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Out of Mind, Out of Sight

OUT OF MIND, OUT OF SIGHT

A Revealing History of the

Florida State Hospital at Chattahoochee and

Mental Health Care in Florida

SALLY J. LING

Sally J. Ling

No part of this book may be used or reproduced in any manner whatsoever

without written permission of the author, except in the case of brief

quotations embodied in critical articles or reviews.

To contact the author, visit her website at sallyjling.com.

Cover design by Susan Rosser

ISBN-13: 978-1480101517

ISBN-10: 1480101516

Out of Mind, Out of Sight

ACKNOWLEDGEMENTS

Writing a book of this scope takes many years and a massive amount of research.

Assisting me with this project was Tara Newman, a former graduate student and

intern from Florida State University. To her I extend my deepest appreciation.

I would also like to thank Diane James, former administrator of the Florida

State Hospital, for access to hospital archives and photos, providing current

hospital information, and arranging the interview with Mrs. Rogers.

I am most grateful to my readers and extend my sincere gratitude to Pat

Keeley for her assistance with story line, and editing, and Joyce Manning for her

superb final editing.

Sally J. Ling

Out of Mind, Out of Sight

Foreword 7

Introduction 13

Chapter I – Recipe for War 15

Chapter II – Housing Convicts 25

Chapter III – Philadelphia to Florida: The Roots of

Institutionalized Mental Health Care 37

Chapter IV – Florida’s Response to the Mentally Ill 53

Chapter V – Transforming the Prison into an Asylum 57

Chapter VI – Entering the 20th Century 71

Chapter VII – New Therapies Stir Hope and Skepticism 83

Chapter VIII – Lobotomies: Cutting Edge Brain Surgery 97

Chapter IX – Hope and Challenges 111

Chapter X – Procedural Status Quo, Medical Discoveries,

and the Wind of Change 125

Chapter XI – Two New State Hospitals Added 139

Chapter XII – Investigation 145

Chapter XIII – Landmark Changes Come to Florida 157

Chapter XIV – Risk and Reward 171

Afterword 183

Postscript 185

Appendix 195

Endnotes 223

Index 241

About the Author 248

TABLE OF CONTENTS

Sally J. Ling

Out of Mind, Out of Sight

FOREWORD

I arrived in Tampa, Florida, in 1966 as a college freshman to attend the University

of South Florida. My father, having just retired from the Air Force, built a lovely

home for our family of five in the northern part of the city across from Lake

Magdalene and next to a producing citrus grove. Having recently returned to the

United States from three years in Japan, however, we found the Sunshine State quite

foreign.

My sisters and I spent our first Christmas frolicking in the pristine spring

fed lake behind our home. That was until Dick Butler, the old citrus farmer next

door, ran down to the water’s edge frantically waving his arms and pointing to a

large alligator swimming toward us from across the lake. After making it to shore,

we breathlessly listened as the farmer chastised us: “You girls should be sent to

Chattahoochee for being crazy enough to swim with a gator that close.”

Unfamiliar with the term “Chattahoochee” I asked the sun-wrinkled farmer

what it meant. He simply hiked up his overalls, rolled his eyes and made several

circles with his dirt-encrusted index finger at his temple. “Loony bin,” he stated

Tampa

Miami

Jacksonville

Tallahassee

Chattahoochee

FLORIDA

Sally J. Ling

flatly. Then he leaned in real close, “And you never want to go there.” His piercing

hazel eyes emphasized his caution.

From then on, every time I heard the word “Chattahoochee,” I knew what it

meant—the Florida State “Mental” Hospital at Chattahoochee. Located in a small

town about forty-five miles west of Tallahassee, the capital of the state, it was an

isolated facility steeped in dark secrets . . . a place where parents jokingly threatened

to send their kids if they didn’t behave.

In those days the facility had quite a reputation—most of it bad. But the

institution wasn’t alone. For decades throughout the country, state facilities earned

shocking reputations for their inadequate care and mistreatment of the mentally ill.

Even more chilling was the incarceration of thousands of men and women who were

not mentally ill at all, but due to ignorance and prejudice on the part of the public,

medical profession, and court system, were confined for sunbathing nude, smoking,

menopause or other ‘egregious’ offenses committed by those deemed mentally

deficient.

Unfortunately, the sensational stories that surfaced from these institutions

tended to overshadow the positive work performed by the facility’s dedicated

medical and professional staff in helping thousands of patients assimilate back into

productive society. On the other hand, it was precisely those sensational stories that

led to changes in commitment procedures, care, and treatment of tens of thousands

sent to mental institutions throughout the country.

The following is a history of the Florida State Hospital at Chattahoochee

from construction of its original buildings in 1834 as part of the Chattahoochee

Federal Arsenal, to its current role, treating individuals who have been civilly and

forensically committed (inmates who have been adjudicated through the criminal

justice system to be incompetent to proceed, or not guilty by reason of insanity).

The buildings themselves give us a remarkable glimpse into the early

history of Florida and its transition from territory to state. As well, the facility’s

many different uses reveal shifts in the needs of Florida citizens as the buildings

evolved from federal arsenal to state penitentiary to mental institution. So important

are the buildings to the overall history of Florida that of the two remaining original

arsenal structures, the William DeWitt Rogers Administration Building, originally

Officers Quarters and one of the oldest structures of its kind in Florida, has been

restored and is listed on the National Register of Historic Places. The other, an old

powder magazine where munitions were warehoused, is currently being restored.

Out of Mind, Out of Sight

Above: Outside of the restored Chattahoochee Arsenal powder magazine. Below: Inside the

powder magazine. Photos courtesy of Joe Blanton and the Florida State Hospital.

Sally J. Ling

History of the buildings aside, this story chronicles for the first time how

Florida dealt with its mentally ill citizenry, and how in the post-World War II era the

state’s burgeoning number of citizens committed to the facility required the Florida

State Hospital to expand from one remote institution into four statewide hospitals. It

also shows how a shift in philosophy regarding treatment of those diagnosed with

mental illness encouraged the nation to transition from state institutions to

community-based mental health treatment centers. (While this book includes the

evolution of mental health care in Florida, it is not intended to be an in depth study

of the topic.)

To put the Florida State Hospital at Chattahoochee in perspective, the story

is set against a backdrop of the evolution of institutionalized mental health care both

in the U.S. and Florida where new emerging treatments—insulin, Metrozol and

electroconvulsive (ECT) shock therapies, as well as lobotomies—became part of

patient treatment plans. It also includes the most compelling medical discovery in

the evolution of patient treatment—Thorazine, a psychotropic drug. Called a

“chemical lobotomy,” this drug, and others to follow, changed the face of mental

illness treatment forever.

Restored William DeWitt Rogers Administration Building. Photos courtesy of the Florida State

Hospital.

Out of Mind, Out of Sight

Despite all the medical advancements, one of the most fascinating

revelations to come out of the hospital’s history is the saga of patient Kenneth

Donaldson. Recounted in his book, Insanity Inside Out, his 15 year struggle for

justice took him from the Florida State Hospital, to Florida’s local and state courts,

and all the way to the United States Supreme Court. His multi-year journey

ultimately resulted in sweeping changes in commitment procedures at the Florida

State Hospital and mental institutions nationwide. Another patient, Emette Foley,

took his experience at the Florida State Hospital to Hollywood, California, where it

ended up on the silver screen in the 1991 movie “Chattahoochee.”

The Florida State Hospital has an amazing history, but for us to truly

understand the facility’s remarkable past and how it became what it is today, we

need to return to the early 1800s and the circumstances that led to its construction.

It is there that the story begins.

Sally J. Ling

Out of Mind, Out of Sight

INTRODUCTION

For decades during the 1800s, Native American Indians were systematically routed

by government troops in an effort to move them west into the Arkansas/Oklahoma

territory where reservations had been established. During this time, thousands of

Indians perished in battles, and remnants of surviving tribes in the southeastern

United States were pushed far into the south toward Florida, a territory under

Spanish control.

While some of the Indians became friends with American colonists and

federal troops and lived peaceably among them, even joining forces against other

Indian tribes, others resented being ousted from their lands and looked upon the

intrusive ‘white man’ as their enemy.

Chapter Photo: Neamathla, 1836. Courtesy of the Florida State Archives.

Sally J. Ling

Skirmishes sparked by this enmity broke out periodically between the

Indians, colonists, and federal troops, resulting in many casualties on both sides.

Forts, built along primary waterways used as main supply and transportation routes,

soon became fortified with U.S. troops, provisions, and munitions in defense against

the Indians.

Creek Indian Chief Neamathla, who as a warrior had been defeated earlier

in the Red Stick Rebellion of 1813 by a rival Creek tribe supported by General

Andrew Jackson and U.S. troops, was forced to move south and now occupied land

at Fowltown, Georgia. Believing the land was available for occupation as part of a

treaty signed between the U.S. and the British to end the War of 1812, Neamathla

settled in. The U.S. government, however, now demanded that the chief and his tribe

give up this land and relocate once again.

With Neamathla unwilling to vacate the disputed land, Major General

Edmund P. Gaines, a hero of the War of 1812 and overall commander of the region,

ordered Major Twiggs and 250 of his men from Fort Scott, Georgia, to march on

Fowltown, just 15 miles to their east, and bring in the defiant chief by force.

On the night of the attack—November 21, 1817—Neamathla noticed

movement outside his village and struck first against the waiting troops. The

skirmish failed to capture the chief, and two days later U.S. troops struck again.

While the Indians were driven from their village, for a second time Neamathla

managed to escape. In the aftermath of these two skirmishes, hundreds of warriors

from nearby Lower Creek and Seminole Indian villages joined forces with the

elusive chief.

A week later, a small military supply flotilla traveled up the Apalachicola

River from the Gulf of Mexico on its way to Fort Scott.

What happened next

proved to be a turning point in Florida history and prompted the construction of a

compound that eventually became the Florida State Hospital.

Out of Mind, Out of Sight

Chapter I

Recipe for War

November 30, 1817

Lieutenant Richard W. Scott of the 7th U.S. Infantry deftly commanded his boat

loaded with forty soldiers, seven of their wives, and four children up the swollen

Apalachicola River in the panhandle of Spanish Florida, heading to Fort Scott,

Georgia. Having rendezvoused downstream near Bristol, Florida, with a small

supply flotilla commanded by Major Peter Muhlenburg of the 4th U.S. Infantry,

twenty of Lieutenant Scott’s able-bodied men had recently exchanged places with

members of the supply boat who were sick with fever. Lieutenant Scott would

deliver the pallid troops to the Georgia fort where they could recover. The

exchanged troops would assist Muhlenberg in continuing his mission of bringing

lifesaving supplies to the same fort.

Chapter Photo: General Andrew Jackson, Courtesy of the Library of Congress, LC

3a52040u.

Sally J. Ling

Well aware of recent skirmishes between U.S. troops and Indians at

Fowltown, it is unclear why Lieutenant Scott headed upriver independent of the

flotilla or why he ignored warnings from plantation owners Edmund Doyle and

William Hambly that Indians were amassing at the river junction with the intention

of attacking the supply boats. He had even dispatched a courier over land to Fort

Scott with a letter to his superiors notifying them of the possibility of such an

assault; and, he indicated grave concern regarding his unarmed men’s ability to put

up any sort of defense.

Still, he proceeded.

As the boat navigated a sharp bend near the present-day site of

Chattahoochee in what is now Gadsden County, the strong current required the men

to guide their vessel close to the shoreline. It was there, hidden along the riverbank,

that several hundred Seminole Indians lay in wait, led by Red Stick Chief

Homathlemico, whose warriors had joined forces with Neamathla.

The Seminoles, a heterogeneous tribe who called themselves yat'siminoli or

"free people,” were made up of Lower Creek Indians retreating from previous wars

with the U.S. government in Alabama, Georgia, and Louisiana, and a number of

other tribes including Red Sticks and Mikisuki (now Miccosukee). Joining them

were numerous African-American slaves who had escaped plantations in Georgia

and the Carolinas.

Building villages near the Seminoles, the slaves established a strong

friendship with the Indians, intermarried, and eventually formed a union to mutually

resist the white man’s attempts to drive out the Indians and return the black slaves to

their owners. So closely allied were these two groups, that the escaped slaves

became known as “Black Seminoles.” It was into this alliance that Lieutenant Scott

unwittingly captained his boat.

In the initial attack from shore, Lt. Scott and most of his men were slain.

Then, wielding knives and hatchets, the Indians stormed the boat and massacred

those who remained.

Four men wounded in the initial attack escaped by jumping

into the river; but the children weren’t so fortunate. Personal letters from officers at

Fort Scott reported that the children were killed when “picked up by their feet and

swung against the sides of the boat until their brains were dashed out.” Later, a most

gruesome discovery was made when the scalps of both male and female victims

were found hanging in a Seminole village near what is now Tallahassee.

On December 4, 1817, General Gaines sadly, yet resolutely, reported the

violence to U.S. Secretary of War John C. Calhoun. His letter stated that the attack

Out of Mind, Out of Sight

was far more severe than those previously committed, and he now called for the

immediate application of force.

While peace was actively pursued, the Seminoles, who considered the

Florida territory their home, became increasingly intolerant of the white man’s

intrusion and the massacre of Lieutenant Scott and his men was just one in a long

string of attacks the Seminoles made against military forces and white settlers with

subsequent retaliation by U.S. forces. With this attack, however, tolerance for the

Indians had worn thin.

Gaines’ letter to Calhoun continued:

. . . I would much more willingly devote my time and humble

faculties in the delightful occupation of bringing over savage man to

the walks of civil life, where this is practicable without force, than

to contribute to the destruction of any one of the human race; but

every effort in the work of civilization, to be effectual, must accord

with the immutable principles of justice. The savage must be taught

and compelled to do that which is right, and to abstain from doing

that which is wrong. The poisonous cup of barbarism cannot be

taken from the lips of the savage by the mild voice of reason alone;

the strong mandate of justice must be resorted to and enforced.

After all that the wisdom and philanthropy of our country and

Government, aided by millions of money, have yet been able in

effect, it is a melancholy truth, that in no Indian nation within my

knowledge, (the Chickasaws excepted), has the scalping knife been

laid aside for any considerable length of time, until their every hope

of using it with impunity has been defeated.

Several weeks later, Secretary Calhoun sent an urgent message to Major

General Andrew Jackson in Nashville, Tennessee. Just two years removed from his

victorious command against the British in the Battle of New Orleans, the General

was immediately ordered to Fort Scott where he was to take command of 1,800

men—900 Georgia Volunteers, a detachment of gunmen from West Tennessee, and

friendly Creeks under the direction of half-breed Chief McIntosh.

Calhoun’s letter

emphasized that, because of increased hostilities by the Seminoles, Jackson might

find it necessary to concentrate his whole force in their direction. If, however, the

force proved too small, Calhoun gave the General complete authority to call upon

adjacent states for whatever troops were necessary.

Sally J. Ling

Routing the Indians

Mounted on his dapple grey steed, the indomitable General Jackson boldly

stepped across the Georgia border into the primitive Spanish-controlled territory

known as Florida. With Spain unable to defend Florida’s expansive frontier, the

U.S. government was confident the land could be opened to white settlers without

interference; however, in order to protect those settlements already established and

to open the land to new colonists, the government needed to put an end to the Indian

attacks. Their solution: Eliminate Native American villages established by the

Seminoles.

Over the next several years, General Jackson set ablaze numerous

indigenous villages all the way to the Suwannee River, captured hundreds of former

black slaves, and hanged three men—an Indian medicine man and two Englishmen

suspected of supplying munitions and provoking the Indians to war with the U.S.

Known as the First Seminole War, these tragic series of conflicts, which ran from

1814 to 1818, set the stage for subsequent Indian wars and prompted the U.S.

government to fortify northern Florida.

Spain ceded Florida to the U.S. in 1821, and through the Territorial Act of

1823, Gadsden was established as Florida’s fifth county, one that stretched from the

Georgia border to the Gulf of Mexico. James Gadsden, for whom the county was

named, was an army engineer who later became aide-de-camp to General Andrew

Jackson during the First Seminole War. He also designed and built Fort Gadsden, an

important stronghold on the Apalachicola River; and, in 1853, while serving as

Ambassador to Mexico, he completed the Gadsden Purchase. This transaction added

45,535 square miles of territory along the southern Arizona and southwestern New

Mexico borders that became the last major territorial acquisition in the contiguous

United States.

With Florida now a territory of the United States, Jackson became military

governor. During his 10-month service, and continuing over the next decade, several

treaties were proposed to the Seminoles. As well, U.S. Indian Agents encouraged

them to abandon their villages and move west of the Mississippi River to the

Arkansas Territory. The Native Americans, however, would not budge. To help

convince them, in 1830, Jackson, now president of the United States, pushed

through Congress The Indian Removal Act

—a decree the Seminoles met with

fierce resistance.

Out of Mind, Out of Sight

The Apalachicola/Chattahoochee Arsenal

Knowing that a second clash with the Seminoles was inevitable, the federal

government looked for strategic locations to build a number of ordnance depots.

With orders from Colonel George Bomford, Chief of Ordnance, Lieutenant John

Hills of the 4th U.S. Artillery arrived to survey a section of Florida between the

Apalachicola and Suwannee Rivers in order to identify a suitable location for an

ordnance depot where arms and munitions could be stored.

After an initial

assessment, Hills suggested that the facility be built along the Apalachicola River

and upgraded from a depot to an arsenal capable of ammunition preparation and

weapon repair.

With the appropriation of $20,000 from the army in 1832, Hills, who had

been recently promoted to Captain, selected the present day site of the Florida State

Hospital for the arsenal because of its high ground and close proximity to the

Apalachicola River. Subsequently, Jackson issued the order to reserve the specified

land in the public domain near the small town of Mount Vernon.

The town was originally a trading post along the Old Spanish Trail at the

Apalachicola River. At the time of the first census in 1825, Robert Forbes, tax

collector, noted the population of Gadsden County was 1,376—815 whites and 561

“negro” slaves. On March 6, 1828, the first post office was established at Mount

Vernon with John McCullock, a river ferry operator, appointed postmaster. Along

with the establishment of the post office, E. H. Calloway prepared a survey of the

town. The grid, laid out in rectangles, outlined several different sized lots from 52’ x

104’ up to one acre. Seven named streets were documented with Washington,

Jefferson, Marion, and Bolivar Streets depicted as they exist today.

Because a Mount Vernon Arsenal had already been established in Alabama,

communications between Captain Hills and Washington regularly became

misdirected. To alleviate the confusion, the Captain convinced the Legislative

Council in Tallahassee to change the town’s name from Mount Vernon to

Chattahoochee (the Cherokee word Chat-to means stone and ho-che colored or

marked). After the name change in 1834, the arsenal became known as the

Chattahoochee Arsenal, or Apalachicola Arsenal.

As there was no suitable stone in the vicinity to use for construction, brick

proved to be the most viable option. In short order, a brick-making plant, contracted

out to Benjamin Chaires of Tallahassee, was built along the river bottom with the

expectation that it would produce 350,000 bricks per month; but, because the owner

Sally J. Ling

Sketch of the Apalachicola/Chattahoochee Arsenal, 1839. Photo courtesy of the Florida State

Hospital.

had no prior experience in brick making, the first firing proved untenable. Realizing

the alluvial clay required heavy tempering with sand, Chaires began experimenting.

