 The
following photographs represent a brief visual history of the Utah
State Hospital beginning in 1885. Included are pictures that are at
times exemplary and at other times disturbing. The history portrayed in
these images parallels treatment in usage at institutions across
America. Even the architectural style of the buildings echoes the style
of other mental health institutions. Many of the photos have not been
seen for decades and most have never been published. They come from a
variety of sources but many were found in old cabinets or boxes in
forgotten closets during the demolition of buildings at the hospital.
Most were taken by unknown photographers, and few were dated. They are
rare portraits of some of Utah's forgotten citizens and of the
compassionate and exceptional people who provided care to those
citizens.
There are many quality works for the reader
desiring a detailed history of mental health treatment. A noteworthy
history specific to Utah is Charles McKell's October 1955 Historical
Quarterly article, “History of the Utah State Hospital. This essay is
not intended as a comprehensive telling of the hospital's history, but
is rather a glimpse into one of Utah's oldest and often misunderstood
institutions.
It was likely that the need to care for
mentally ill persons in Utah had existed since pioneers first came West
in 1847. However, it was not until February 20, 1880 that an act to
establish a Territorial Insane Asylum was passed by the Utah Territorial
Legislature. In 1881, Provo was selected as the new site for the
asylum. The site was selected due both to the ample supply of spring
water and because it was located far from the center of town. In
keeping with attitudes of the era, Provo City was protected from the
asylum by both a swamp and the trash dump.
The original Utah Insane Asylum taken just before the opening on July 15, 1885. (Utah State Hospital Museum Collection)
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The original asylum building was dedicated
on July 15, 1885 and five days later, the first patients were admitted.
The asylum would become the primary care facility for those with a
mental illness for the next eighty three years. In 1967, Utah's first
community mental health center opened, gradually ten more would follow.
Today, the Hospital is one part of the continuum of care for Utah's
mentally ill citizens.
The Utah Territorial Insane Asylum with
the addition of the north wing and administration portion of the
building. c. 1900. (Courtesy of Allen's Camera)
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As more patients arrived, the need for more space increased at the
Asylum. In 1890, a new north wing was added and the original building
became the south wing of the growing complex. In 1891, the
Administration building was added which provided no new patient housing
but provided additional office space as well as new living quarters for
staff.
The original building after extensive
remodeling. c. 1936. (Used by permission, Utah State Historical Society,
all rights reserved)
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The main building as it appeared in the 1930's had undergone a
dramatic renovation. The old gothic style of architecture had given way
to a more modern and sleek look. The name of the institution also
changed with the changing attitudes about mental illness. In 1896, Utah
achieved statehood; consequently the Asylum became the Utah State
Insane Asylum. In 1903, it became the Utah State Mental Hospital, and in
1927, the Utah State Hospital.
Over the years, additional buildings were added to accommodate the
ever growing population. Each new building represented the best
thinking of the time. Two cottages built in 1901 were a radical change
from large wards and multi floors. Both were single wards designed to
house thirty patients and consisted of only one floor. The Milton Hardy
building, constructed in 1908 consisted of two floors and was most
likely a compromise between the original building and the cottage plan.
By the time the George Hyde Memorial Building was competed in 1922
and the Frederick Dunn building in l932, multiple floors and large dorms
were again back in vogue. The difference between the two buildings
reflected the treatment philosophy around patients need for recreation.
The Hyde Building contained a billiards room, one lane bowling alley and
swimming pool. The Dunn building, completed during the depression
contained no such amenities. Hospital buildings constructed in recent
years reflect a patient's need for privacy and space. All of the wards
provide one and two bed room dorms, a number of day rooms and open court
yards. Beginning with the Milton Hardy building in 1908, each new
building would be named after the superintendent in office at the time
of construction. This practice would be discontinued in 1951 with the
construction of the student nurses home.
This turn of the century photo of Asylum
personnel included Superintendent Dr. Milton Hardy, who is seated center
front. c. 1900. (Utah State Hospital Museum)
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Early employees lived on the Asylum campus, worked six ½ days per
week and were responsible for every aspect of patient care. The work was
hard, the hours long and by today's standards, the salaries seem low.
