asylums”. No effective system was designed to replace the
asylums as they began closing their doors in the 1960s-1980s. Dr. Goddard’s
model of a humane, beautiful and calming hot springs asylum could have offered
better treatment, and can be looked at as a model of what treatment could be
like. Instead of locked wards and solitary confinement, where many mentally ill
people continue to find themselves over 170 years after Dorothea Dix first
brought the problem of the mentally ill being imprisoned to light, a
treatment-focused program that is respectful of the patient and does not treat
them as an inmate could be beneficial.
Today, there
are many families who do not know what happened to a relative in their family
tree. When a person was transferred to an insane asylum during this era, they
were often never heard from again, and buried in an unmarked grave. There is
currently a project to find patients who were transferred to Morningside
hospital from Alaska. In looking over archival documents from Morningside, many
of the names on the lists are those of Native Alaskans. In the early 19th
century, many Native Americans were removed from their homes and sent to Indian
Schools or other institutions where attempts were made to assimilate them into
white culture. Morningside was one of these institutions. It is difficult to
say how Dr. Goddard would have handled this had his therapeutic Hot Springs been
a success, but at least people wouldn’t have been completely transferred out of
their state. Portland was a great distance from many parts of the Alaskan
Territory.
[i]Family friend and neighbor Submit
Townsly, who features prominently in the Spaulding letters.
[ii]Biennial
Report of the Western Washington Hospital for the Insane, Years 1896-7-8, Located at Fort Steilacoom. 49.
[iii] Insane Care from Alaska is Described
article, Daily Alaska Dispatch, Juneau, Juneau County, Alaska, 8 Jun 1916, p.
2/col. 2 & 3
[iv]Coe, Henry Waldo, M.D. "A
Detailed Report of the Patients Who Have Been or Are Now under Our Charge as
Insane from the District of Alaska." Letter to To the Honorable Secretary
of the Interior, Washington, D.C. 26 June 1916. MS. The Sanitarium Company,
Portland, Oregon.
[v]Viola at this time was heavily
involved in the women’s suffrage movement in Oregon and in 1912 had become chair
of the Oregon State Equal Suffrage Association. That year Oregon women won the
right to vote.
[vi]Coe, Henry Waldo, M.D., comp. The Insane of Alaska: Cared for by the
Sanitarium Company at Portland, Oregon, under Supervision of the Department of
the Interior. Portland, OR: Boyer Printing, 1917. Print. 26.
[vii]"Henry Waldo Coe, M.D."
Multnomah County OR Archives Biographies.USGenWeb Archives, 25 May 2007. Web.
17 Dec. 2012. .
[viii]Anchorage's Federal jail was
criticized as a "fabulous obscenity" article, Daily Sitka Sentinel,
Sitka, Sitka County, Alaska, 4 Apr 1950, p. 2/col. 1 & 2
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