After an eight-month delay, enough bricks were finally delivered to the site, and

construction got underway in the spring of 1834.

By July 1834, the walls of the Arsenal and tower had been erected and

covered by a suitable, yet temporary, roof; however, sweltering summer heat,

compounded by fever among the workers, prevented them from continuing, so work

was suspended and the laborers discharged. The brick factory, however, continued

production, and by the end of the year, 500,000 suitable bricks had been delivered to

the site. Construction resumed in the spring of 1835 using English immigrant

bricklayers.

By all accounts, the arsenal was a well-constructed facility built of lilac-

colored brick and situated in aesthetically pleasing surroundings, as described by an

anonymous traveler in the December 5, 1835 issue of the Tallahassee Floridian:

Out of Mind, Out of Sight

. . . It is a splendid structure, the brickwork of the main building,

already completed, and wall, when finished, give the place an

interest and worth, it could never otherwise possess. The scenery,

as observed from the tower, is beautiful and picturesque. A rapid

glance, as far as the eye can stretch on the boarder of the horizon,

could not fail to animate the poetic and delight the romantic; but to

my less brilliant genius, the appearance, presented (the inequality of

the height of trees being lost in the distance) was that of a green

wheat field broken by easy declivities, and gently swelling hills.

The untimely deaths of Captain Hills in February of 1835 and his

replacement Lieutenant Charles Petigru in October of the same year, resulted in the

appointment of Lieutenant John Williamson, whose charge it was to complete the

arsenal. The two deceased officers were buried in Mosquito Creek swamp, a site

near what was later to become the cemetery for deceased patients of the Florida

State Hospital.

When complete, the arsenal cost a total of $226,932.50

and consisted of a

four-acre quadrangle with nine buildings: three workshops, barracks, officer’s

quarters, guardroom, office, gun carriage storage building and an octagonal five-

story tower, at the time the tallest building in Florida. Surrounding the compound

was a nine-foot-tall by thirty-inch-thick perimeter wall. Completing the complex

were four outer buildings, including two gunpowder magazines, a laboratory and a

sutler’s store,

a civilian-owned store that sold provisions to the army.

The Second and Third Seminole War

Almost 4,000 Native Americans had made the forced move to the Arkansas

Territory, also known as Indian Country, by 1834. Seminole Chief Osceola,

however, vowed to fight on. Because of his resistance, he was briefly imprisoned.

Shortly after his release, he resumed attacks. On December 28, 1835, Osceola

murdered Indian agent Wiley Thompson. That same day near Fort King (Ocala),

300 Seminole warriors ambushed a contingent of 107 U.S. soldiers led by Major

Francis Dade, for whom Miami-Dade County was named. Thus began the Second

Seminole War.

By the time Seminole and Creek Indian attacks reached settlements around

the Chattahoochee arsenal in 1839, the facility was fully operational. It was there

settlers are said to have found refuge following raids by the Indians into nearby

Sally J. Ling

Seminole Indians attacking a fort (possibly Fort Clinch) on the Withlachoochee River (1935).

Photo courtesy of the Library of Congress, LC-DIG-ppmsca-19924.

settlements, such as Liberty County where more than a dozen men, women, and

children were slain and their homes and farms set ablaze.

The arsenal also lent its

munitions to local volunteers setting out to look for the murderous Indians.

The war ended in 1842, when 4,420 Seminoles surrendered and were

deported to Oklahoma. The remainder of the tribe hid out in the Everglades under

the leadership of Chief Billy Bowlegs; however, peace was short lived. Fighting

broke out again in 1855, when Bowlegs retaliated against a military surveying party

that had ravaged his banana trees. Thus began the final confrontation—the Third

Seminole War—that lasted until 1858. Though most of the Seminoles surrendered,

many forged deeper into the Everglades and never capitulated. They and their

massive casino enterprise are still there.

As the bloodshed subsided, military storekeepers managed the arsenal’s

arms and munitions and additionally maintained the grounds and buildings;

however, by 1861 only a small military party of four manned the complex. The

arsenal, though, would soon play a role in a larger conflict, one that pitted neighbor

against neighbor and father against son—the Civil War.

Out of Mind, Out of Sight

The Arsenal during the Civil War

For decades, philosophical and political differences placed the North and

South at bitter odds. With the election of Abraham Lincoln as president, those

differences boiled over, and southern states began systematically seceding from the

Union. As the Florida legislature prepared for secession, gaining control of the

arsenal at Chattahoochee was imperative. In question, however, was just what kind

and how much ordnance remained there.

U.S. Florida Senators David Levy Yulee and Stephen Russell Mallory sent a

joint letter to Acting Secretary of War General Joseph Holt requesting an inventory

of the arsenal. Knowingly suspicious of the Senators’ request, Holt kept the

inventory to himself—one six-pounder iron gun and carriage with 326 shots and

canisters for same, 57 flintlock muskets, 5,122 pounds of powder, 173,476

cartridges for small arms, and a quantity of different kinds of accoutrements

—and

notified the senators that because of the sensitivity of the information, it would not

be made public.

In the meantime, on January 5, 1861, Florida’s Governor Madison Starke

Perry sent out secret orders, and a Gadsden County Military unit known as the

“Young Guards” immediately left for the arsenal. When they arrived, they were

surprised to find only three soldiers manning the post. Without the discharge from a

single weapon, the Florida Militia took possession of the facility. Four days later,

Florida seceded from the Union.

The arsenal became the gathering place for companies of militia sent to

defend various forts both in and out of Florida, and on April 5, 1861, several of the

companies were inducted into service with the Confederacy as the First Florida

Infantry. Their service would last one year.

After the War

Believing there was more than enough room to accommodate substantial

faculty and as many as 300 cadets, at the end of the war in 1865, Governor John

Milton recommended that the state convert the arsenal into a military academy and

state arsenal. The assembly disregarded Milton’s recommendations and transferred

the arsenal from the Ordnance Bureau to the Bureau of Refugees, Freedmen, and

Abandoned Lands, more commonly known as the Freedmen's Bureau.

subsidiary of the War Department, the Bureau assisted in relief efforts relating to

Sally J. Ling

refugees and freed slaves called “freedmen,” including the issuing of food, clothing,

and medicine. The Bureau also assisted freedmen in regaining custody of lands

appropriated by former Confederate States.

In the aftermath of the war, Southern States, including Florida, experienced

great disorder with local jails unprepared for the confinement of so many sentenced

prisoners.

In light of this, Florida’s Governor Harrison Reed personally appealed

to both the Secretary of War and the Freedman’s Bureau to use the arsenal as a state

penitentiary. His idea was to lease the inmates as laborers based upon a system that

would both punish and reform the criminals while, at the same time, generating

revenue for the state.

The 41st Congress approved the request and donated the arsenal to the State

of Florida.

The Freedman’s Bureau subsequently closed its doors, and the former

arsenal at Chattahoochee became Florida’s first state penitentiary—a move that

would produce scenes one could only find in a horror film.

Out of Mind, Out of Sight

Chapter Photo: Florida State Prison, ca. 1925 Courtesy of the Florida State Archives.

Chapter II

Housing Convicts

The first prisoners shuffled into the Florida penitentiary at Chattahoochee in 1868;

and, while the nine inmates along with their 14 guards initially occupied the former

arsenal, it was less than fit for those few inhabitants, let alone the several hundred

future inmates for which it was intended. The buildings were in a total state of

disrepair with windows and shutters missing, doors barely hanging on their hinges,

roofs devoid of waterproof leading, and everything useful carried away. Little better

than ruins, the dilapidated structure was anything but a secure place to confine

criminals.

In fact, due to the lack of cells the prisoners were herded together at

night in one common dormitory.

During the day, convicts plowed land adjacent to the prison in order to

establish a farm. The intention was to provide meat, milk, and fresh vegetables for

the inmates and for the farm to become self-sustaining by selling crops, produce,

and dairy products to local residents. While some of the inmates worked on the

farm, others were assigned work off prison property for which the prison was paid

for their labor. This income helped offset the expenses of running the prison.

Sally J. Ling

Malachi Martin, 187?. Photo courtesy of the Florida

State Archives.

Malachi Martin: First Prison Warden

Colonel Malachi Martin, a former military man and one of Florida’s leading

carpet baggers during reconstruction,

became the prison’s first warden. His rein

would be mired in controversy, rumors of unspeakable cruelty, and good ol’ boy

Florida politics.

Born in Ireland in 1822, Martin immigrated to the U.S. at the age of 25 and

became a dry goods merchant in New York City. He entered military service in

December of 1861 and became an officer in the Union Army, serving both in New

Orleans, Louisiana, and Key West, Florida. Ordered to the headquarters of the

District of Florida in Tallahassee, he assumed duties as chief quartermaster on the

staff of Brigadier General John Newton a few months after Federal troops occupied

the state capital.

After the war, he was discharged. Instead of returning to New

York, true to the persona of a carpetbagger, Martin saw opportunity in Florida and

remained to invest in both its economic and political promise.

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At first, he engaged in several agricultural ventures around Tallahassee.

Proving inept as a farmer, however, he subsequently made his entrée into politics. In

May 1868, he became an agent of the Bureau of Refuges, Freedmen, and

Abandoned Lands, serving as bureau agent in Leon and Wakulla Counties. When

the Freedman’s Bureau closed, Martin used his military connections to gain

appointment as warden of the penitentiary at Chattahoochee.

The Prison’s First Inmate Arrives

Calvin “Cy” Williams, an African American, arrived at the Chattahoochee

penitentiary in November 1868. Entered into prison records as “No. i,”

the prison’s

first inmate, he was there to serve a sentence for committing a felony. While several

references address Williams’ arrest and incarceration, they conflict in his age and

length of stay. The prisoner record book reports his age as 40; however, J.C. Powell,

in his book The American Siberia, Or Fourteen Years' Experience In a Southern

Convict Camp gives an entirely different account and shares a vivid look at his

incarceration at Chattahoochee:

He did not know his age, but when he was a mere pickaninny,

running about in the one garment that forms the costume of all

negro youngsters in the South, he was arrested for stealing a horse.

He was not large enough to mount the animal, and was caught in the

act of leading it off by the halter, for which he was duly sentenced

to twenty years imprisonment.

Because of his small size and the fact that Warden Martin had never had

such a young inmate, Powell noted that Williams was assigned a most monotonous

task during his daylong work shift—carrying bricks from one end of the prison yard

to the other. Martin placed two pairs of bricks at opposite ends of the yard and gave

Williams a third pair. He was ordered to transport the two bricks to one of the piles,

put them down, pick up the two other bricks, and return to the first pile. He was to

continually make the exchange, always carrying two bricks, and was warned he

would be whipped should he not complete this task, not pile the bricks neatly, or

broke any of the bricks. The mere repetition of the task wore out four sets of bricks

before prison authorities assigned him an alternate chore.

According to Powell, after 17 years Williams was finally released with

almost three years shaved off his prison term, the result of gain time, the earning of

sentence reduction for good behavior. (Earning three days for each month a prisoner

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had not been punished, prisoners could earn an additional five days each month for

good work performance and adhering to prison rules.)

Williams wasn’t the only youth to be locked up at the ill-kept prison. In an

annual report, Martin wrote to the Adjutant General of the State of Florida that there

wasn’t one room where convicts could be safely locked up without a guard.

Additionally, he expressed concern that young boys sent to Chattahoochee for what

he considered to be a “trifling crime,” had to occupy the same dormitory as the most

hardened criminals. To support his apprehension, he noted that even criminals with

good conduct records often remarked that they would rather be assigned hard labor

than be confined with the worst prisoners in the same room.

Prison Receives Indigent Insane

By 1873, the prison facility at Chattahoochee housed 82 convicts: 14 white

males, 65 “colored” males, and three “colored” females. Among them was Betsey

(also spelled Betsy) Yulee, an African American from St. Augustine, who arrived on

June 23, 1870, as the facility’s first “insane” resident. She wouldn’t be their last.

Over the next several years, other mentally ill patients were sent to the prison until a

more suitable place could be provided.

Among them were Nancy Monroe (39,

black), who arrived in 1874; Jane L. Buford (37, mulatto-mixed white and black)

and Mooney Floyd (35, black), who arrived in 1875; and the trio of Charles Baldwin

(40, black), Sharpless Evans (17, white), and Henrietta Wilson (20, black), who

arrived in 1876.

Unhappy being charged with care of the state’s mentally ill, Martin made

his feelings known in a letter to the State Legislature:

I have agreed to take them and give them such care as we could,

simply because they could not be otherwise provided for [but] wish

to say right here that there is no suitable place for such unfortunates,

and I hardly know how to express my feelings on the subject. They

are simply held here, get plenty to eat and clothing to cover them

comfortably, with a good house to live in. But as to means of

treating such persons as they ought to be treated, I hold that we have

none . . . I feel that it is inhuman not to provide a suitable asylum

for our insane, and that the authorities will be held responsible

hereafter for a gross neglect of their official duty if such an asylum

is not provided.

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David Levy Yulee, Photo courtesy of the

Library of Congress, LC-BH82- 5271 B

Even the surgeon of the state prison, W.J. Scull, wrote to the legislature

bemoaning the fact that “lunatics” were confined to the prison and implored those

governing to devise a plan for their care. He laid the blame for the present

predicament directly at the feet of the legislature, noting that they had been informed

repeatedly of the need for adequate care of the mentally ill yet had turned a deaf ear.

He also left them with a dire warning--“As we sow, so we must reap.”

It would be several more years before the State Legislature acted upon those

pleas.

Yulee More than a Patient

Aside from Betsey Yulee being

the first insane patient at Chattahoochee,

it is her last name that leads us on a

curious journey, one that connects her to

one of northern Florida’s early white

pioneers—David Levy Yulee—a railroad

mogul, plantation owner, and Florida’s

first Senator. (Yulee was the same

staunch supporter of the Confederacy

who sent the letter to Secretary Holt

requesting information on the status of the

arms at the Chattahoochee Arsenal.)

Born David Levy on June 12,

1810, in Charlotte Amalie, St. Thomas, in

the Dutch West Indies (now part of the

U.S. Virgin Islands), he was the son of

Moses Elias Levy, a wealthy and

cultivated merchant who descended from

a long line of influential Jewish courtiers

to the sultans of Morocco.

A prominent Caribbean merchant, Moses Elias Levy traveled to Florida

where he purchased substantial acreage near Micanopy, Florida, in Alachua County

and established Pilgrimage Plantation, a large sugar plantation. It was there as a

young man that David Levy learned the sugar business, a lesson that would prove

most beneficial later in his life.

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Drawn to the legal profession, David Levy moved to St. Augustine, where

he studied law under Robert Raymond Reid. He passed the bar at age 22 and later

helped Reid became territorial governor of Florida. A staunch supporter of

statehood, David Levy became a member of the Florida Legislative Council in 1836.

In 1845, when Florida became a state, he served as Florida’s first Democratic

senator and the state’s first Jewish senator.

In 1846, shortly before David married Nannie C. Wickliffe, daughter of

Charles A. Wickliffe, former governor of Kentucky and Postmaster General under

President John Tyler, he added the name Yulee, his grandfather’s Sephardic Jewish

name, to his own to become David Levy Yulee. He also converted to Christianity.

In 1855, David Yulee began construction on the Florida Railroad, the first

cross-state railroad from Fernandina on the Atlantic to Cedar Key on the Gulf. In

that same year, he was re-elected to the Florida Senate. Just six weeks after the

completion of his 155.5-mile railroad track on March 1, 1861, the Civil War began.

It was at this time that David Yulee shored up his support of slavery and Florida’s

desire for secession; subsequently, he left the Senate after Florida joined the

Congress of the Confederacy.

In addition to his railroad business, David Yulee owned plantations—

Margarita, a 5,100-acre sugar plantation near Homosassa Springs, and Cotton Wood

in Archer near Gainesville—on which he employed slaves. It was on these

businesses that he concentrated his efforts during the Civil War.

After the war, David Yulee fell out of favor with Washington, and his

former letter requesting information about arms and munitions at the Chattahoochee

arsenal just prior to the war now returned to haunt him. He was tried and convicted

of treason by the government, and, after he served ten months at Ft. Pulaski,

Georgia, General Ulysses S. Grant intervened. The intercession resulted in David

Yulee’s release in 1866.

Just what was Betsey Yulee’s relationship to the successful businessman

and politician? Charles Tingley, senior research librarian at the St. Augustine

Historical Society, conducted research to find out more about Betsey Yulee, the

asylum’s first admission and her connection to the Senator. He concluded: “Yulee is

such an unusual name, being derived from Senator David Levy Yulee's mother's

maiden name. Any blacks with this surname, one must assume, are associated with

slaves owned by this prominent politician, plantation owner, and railroad owner.”

Out of Mind, Out of Sight

While no documents exist to denote her type of mental illness or why she

was sent to the prison at Chattahoochee, Betsey Yulee remained a resident of the

facility for 32 years and died of undocumented causes on July 9, 1902. Her final

resting place in the Florida State Hospital Cemetery is marked by a plaque: “Plot:

div 3, cem 2, row 6, grave 4.”

Mixing Prison and Politics

With Martin’s political ambition rising to the surface, in 1872, he was

elected to the Florida Assembly as one of Gadsden County’s representatives. As a

member of the moderate Republican “ring,” he nominated Marcellus Stearns for

governor. The election placed rival Ossian Hart in the governor’s seat, and Stearns

had to settle for Lieutenant Governor. Within a few short months, Hart died and

Stearns became governor. Martin subsequently tried his bid at becoming speaker of

the Assembly. He banked on Democrats voting for him rather than putting his

opponent, a black man, in the speaker’s seat; but, the plan backfired, and Martin lost

out to radical black Republican Simon Conover. Regardless of the outcome,

Martin’s entrée into Florida politics was now solidified, a move that would serve

him well during his next bid for the same position the following year and throughout

the Republican years.

By 1873, rumors swirled that conditions at the prison were so intolerable

that citizens living near the convict camps were sometimes helping the prisoners

escape.

Several legislators were sent to investigate, including two black

representatives, who, according to Martin, were intent on finding signs of

mismanagement. Trying to prevent them from reaching Chattahoochee, Martin gave

the men a false departure time for a special train he had prearranged. Despite the

deception, the resourceful men found their way to Chattahoochee only to claim that

once they arrived they were marched off the grounds at bayonet point after they

discovered some prisoners chained on their backs. The Assembly failed to censure

Martin and simply called for another investigation of the prison. The session ended

before an inquiry could take place.

In March of the next year, a special investigator was sent to the prison to

assess the treatment of federal prisoners at Chattahoochee. His report noted there

were 81 prisoners at the facility with most working under guard on the prison farm.

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He further described housing conditions as filthy and vermin-ridden. No action was

taken, however, and questions regarding conditions at Chattahoochee subsided.

Martin was reelected to the Florida Assembly in 1875 and again in 1876,

but he did not regain the speaker’s seat. In addition, now that control of the

legislature was in the hands of the Democrats, things were about to change. Martin

braced himself for an attack from ruling Democrats and knew it would be only a

matter of time before his rein at the prison came to an end.

Governor George Drew recommended to the 1877 legislature that the state

prison be made self-sustaining through the leasing of prisoners. He further suggested

that the position of warden be eliminated, or at least allocated a lower salary. About

the same time, investigators were sent to the prison to make recommendations on its

operation.