However, before the turn of the century they were considered adequate.
Salaries in 1885 ranged from $125 per month for Medical Superintendent
Dr. Walter Pike, to the third female attendant who received $17.50 per
month. Interestingly, the male attendant made $25 per month and the
male supervisor made $37.50, $4.17 more a month than the matron who
received $33.33 per month. [1] It would be well into the 20th century
before female and male employees were paid the same salary and everyone
worked a 40 hour week.
The Asylums first pharmacy adjoined the
office of Superintendent, Dr Milton H. Hardy who is seated on the left.
c. 1900 (Utah State Hospital Museum Collection)
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The Asylum's first pharmacy was called the dispensary and adjoined
the Superintendent's Office. The first recorded inventory of the
Dispensary can be found in the asylum's Biennial Report in 1886. It
consisted of 130 items, including an odd array of pills, powders and
herbs. Some of the more unusual items included; 1 gallon of bourbon,
whiskey, sherry wine, powdered rhubarb and Jamaica ginger. [2] The first
effective medicines for the treatment of mental illness would not be
developed until the 1950's with the discovery of a new group of
medicines know as the phenothiazines.
Shown is a restraint known as the Utica Crib. The crib, patterned
after a child's crib, was approximately six feet long, weighed about one
hundred and fifty pounds and had a hinged top that could be fastened at
night thus restricting movement and supposedly enforcing rest. It was
believed that some types of mental illnesses required rest as a
therapeutic measure. It was first used in 1846 in Eastern asylums and
records show that it was used at the Utah Territorial Insane Asylum when
it opened in 1885; it was discontinued in the 1920's when more humane
restraints were developed. (Utah State Hospital Museum Collection)
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A patient shown wearing a canvas straight
jacket in 1954. The straight jacket was a common type of restraint used
at hospitals across the country. It was used extensively at the
hospital until the late 1950's. (Courtesy of the Provo Daily Herald)
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For the first 70 years of the institution's history, care remained
primarily custodial. Therapeutic care was almost unknown in those early
years. Over the years various forms of ‘‘treatment'' were used including
the Utica crib, straight jacket and a variety of other devices which by
today's standards would be considered punishment rather than treatment.
However, from the beginning no restraint could be used without a
doctor's order and earliest records indicate that superintendents
continued to make an effort to minimize their use. Superintendent, Dr.
Walter Pike noted in his first Biennial Report to the Governor in 1888,
“We have endeavored to carry out the “non-restrain” principle as far as
possible, consistent with the safety of the patients, but have found
ourselves obliged to make use of some restraint to prevent patients,
while violent, from harming their fellow patients. We endeavor to get
along with as little display of restraint in any form, as possible. But
these evils cannot be avoided until we are able to classify”. [3] Most
restraints were used to contain patients, especially those diagnosed
with mania.
This photo taken in 1918, shows a patient
receiving a form of hydrotherapy known as a tonic “douche”, as sprays
were called at the time. A number of different sprays were used
depending on the need of the patient. (Photo from the-Report of the
Board of Insanity and Superintendent of the State Mental Hospital: For
the Biennial Period Ending November 30, 1918: 11)
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This 1918 photos depicts another form of
hydrotherapy in which tubs were used instead of sprays. In this version
patients were placed in warm tubs filled with warm water, canvas cover
were placed over the tubs to retain the heat and keep the patient in the
tub. (Photo from the Report of the Board of Insanity and Superintendent
of the State Mental Hospital: For the Biennial Period Ending November
30, 1918: 12)
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This last version of hydrotherapy
included a consol that could produce a variety of different spray and
also included a heat lamp. c. 1950 (Utah State Hospital Museum
Collection)
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A new treatment known as hydrotherapy began at the hospital in 1910.
The practice of hydrotherapy began in state hospitals around 1890 and
was based on the medical use of water for other illness such as the
immersion in cold water for the treatment of a high fever. Perhaps its
use was also based on the popularity of spas during that era.
Hydrotherapy included saline baths, sitz baths, hot and cold wet packs,
and hot and cold baths. Cold wet sheet packs were often used as
sedatives for excited patients instead of the old forms of mechanical
restraints. Warm baths were used to simulate those patients who were
depressed or catatonic (a phase of schizophrenia in which the patient is
unresponsive).While the method of hydrotherapy may seem simple, the
technique of administering it was not. Care had to be used in both the
application of cold and hot water in order to prevent serious injuries.
By today's standards hydrotherapy may seem old fashioned and more
like a restraint but at the time it was widely used in state hospitals
as well as in general hospitals for other illnesses. It is that doubtful
that hydrotherapy was ever in its self a cure; at best it was most
effective as a sedative, tonic or as stimulation with only temporary
benefits. The use of hydrotherapy was phased out with the advent of
medications in the 1950's.
A patient being prepared for insulin shock therapy-c. 1950. (Utah State Hospital Museum Collection)
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In 1934, a new treatment known as convulsion therapy was added to the
growing list of new therapies being introduced at state hospitals
therapy the drug Metrozol was administered to produce the required
convulsions that the therapy required. In 1937, Hypoglycemic therapy,
more commonly known as insulin shock therapy was introduced at the
Hospital and Metrozol therapy was slowly discontinued. Insulin shock
therapy patients were given large doses of insulin, this lowered the
sugar content of blood and produced a diabetic coma. The object was to
place the patient in an unconscious state for several hours. The usual
treatment schedule was five times a week with up to 50 or 60 treatments.
Insulin shock therapy was used to help restless or agitated patients
become calm and tranquil. Both convulsive and hypoglycemic therapies
were considered dangerous and were eventually discontinued as other more
effective treatments were developed.
Dr. C.V. Kivler administering Electro
Convulsive Therapy (ECT) with the Reiter machine in 1955. (Utah State
Hospital Museum Collection)
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Electro Convulsive Therapy or ECT, which was introduced at the
hospital in 1947, would become the most common of all the convulsive
therapies. The earliest method of ECT could produce a rather violent
convulsion so care was given to make sure that no injuries occurred.
According to treatment protocol convulsion therapy was administered
three times a week and included from five to fifteen treatments.
Today, ECT is still considered a viable and effective treatment for
severe depression. New methods have made the procedure considerably
safer and it is only used with patients consent.
By 1950, the list of treatment options at the Hospital had grown to
include hypoglycemic therapy, electroshock therapy, hydrotherapy,
psychoanalysis, group therapy and narcoanalysis (a form of psychotherapy
in which barbiturates are used to put the patient into a light
anesthesia to help them talk about events that might be suppressed).
Although some of the early therapies seem ineffective when compared with
current treatment options, they were considered a standard practice for
state hospitals. When medications were developed in the 1950's that
were considered safer and more effective than earlier treatment
modalities, nearly all of the other forms of therapies were
discontinued. Today, the hospital provides a broad array of therapeutic
programs including recreation, vocational, rehabilitation and physical
therapy.
This surgical room was located on the
first floor of the main building until a modern Medical Surgical
Building was completed in 1955. c. 1910. (Utah State Hospital Museum
Collection)
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Surgeries were performed at the asylum from the time it opened in
1885 until the mid-1970's when it became too costly to maintain current
surgical equipment. Nearly every surgery that was available at a general
hospital was available at the Utah State Hospital, including the birth
of a few babies. Today patients who need surgical care are referred to
local hospitals.
Along with a discussion of early treatment modalities it is
interesting to note the variety of reason that people were committed to
the institution in the early years. Some of the more interesting ones
were: reading novels, solar heat exposure, spiritualism, financial
embarrassment, disappointment, mental strain, overwork, fear of poverty,
religious excitement, fright, remorse, sedentary life, over study in
school, hypnotism and sheep herder. By today's standards those are
flimsy reasons for years of hospitalization.