The fatal blow came later that year when the legislative investigating

committee charged Martin with using prisoners for his own personal gain and

recommended that the lands surrounding the prison be rented out.

Records showed

that Martin used Chattahoochee inmates to build an octagonal-shaped house on his

200-acre plantation at Mt. Pleasant called “The Hermitage” and to work in his

vineyard and winery. Producing five different kinds of wine from 500-gallon wine

vats in his three-story winery, Martin was touted in conflicting reports making a

modest income to a fortune, a feat no doubt accomplished in part by his contract

with the state to provide wine for state occasions.

(Martin’s house, which stood for

over 100 years, was listed on the National Register of Historic Places in the 1970s. It

was subsequently razed by its owner in 1984.)

Martin’s rein at the Chattahoochee prison finally came to an end, but fear of

reprisal remained forefront in his mind. Believing his life in danger from those who

vehemently opposed him throughout his tenure at the prison, he left Florida and

moved north.

Prisoners Moved from State Pen to Work Camps

When the Florida Legislature turned the penitentiary at Chattahoochee into

the state’s first mental hospital, Asylum for the Indigent Insane, inmates were

transferred from state to private oversight and relocated to work camps throughout

Florida. Wearing the customary striped clothing and shackled together with heavy

chains, the prisoners were leased to businesses as physical laborers where they

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worked on a plantation, the St. Johns and Lake Eustis Railroads, and a turpentine

farm.

As the first thirty prisoners to be relocated to the camps staggered off the

train in the northern Florida city of Live Oak, Powell, who served 14 years as

Captain of several Florida Convict Camps, was on hand to witness the roadside

procession. He described the former Chattahoochee inmates who had subsequently

been assigned to the Lake Eustace work camp:

The sun never shone upon more abject picture of misery and

dilapidation. They were gaunt, haggard, famished, wasted with

disease, smeared with grime, and clad in filthy tatters. Chains

clattered about their trembling limbs, and so inhuman was their

aspect that the crowd of curiosity seekers who had assembled

around the depot shrank back appalled.

These thirty starved and half-dying wretches were about half of the

convicts of the State of Florida. They were those who had emerged

alive from as awful an experience as men were ever fated to

undergo . . .

Powell went on to note that the state had rid itself of its early prisoners by

turning them over body and soul to Martin, who was paid handsomely for the

responsibility. Unrestricted by the state, prisoner abuse became routine. The backs

and legs of the inmates bore evidence of this brutality as both were scarred from

bayonet wounds. If an inmate on the line dropped from fatigue, he was “instantly

and mercilessly prodded with the cruel steel.”

Martin wrote in his Annual Report that the only punishment meted out to

prisoners was solitary confinement with, upon occasion, meals consisting of only

bread and water.

One must wonder how accurate this report was, however, and

what direct supervision Martin actually gave the inmates and guards at

Chattahoochee given the fact that serving in the legislature, overseeing the building

of his plantation, and managing his winery required considerable time away from

prison grounds. Perhaps that is why Powell recalled Martin’s discipline to be

distinctly different.

Powell noted that punishment for insubordination, escape attempts, or lack

of adequate work effort, took three forms: sweating, watering, and stringing up by

the thumbs.

Sweating consisted of enclosing the prisoner in a box-cell without

ventilation or light. Watering involved strapping down the prisoner and forcing a

Sally J. Ling

Chain gang serving at the Florida State Prison, 191? Photo courtesy of the Florida State Archives.

funnel in his mouth into which water was poured. This resulted in the distention of

the inmate’s stomach, producing unspeakable agony and a sense of imminent

death.

While Powell never witnessed the infliction of the first two punishments, he

did witness the physical consequences of the third, when Robert and Eugene Weaver

got off the train that day in Live Oak. It was their hands that gave them away: “They

resembled the paws of certain apes, for their thumbs, which were enormously

enlarged at the ends, were also quite as long as their index-fingers, and the tips of all

were on a line. This deformity was occasioned by stringing up, and when one stops

to consider the amount of pressure necessary to stretch out a man's thumb fully three

inches, some idea can be formed of the severity of the punishment.”

Escapes and Escapees

Stringing up by the thumbs paled in comparison to the guards’ plotting

certain death for other troublesome inmates. Tired of a specific prisoner’s frequent

attempts to flee, the guards learned through an informant of the prisoner’s plot to

escape through the barrack’s window after dark. All night the guards lay in wait

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intending to kill the escapee. Believing something was amiss, however, the prisoner

aborted his plan; yet, that didn’t stop the guards from plotting against him one last

time. The next day, they assigned him to the blacksmith shop where they purposely

left the window open. With the lure of freedom more than the inmate could bear, he

bolted through the opened window only to be ambushed by the waiting guard.

Others escaped with equally tragic consequences. One such prisoner fled the

Lake Eustace experience by trekking 70 miles to the south into LaFayette County.

An area riddled with thick impenetrable forests intersected by wide lagoons and

palmetto flats, so monotonous was the setting that a man could wander for days and

not know whether he had made any progress at all. It was into this jungle labyrinth

filled with hungry reptiles and feral beasts that the convict soon found himself.

The tattered pieces of a stripped prison uniform were found deep in the

woods several months later. Along with the cloth remnants was a pair of prison-

issued shoes, complete with gaiter, a cloth or leather covering for the instep and

ankle. They were recognized as belonging to the escaped prisoner. When disturbed,

the rags disintegrated to reveal a pile of human bones. Powell could only suggest

that the prisoner’s death must have been dreadful.

While some escaped prisoners met their demise, others had successful

escapes, even if only temporary. Take for instance, the Deacon. In preparing to build

a new church in Live Oak, the Deacon’s congregation acquired all the necessary

construction materials except for those of most vital importance—nails. Knowing

the lack of these necessary items was causing great distress among the congregants,

the Deacon, described as “a big, tall, and very bow-legged African,” miraculously

produced a keg of the metal spikes. With his lips sealed tight about where he had

acquired them, church members were left to wonder whether this delivery was a gift

from God.

Coincidently, Major Wise, who owned a general store in Live Oak, soon

discovered a keg of nails missing from his warehouse. Putting two and two together,

Wise summoned the law on the Deacon. The jury, refusing to believe the appearance

of the nails was due to divine intervention, sentenced the Deacon to two years at

Chattahoochee. After serving a portion of his time, the Deacon escaped.

Several years later, Wise happened to be in Eufala, Alabama, and observed

a bow-legged black man loitering around the railroad depot. Recognizing him as the

Deacon, Wise had him arrested and brought to the newly established prison camp

where the Deacon completed his sentence without further incidence.

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Inmate Deaths

Powell’s assertion that the state turned over its charges “body and soul” to

Martin, and, in essence, washed its hands of them, was substantiated by frequent

deaths. Though no records of the names of the deceased were kept, their bodies were

buried on Chattahoochee grounds. Wrapped in blankets, they were laid in a shallow

trench with dirt barely covering the remains; consequently, some of these graves

were desecrated by domestic animals.

A year after the prisoners disembarked at Live Oak, Dr. J.S. Hankins,

surgeon for the convicts, explained in his annual report to J.J. Dickison, adjunct

general of Florida, that many of the prisoners died during their first year after

leaving Chattahoochee and the work camp. Of the 27 prisoners reporting to the first

work camp, 19 were sick with chronic dysentery, some complicated by typhoid

fever. Two other prisoners near death eventually died and were buried within three

days of their arrival. An additional six more lived for only a short time before dying

of malaria. Still, others that seemed to recover from their dysentery were left with

such damaged bowels they died the next year.

Insane Occupy Asylum

With the transfer of inmates to work camps in 1877, the incarceration of

prisoners at Chattahoochee came to an end, but hundreds of citizens considered

mentally ill soon took their place. Like prisoners before them who occupied the

penitentiary for breaking the law, these new inmates were consigned to the isolated

state facility, now called the Florida Asylum for the Indigent Insane, for breaking

something else—normal and acceptable behavior.

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Chapter Photo: Pennsylvania Hospital Photo courtesy of the Library of Congress, HABS

PA,51-PHILA,39—4.

Chapter III

Philadelphia to Florida: The Roots of

Institutionalized Mental Health Care

In order to truly understand the history of the Florida State Hospital at

Chattahoochee and the evolution of the state’s institutionalized mental health care

system, we must first understand how America originally dealt with its insane

citizenry and trace the development of institutionalized mental health care and

psychiatry in the U.S. Only then can we put the experiences of Chattahoochee in

perspective.

From the Divine to the Personal

Under British rule during the Colonial Period (1607-1783), religious beliefs,

such as those held by Cotton Mather, an eminent Puritan minister, played a

dominant role in setting the cultural tone in America regarding the mentally ill. In

his book The Mad Among Us, Gerald Grob stated that Mather saw Satan as a

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tempter, someone who lured individuals into madness by exploiting their moral

weaknesses. He further explained that Mather believed sin to be at the heart of the

human condition, with madness the obvious consequence.

Because of Mather’s influence, to some, mental illness was considered of

divine origin with God and Satan at odds, and sincere personal confession the

antidote. With the advent of the Enlightenment (1690-1800), this viewpoint began to

change as personal responsibility for one’s actions, rather than the imposition of the

will of God, became the more dominant belief.

Called “distracted” or “lunatick”

—the latter word a derivative of the

Italian word lunacus, a byproduct of the traditional link between madness and the

phases of the moon

—the mentally ill were deemed the responsibility of families

and neighbors and were given whatever care considered appropriate to alleviate the

effects of the illness.

Those able to function did so amid the mainstream of life; however, many

of the severely afflicted were relegated to living in locked rooms or in small

outbuildings on the family property. Here, they would be given the necessities of

life—food, clothing, and shelter—but little else.

Those poor souls without families, or whose families were unwilling or

unable to care for them, wandered the streets of the larger cities, not unlike our

homeless today. Treatment of these individuals consisted of confinement to jail cells

or poorhouses, facilities created by local or state governments to care for the

physically ill indigent. By contrast, the mentally ill indigent received little or no

treatment at all.

With the opening of the first hospital, however, formal care of the

mentally ill began.

Caring for the Mentally Ill

The roots of institutionalized mental health care can be traced back to the

mid-1700s with the opening of the nation’s first hospital, Pennsylvania Hospital in

Philadelphia, then the largest city in America. Inspired by Dr. Thomas Bond with

support from his close friend Benjamin Franklin, the hospital was established

through philanthropic means to care for Philadelphia’s impoverished physically ill.

The ability to pay was a consideration for admittance, yet the hospital did try for

balance between paying and nonpaying patients.

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Drawing up guidelines for patient admittance in January of 1752, the

managers decided to admit all but three types of patients—those judged incurable,

with the exception of lunatics, those suffering from smallpox, itching, or other

infections until proper departments were built, and women with young children,

unless the children were taken care of elsewhere.

The first two patients admitted on February 10, 1752, were Margaret

Sherlock, whom Franklin noted had “a prolepsis uteri,” and Hanna Hines, “a

lunatic.” While the hospital’s main goal was to care for the physically ill, increased

concern over mentally deranged persons wandering the streets of the growing city

prompted the inclusion of four psychiatric patients among the first six admitted.

In the hospital, the mentally ill were kept in cold, damp cells in the

basement where chamber pots used as toilets spewed out noxious odors. Acceptable

treatment included mild purging (cleansing of the intestinal system) and warm baths.

Patients were often restrained by the use of hand irons, leg locks, and mad-shirts

(straitjackets). To sedate violent patients, hyoscyamus (a cerebro-spinal sedative that

relieves pain and promotes sleep), camphor, and opium were administered.

Elopements—escapes—were a regular occurrence.

As if the mentally ill didn’t have enough with which to contend, their

confinement became nothing short of a curiosity. Great numbers of inquisitive

onlookers frequently visited the hospital to gawk at and converse with those

confined to the cells. Eventually, a fence with a hatch door was constructed, and

those wishing to observe the insane were required to pay four pence.

Treatments

With the mentally ill looked upon as wild beasts, early interventions

covered a wide range of treatments, each devised to subdue, and hopefully cure,

those with the affliction. The rationale for these early interventions, designed and

administered with all good intentions, seemed to be that since these patients were

already irrational, any treatment that would restore rationality was commendable.

Of course, today, we would consider these interventions to be cruel and inhumane

with little curative effect, but at the time, they were considered state-of-the-art,

supported by well thought out rationales.

Up until modern medicine, the theory prevailed that the biological basis of

physical and mental wellbeing was seated in the balance of the four humors

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Bloodletting booklet. Photo courtesy of the Library of Congress, LC-USZ62-95239.

(substances) that filled the body. These four substances—black bile, yellow bile,

phlegm, and blood—would increase or decrease based upon diet and exercise. An

excess of one type of fluid would cause an imbalance in the body, thus affecting

one’s personality or physical wellbeing.

Each fluid represented a specific personality characteristic. Blood was

associated with a sanguine personality—laughter, music, and a passionate

disposition. A phlegmatic personality was sluggish and dull. Yellow bile represented

someone quick to anger or choleric (cholera meaning yellow as in yellow fever).

Lastly, black bile represented a melancholic or depressed personality, melan

meaning black.

Treatments varied and, for the most part, were experimental as physicians

tried to bring the humors into harmony.

Bloodletting/Transfusion

While bloodletting was rarely used in mental hospitals, it was a widely

accepted eighteenth-century cure-all. Having lost copious amounts of blood, by

having leeches placed on the skin or an incision made where blood was suctioned,

the patient would be left feeling depleted, exhausted, and noticeably anemic. For

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patients diagnosed with agitated psychosis, the drop in blood pressure produced

sedation and therefore temporary relief from the agitated state. Even Dr. Benjamin

Rush (see page 49), practiced bloodletting, believing the treatment a sure cure for

almost any ailment. When newer treatments proved bloodletting archaic, he still

refused to consider it dangerous.

Blood transfusions, sometimes using animal blood, were also administered

in the hopes of balancing the humors.

Animal blood transfusions, however, proved

highly dangerous and ineffective as they compromised the individual’s immune

system causing shock and, many times, death.

Restraint

The use of chains, shackles, cuffs, straitjackets, Utica crib (an apparatus

shaped like a baby’s crib with a hinged lid on top that was fastened over the patient

at night, thereby restricting movement), and other types of restrictive devices was

prevalent during both the 18th and 19th centuries to restrain aggressive patients. In

most cases, these devices were used to prevent injury to both the patient and others,

as well as destruction of property.

Attendants also used the devices as punishment

for the unruly. Similarly, cold plunge baths, plunging the patient into ice water, were

also employed as a curative treatment as well as to subdue patients that were

uncontrollable.

Purging

Purging was used to balance the humors. By using an emetic, vomiting was

induced in the hopes of expelling anything that was harmful to the body.

Devices

Hollow Wheel – The German psychiatrist, Johann Reil (1758-1813),

designed the hollow wheel to assist in the calming of patients. A patient was placed

in the interior of the wheel and could either remain stationary or move the wheel

forward or backward by walking or running. Except for visits to the restroom, it was

not unusual for a patient to spend 36 to 48 hours in the wheel. It was hoped that,

through exercise, he/she would escape his/her hallucination-filled world and return

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Whirling device, with patient seated in it wearing a straitjacket. Photo courtesy of the

National Library of Medicine, A013026.

to reality or be so fatigued that he/she would conform to facility protocol without

rebellion.

Tranquilizer chair – Invented by Dr. Benjamin Rush, this apparatus

involved the patient’s arms, legs, and torso being strapped to the chair to reduce

motor activity and his or her head enclosed in a box to decrease sensory and visual

stimulation. Rush believed this would lessen the flow of blood to the brain and

produce a calming effect. The chair was also called the “sensory deprivation

chair.”

Twirling Devices – Several twirling devices were designed to alleviate

mental illness. The first was the twirling chair in which a person spun about his own

axis. This was supposed to separate the humors, thus producing a relaxed affect. Dr.

Rush designed a variation of this known as the Gyrator. A patient was strapped to a

horizontal board and spun to stimulate blood circulation. Still another version,

O’Halloran’s swing, was developed by an Irish physician. This device rotated a

patient one hundred times a minute forcing blood to the brain with the hopes of

obtaining obedience.

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Hydrotherapy

Hydrotherapy, or the use of water as therapeutic treatment for the body, has

been around since ancient times. Father Sebastian Kneipp, a nineteenth-century

Bavarian monk considered the “Father of Hydrotherapy,” believed water could be

used to cure diseases by eliminating waste from the body and thereby balancing the

four humors, which was essential to one’s over all wellbeing. While he may not

have understood the physiological ramifications of such therapy, later research

supported his notion. Cold causes superficial blood vessels to constrict and diverts

blood to the internal organs while hot water is relaxing and causes blood vessels to

dilate, removing waste from body tissues.

We know hydrotherapy today as sitz

baths, saunas, whirlpools, hot tubs, and steam or Turkish baths.

In the early nineteenth-century, citizens suffering incurable physical

diseases flocked to cities such as Hot Springs, in the Appalachian Mountains of

North Carolina. Springs, with temperatures varying from 62-106 degrees Fahrenheit

and containing calcium, magnesium, sodium, sulfur, iron, Lithia or lime, were

believed to have healing powers. The Civil War brought an end to the popularity of

many of these springs when hotels surrounding them were converted to hospitals for

the wounded. Others were destroyed by fire. One warm springs resort built in 1832

near the town of Bullochville, Georgia, burned to the ground in 1865, and was later

rebuilt. The springs gained national prominence when, in 1924, President Franklin

D. Roosevelt found the resort’s warm waters therapeutic after his attack of polio. He

subsequently founded the Warm Springs Foundation to provide therapeutic

treatment for other victims of the disease.

While hydrotherapy as a curative treatment for the physically ill dates back

centuries, using it to help cure the mentally ill has a much shorter history and only

dates back to the 1700s when Johann Reil, the inventor of the hollow wheel,

advocated throwing patients into the sea and keeping them under water as long as

possible. He also was a proponent of tossing patients into the water while firing a

cannon. He felt that this type of terror would restore the mentally ill to their senses.

In 1891, Germany psychiatrist Emil Kraepelin found that demented patients

for whom no treatment was available gained great benefits from prolonged bathing.

Shortly thereafter, Alois Alzheimer introduced bath therapy at an asylum in

Frankfurt. Soon the treatment spread to America, and by 1910, hydrotherapy was

considered accepted treatment for nearly all patients, regardless of diagnosis.

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Prior to the introduction of the more sophisticated therapies of the 1930s,

physicians had few options when it came to calming and restricting the movements

of the severely mentally ill. This resulted in the use of restraints such as the

camisole, crib, straitjacket, hand and leg cuffs, chains, and the like. Yet, the

introduction of hydrotherapy showed promise and soon gained extensive acceptance

as the first somatic therapy to be placed into widespread use by mental health

professionals.

Even though the equipment was expensive, state hospitals made the

investment in order to provide the most up-to-date treatment.

Hydrotherapy treatment included hot and cold wraps, showers, needle

sprays, Scotch douches, sitz baths, and continuous baths, each type having its

specific advantage in treating different types of cases. Regardless of the type of

treatment used, Dr. L.D. Hubbard stated in his 1927 article, “Hydrotherapy in the

Mental Hospital,” that for the treatment to be of greatest benefit, it needed to be

enjoyable. He further asserted that while patients may be apprehensive at first, it was

seldom that they did not experience great pleasure and relief from hydrotherapy

once they adjusted to it.