Hundreds of pieces of beautiful wicker
furniture were made by patients and staff. c. 1930 (Utah State Hospital
Museum Collection)
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A Patient working in the hospital
greenhouse c. 1940's. The farm and dairy provided nearly all of the food
used by the institution. (Utah State Hospital Museum Collection)
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In 1938, patients and staff canned over
“329,340 quarts of fruits and vegetables”. c. 1920's [4] (Utah State
Hospital Museum Collection)
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Employees and patients working together
made a number of different items including brooms, scrubbing brushes,
dressers, screen doors, just to name a few. c. 1930 (Utah State Hospital
Museum Collection)
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From the opening of the Asylum in 1885, patient labor was important
to the operation of the facility. Every conceivable item was made
including, tin cans, mattresses, and wicker furniture, shoes, clothing,
towels, blankets, etc. Patients worked in the sewing room, laundry,
kitchen, boiler house, farm and dairy. Patients were also involved in
the construction of every new building until 1955. Superintendent Walter
Pike noted in 1887 “That the employment of patients in pursuits which
occupy the mind, and for the time being distract them from dwelling upon
their delusions and insane ideas, is one of the most powerful aids to
treatment and every means should be used to furtherance of such
employment”. [5]
The farm was an important part of the treatment program as well as
the fiscal efficiency of the hospital. In the 1924 Biennial report, Dr.
Frederick Dunn noted in his report on the progress of the farm, “That
with more land added to our present holdings, this Institution will
have made the long step toward self support”. [6] By the 1930's, the
farm complex included hogs, chickens, turkeys, cattle, horses and an
apiary. However, it was not until 1956, a professionally directed
industrial therapy program was introduced that began to coordinate the
labor needs of the hospital with the treatment needs of the patient. The
farm program was phased out in the 1960's and nearly all of the
original industrial programs have been discontinued. Today, the hospital
no longer relies on patient labor; the mission of the hospital is to
aid patients in life skills and to return them to their communities as
soon as possible.
The hospital kitchen staff c. 1900. All
most all of the food was grown at the hospital and all the meals were
prepared by staff and patients. It wasn't until 1937 that the coal
stoves were replaced with gas. (Utah State Hospital Museum Collection)
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The food was transported from the kitchen
to the various wards on these hand-pulled carts until the late 1950's.
c.1940. (Utah State Hospital Museum Collection)
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In the early years patients ate family style on their respective
wards. They were allowed cups, saucers, a tin bowl, knives and forks.
As overcrowding became problem knives and forks were seen as potential
weapons and soon a metal spoon was the only utensil provided. It was not
until the late 1950's that knives and forks reappeared.
A typical crowded ward- c. 1950. (Utah State Hospital Museum Collection)
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Beds in the hall of the men's ward-c. 1940's (Utah State Hospital Museum Collection)
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A women's ward –c. 1930's (Utah State Hospital Museum Collection)
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A men's ward day room- c. 1940's (Utah State Hospital Museum Collection)
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The strong room- c. 1940's (Utah State Hospital Museum Collection)
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A women's ward “birdbath”- c. 1940's (Utah State Hospital Museum Collection)
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Due to the constant problem of overcrowding and budget restrictions,
many inhumane conditions existed at the hospital. A typical patient
dorm area from the 1920's through the late 1950's housed between twenty
and as many as fifty patients, which resulted in a total lack of
privacy. There were neither dressers nor mirrors and patients were
allowed to keep very few personal belongings, any they did manage to
have had to be tucked under their mattress or hidden in their clothing.
Patients were allowed one bath per-week; during the rest of the week
they would wash in large sinks know as bird baths. Bathrooms also
allowed little privacy and until the 1950's there were no toilet paper
dispensers. Patients would be required to ask a staff member for toilet
paper.
By the 1940's, wards had became so crowded that beds were placed in
alcoves and ha1ls. In 1955, the hospital population peaked at 1,500
patients, which was nearly 200 over capacity. In 1957, the State
Legislature doubled the funding for the hospital. With the extra
funding and the leadership of Superintendent Dr. Owen P. Heninger, the
hospital was divided into small treatment units each with its own
treatment team. This allowed for individual treatment plans and more
personal care.
When Dr. Heninger became the superintendent in 1942, he was
determined to remove an area in the hospital known as the strong room.
The strong room, erected in 1932, was built to house criminally insane
men who were considered dangerous. The room consisted of four jail cells
and the men who were placed in them were never let out. It took him
eight years but in May, 1950, the cells were finally removed.