Treatments, he explained, were not determined by chance: “Years of

research into the physiological effect of the different methods of application have

resulted in carefully prepared formulas calling for a certain number of seconds at a

certain temperature and a certain number of pounds of pressure. On the basis of

these formulas, the hospital physician prescribes hydrotherapeutic treatment with as

much care as he would prescribe drugs, and only after he is thoroughly acquainted

with the patient’s physical and mental condition.”

Hydrotherapy did not remain part of the patient’s routine from the beginning

of his illness until discharge. Treatments were discontinued when they failed to be

of benefit to the patient.

Considered as effective as sedatives and barbiturates as a

possible cure, hydrotherapy was used until the 1930s when shock therapies and

lobotomies took its place.

Types of Hydrotherapy

Continuous Tub Therapy

This type of hydrotherapy was used as a sedative to reduce agitated

behavior and to relieve insomnia: “Conditions of tenseness are relaxed and

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restlessness relieved by the soothing action of the warm water and it is perhaps the

most immediately appreciated of all the forms of hydrotherapy.”

The patient lay on a canvas hammock attached to a metal frame and was

placed into a tub that had a steady flow of water at a prescribed temperature

(anywhere from 97-99 degrees). The water covered the patient to the chin and a

sheet was limply laid over the patient so he/she could rest unrestrained. Only in the

case of severely agitated patients was a covering used that prevented the patient’s

escape.

A 1930 textbook indicated that the tub bath should last from eight to 24

hours; but, in some hospitals in Germany, patients remained in continuous baths for

days or weeks at a time, sleeping and eating there. By the 1950s, however, nurses

who administered tub baths indicated that the bath should last anywhere between 15

to 45 minutes, or whatever the physician ordered.

Wet Sheet Wraps or Packs

This form of hydrotherapy could be of two types, either hot or cold,

depending upon the type of patient being treated and what the physician ordered.

Cold wraps were typically prescribed for agitated patients, while warm wraps were

given frail patients. Duration of the wrap was between 45 to 60 minutes.

A sheet was dipped in water from 40 to 100 degrees Fahrenheit, wrung out,

and the patient wrapped snuggly in it, similar to swaddling a baby. During this

process, nurses made sure the sheets were tucked around the extremities in such a

manner that body surfaces did not come in contact with each other. Next, two

blankets were then tucked around the patient’s neck and feet to eliminate drafts, and

a wet towel was placed across the forehead.

With the cold wrap, the first sheet acted like a stimulant to the circulatory

system, though not as severe as the cold plunge. Within minutes, a warm, soothing

glow, often inducing sleep, crept over the patient. With the warm pack, the patient

didn’t experience the tonic effect, and the result was merely sedative. Nurses

recalled that it took up to five nurses to wrap an uncooperative patient, but less than

an hour for that patient to become calm.

If a first wrap did not sedate the patient,

the process was repeated. Because of the amount of liquids loss during the sweating

process, fluids were frequently administered through a straw.

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Hydrotherapy patient sitting in a whirlpool bath. Photo courtesy of the National Library of

Medicine, A022698.

While some patients initially displayed anxiety about lying down on cold

wet sheets, former state hospital nurses stated that once the patient experienced the

treatment they often requested packs when unable to sleep, or when they got excited.

In fact, one patient unable to sleep tried to administer her own cold pack by soaking

her sheets in tap water and then rolling up on them in her bed.

Wet wraps proved to be a very popular therapy because they were

inexpensive, easy to administer, and had an almost immediate calming effect; but,

nurses lamented that this effect didn’t last long.

Sitz Bath

With this treatment, the patient sat in a tub up to his or her pelvis

surrounded by continuously flowing water, the temperature slightly above body

temperature. The effect, like that of continuous tub therapy, was relaxing, with a

side benefit of relieving tension and irritation in the pelvic region.

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A male patient stands in a shower stall while a physical therapist gives him a heavy spray of water

aimed at his back. Photo courtesy of the National Library of Medicine, A020852.

Shower Baths and Needle Sprays

Both of these treatments involved forceful sprays of water of varying

degrees directed at the patient. In Needle Sprays, the patient would stand in a steel

box where tiny jets sprayed the patient with water under high pressure. The principal

underlying the use of this treatment was that the water striking the skin had a

positive effect on the circulation and nervous system. The belief was that the

temperature of the water, combined with the powerful spray, would assist in toning

the surface blood vessels and stimulating peripheral nerves. The dilation and

contraction of these blood vessels was believed to draw blood to the internal organs

where they would be returned to normal volume. Dr. L.D. Hubbard, a proponent of

hydrotherapy, was convinced this type of treatment had great advantage because it

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could be tolerated well by patients, especially those who were too feeble or ill to

undergo more drastic methods.

Scotch Douche

This method, which combined the effect of temperature and pressure, used a

high-pressure stream of alternating hot and cold water upon the spinal nerves. Like

the Needle Spray, this method was thought to stimulate the nerves.

Other types of douches included:

 Fan Douche – the spraying of water over a standing person

 Jet Douche – The spraying of water to a person’s back

 Vapor Douche – stream of vapor was applied to a small area

 Pail Douche – Pails of water at three different temperatures were

poured over the patient

 Perineal Douche – Water applied to a seated patient’s perineum (the

region of the body inferior to the pelvic diaphragm and between the legs)

100

Dry Wraps

While these are not part of hydrotherapy treatments, their purpose was to

give relief to the agitated patient sufficient enough to allow him to sleep. The patient

was wrapped from head to toe in several layers of blankets tight enough to restrict

the patient’s movement, but not so tight as to prevent him or her from turning or

getting into a comfortable position. The patient would remain in the wrapping for an

hour or more, allowing blood to be brought to the surface and for the patient to

perspire. At the conclusion of the treatment, the patient was given a shower to

balance circulation and eliminate debris deposited on the skin as a result of the

sweat.

101

Dr. L.D. Hubbard noted that patients who recovered with the help of

hydrotherapy were so appreciative of this treatment that even years after they were

discharged, they would return to the hospital and request treatments to help them

through some stressful situation.

102

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Dr. Benjamin Rush. Photo courtesy of the

National Library of Medicine.

Moral Treatment and the First Freestanding Asylum

Moral treatment was introduced in the late eighteenth-century. Frenchman

Philippe Pinel began the movement and called for reform—replacing restraints and

abuse with kindness and patience, and advocating recreation. About the same time,

William Tuke, an English Quaker, rejected traditional medical intervention and

encouraged small quiet retreats where the insane could participate in “reading, light

manual labor, and conversation,” and where staff could focus on the individual

needs of its residents.

103

Thus, the small asylum tucked away from the hustle and

bustle of the city came into existence.

Virginia, a colony that had no urban center, created the first public hospital

devoted exclusively to the care and treatment of the mentally ill. Isolated in

Williamsburg, the Virginia Eastern Asylum, as it was later called, opened in 1773

with a 30-bed capacity. A keeper oversaw patients, and a traveling physician

rendered medical care.

104

At the Pennsylvania Hospital, Dr. Benjamin Rush, who was a signer of the

Declaration of Independence and had joined the hospital staff in 1783, believed

mental illness was a disease of the mind

rather than what some referred to as

“possession by demons, moonbeams,

celibacy or tobacco use.” He also believed

in moral treatment and that the mentally ill

deserved to be cared for with dignity and

receive the best available treatment. That

philosophy, coupled with the fact that the

mentally ill often came from wealthy

families who could well afford treatment

that could support hospital operations,

prompted the doctor to take on their care.

His work in revolutionizing treatment for

the mentally ill earned him the moniker,

“Father of American Psychiatry.”

105

Rush put an end to the viewing of

patients as entertainment, and he introduced

occupational therapy, believing patients

would get better if they had something to do. He also did away with the use of

straitjackets and substituted his tranquilizing chair.

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Soon, insane patients outnumbered those with medical ailments, and it

became necessary for the hospital to build a separate asylum to confine the mentally

ill. In the winter of 1841, 100 patients were transported by carriage from the city to

their new facility, the Pennsylvania Hospital for the Insane.

The hospital, with such features as stone arches and large parlors, sat on one

hundred and one acres surrounded by woods and meadows. Patient rooms had

plenty of sun, heat, plumbing, and ventilation, more than the rooms of above

average Philadelphia homes. On the grounds, amenities included a deer park, flower

garden, railroad built for patient’s amusement, and Gentlemen’s and Ladies’

Pleasure Grounds. Overseeing the new facility as superintendent was Dr. Thomas

Story Kirkbride, who moved, along with his family, into a mansion on the

property.

106

While this was not the first freestanding psychiatric hospital in the U.S.

(there were several private psychiatric facilities), it was among the first to be

affiliated with a general hospital. Under the direction of Kirkbride, a Quaker,

kindness, not restraint, was advocated, and he encouraged recreation, exercise,

visiting the library, and participation in lectures and evening entertainment.

Moral Treatment Wanes

The second half of the nineteenth-century saw a downturn in the optimism

surrounding moral treatment due, in part, to the arrival of industrialization and the

growth of immigration into the United States. Pressures placed on mental hospitals

to admit more and more clientele soon dissolved visions of small facilities where

mentally ill people would receive individual treatment and degenerated into large

facilities where little attention was given to the individual.

107

Emerging “insane asylums” built on the outskirts of larger cities soon

became little more than the gathering of the mentally ill into isolated confinement.

Medical staff was untrained and incompetent, facilities overcrowded and

understaffed, patient abuse widespread; and in many cases, convicted criminals were

housed alongside the mentally ill.

With the founding of asylums, psychiatry emerged as a medical specialty,

the next to be recognized after surgery; yet, it must be noted that its emergence

began as a byproduct of the establishment of the asylums and not the reason for

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them. This mutually dependent relationship eventually reinforced and legitimized

both psychiatric facilities and psychiatry as a profession.

108

Even with the emergence of psychiatry as a specialty, confinement of

persons to any mental hospital remained highly subjective, with husbands and

families convincing authorities of the need of commitment rather than medical

professionals using any formalized method of evaluation. This led to many being

sent away simply on a family member’s word and for a wide variety of reasons,

many of which did not have anything to do with mental illness. Such was the case

for Elizabeth T. Stone from Massachusetts, who was institutionalized from 1840-

1842.

Committed by Deception

A sullen child who was taunted unmercifully by her family, Stone

eventually left home at age 15 to work in a factory. Eight years later, she found joy

and peace when she became a follower of Jesus Christ. Stone recounted, however,

that her family was most disturbed by her newfound faith:

I now commenced a new life, and on my return home I told my

parents of it, and brothers and sisters how I had dedicated myself to

God and his Gospel, and then the vilest hatred of the family was

brought down upon me; but I was happy amidst their cruel

treatment, always rejoicing before them in the God of my salvation .

. . until my sister Nancy and brother James declared I should not go

to meeting any more. Because I had chosen the Christian

denomination to worship with, they sent for my brother, Stephen S.

Stone, to come and get me, shutting me in a room, not allowing

anyone to see me, abusing me in the most shameful manner,

because I would pray to God.

109

At Thanksgiving dinner, Stephen asked Elizabeth to go for a ride after the

meal. It was then that he had his sister committed to Charlestown McLean Asylum

in Sumerville, Massachusetts. According to Elizabeth, her brother had hired a

perfect stranger, Dr. Wheelock Graves, to sign commitment papers, even though she

had not been sick, nor had there been any sign of disease. She concluded that it was

only her faith that separated her from her family and allowed Dr. Graves to deprive

her of her liberty.

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In the asylum, she endured experiments that she likened to the Spanish

Inquisition.

110

These often included cold plunge-baths into ice water, wrapping her

in wet bandages for an entire day, and forcing her to take medications. When these

medications hit her system, she experienced violent convulsions and agony beyond

her ability to even describe it. The medication, which affected her brain and

autonomic nervous system, resulted in her rolling from side to side in her bed in

excruciating pain.

111

Unfortunately, Elizabeth’s fate was not an isolated case. Across America,

men, women, the elderly, and sometimes children, were sent to asylums for nothing

more than being a bother or having differing views.

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Chapter photo: Dorothea Dix. Photo courtesy of the Library of Congress, LC-USZ62-9797.

Chapter IV

Florida’s Response to the Mentally Ill

The earliest record of concern for Florida’s mentally ill was found in two

Jacksonville documents from the 1830s. In the first, it was noted that a mentally ill

person could be sent to an out-of-state institution if the family had the financial

ability to support him or her.

112

In the other, the state of Florida gave newly

incorporated towns the authority to levy taxes that could be used to care for the

mentally ill;

113

but, no move was made by the legislature to care for the mentally ill

in a state facility.

By 1840, only 11 states across America had hospitals that admitted mentally

ill patients, certainly, not enough to care for their growing number. This gave rise to

the conviction that the country needed to build separate hospitals dedicated to their

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care. Dorothea Dix became the first advocate for the establishment of these asylums.

While she never traveled to Florida, from the 1840s through the 1860s she traveled

the Northeast and South convincing legislatures to create these institutions with their

operation funded by tax revenue.

114

Recognizing that the state of Florida lagged behind the rest of the country in

providing for its mentally ill citizenry, Attorney General D.P. Hogue suggested in

his 1850 annual report that the legislature make provisions for their care. He also

recommended sending the “indigent insane” to hospitals in other states where they

could receive appropriate treatment and, hopefully, a cure.

115

The Case of William Crawford

The House of Representatives voted down a resolution to provide care for

Florida’s mentally ill indigents, but the topic did not die. The case of William

Crawford of Hernando County prompted Hogue to keep his campaign alive.

Charged with “violent deeds toward other persons,” Crawford was judged “violently

insane” and sent to the county jail.

116

Convinced the prisoner could be better cared

for in an institution, the sheriff of Hernando County petitioned the State Legislature

for Crawford to be sent to an out-of-state facility. After ascertaining that, with the

sale of Crawford’s estate he could afford to be transported to and maintained in an

institution for a period of time, permission was granted. On March 14, 1853, Whit

Smith, appointed guardian, escorted Crawford to the South Carolina Asylum.

117

By 1854, Crawford’s estate was bankrupt. When Smith, who subsequently

paid for Crawford’s care out of his own pocket, reported this to the legislature,

Hogue recommended that he be paid $350 for serving as guardian and another

$776.62 for out-of-pocket expenses.

118

Although the Legislature did not consent to reimburse Smith for Crawford’s

expenses, it did pass an act that turned sole responsibility for Crawford’s

maintenance over to the state of Florida.

119

The Governor disagreed and vetoed the

measure on November 24, 1855.

120

Growing public concern regarding care of the

mentally ill, however, could not be squelched. The subject resurfaced in the House

of Representatives during the next session.

The House passed a bill to provide for the maintenance of Crawford, but the

Judiciary Committee in the Senate refused to consider it on the grounds that it was

unfair to other communities in the state. Nevertheless, the question of caring for the

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state’s mentally ill needed to be addressed, and the committee then recommended

that the state devise a definitive plan for their care and treatment.

121

The Grand Jury of Leon County quite poignantly brought this ongoing

problem to light in a plea to Florida legislators in the Fall Term of 1856:

. . . this Grand Jury[is] urgently required to compel the County

Commissioners of the Counties to provide for the support of

Lunatics in some other way than by containing them in the county

jail, where only forty cents a day is allowed for their support, and

consequently this unfortunate class of individuals are treated in the

same manner as common criminals, there being at this time an

unfortunate man confined in our jail, who was sent there by

Gadsden County more than a year ago, and who might have been

cured had he been sent to a Lunatic Asylum where he would have

received proper treatment.

122

Following the appeal by the Grand Jury, a concerned citizen calling himself

“Humanity” suggested that the Legislature appropriate funds to place Florida’s

mentally ill in neighboring state facilities. Initiated by hearing the “piteous cries, and

heart-piercing shrieks of the poor manic who is now confined in the comfortless

tenement erected for felons,” the writer challenged the Legislature to punish the

guilty, but console the unfortunate.

123

Following these petitions, in 1856, the Florida Legislature enacted a law

charging circuit judges with the responsibility of determining the sanity of its

citizens. The individual was sent out of state if found in need of hospitalization;

124

and, if the individual was impoverished, travel, as well as room and board for the

length of his or her stay, was reimbursed from the Florida Treasury.

125

While this

measure was a step in the right direction, unfortunately it left the decision of

establishing the insanity of a person solely in the hands of the Circuit Court without

input from a medical professional.

In 1858, Governor Madison S. Perry proposed to the legislature that

$20,000 be appropriated to erect a well-appointed asylum large enough to care for

35 to 40 patients.

126

Once again, the measure died in committee. Yet, some good

came out of the session. The legislature did agree to reimburse Smith’s out-of-

pocket expenses for Crawford’s care prior to 1856,

127

and they agreed to continue to

pay maintenance to the South Carolina asylum until March 16, 1865, when he was

discharged as cured.

128

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Ten Floridians were patients in out-of-state asylums in Georgia and South

Carolina from 1853 to 1860.

129

With this arrangement, Florida became one of only

five states that did not have facilities to care for its mentally ill.

130

In addition to the

expenses incurred for those patients sent out of state, mentally ill citizens being

cared for by family and friends within Florida were partially, or entirely, supported

by the state. By 1876, mentally ill individuals being cared for by the state numbered

45, prompting expenses to rise to an all-time high of $13,194.68.

131

At the same

time, more mentally ill citizens were being sent to the State Penitentiary at

Chattahoochee. These individuals were confined to one room with the burden for

their care falling ultimately upon the ill-prepared guards, prison warden, and

surgeon.

After 20 years of supporting Florida’s mentally ill citizens in out-of-state

facilities, in 1877, the Florida Legislature appropriated $3,000 to convert the facility

at Chattahoochee into the Asylum for the Indigent Insane. An additional $7,000 was

earmarked for patient maintenance, support, and treatment.

132

This act became

known as the 1877 Lunacy Law. The Adjutant-General, under the direction of the

Board of Commissioners of State Institutions, was charged with supervision of the

Asylum.

133

The Chattahoochee arsenal, turned state prison, was now poised to service

Florida’s mentally ill. Here, they could be cared for in one designated facility, a

place isolated from the rest of the state’s population—out of mind, out of sight.

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Chapter Photo: Postcard of the Florida State Hospital at Chattahoochee, Florida. Postmarked July

1913. Photo courtesy of Florida State Archives.

Chapter V

Transforming the Prison into an Asylum

In the wake of departing inmates from the Chattahoochee prison, many of the

buildings stood in ramshackle condition. The building for white males was

completely devoid of floor, window sash, or blinds.

134

There was no running water

or heat, except for a few wood stoves or fireplaces, and rooms contained few

amenities. Among the limited usable items were a clock, two desks, one bookcase

with prison-related volumes, several blankets, three stoves, one cooking stove, and

“some medicine of no great value.”

135

According to an interview with now deceased Dr. W.D. Rogers, former

superintendent of the Florida State Hospital, the old administration building was

renovated into the superintendent’s residence. The tower of the old arsenal was used

as part of the white male building; the barracks were repaired for use of the colored

males; and the two-story office building remained as it was.

136

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Above: Workers in the cane field. Below: Cane mill. Photos courtesy of the Florida State Hospital.

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Dairy at the Florida State Hospital. Photo courtesy of the Florida State Hospital.

Since the prison had partially supported itself with a working farm on which

the prisoners raised livestock and produced grains and vegetables, left behind was an

assortment of farm equipment along with six mules, 12 hogs, six cattle, and one old

horse. The only provisions that remained included 370 bushels of corn and 12

barrels of corn syrup.

137

In light of the inadequate and dilapidated living quarters and

well-worn equipment, adjunct general J.J. Dickison used appropriated funds to

improve the facility. By the year’s end, upgrades included building repairs and

furnishings to the white female, white male, “colored” female, and “colored” male

departments. Adding to the upgrades were purchases of medicine, clothing,

additional livestock and farm equipment, and the stocking of provisions in the

storeroom.

In his annual report, Dickison stated that the garden farm was well

cultivated by the patients and that they were able to grow as many vegetables as they

needed. During the current year, they raised 300 bushels of Irish potatoes and 500

bushels of sweet potatoes, along with other vegetables in similar quantities. In

addition, several acres were planted in grains that produced enough oats to feed all

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the livestock for six months. He concluded that with additional facilities, the farm

could be made quite profitable.

138

While these repairs and upgrades were being made to the facility, Dickison

personally retrieved Florida’s mentally ill from asylums in Georgia, South Carolina,

Maryland, and Pennsylvania. When he returned in July 1877, he began hiring

suitable staff. Initial employees included a bookkeeper, cooking staff, attendants, a

night watchman, assistant physician, and a small maintenance crew.

139

Heading up

the staff was Dr. H.H. Allison, superintendent, and chief physician Dr. W.B.

Foreman. Both were medical professionals, yet neither had much experience with

the mentally ill. Still, both were committed to making the patients’ experience at

Chattahoochee as tenable as possible, as noted in Allison’s biennial report:

The grounds are thoroughly swept and cleaned every day, the

weather permitting, the houses are constantly scoured and cleaned,

the water closets [toilets] are frequently washed out and

disinfectants used to correct foul odors, and in fact every effort is

made to keep the institution clean and healthy. The patients are

warm and comfortably clad, well fed, and well provided for in every

way. We have been fortunate in securing kind and attentive

attendants, whose time, day and night, is devoted to watchful care

over our unfortunate patients.

140

Declaring One Insane

Not unlike the rest of the country, declaring someone insane was typically

based upon the observation of unusual social behavior. In Florida, citizens were

often sent to Chattahoochee by neighbors and/or authorities that identified them as

socially abnormal or simply undesirable. Included among the insane were those

afflicted with senility, epilepsy, alcoholism, homosexuality, and “mental

retardation.”

141

No firsthand accounts of early Florida asylum life have been uncovered, yet

experiences of patients in other state asylums can be of value in depicting their

commitment and treatment as typical of the time. Adriana P. Brickle of Philadelphia,

Pennsylvania, spent 28 years in the State Hospital for the Insane at Harrisburg,

Pennsylvania. Confined in 1857, she claimed she was declared insane and put into

the asylum for several reasons—“extravagance of spending and fondness of

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dress”—and the fact that her family wanted to spare her the public disgrace of being

accused of “obtaining goods under false representation.”

Ultimately, her father, and a physician whom she did not know, committed

her as an alternative to putting her in jail for purchasing furniture on credit she

neglected to pay off. In the book Women of the Asylum, her father explained that

while he did not think she was “insane,” he claimed “it was all that could be done

under the circumstances.”

142

In 1865, Tirzah F. Shedd became consigned to the Jacksonville Insane

Asylum in Illinois for an indefinite length of time by her husband on the charge of

monomania or spiritualism.

143

Others—Anna Agnew (1878-1885)

144

and Charlotte

Perkins Gilman (1877)

145

—explained that their confinement was due to nervous

prostration, a condition we now know as depression, and in some cases postpartum

depression.

Gilman stated that even though she was an industrious person by nature, the

depression rendered her so weak she couldn’t even lift a knife and fork to eat:

I could not read nor write nor paint nor sew nor talk nor listen to

talking, nor anything. I lay on that lounge and wept all day. The

tears ran down into my ears on either side. I went to bed crying,

woke in the night crying, sat on the edge of the bed in the morning

and cried—from sheer continuous pain. Not physical, the doctors

examined me and found nothing the matter. . . The baby? I nursed

her for five months. I would hold her close—that lovely child!—and

instead of love and happiness, felt only pain. The tears ran down on

my breast—Nothing was more utterly bitter than this, that even

motherhood brought no joy.

146

No matter how or why the commitment occurred, conditions in early

asylums were, in most cases, intolerable. Such was the experience of Ada Metcalf

who spent four years (1869-1873) in a Massachusetts institution:

I have awakened in the night and found the atmosphere in our room

so rife with stench, that it was distressingly sickening and

suffocating to me. I discovered the cause to be, two or more tin

vessels, without lid or cover, filled half full, or to the brim, with

every conceivable filth, for us to inhale. And I have staggeringly

walked to a window, and for long, weary hours, pressed my face

close between the iron bars to catch a few breaths of the pure air

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that God has bountifully scattered throughout the length and breadth

of the land—free to all—but which I was dragged from, and

deprived of, through ignorance, bigotry, indifference, and a spirit of

tyranny and oppression that grows rank in the hearts of those under

whose dominion the helpless and unfortunate are kept subject.

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Underfunded, Understaffed, and Inadequate Training

By December 31, 1878, Florida’s asylum at Chattahoochee had received 86

patients, who were housed in buildings according to race and gender: White

Women, White Men, Colored Women, and Colored Men. (A time of segregation,

especially in the south, separating patients on the basis of race was not unusual.) Of

these initial patients, the end-of-year report noted that 19 were discharged, 12 died,

and 55 were still in the hospital.

148

Despite facility improvements, the hiring of well-meaning personnel, and

the commitment of the superintendent and physician, the facility remained woefully

underfunded and understaffed with inadequate employee training—problems that

faced every asylum in the country. Unfortunately, these overwhelming challenges

often boiled over into frustration that resulted in the abusive treatment of the

patients.

In her account of time spent in the State Hospital for the Insane at

Harrisburg, Pennsylvania, Brickle noted the cruelty she witnessed at the hands of

nurses: “I saw a harmless patient who was sitting listlessly on a heating register

attacked and beaten because she would not work. One nurse knocked her down and

then called another with homicidal mania to join, and they pounded the unfortunate

creature until she was black and blue. Her brother and husband happened to call and

see her that very night, and to them some untrue story of the cause of her bruises

was given. They were not satisfied, however, and they removed her.”

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At Chattahoochee, restraint was rigidly imposed, and with only slight

provocation, brutal force was applied. The use of straitjackets, muffs, handcuffs, and

shackles prevented violent outbursts and saved the destruction of valued clothes and

furniture. Many times, this type of restraint was used for no other reason than that

there was no one to watch the patient; but, this only led to greater distress and more

violent outbursts.

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Perhaps some of the cruelest abuse didn’t come from the hands of attendants

at all but from the mouths of other mentally ill patients. E.B. Fleming, who was

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diagnosed with melancholia (depression), spent three years in the North Texas

Hospital for the Insane in Terrell, Texas, before he escaped in 1889. In his book

Three Years in a Mad House he explained that while the asylum was generally quiet

during the day, at night, when the candles were extinguished, it became a “perfect

Babel.” He likened the dreadful howls of the dozens of maddened lunatics to

“hideous, wild and unearthly noises that joined together in a nightly demon’s

concert of which no description could do it justice.”

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Wanting a Change in the Lunacy Law

With the passing of the Lunacy Law in 1877, Florida’s Asylum for the

Indigent Insane was restricted to admitting only those individuals who were

financially destitute. Also included was a provision that allowed the option of

families, friends or relations to either send the mentally ill to the Asylum or keep

them at home and receive $150 per year from the state for their care. By the end of

1879, however, Governor George F. Drew wanted to amend two important aspects

of the law that would save the state money. The first was to discontinue the option

of allowing patient care outside the facility. He believed that if this was enacted

many patients currently receiving care would most certainly be cured once

remuneration to the families ceased. This would leave those who really needed the

care with adequate financial support from the state. The second proposal was to

allow patients into the asylum whose families were able to afford their care and

maintenance. Eventually, the state adopted both of these recommendations.

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Upgrading the Facility

In 1881, Dr. J.H. Randolph was appointed superintendent. Over the next

several years, he and Dr. Foreman made numerous improvements to the

Chattahoochee facility. An old workshop was converted into 12 large double rooms

for the black females, and a newly built cistern supplied water to the facility. White

female patients moved into a freshly constructed 30- by 50-foot wooden building

complimented by a white picket fence. A small chapel, completely furnished

including an organ, was also added. Later, a minister was hired to conduct regularly

scheduled services.

The old three-story army barracks was renovated to include a kitchen and 56

large rooms with fresh water piped into each. Iron bars on the windows were

replaced with glass, giving the facility the look of a hospital rather than that of a

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Colored Women’s Ward. Photos courtesy of the Florida State Hospital.

prison. This renovation alone helped decrease the number of violent outbursts by the

white male patients who occupied the refurbished facility.

153

While these improvements were adequate, by 1884, the population of the

facility reached 157—an upward trend that would afflict Chattahoochee as well as

other state institutions for the next three-quarters of a century.

In 1885, Randolph returned to private practice, and W.D. Mozely became

the superintendent. Although he was not medically trained, under his direction the

facility flourished; yet, his tenure was not without its tragedies. In his first year, 11

of 44 black patients died due to lack of ventilation in the building they occupied.

Mozely immediately upgraded the facility by making repairs to the walls and

painting the rooms. With these improvements, deaths of black males dropped to

one.

154

Also during this time, the hospital changed its name to the Florida Hospital

for the Insane.

Other improvements were made to the facility at large. Kitchens were added

to each building, stoves heated the dining room, and the water system was enhanced

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with a cistern capable of meeting the demands for cooking and drinking water.

Mozely did away with crib restraints, and fired two employees for patient abuse. So

successful was his tenure that, during the year 1887-1888, there were no homicides

or suicides. Deaths by other means were reduced to zero, and recoveries increased

substantially—an amazing accomplishment considering that at this time there were

no sophisticated treatments or psychotropic drugs.

Even with all the improvements, the facility lacked two essential

components—a hospital to treat the physically ill and enough nurses to eliminate the

need for mechanical restraint. When the Board failed to allocate the necessary funds,

Mozely opened the asylum to the press and public during certain hours. His hope

was that the public would obtain a better understanding of the mentally ill and help

force the legislature to fund the improvements. Unfortunately, neither of these goals

was realized. There was more—much more—that needed doing, but without the

backing of the legislature the superintendent’s hands were tied.

In 1889, Mozely’s frustration at the legislature’s turning a deaf ear to the

plight of the insane, led to his resignation. Superintendents and physicians alike

would repeat this act many times in subsequent years; yet, Gerald Grob in his book

The Mad Among Us expressed the conviction that, “despite massive overcrowding

and inadequate funding, state institutions were generally committed to a therapeutic

ideal, even though reality proved quite the opposite.”

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When Superintendent Dr. J. Newton Smith arrived at Chattahoochee on

October 1, 1889, he found the system of ‘control by restraint’ run riot, with patients

habitually restrained at the whim of those charged with their care.

156

The only

superintendent who, up to this time, had any experience with the mentally ill, he

issued orders that no patient be restrained without his permission. Decades followed,

however, when the use of restraint not only increased, but was applied quite

liberally.

Smith also found an ongoing and deplorable sanitation condition. Noxious

gases from an excrement dumpsite outside the asylum (excrement was carried in

buckets from the water closets, or bathrooms, to the dump site) invaded patients’

living quarters. An inadequate water supply for bathing, coupled with the fact that

many of those who were committed to the asylum by the judges were already in

moribund condition, contributed to a high mortality rate—35 of the 313 residents.

Smith explained in his annual report that while the death rate was exceptionally high

for the prior six months due to these adverse conditions, one had to also take in

account that during the 12 years the facility had been occupied, the walls and floors

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had become saturated with “miasma and effluvia . . . against which no amount of

scrubbing, scouring, deodorizing and disinfection would avail.”

157

He concluded

that nothing short of a fire would rid the hospital of such a deplorable situation.

With cistern and water tanks empty, and the windmill only capable of

pumping a few barrels of water at any given time, the asylum desperately needed a

30- to 40-horse power engine to pump water for daily needs. Since the facility didn’t

have such an engine, Smith pulled teams of horses off the farm to haul the necessary

15 to 30 barrels of water a day. His concern for an adequate water supply intensified

when the possibility of a fire was thrown into the mix, and he believed it was only

divine mercy that had prevented this from becoming a reality.

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Even with these setbacks, Smith was able to generate many admirable

improvements, including adding 102 beds and making the farm self-sufficient.

Despite the increase in beds, though, there were never enough, and by the end of

1892, patients numbered 350. Most were admitted for chronic mania (presence of

manic symptoms—euphoric mood, hostility, aggressiveness, irritability),

159

followed

by those with dementia, acute mania, moral insanity, epileptic mania (manic

symptoms coupled with epilepsy), and simple epilepsy.

160

Of these, 188 were

Floridians with others coming from nearby states such as Georgia, South Carolina,

and North Carolina. The balance came from 12 other countries including Austria,

Cuba, England, France Spain, Germany, and Ireland.

Chief Physician Foreman retired in 1892 followed by Superintendent Smith

in 1893. The next superintendent, J.W. Trammell, was to bring continued positive

change to the institution.

Changes Enhance Living Conditions

Under Trammell, the patients built a sewage system serving the grounds and

buildings, and hot and cold water were piped into all departments, allowing the

patients to take daily baths. There was also, for the first time, an ample quantity of

medical drugs. In spite of his commitment to caring for those in his charge,

Trammell was unable to overcome the challenges in overpopulation and inadequate

funding that continued to plague the institution. This led him to implore the

legislature to appropriate $20,000 to enlarge the asylum. A persuasive man, he was

finally given approval and construction commenced.

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Laundry . Photo courtesy of the Florida State Hospital.

Along with new rooms, a small laundry was erected and black patients were

assigned to the facility. Farm acreage was added, yields increased, and diets

improved. To save existing patients the trauma of watching the corpses of those who

died being carried out during the daylight, Trammell directed the staff to bury

bodies at night.

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Burying the Dead

To the north of the hospital, 27 acres of land became the final resting place

of thousands of patients who died while in the state’s care. Known today as the

Florida State Hospital Cemetery, early patients were buried behind a locked gate

that bore no official identifying marker. Record keeping was poor in the early years

of the hospital, and unless families provided stone grave markers, gravesites were

marked with wooden plaques. After many years, those decayed leaving gravesites

mostly unmarked. Documentation improved when a new section was opened in

1932; and, over the years, the Genealogical Society has diligently documented as

many graves as its members could find.

162

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Mortuary. Photo courtesy of the Florida State Hospital.

Since around one third of patients who died in any given year were buried in

the adjacent cemetery, by 1976, the hospital opened its own mortuary complete with

a full-time funeral director and mortician. Families were not required to pay for

burials, but voluntary payments, in the amount of $170, were gratefully accepted.

Services, if desired, were held in a small chapel at the hospital morgue on Mondays,

Wednesdays and Fridays only, in order to accommodate the work schedule of prison

laborers.

Inmates from the River Junction state work camp, which at the time was

located on hospital grounds, dug graves, making sure two graves were always

available. As soon as one grave was filled, another was dug about a foot away. To

accommodate the many burials, the hospital maintained a carpentry shop that

fashioned coffins from medium grade pine. When completed, the coffins were lined

with white muslin and painted battleship gray. Gravestones were also produced on

hospital grounds, however due to confidentiality concerns, a number instead of a

name marked most graves.

163

Lunacy Law Contributes to Overcrowding

Improvements to the hospital were most welcomed, yet even with the

upgrades, Florida’s outdated Lunacy Law continued to dump myriad residents into

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the hospital, exacerbating an already overcrowded situation. Among the committed

were those whose insanity was due to such diagnoses as pregnancy, heredity,

lightning strikes, abnormal menstruation, cigarette addiction, poverty, religion, and,

in one case, excessive masturbation.

164

Of the 230 patients admitted to the institution in 1896, many had medical

conditions unrelated to mental illness, yet were admitted when the term “insanity”

was used to deceive the jury during the commitment process. This led Trammell to

suggest to Governor William D. Bloxham that the legislature appropriate monies to

establish a separate department that would admit individuals who did not exhibit the

dangerous mental and physical predisposition typically associated with one

considered mentally ill.

165

Two unusual cases in 1896 exposed the absurdity of the existing law and

admittance procedure. In the first, a boy from Orange County was sent to

Chattahoochee despite the fact that he was in fine health except for occasional

epileptic attacks.

166

Incensed, Trammell wrote that the small boy was not the least

violent and cited the only reason he was committed was because he was “dumb and

unable to defend himself in court.”

167

Just a week later, an eight-year-old deaf mute, who was otherwise mentally

and physically sound, was committed to Chattahoochee. At the urging of Trammell,

adjunct general David Lang wrote the sentencing judge of the atrocity of committing

the child to a “lunatic asylum.” He described the patient as “fine a child as you

would find among a hundred and if taught may make a useful contribution to

society.”

168

Both children were removed, but it was their age, not their diagnosis or

the system, that kept them from an extended stay.

Though Trammel’s continued lobbying of the Legislature to revamp the

Lunacy Law did not change the basic tenants of the law, it did bring about an end to

one important aspect of it, that of allowing private parties to care for the mentally ill.

In his report to the governor, Trammel notes why changing the law was so

important:

In many cases, nurses going after lunatics reported finding the

dependent objects of their mission confined with criminals in jail

cells, with evidence of merciless care. Some lunatics are found

nude, requiring the immediate purchase of clothing; some exposed

with means of comfort and repose at night, and either injured or

sick, many are found suffering without medical attention.

169

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Because so many epileptics were being admitted to the asylum as part of the

Lunacy Law of 1877, Trammell recommended to the Governor that an epileptic

colony be established. Later, in 1915, the State Legislature acknowledged the need

for such an institution, but it wasn’t until 1921 that the first epileptic colony was

established at Gainesville.

170

By the end of the century, the hospital name changed to the Florida State

Hospital and now held over 600 patients. While the physical facility continued to be

upgraded, adequate medical and psychological care lagged far behind. Patients were

still being restrained, and rumors of mistreatment began to leak to the public—a

firestorm that had been brewing on the horizon for years.

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Chapter Photo: Lab. Photo courtesy of the Florida State Hospital.

Chapter VI

Entering the 20th Century

Scandal Rocks the Institution

When Trammell retired in 1901, Dr. V.H. Gwynn succeeded him. A general

practitioner who believed amateur operas, patient dances, and religious services

would relieve patients of their mental illnesses and bring about an improved

condition,

171

his first few years remained quiet. That was soon to change.

In 1904, rumors implicated Gwynn in a scheme to coerce hospital

employees to vote for gubernatorial candidate Napoleon Bonaparte Broward of

Jacksonville. To avert a scandal once he took office, Governor Broward removed

Gwynn and replaced him with B.F. Whitner, a former legislator.