Interestingly, the four men who were moved from these cells into the
general hospital population never caused another problem.
The large number of men on this walk is
indicative of how overcrowded the hospital was in the 1940's. For many
these walks were the only opportunity to escape the crowded wards- c.
1940. (Utah State Hospital Museum Collection)
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This courtyard was located behind the
Dunn Building and was modeled after a prison exercise yard, without the
armed guards- c. 1935. (Utah State Hospital Museum Collection)
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Patient enjoy a Forth of July Celebration on the hospital lawn- c. 1940. (Utah State Hospital Museum Collection)
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The Red Cross Gray Ladies and patients enjoy a visit from Leta, the dog-1960. (Courtesy of the Provo Daily Herald)
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Recreational activities for patients varied over time and were often
dependent on volunteers and the availability of staff and resources.
Movies were shown when available and community groups would often
provide entertainment. Christmas and Fourth of July celebrations were
held each year along with frequent dances. In the 1950's, the Red Cross
Gray Ladies began to provide a number of regular activities for
patients, they were also involved with the establishment of a new
patient recreation center that included games, ping pong tables, books,
magazines, a radio, phonograph and records. By the 1960's patients were
routinely allowed to go off campus for recreational activities.
Today, patients enjoy many community activities as well as campus
recreation facilities. Recreation provided on campus include a modern
library, gym, swimming pool, weight room, ropes course, fish pond and on
ground camping facility. However, volunteers are still an integral and
valued part of the recreational as well as religious programs available
to patients
Demolition of the last remaining part of the original building- 1981
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With the advent of community mental health centers in the 1970's the
hospital population began to decline and the large old fashioned wings
of the original building were no longer needed. They were demolished in
1976 and the remaining portion was demolished in 1981. Most of the old
buildings have now been replaced with modern new facilities that provide
both a therapeutic environment with a comfortable living arrangement
that includes both private and semi-private bedrooms.
Gone are the large custodial intuitions of the past. The Hospital has
moved from a custodial asylum to a hospital in every sense of the word.
It is no longer the only mental health facility in the state, but
rather serves a supporting role to a broad community mental health
system Today, most people needing treatment for a mental illness will
remain in their communities. Individuals needing more intensive
treatment are referred to the hospital from one of eleven community
mental health centers. The hospital currently employs 800 staff who
provide a full array of services to 354 individuals including children
ages 6-18; adults ages 18 and up and forensic patients committed through
the Criminal Courts. However, as former Superintendent Dr. Owen P.
Heninger noted in an evaluation report to the Welfare Commission in
October, 1951 “It is a mistake to center our attention on either the
good or bad to the exclusion of the other. The hospital record is
neither black nor white; it is a mixture of both, which results in a
variable shade of gray, that on occasions is lighter or darker,
depending upon the will of the citizens and officials to who they gave
responsibility. There may have been some excuse for the neglect of past
years when society knew no better, but future generations will not be
so generous in their evaluation unless advantage is taken of the
knowledge now available”. [7]
The progress is not complete. The Hospital history is still being written.
1-Biennial Report of the Board of Directors and the Annual Report of the
Superintendent and Treasurer of the Insane Asylum of Utah
Territory-1888: 51.
2-Biennial Report of the Board of Directors and the Annual Report of
the Superintendent and Treasurer of the Insane Asylum of Utah
Territory-1886: 58-60.
3-Biennial Report of the Board of Directors and the Annual Report of
the Superintendent and Treasurer of the Insane Asylum of Utah
Territory-1888: 27.
4- Report of the Board of Trustees and the Superintendent of the Utah
State Hospital: For the Biennial Period Ending June 30 1938: 31
5- Biennial Report of the Board of Directors and the Annual Report of
the Superintendent and Treasurer of the Insane Asylum of Utah
Territory-1888: 26.
6- Report of the State Board of Insanity and the Superintendent of
the State Mental Hospital: For the Biennial Period Ending November 30,
1924: 7
7-Charles McKell, “The Utah State Hospital: A study in the Care of
the Mentally Ill”, Utah Historical Quarterly, Vol. XXIII (October,
1955): 323.
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