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Upon his arrival

at Chattahoochee, Whitner was appalled to find the facility in such deplorable

condition, and subsequently implored his former legislative colleagues to launch a

full investigation. The inquiry, conducted by a six-man investigative joint

committee, took a year to conclude and absolved the Whitner administration of any

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wrongdoing, and placed the blame squarely on the shoulders of Gwynn’s

administration.

The committee revealed many evils in the May 17, 1905 investigation, yet

the hyperbole of the report suggested the inquiry was based more on a grudge

against the previous administration and the Board of State Institutions.

173

The

Florida State News headlined its coverage of the report in an article entitled

“Asylum Report is Sensational” and included excerpts for their readers. Outlined in

the selections were the type of patients who were “dumped” into the asylum without

being indigent or insane—“little children, young men and young women, middle-

aged men and women, old, feeble and decrepit men and women afflicted with all

sorts of mental and physical ailments.” These people, the report suggested, should

be at home with parents or relatives, in the county poorhouses or infirmaries, or free

to earn their own living.

The article went on to state that evidence presented confirmed that, in some

instances, management had been cruel, negligent, and heartless. It also accused

attendants and nurses of being drunk while on duty and brutally and inhumanly cruel

to the helpless. The suggestion that the very institution had been infiltrated by “vice

and immorality to the extent that even inmates have begged and pleaded to be

released on account of it,” left citizens living nearby feeling outraged.

174

Some of the incidents noted in the report included widespread use of bodily

restraints,

175

severe whipping, choking, hitting, slapping, and stomping.

176

Under-

aged patients were reportedly found beaten and barely clothed,

177

and a white patient

Eugene Davis allegedly died as the result of a beating. The committee charged with

the investigation questioned Dr. Christie, a physician at the facility from July 1904

through March 1905, regarding Davis’ death. Christie confessed that he had seen

patients bruised with streaks across their faces and that other attendants admitted

seeing the abuse as well. He also recounted that patients told him the assaults were

committed by the attendants.

Asked whether he had treated a patient who had been inflicted with cruel

treatment, Christie cited the case of Eugene Davis from Live Oak, Florida, who had

been severely whipped. According to Christie, Davis had remained in “bad shape”

for four or five days but was ultimately put in the hospital where he eventually died.

Asked if Davis had died of his injuries, Christie replied that Davis had stayed in the

hospital a little longer than a month, but he stopped shy of admitting that injuries

from the whipping had killed him.

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Men’s Ward. Photo courtesy of the Florida State Hospital.

Christie acknowledged that several other incidents of severe beatings had

occurred and that Mrs. Mercer, a patient, had told him she had been severely

punished by four attendants who held her down and stuffed an apron in her mouth.

Though Christie avowed he reported the incidents to Superintendent Gwynn, he said

most of the staff had been retained.

179

In addition to investigating the physical cruelty inflicted on the patients,

interviews conducted with the nurses disclosed that aside from their on-the-job

training, most of them had little medical to no psychiatric instruction.

180

The report

also accused some of the staff of being addicted to morphine.

The committee made a thorough site inspection of the facility. Their

findings indicated that the powerhouse, laundry, kitchen and cooking department,

and dairy to be quite suitable,

181

but upon inspection of the White Male Wards 1, 2,

and 3, which were part of the old arsenal, the committee found that the interiors

were in deplorable condition. Debris from Ward 2 dropped onto the wooden floor in

Ward 1 filling the seams with “poisonous filth that emitted foul orders and caused

the floor to rot.” So unsanitary was this condition that the committee noted it was

“cruel and inhuman to compel even human beings totally oblivious to their

surroundings to live and stay in it.”

182

Their recommendation was to replace the

wooden structure with one built of brick and mortar.

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The committee further noted a serious condition that had plagued the

institution since its inception—no systematic or scientific system of treatment for

the restoration of the mind.

183

Other areas of concern were noted, but the committee

admitted these problems were not the hospital’s fault and instead planted the blame

directly on the Legislature that had failed to appropriate necessary funds for

improvements.

Once the report was made public, press across the state had a field day. The

St. Augustine Record recommended that the Legislature act immediately with a

thorough housecleaning to remove the “blight that is worse than death.” The

Pensacola Journal referred to the situation as “a chapter of high crime unparalleled

in the history of this or any other State,” and called for an investigation in which “no

guilty man should escape.” And the Fort Pierce News suggested that the guilty

should be punished to the fullest extent of the law even if it meant the investigation

would reach “crowned heads.”

184

Nurses, who found themselves depicted in a most offensive way by the

investigative committee, sent a telegram to the Speaker complaining that their

character was “besmudged” by the committee’s report.

185

Members of the House of

Representatives vigorously debated the merits of the investigation, yet the document

was ultimately accepted by a vote of 52 to 10.

Following the report, several newspapers called for a full investigation of

the institution, suggesting that politics had played a large part in initiating the

investigation and in trying to cover up the committee’s report. One paper accused

Governor Broward and his Board of State Institution of denying all charges made

against the asylum management,

186

while another accused Speaker General Gilcrist

of shielding from investigation and punishment those responsible for a large part of

the crookedness at the hospital.

187

Both papers indicated the lack of action by the

legislature was due to upcoming reelection bids.

Scandal Brings Changes

While politics may have been the catalyst for the investigation, the scandal

finally brought to light the plight of the State’s forgotten insane; but, since the

legislature met only every other year, it wasn’t until 1907 that monies were

appropriated to expand the hospital facility. Whitner added a new laboratory and

operating room and purchased an ice plant.

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These improvements were minor

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compared to the hospitals ongoing and more pressing issues that remained

consistently ignored—gross overcrowding and understaffing.

Acquiring and retaining qualified attendants remained a constant challenge.

Because of competing medical facilities where wages were higher coupled with the

inaccessibility of Chattahoochee and its lack of recreation or amusements, workers

were reluctant to relocate. To counter these obstacles and attract workers to the

hospital, Whitner increased salaries.

189

With only two physicians on staff, in a 1910 report Whitner stated what he

believed: by the end of 1911, the population of the institution would be over

1,000.

190

Records show he wasn’t far off. Patient count numbered 929 at the end of

1910, and 1,107 at the end of 1912.

To extend more humane medical care to those in need, patients were no

longer secluded in small rooms, and the crib,

191

straitjackets, and camisoles were

eliminated.

192

Another physician was added to the permanent staff, and over the next

several years, Whitner hired five additional interns and four visiting doctors to serve

at various times throughout the year. Not paid any salary, the visiting doctors were

only reimbursed for traveling expenses, a sum far less than what they would make in

private practice.

The number of permanent physicians still wasn’t ideal, yet it proved quite

adequate when, in 1911, a black female patient came down with a mild case of small

pox. Quick action by the medical team to confine her to a separate ward averted a

deadly epidemic.

In 1912, the operating room was outfitted with new surgical instruments and

sterilizers, and six visiting doctors made regular visits. Unfortunately, the four-

month interval with which the doctors visited coupled with the increase of

patients—1,366 in 1914—was little help to the three full time physicians who

remained on call day and night.

193

There was some good news, however. For the

first time, the hospital employed a full-time resident dentist, Dr. J.G. Wilson.

194

Whitner resigned in March of 1913, and W.W. Trammell succeeded him.

195

From 1914-1916, few physical improvements were made to the hospital despite the

superintendent’s repeated requests. The high price of labor during World War I may

have been the cause;

196

yet, great strides were made during the next six years with

the construction of two new hospitals—a receiving hospital and a tuberculosis

hospital.

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Class of 1923: Dora Fulgham, Eula McDonald, Wilma Ramsey, Martha Lightsey and Natalie

Ramsey.. Photo courtesy of the Florida State Hospital.

As was typical of the times, the facilities remained segregated. Black

patients were restricted from entering the receiving hospital and similarly were not

allowed in the white operating room. Instead, the supervisor’s office served as their

operating room, with instruments for operations owned by the physician. This

inconvenience paled in comparison, however, to the bigger problem facing

physicians—no case histories. Without them, it was extremely difficult to properly

diagnose or treat patients. Clerical help would have alleviated the problem, but the

Board refused to approve such expenditure.

Adding to the hospital’s woes was the appalling manner in which garbage

was removed and dumped. Flies infested the garbage pile and eventually spread

throughout hospital grounds, causing both an annoyance and extremely unsanitary

conditions. Exacerbating the problem was the lack of cleanliness on the farm and the

fact that most of the equipment failed to function properly. The equipment was so

dilapidated it presented a major health hazard, yet no funds existed to rectify either

situation.

197

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Occupational Therapy Room. Photo courtesy of the Florida State Hospital.

Improvements Made

On the bright side, several significant improvements were made. The first

was the opening of a nurse’s training school in 1919.

198

Under the supervision of

Miss Pearl Summerford, three female students made substantial contributions to the

institution during their training, and upon graduation in 1921, they stayed on at the

hospital.

199

For decades to come, the nursing school would play a major role in

providing trained professionals to the institution.

Music became part of the patient’s therapy and with the inclusion of an

electric piano, four phonographs, singing, movies, and dances, the patients were

easily distracted from their depressed states.

200

Contributing to the overall success

of Trammel’s tenure was the Red Cross and Women’s Clubs, who found placements

for borderline cases. This resulted in a record number of patient discharges.

The physical plant was improved with the addition of a new kitchen, and the

building of a power plant allowed for the purchase of the single most enhancement

to the medical facility—an X-ray machine purchased from surplus World War I

equipment. Now, for the first time, doctors could thoroughly examine each patient.

While improvements to the facilities continued, no consideration was given

to increasing the medical staff that, by this time, cared for patients at a ratio of one

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doctor to every 400 patients. Hoping to improve this situation, the medical staff

pressured the Board to create the position of clinical director, a position that

garnered much more respect, even though duties were comparable to that of the

chief physician. Dr. W.H. Spiers, an assistant physician on staff, was the first to be

appointed to this position.

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Decade Sees Substantial Improvements

During the 1920s, the hospital experienced amazing growth. With support

from the Board of Commissioners of State Institutions and Governors Cary A.

Hardee (1923-1924) and John W. Martin (1925-1926), Superintendent William V.

Knott (who later became State Treasurer) and the new clinical director Dr. Folmar,

saw to it that the needs of the hospital were met. The receiving hospital was fully

equipped and a 150-bed annex constructed. For the first time, black patients were

admitted to the receiving hospital and all patients were weighed, bathed, and given a

thorough examination. Old buildings were renovated with new bathrooms and

showers, and 70 telephones were installed throughout the complex.

202

The erection of a 250,000-gallon water tank allowed for the installation of

water fountains in the yard of every ward. This resulted in completely eliminating

communicable mouth diseases that in previous years were spread by patients

drinking from communal cups. Classes in needlework, gardening, and basket

weaving bolstered those in occupational therapy, and recreation was expanded to

include dances every Friday night with employees acting as partners for the patients.

From Custodial Care to Curative Treatment

With 10 physicians—six full time residents and four visiting physicians—

coupled with the graduation of 24 nurses from the nursing school, by the end of the

decade the hospital began its transition from custodial care (simply monitoring the

patients) to curative care (actually providing proven treatment). Unfortunately, an

influenza epidemic riddled the hospital in the spring of 1926, killing 413 out of the

3,843 patients; yet, despite this, a discharge rate of 51 percent was the highest in the

hospital’s history

203

—quite a feat considering the patient population exceeded

capacity by 800.

204

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Case Histories

Several case histories from the late 1920s give an example of the type of

individuals that were admitted to the Florida State Hospital at Chattahoochee. While

some of the descriptions are sketchy, they do give a colorful picture of the era and

the culture that surrounded admissions to the hospital.

Ferris Todd

(Admitted: 8/3/1928 – Discharged: 11/3/1928)

Ferris Todd was an indigent 21-year-old white male laborer from the

northern Florida town of Sopchoppy, in Wakulla County. Notes reveal he held

several jobs—poultry worker, butcher, and laborer on the railroad. He had never

been a mental patient, and there was no insanity or epilepsy in the family history,

although an uncle did commit suicide. While his father’s relatives were heavy

drinkers, no drug addicts were found in the immediate family.

His family committed him to Chattahoochee because they felt this was a

better alternative than his being returned to the state penitentiary at Raiford where he

had previously served 31 months for killing a man in self-defense. Sent up for 20

years, a conditional pardon secured his release.

Upon examination, it was noted that Todd sat quietly in his chair, answered

questions in coherent fashion, was tidy, cooperative, insightful, and showed good

judgment. He stated that, after he was released from Raiford, he drank occasionally,

and on one occasion while intoxicated, he got into a car that he thought was his. He

claimed the car was the same make and model as his own and was parked beside it.

As soon as he discovered his mistake, he returned the car to its owner. Later, he was

arrested and tried for theft. This incident was the only reason he could think of for

sending him to Chattahoochee, except that he drank up to that time. After that

incident, he gave up drinking and believed there was nothing wrong with his mind.

The Examining Board found no psychosis, yet Todd was not discharged.

Instead, he was transferred to General Wards at Chattahoochee. On October 22,

1928, he escaped from Ward 5 and was returned the same night. He was discharged

less than a month later.

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Death certificate of Peter Christofoli. Photo courtesy of the Florida State Hospital.

Peter Christofoli

(Admitted 8/25/1915 – Died 8/30/1929)

From Duval County, Peter Christofoli, age 29, entered Chattahoochee on

August 25, 1915. An Italian epileptic who spoke no English, he entered the facility

with a diagnosis of Epileptic Insanity. Records from his file indicate that the only

physical injuries he sustained while at the facility were an infected foot, which was

eventually cured, and a fractured nasal septum that resulted from a fall during a

seizure.

Christofoli’s record includes a partial Convulsion Report tracking his

epileptic convulsions from October 10, 1917, through September 30, 1929. It

indicates that he had convulsions on an average of four and one half days per month,

with seven convulsions in August 1929. The last convulsion occurred on August 30,

1929, resulting in his death at 3:20 p.m. He was 43. The direct cause of death is

listed as Staticus Epilepticus, epilepsy with mental deterioration.

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Upon his death the hospital gave Mrs. Louise Christofoli the choice of

having the body shipped back to Tampa for a fee of $47, which included embalming

and transportation. A casket and robe would cost an additional $55 to $95,

depending on the quality and color of the casket, grey or black. Unable to afford

these charges, John Christofoli requested that his son be buried on hospital grounds.

A note in the file indicates the body was buried in the Hospital Cemetery on

September 3, 1929.

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Benjamin Alva Mendoza

(Admitted 1925, Died 1941)

Another epileptic, Benjamin Alva Mendoza, a product of the country’s

itinerant farmer landscape, was consigned to the Florida State Hospital as an older

teen. The second child of Charles Mendoza Sr. and Virginia Torres Mendoza,

Mexican immigrants, Benjamin was born on July 23, 1907, in Bridgeport, Texas,

and was the eldest son of what would eventually be 13 children. His father worked

the cotton fields of Texas and beet fields of Wyoming before moving the family to

Tampa, Florida, in the early 1920s. Tony Mendoza, Benjamin’s youngest brother,

recalled that: “The family was very poor, sometimes on welfare, but always hard-

working. Charles worked as a pipefitter helper for the gas company, and all the kids

that could work, did as much as they could.”

While it is unknown when Benjamin had his first seizure or its severity, in

1925, at the tender age of eighteen, he was sent to the hospital at Chattahoochee for

custodial care. Tony believed it was unlikely that the family ever saw Benjamin

again since Chattahoochee was a long way from Tampa, the family was very poor,

and the economy was depressed.

Sadly, Benjamin contracted TB while at the hospital and died on August 31,

1941. Buried in the hospital cemetery, his grave was lost to the family until the

early 1980s when, with the help of hospital officials, they were finally able to locate

the gravesite. Later, the family had a proper headstone installed and returned to

place flowers on Benjamin’s grave.

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Death certificate of Benjamin Mendoza. Photo courtesy of Rebehak Mendoza.

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Chapter Photo: Shock treatment room. Photo courtesy of the Florida State Hospital.

Chapter VII

New Therapies Stir Hope and Skepticism

Legislative indifference marked the hospital during the early years of the 1930s; but

in 1934, when Preston Ayers became superintendent and Dr. J.H. Pound was

appointed clinical director, things began to change. At the time, 17 doctors, 60

nurses, and 220 attendants treated a record breaking 3,740 patients with the doctor to

patient ratio reaching one to 588 compared to other states at one to 226. In fact, the

overcrowding at the hospital became so critical that, in 1935, new patients were

refused altogether with the exception of the most violent who had to be approved by

a unanimous vote of the Board.

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This prompted Ayers and Pound to undertake a

complete overhaul of the institution.

209

Over the next several years, six new

departments were added with Occupational Therapy, Horticulture, and Recreation

being among the first.

Unlike today’s Occupational Therapy profession that deals with acts of

daily living and rehabilitation of fine motor coordination, the hospital’s

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Occupational Therapy Department helped organize and direct employment for those

patients who were able to work. Utilizing patient manpower, the hospital reduced

outside labor costs and provided essential job training for those anticipating future

release. The Horticultural Department, responsible for landscaping and maintaining

the grounds, employed many of these patients.

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The Recreation Department,

considered on par with occupational therapy in channeling patient energies,

introduced new activities such as baseball games, picnics, concerts, and card

games.

211

In February 1935, the Department of Corrections established a prison camp

on hospital grounds. Fifty-seven white and 44 black prisoners, in separate camps,

paid their penance by working the hospital farm. The two camps operated according

to the rules of the State Prison Commission under the direction of the

Superintendent of the hospital. The white prisoners were mostly young boys ranging

in age from 16 to 22, many first time offenders. With the aim of the camp to

rehabilitate these young men, they did not wear the customary stripped prison

uniforms, nor did they adhere to stringent rules. Instead, they were provided a

variety of recreational opportunities and granted privileges not ordinarily extended

to state prisoners.

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Other departments were added later at Chattahoochee, including the

Sanitary and Peace Department that served three main purposes: eradication of all

unsanitary conditions, maintenance and order, and protection of state property. The

responsibilities of this department were far more reaching, however. Assisting in the

capture of escaped prisoners from the hospital prison camp, the department logged

over 11,000 pursuit miles. In addition, the department manned the 24-hour

information booth at the entrance to the hospital and guarded the 1,300-acre wild

game preserve from fire and theft.

213

214

For all practical purposes, the nine officers

in this department acted as guards whose main function was protecting “life, liberty,

and property of the Florida State Hospital . . .”

215

Prior to the establishment of the Extermination Department, in February

1936, all the ward buildings, as well as many other structures on the campus,

experienced a severe infestation of roaches, mice, ants, bed bugs, fleas, water bugs,

moths, and rats. So severe was this problem that at night rats regularly ran across the

beds in the wards and hospital buildings and bit the patients. Organized to eradicate

all infestations of rodents and other pesky insects, this department proved invaluable

when, by the end of their initial program, 5,000 rats, over 1,000 mice, and more than

three barrels of roaches and water bugs were expunged from the hospital.

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Aerial view of the Florida State Hospital 1930s. Photo courtesy of the Florida State Hospital.

Along with the introduction of the previously mentioned departments, four

new buildings were added to the complex, including a tuberculosis hospital, partially

funded by the federal Public Works Administration.

217

With the hospital facilities

housing 952 patients over capacity, it was hoped that the allocated 966 additional

beds would alleviate the overcrowding.

218

Unfortunately, funding to equip the

buildings was not appropriated, and occupation was postponed.

While this delay was most disappointing, a major innovation occurred in the

White Female Department—the installation and operation of a beauty parlor.

Operated by a certified beautician, six patients, who acted as assistants, received

daily instruction, and patients capable of taking care of themselves were given a

powder puff, powder, and rouge. The Superintendent’s report noted that the beauty

parlor provided invaluable service by instilling pride in the women’s personal

appearance and increasing their morale.

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The asylum employed over 800 workers by 1936. As most were support

staff, this left the doctor/patient ratio acutely high and the facilitation of normal

everyday rounds a challenge. Similar challenges faced other departments, including

the kitchens where 13,080 meals a day were served to over 4,000 patients.

220

Knowing how important proper nutrition was to patient recovery, Ayers insisted

diets be balanced with the proper amounts of fruits, vegetables, meats, fish, eggs,

and cereals.

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He also knew that the hospital could not run effectively without proper

accountability and, therefore, instituted weekly department reports, something that

up to that time was not required. One of these reports came from the Chief

Physician, who recommended passing a startling new Eugenics Law—one that

would allow for the sterilization of insane patients. His contention was that the

measure would eliminate, to a certain extent, the real source of supply of insanity

since, in his mind, insanity would continue to increase so long as persons unfit to

procreate were allowed to do so.

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The suggestion was dismissed.

Inspection and Survey Uncovers Strengths and Deficiencies

It is unknown what specific incident or circumstance prompted an

inspection and survey to be conducted at the Florida State Hospital at

Chattahoochee; however, sometime in the mid-1930s, Dr. Marynia Farnhan was

asked to offer recommendations for improvement to the hospital and to evaluate the

number of patients who might be discharged.

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Discoveries included:

 Severe lack of privacy - communal showers, just feet from the

washbasins and toilets, some with no seats, forced patients to bathe

while others used the facility.

 Toddler found - a normal male child of three was found living in a

white female ward among the acutely physically ill and several

intensely violent and disturbed patients. The mother, who was

pregnant at the time she was brought to the hospital for treatment by

the father, was taking care of the child since locating the father was

unsuccessful. According to the hospital, the toddler was there only

after every effort was made to place him elsewhere, and the child’s

county of resident had refused to take responsibility

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Colored Men’s Ward bathroom. Photo courtesy of the Florida State Archives.

 Restraint - use of leather cuffs, as well as chains, was widespread

due to so few attendants.

 Food - meals were found to have excessive use of starches and

syrup while being almost devoid of fresh fruits. One menu cited

included beef stew, Irish potatoes, grits, macaroni, light bread, and

syrup.

 Physician to patient ratio – was “clearly ridiculous,” and Farnhan

blamed this for the fact that many patients could not be seen for

years at a time.

A condensed version of her report (found in the Appendix with a complete

version online) offers an unprecedented look at the Case History of the physical

facility, hospital operations, and the conditions both patients and staff experienced

during this time in the institution’s history.

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Hospital Initiates New System

By the late 1930s, a system was in place that would better record patient

information. One of the earliest documented, and most unusual case histories, was

that of Percy A. Graham.

Percy A. Graham

(Admitted - May 1938, Died - October 1938)

On April 29, 1938, county judge C.M. Wiggins of Bartow, Florida, sent an

urgent letter to the Board of Commissioners of State Institutions regarding Percy A.

Graham, 46:

No insanity was apparent until tooth was extracted five weeks ago.

The next day he developed 105 degrees of fever and rapidly

developed insanity . . . Started singing, whistling and laughing.

Soon became moody, angry and threatening. Turned against his

wife – centered love in 16-year-old daughter. Last Sunday near

midnight made murderous attack on wife and attempted rape of

daughter who interfered and beat down aged relative who came to

rescue . . . Now restrained in special part of hospital with two men

guards. Thinks he is Jesus Christ and the doctor is the devil. He is

violently afraid of everyone, and, thinking they wish to kill him, he

attacked first . . . VERY ANXIOUS TO SEND HIM TO STATE

HOSPITAL AT EARLIEST POSSIBLE MOMENT.

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Lakeland physicians John J. Wilson and Edgar Watson signed papers on

May 2, 1938,

225

sending Percy, who was considered very dangerous and needed to

be confined, to the Florida State Hospital. He was admitted on May 4, 1938, with

the tentative diagnosis of Paranoia with homicidal tendencies.

226

A detailed family history was obtained from Percy’s wife Lena in which

she noted that after Graham’s tooth extraction he’d suffered a heart attack.

Subsequent to that, Percy had described the experience as something that had “burst

or exploded . . . similar to the report of a rifle, or the pricking of a balloon, inside his

body.” She also told doctors that Graham’s mother had committed suicide by gas

and felt the malady inherited. While she was optimistic about his outcome, she

expressed genuine concern and was anxious to know if he could ever return home.

227

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Doctors gave Percy a follow up evaluation on August 18. He was found to

be acutely excited and disturbed with apparently no change since his admittance. His

diagnosis was manic depressive psychosis with a poor prognosis.

228

During his

hospital stay, letters regarding Percy’s condition were exchanged frequently

between Dr. Stevens and the family as well as with Dr. Wilson, the family

physician. In them, Stevens pointed out that Percy was still very much disturbed,

restless, over-talkative, expressed some grandiose ideas, and reacted to

hallucinations.

229

On October 22, a Western Union telegram arrived at Lena Graham’s home

informing her that Percy had passed away quite suddenly at 5:30 a.m. that

morning.

230

No reason for his unexpected death was given; however, a subsequent

letter indicates that it was Dr. Stevens’ belief he died from “absorption of poison

from his low grade infection and continuous brain excitement.”

231

Unlike many of the patients who died at Chattahoochee and were buried just

outside hospital grounds, Percy was transported by hearse back to Lakeland for a

family burial.

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New Therapies Stir Hope and Skepticism

In the 1930s, the hospital underwent tremendous physical and

organizational changes; but, the most startling change did not come about by the

hiring of more staff, the building of more wards, or changes in the hospital’s

operating procedures. Instead, it came about by the introduction of new innovative

treatments—fever, insulin, metrazol, and shock therapies, as well as lobotomy—

treatments that would profoundly impact those who were institutionalized. With the

introduction of these new treatments, the possible recovery of tens of thousands of

severely and chronically mentally ill patients was now within reach.

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Fever Therapy

Trained at the University of Vienna, Julius Wagner-Jauregg noticed that

symptoms of mental illness occasionally disappeared in patients with typhoid fever.

To further study this phenomenon, he obtained blood infected with malaria and

inoculated several soldiers who were diagnosed with psychoses. Of the eight

administered this treatment, four showed complete remission while two others

improved.

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Florida State Hospital Physicians – Back Row: W.H. Spiers, W.M. Bevis, A.E. Couter; Front

Row: H.M.Smith , man on right unidentified. Photo courtesy of the Florida State Hospital.

Holding much promise for the recovery of paretic (a condition typified by

partial loss of movement) and psychotic patients, Wagner-Jauregg’s work garnered

him the Nobel Prize in 1927. So popular was this therapy, it quickly spread to the

U.S. Subsequent use by physicians, however, resulted in less than stellar results, and

a 1939 article by Oskar Diethelm condemned the “enthusiasm for novel but untested

therapies.”

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Insulin Shock Therapy

Viennese physician Manfred Sakel introduced insulin shock treatment in the

mid-1930s. Having observed mental changes in diabetic drug addicts treated with

insulin, he used the technique on psychotic patients, specifically schizophrenics. The

injection of insulin lowered the sugar in the blood resulting in a hypoglycemic state

of “shock.” While in shock, the patient fell into a deep coma that was relieved by the

administration of sugar. Sakel claimed that the procedure was highly effective in the

treatment of mental illnesses.

235

Since insulin therapy was decidedly controversial for its experimental

nature, some physicians were reluctant to jump on the insulin therapy bandwagon.

One physician challenged this treatment in a letter to a colleague: “I have a

suspicion that some of these schizophrenic patients get well with insulin shock

treatment and other similar methods that are exceedingly painful and disagreeable in

order to get out of the sanitarium where they use such methods, or at least to escape

their repetition.”

236

Others expressed more openness to the procedure that could potentially help

thousands, especially at a time when state hospitals were overwhelmed with

patients, a high number of which had no hope of recovery.

At the Florida State Hospital, Dr. A.L. Huskey found mixed results when he

used insulin shock therapy on a number of schizophrenic patients. Each male patient

was physically healthy, under 30 years of age, and had been afflicted with mental

illness from two months to seven years. With one physician and one attendant

treating six patients at a time, each patient was given an intramuscular injection of

insulin at 7:30 a.m. on a fasting stomach. This was repeated over a series of days

until a “shock dosage” was reached (patient went into a coma). After that, the

patient was shocked daily, except on Sundays.

Huskey noted that the most difficult part of this type of therapy was

controlling the depth and length of each coma. It was generally believed that the best

method was to take the very depressed patients to a highly excitable stage and then

stop the treatment. In hyperactive patients, a deep coma was induced for some time

before interruption. There was, however, no definite rule, and it was only through

close and careful observation of each individual patient that the desirable depth of

coma was determined.

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Of the 15 cases covered in Huskey’s report, five were greatly improved

(showed no psychotic residuals), three were moderately improved (patients had

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some psychotic residuals but were able to make a social recovery), five were slightly

improved (patients retained most of their psychotic trends but were able to repress

them somewhat), and two were unimproved.

While no patients died during these treatments, one did sustain a fracture-

dislocation of the shoulder joint due to muscular violence during the procedure, and

one patient went into an extended coma for 30 hours.

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Every patient, however, was

furloughed from the institution with guardians given explicit instructions on how to

care for them.

Metrazol Shock Therapy

At the same time insulin shock therapy was taking hold, Hungarian

physician Ladislas von Meduna introduced pentilenetetrazol, also known as

Metrazol. When given intravenously in large doses, the synthetic cardiac and

respiratory stimulant caused quick and violent convulsions. Despite the dramatic

physical effects of the treatment, von Meduna reported a discharge rate of 50

percent and even dramatic cures after he treated 110 mental patients.

Dr. M.E. Sabitini noted in his paper “The History of Shock Therapy in

Psychiatry” that there were distinct differences between insulin and Metrazol shock

therapies. First, while insulin coma required five to nine hours of hospitalization and

close follow-up, it was easily controlled and stopped with injections of glucose or

adrenalin, when needed; Metrazol, on the other hand, was stronger and more

difficult to control. Second, insulin therapy caused few side effects while Metrazol

convulsions were so severe that they caused spine fractures in 42 percent of the

patients. Third, and the only down side, insulin was more expensive and less reliable

than Metrozol in inducing convulsions.

239

Dr. Huskey administered Metrazol therapy to a few patients at the Florida

State Hospital, but it did not prove as promising as treatment with insulin; still, he

remained optimistic, believing that improvements in the technique would prove

comparable with insulin shock therapy because it had the advantage of requiring

much less time for administration and a less experienced staff.

240

With all its promise, Metrazol shock therapy proved to be short lived; and,

with the advent of electroconvulsive therapy (ECT), was slowly phased out. It

disappeared completely by the late 1940s.

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Electroconvulsive Therapy (ECT)

Italian physician Ugo Cerletti believed Metrazol shock therapy was useful

in the treatment of schizophrenia; but, unlike insulin therapy, control of convulsions

was tenuous at best. Looking for an alternative, he drew upon his experience as an

epileptic specialist and his experiments with electroshock treatment to produce

repeatable and reliable epileptic fits in dogs to ascertain their effects.

The idea of applying ECT to humans came as a result of Cerletti’s

observation of pigs being anesthetized with electroshock before being butchered.

241

Convincing physicians Lucio Bini and L.B. Kalinowski to assist him, in 1937,

Cerletti worked to design and test a device that would deliver electroshock to

humans. The results were nothing short of astounding. The device proved reliable,

the administration controllable, and the outcome had unexpected beneficial results.

After treatment, ECT patients experienced retrograde amnesia, eliminating any

negative feelings associated with the procedure that had been experienced by

patients treated with Metrazol.

ECT was administered in a series of treatments over several weeks. The

patient was strapped to a gurney, gel and conductors applied to the temples, and a

bite guard placed in his or her mouth (this prevented the patient from biting his/her

tongue). The electricity was then sent to the brain in a predetermined strength and

length. This produced violent convulsions that many times resulted in broken bones

and vertebrae (later patients were sedated). Side effects included memory loss

(temporary to severe), headaches, nausea, confusion, and muscle ache or soreness.

While medical professionals were, and still are, unable to explain the exact

reason why this treatment works (it may be the result of neurotransmitters being

released in the brain as a result of the seizure); nevertheless, it proved to be the

“miracle” many doctors and patients were looking for, and it didn’t seem to damage

the brain.

To promote the use of ECT, in 1939, Kalinowski traveled the globe

eventually coming to the United States. Treating patients with severe depression,

who were resistant to other types of therapies, researchers found that depression

disappeared in 90 percent of the cases after three to four weeks. The results were so

profound, that in hospitals and asylums around the world ECT was heralded as the

panacea to depression;

242

but, its use soon became a “cure-all” for every type of

mental disorder, and indiscriminate use became widespread.

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In The Mad Among Us, Grob noted a study conducted by Horatio M.

Pollock in which the leading psychiatric statistician concluded: “The promiscuous

use of E.C.T. [sic] without other adequate psychiatric therapies has become a

medical scandal. Many institutions use it wholesale for all forms of mental illnesses

without any other therapy—no proper nursing supervision, no occupational therapy,

no psychotherapy—simply a pure physiotherapeutic procedure.”

243

Over the years, ECT has been refined and remains the only somatic therapy

from the 1930s in widespread use today, as noted in this document on the Florida

Department of Children and Families website:

Electroconvulsive Therapy (ECT). ECT is a highly effective

medical treatment generally reserved for those with severe mental

illnesses who are unresponsive to or unable to tolerate medications or

other treatments. ECT may be used with severely depressed individuals

when other forms of therapy, such as psychotherapeutic medications or

psychotherapy, have not been effective, cannot be tolerated, or in life

threatening cases, when other treatments will not help the individual

quickly enough. ECT is most effective and most rapidly acting

treatment available for severe major depression. ECT also helps

individuals who suffer with most forms of mania, some forms of

schizophrenia, and a few other mental and neurological disorders. ECT

is also useful in treatment of these illnesses in older individuals for

whom certain medications may be unadvisable due to side effects.

Modern methods of administering ECT employ low “doses” of electric

stimulus to the brain along with general anesthesia and muscle relaxants

to minimize the risk and unpleasantness for the individual. Side effects

of this treatment may include mild confusion, memory loss, and other

cognitive problems which are common yet typically short-lived.

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Lobotomies

Fever, insulin, Metrozol, and ECT therapies made a big a difference, but

without a doubt, psychosurgery (lobotomy) became the most striking innovative

therapy of the 1930s and became both a famous and infamous method of treatment

for tens of thousands of mental patients worldwide, including those at the Florida

State Hospital. The prevailing environment that allowed for the introduction of this

radical treatment included severe overcrowding at state institutions and the presence

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of tens of thousands of chronic schizophrenic patients for whom shock therapies

were ineffective. This opened the door for psychosurgery to be introduced as a

promising addition to hospital-based therapies.

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Chapter Photo: Operating room. Photo courtesy of the Florida State Hospital.

Chapter VIII

Lobotomies: Cutting Edge Brain Surgery

The term lobotomy comes from two Greek words: lobos (lobe of the brain) and

tomos (to cut/slice). A neurological procedure, lobotomy, or leucotomy as it was

originally called, consisted of cutting the connections to and from the prefrontal

cortex located at the front part of the brain. Associated with memory, planning, and

decision-making, this portion of the brain is critically involved in behavior,

language, and reasoning.

Early Beginnings

Evidence of psychosurgery dates back to approximately 2,000 B.C., when

skulls found by archeologists showed evidence of precise holes that appeared to

have been intentionally bored. In a process called trepanation, some cultures bored

holes through the skull to allow evil spirits to escape. Although it is uncertain

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whether brain matter was extracted, the holes also might have been drilled to relieve

pressure in the skull.

246

Modern psychosurgery, known as leucotomy, had its roots in Switzerland in

1888, when Gottlief Burckhardt, psychiatrist and director of a mental asylum in

Switzerland, experimented on six mentally ill patients by removing pieces of their

cerebral cortex. Five of the six patients suffered from “primare Verrucktheit,” a

clinical category considered equivalent to schizophrenia.

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Burckhardt claimed 50 percent success, with three patients showing partial

improvement. The procedure itself, though, coupled with inadequate patient follow-

up, brought harsh criticism from colleagues, and Burckhardt ended his research. He

summed up his pioneering philosophy in an 1891 paper: “Doctors are different by

nature. One kind adheres to the old principle: first, do no harm (primum non

nocere); the other one says: it is better to do something than do nothing (melius

anceps remedium quam nullum). I certainly belong to the second category.”

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Two decades later, Estonian neurosurgeon Ludvig Puusepp operated on a

few patients; and, in 1935, Portuguese physician and neurologist Antonio Egas

Moniz performed a new surgery called prefrontal leucotomy. This involved drilling

holes in the skull and injecting alcohol to destroy the patient’s tissue in the frontal

lobes. Later, Moniz used an instrument called a “leucotome” that consisted of a

retractable wire loop that was inserted and then rotated to cut the brain tissue.

In his article “Controversial Psychosurgery Resulted in a Nobel Prize,”

Begnt Janssan noted that at the time no effective treatment existed for schizophrenia

and that leucotomy, at least, managed to make life more bearable. The treatment

became quite popular in many countries and Moniz received the Nobel Prize in

1949.

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Drs. Walter Freeman and James Watts Perform First Lobotomy in U.S.

Intrigued by Moniz’s initial work, in 1936, American neurologist and

psychiatrist Walter Freeman hired neurosurgeon James W. Watts to perform the first

U.S. prefrontal leucotomy at George Washington University Hospital in

Washington, D.C. Alice Hammatt, who suffered with insomnia, anxiety,

depression,

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and was facing institutionalization, became the doctors’ first patient.

Transcripts from “The Lobotomist,” the PBS special aired as part of the

American Experience, noted: “It was clear in those days when you were committed

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Dr. Walter Freeman. Photo courtesy of National Library of Medicine.

to a mental hospital, this was not a voluntary affair, there was no way out. There

would be no treatment because there’s nothing seriously that anyone could do.

These were warehouses for people that society wanted to forget.”

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Leucotomy, at

least, provided hope that the person could be discharged.

The procedure that Freeman and Watts used was through a burr hole in each

temple. Freeman would scrub up and position himself opposite Watts. Then guiding

Watt’s every move, Freeman would wave his hands this or that way to direct the

angle of insertion of the lobotomy instrument.

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After the operation, Freeman

commented that Hammatt’s face reflected a placid expression, and by evening she

was quite alert, manifesting no anxiety or apprehension.

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100

Freeman and Watts operated on a dozen patients; and, while Freeman noted

altered behaviors, he also realized the patients suffered unsettling side effects, with

many experiencing reccurring symptoms requiring a second, and sometimes, a third

operation. Edward Shorter, a medical historian, stated in “The Lobotomist” that

Freeman’s definition of success was that the patients were no longer agitated. He

went on to explain: “That doesn’t mean that you’re cured, that means they could be

discharged from the asylum, but they were incapable of carrying on normal social

life. They were usually demobilized and lacking in energy. And they were that on a

permanent basis.”

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Despite these dubious results, and upon occasion the patient’s death,

Freeman was not deterred.

Rosemary Kennedy: Freeman’s Most Infamous Case

Freeman and Watts received a call from elder statesman Joseph P. Kennedy

in 1941. The patriarch’s daughter, Rosemary, sister of John, Robert, and Ted

Kennedy, was described as “slow and shy-seeming from early childhood, possibly

dyslexic, and apparently retarded.”

255

Ronald Kessler, in his article “Rosemary Kennedy’s Inconvenient Illness,”

pointed out that Rosemary’s learning ability had always been slower than the other

Kennedy children, though as a teen she was quite capable of writing endearing

letters, dancing, and doing arithmetic. As she grew older, however, her temperament

“soured” and she often flew into uncontrolled and violent rages.

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In a 2005 Washington Post article “Rosemary Kennedy, 86: President’s

Disabled Sister,” Martin Weil referred to an excerpt from a book by historian Doris

Kearns Goodwin in which it was stated that to Joseph P. Kennedy, Sr., a lobotomy

was an “obvious solution to the frustrations she [Rosemary] experienced in trying to

find a place for herself in a hard-driving [Kennedy] family.”

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Dr. Brown, special assistant to President Kennedy and executive director of

the President's Panel on Mental Retardation, later learned from doctors retained by

the Kennedy family that Rosemary was not mentally challenged at all, but suffered

from depression. He concluded that the Kennedy family considered being mentally

challenged far more acceptable than being mentally ill.

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101

Freeman and Watts performed their 66th lobotomy on Rosemary, then 23.

After mildly sedating her, Watts penetrated the brain through an incision in the

skull. Using an instrument resembling a butter knife, he cut the brain tissue by

moving the instrument up and down. During the operation Rosemary was asked to

perform cognitive exercises—to count backwards or sing a song.

Kessler interviewed Dr. Watts who explained that the doctors would

determine how far to cut based upon how Rosemary responded. When she started to

become incoherent, Freeman and Watts stopped.

259

The procedure left Rosemary

with the development of a two-year-old. She was unable to dress, wash, or clothe

herself and needed constant supervision.

Joe Kennedy sent Rosemary to St. Coletta's School in Wisconsin where she

received extensive custodial care. The family, who had represented themselves as

loving and caring, now ceased to acknowledge Rosemary’s existence. Letters,

written by Rose Kennedy did not refer to her, and Eunice later said she had no idea

where she was. The press didn’t learn the truth until John Kennedy was elected

president. Only then did Eunice feel comfortable talking about Rosemary in public.

On the premise that Rosemary was mentally challenged, Eunice Kennedy Shriver

founded Special Olympics International, Inc. in 1968.

260

Rosemary remained permanently incapacitated until her death at Fort

Atkinson Memorial Hospital in Wisconsin on January 7, 2005.

Lobotomies in the Sunshine State

In the southernmost state of Florida, another physician, Dr. James G.

Lyerly, Sr. became intrigued by Monitz’s work. Lyerly graduated in 1920 from

Medical College of Virginia, and after interning at Memorial Hospital, served

several years under Dr. C.C. Coleman, Professor of Neurosurgery. Moving

permanently to Jacksonville, Florida, in 1934, with his wife Emily and three

children, he set up a solo practice. At the time, he was the only neurosurgeon in

Florida, with others located in the southern cities of Richmond, Atlanta, New

Orleans, Memphis, and Louisville.

261

Developing a relationship with Dr. Ralph Greene, Sr., a Jacksonville

neurologist who had served several years as superintendent of the Florida State

Hospital, Dr. Lyerly, Sr. became informed about the hospital and its need for a

neurosurgeon. Dr. Edward Sullivan, one of Dr. Lyerly, Sr.’s associates who later

Sally J. Ling

102

Dr. James Lyerly, Sr., a neurosurgeon

from Jacksonville, Florida, performed

lobotomies at the Florida State Hospital.

Photo courtesy of the American

Association of Neurological Surgeons’

Cyber Museum of Neurosurgery

assisted him with lobotomies at the hospital,

recalled that in Dr. Lyerly, Sr.’s earlier

association with the hospital, he would visit

once a month: “They would give him a list of

patients to evaluate and offer an opinion, and

occasionally he would schedule an operation

for subdural hematoma or a benign brain

tumor.”

262

Dr. Lyerly, Sr.’s work with the

mental patients eventually piqued his interest

in the emerging psychosurgery known as

lobotomy. Following Monitz’s lead, he

devised his own procedure, which later

became accepted worldwide. This procedure

was an open operation done over the frontal

lobes through two trephine openings,

allowing visualization of the cut fibers and

bleeding control if necessary.

263

Proper patient selection was highly

important to Dr. Lyerly, Sr. as he firmly

believed that not all mental diseases would benefit by this operation;

264

therefore, he

performed lobotomies only on cases of severe involutional melancholia and agitated

depression.

265

The type of lobotomy to be performed was determined by the severity of the

mental disorder. Unilateral prefrontal lobotomy (on one lobe) was preferred in

milder forms of mental disorders or on young patients when the least change of

personality was desired. Bilateral prefrontal lobotomy (both lobes) was performed

when ECT failed or another procedure was indicated. It was also used for the relief

of drug addiction, intractable pain, and on patients with nervous and mental

symptoms.

266

Initial patients at the Florida State Hospital on whom Dr. Lyerly, Sr.,

performed lobotomies from October 1937 to March 1938, included four males and

three females, ages 47 to 66. Each suffered from involutional melancholia, a mental

illness characterized by severe depression, feelings of wanting to die and/or

attempted suicide that lasted four months to two years.

267

In his article “Transsection

Out of Mind, Out of Sight

103

of the Deep Association Fibers of Prefrontal Lobes in Certain Mental Disorders”

published in The Southern Surgeon, Dr. Lyerly, Sr. described how he determined

which patients would benefit from the operation:

In every case the patient was examined by a psychiatrist before the

operation. If these patients are not benefited over a reasonable

period of time under the medical and psychiatric treatment, rather

than let them stay in some hospital indefinitely while mental

deterioration sets in, it may be better to give them the benefit of the

operative procedure outlined, when a remission is secured in a few

weeks time. The time saved in restoring the patient to society, the

lessening of the financial burden, the relief from mental suffering,

and the lives saved from suicide and inanition are important factors

in favor of the operation.

268

To perform the operation, Dr. Lyerly, Sr. removed two small buttons of

bone on either side of the forehead at the hairline, opened the dura, and made an

incision in the cortex. A lighted brain speculum was inserted and the associated

fibers cut diagonally. The dura was then closed and the buttons of bone replaced in

the wounds.

269

Lylerly’s Lobotomy Patients

Dr. Lyerly, Sr. noted that many of the patients he treated at the hospital had

been in restraint for 10 to 15 years. After the lobotomies, some showed remarkable

improvement. Most were able to function without the use of restraints, and some

were eventually discharged and became employed.

One of Dr. Lyerly, Sr.’s patients, a 12-year-old feeble-minded child

described as psychotic, remained constantly agitated, restless, noisy, and was a

disturbance to the other children in the institution. After a lobotomy, Dr. Lyerly, Sr.

noted that although the young girl remained institutionalized, it was much easier to

take care of her.

270

Another patient, identified only by the initials J.H.M., was a white druggist,

aged 47, who was married with two children. A physical examination showed he

was in good health, and there was no family history of mental illness prior to his

admission to the hospital on May 29, 1937. According to records, his symptoms

started three months prior with worry and depression that gradually became worse.

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104

He frequently cried, his memory became impaired, he felt as if he had wronged

people, and everybody was against him. In addition, he felt as though an unknown

power was driving him down. He had attempted suicide on two occasions.

271

During his stay in the hospital J.H.M.’s symptoms did not improve.

272

Diagnosed with involutional melancholia, on November 29, 1937, Dr. Lyerly, Sr.

gave J.H.M. a lobotomy.

On the first postoperative day the patient said he felt better and was

smiling. His outlook was brighter; he did not worry. He said he

wanted to go home and help his family. On the fifth day he was a

bit confused and complained of a little headache. Sutures were

removed on the sixth day and the wound was healed. On the next

day he smiled and asked questions readily. He was slightly worried

about his wife and children. He was not depressed. He was brighter

and more alert. He said he wanted to go to work. He was furloughed

from the hospital to his home on the fortieth postoperative day, Jan.

8, 1938. At that time, the patient was alert, and the future looked

bright and excellent.

273

After discharge, Dr. Lyerly, Sr. received several letters from the patient’s

wife expressing thankfulness that her husband had been restored to his home and

family and that his attitude and personality were better than she had ever known

them to be.

274

One of the doctor’s more notable cases involved a patient nicknamed “the

old metal eater.” Constantly eating odd objects—nails, spoons, and other metals that

he could swallow, in addition to twigs, wood, paper, and any other foreign material

he could get his hands on—he’d undergone numerous abdominal operations to

remove the foreign objects and intestinal obstructions. Unable to quit this obsession,

he was finally given a lobotomy. Following the operation, he improved

significantly, and his tendency to swallow foreign material abated.

275

Results of the elder Lyerly’s first seven operations indicated that five of the

patients became “well,” and two “greatly improved.” Four of the patients were

discharged from the hospital within 10 weeks of their operation; and, at the time of

the report, several were still recovering.

With the growth of Dr. Lyerly, Sr.’s Jacksonville practice, in 1947, he

established a board-approved one-year neurosurgical residency program at St.

Vincent’s Hospital.

276

Dr. Edward “Sully” Sullivan, a graduate of Georgetown

Out of Mind, Out of Sight

105

The Lyerly Group: Drs. Edward Sullivan, Tom Boulter, Howard Chandler, James Lyerly, Sr.,

James Lyerly Jr., Gaston Acosta-Rua. (mid 1970s) Photo courtesy of Dr. James Lyerly, Jr.

University School of Medicine who studied under Dr. Walter Freeman while a

medical student assigned to the neurosurgery department at Gallinger (Public)

Hospital in Washington, trained as a resident in this program from 1948-1950.

In 1954, he became an associate of the Lyerly practice and in 1956, became

partners with Dr. James G. Lyerly, Sr. and his son, Dr. James G. Lyerly, Jr., when

the three formed the Lyerly Group (now known as Lyerly Nuerosurgery). Later,

Sullivan served 20 years as Chief of Neurosurgery at St. Lukes Hospital in

Jacksonville, Florida.

277

Sullivan assisted Dr. Lyerly, Sr. with lobotomies at the

Florida State Hospital for five years. Describing their routine, he said they got up at

4:00 a.m. and drove to Chattahoochee once a month where they operated about 9:00

a.m. Sullivan said the two performed one or two lobotomies a day and that he

participated in about 100 at the Florida State Hospital, with many having “fantastic

results.”

278

One of the private patients on whom Sullivan performed lobotomies was a

nurse who had tried to commit suicide several times. On the first occasion she tried

to asphyxiate herself by turning on the gas in her oven.

Sally J. Ling

106

Alerted by the smell, a neighbor rescued her. On her last attempt, she shot

herself on the right side of the temple with a .45 automatic. As the gun contained old

ammunition, the bullet didn’t penetrate very deeply into the right temporal lobe.

Sullivan stopped the bleeding; yet, knowing she had tried several times to commit

suicide, he performed a unilateral lobotomy. “After that, she never tried to commit

suicide again,” stated Sullivan.

279

While Dr. Lyerly, Sr. performed open lobotomies and hosted physicians

from the Mayo Clinic who came down to observe his method,

280

Walter Freeman

was in the throes of developing a new technique—one that was both revolutionary

and revolting.

Freeman Introduces “Ice Pick” Lobotomy

Freeman’s initial technique involved drilling into the skull, a procedure that

required an operating room and trained neurosurgeons. These accommodations,

however, were not available in many mental institutions. To make matters worse,

during and at the end of World War II, thousands of traumatized service men

returned home to state institutions that were horribly overcrowded. In fact, in 1943,

state mental institutions admitted 100,000 new patients with only 67,000 discharges.

Three years later, admissions rose to 271,000; and, just a year earlier, mentally ill

patients occupied approximately one-half of public hospital beds.

281

This situation

prompted Freeman to consider a more simplified technique. By training psychiatrists

to carry out the procedure in state hospitals that had limited financial resources and

no operating rooms, surgeons, or anesthesia, he hoped to help the 600,000 patients

now occupying those facilities.

Freeman first used his new technique in 1946 on Ellen Ionoesco, a 29-year-

old housewife and mother considered so depressed she stayed in bed for days on

end.

282

Freeman rendered her unconscious through the use of electric shock, and

then peeled back her eyelid. Using a common ice pick, and keeping it in the same

plain as the nose, he pushed the instrument into the orbital cavity (just above the

eye) until it hit thin bone. With the tap of a hammer, he punctured the skull and

inserted the instrument until the prefrontal area was located. Freeman then moved

the ice pick “back and forth like a windshield wiper.”

283

Out of Mind, Out of Sight

107

Dr. Walter Freeman gives a lecture on transorbital lobotomy to staff at Western State Hospital in

Tacoma, Washington. Freeman gave up a portion of his vacation, which he was spending in the

Pacific Northwest, to introduce the procedure, as well as supervise the selection and operation of

the initial thirteen cases. Photo courtesy of Western State Hospital.

Harry Merliss, M.D., Freeman’s former student who was present to study

the technique, said he had a hard time being part of the innovative treatment: “When

I walked in that room the first time, and to see this thing, I really wanted to run. I did

not want to be there. To see somebody nailing, what I call a nail, through

somebody’s skull. I just could not see at eighteen years old how that made any

sense.”

284

Merliss wasn’t the only one to balk at the new procedure. When Watts saw

this technique performed for the first time, he threatened to break off his partnership

with Freeman if he continued to perform lobotomies himself and treat them as

“office procedures done without surgical gloves or sterile draping.” From then on,

Freeman performed this procedure alone and outside the office.

285

By lining up hospitals that wanted to learn the technique, Freeman traveled

the country in his own personal van that he called his “lobotomobile.” If hospitals

weren’t available he’d perform the operation in a hotel room, often lobotomizing

Sally J. Ling

108

Dr. Freeman gives twelve-year-old Howard Dully an ice pick lobotomy. Photo courtesy of

Howard Dully and the Special Collections Research Center, Gelman Library, George

Washington University.

children as young as 12 for delinquent behavior, and housewives who had lost their

zeal for domestic work.

286

Lobotomy Boom and Bust

In his article “Frontal Leukotomy and Related Psychosurgical Procedures in

the Era Before Antipsychotics,” Dr. Victor W. Swayze, II described the factors that

contributed to the escalating use of psychosurgery: “First, there were no alternative

therapies available for chronically institutionalized patients who had already

received somatic treatments and had only a temporary response or none. In a time

when little could be done . . . it was remarkable that dramatic changes in symptoms

were frequently observed within a relatively short time after an operation.”

287

During the 1940s and 1950s, dozens of doctors around the world performed

tens of thousands of lobotomies using a variety of techniques.

288

Freeman himself

recorded 3,439 lobotomies in 55 hospitals in 23 states,

289

most with his new

assembly line technique designed to reduce time and the necessity for an operating

room and surgeon. In February 1967, Freeman’s lobotomy career came to an abrupt

end when Helen Mortenson died of a brain hemorrhage. He lost his hospital

privileges and shortly thereafter retired.

290

Out of Mind, Out of Sight

109

Later, at the age of 72, Freeman traveled the country trying to locate his

former patients. By speaking to them, he was hoping to prove to the world that

lobotomies hadn’t been the great medical disaster people thought they were.

291

died of cancer on May 31, 1972.

End Results in Florida

From 1937 to 1951, Dr. Lyerly, Sr. performed 182 lobotomies, many at the

Florida State Hospital. Of the reported cases, 72 involved relief from involutional

melancholia, 25-manic depression psychosis, 35-schizophrenia, 30-psychoneurosis,

17-intractable pain, two-Parkinson’s Disease, and one was psychopathic feeble

minded ness. Of these, 90 of the patients were discharged (went home and became

employed), 44 showed moderate improvement (home but not yet employed, though

capable of doing so), 42 showed slight improvement (still in the hospital), and six

were considered failures (showing no improvement).

292

During 1950, three deaths were documented; however, autopsies indicated

these occurred from other complicating illnesses and not as a result of the

lobotomies.

293

According to Sullivan, Dr. Lyerly, Sr. never used Freeman’s “ice

pick” technique privately, and no records indicate this procedure was ever

performed on patients at the Florida State Hospital.

Writings from Dr. Lylerly, Sr. coupled with personal interviews from Dr.

Lylerly, Jr. and Dr. Edward Sullivan, note that lobotomies were a significant part of

patient treatment at the Florida State Hospital from the 1930s through the 1950s.

Curiously, however, hospital biennial reports do not include any information

regarding them and only mention Dr. Lylerly, Sr. in cursory fashion when noting

that neurosurgeries were performed at the hospital.

294

Lobotomies continued in great numbers until 1955, when Thorazine was

approved for use in the United States. Called a “chemical lobotomy,” the drug was

prescribed for patients suffering from schizophrenia and severe depression and

resulted in improved mood, making it easier for them to function in everyday life.

Once Thorazine was introduced, the need for lobotomies dropped significantly.

After Dr. Lyerly, Sr. no longer performed lobotomies at the Florida State Hospital or

in his private practice, Dr. Lyerly, Jr., stated, “My father never spoke of them

again.

295

Sally J. Ling

110

While Thorazine ushered in decades of development, testing, and the use of

other antipsychotic drugs, a number of lobotomies are still performed today.

Out of Mind, Out of Sight

111

Photo: New fire station. Photo courtesy of the Florida State Hospital, Florida State News Bureau,

Tallahassee.

Chapter IX

Hope and Challenges

Innovative treatments of the 1930s continued into the next decade bringing hope for

increased patient discharges to institutional mental health care workers; but, day-to-

day reality was quite sobering. The Florida State Hospital experienced its largest

patient population to date and moved into the middle of the decade remarkably

understaffed due to the involvement of our nation’s men in a history-altering

event—World War II. This event, though, would produce some unexpected positive

results in the field of mental health care.

World War II Introduces New Challenges and Treatment Philosophy

The war created a swell in patient population from discharged soldiers that

added to the already overcrowded situation in the hospital, and it created a

secondary challenge to the administration—loss of medical staff to the war effort.

296

Sally J. Ling

112

Even the dental department felt the pinch when seven of 12 persons on staff entered

the armed services leaving the department with the most changes in personnel in the

department’s history. With openings difficult to fill, the department operated with

personnel comparable to that of 15 years prior and a patient load of almost double

that period. As a result, there was an increase in the number of emergency

operations and a reduction in the number of restorative operations.

297

The war did prove, though, to have positive effects as well. This came in the

form of a shift in philosophy of treatment. According to Grob:

During that conflict, military psychiatrists found that

neuropsychiatric disorders were far more pervasive and serious than

had been previously recognized, that environmental stress

associated with combat contributed to mental maladjustment, and

that early and purposeful treatment in noninstitutional settings

produced favorable outcomes. . . A logical conclusion followed:

treatment in civilian life, as in the military, had to be provided in a

family and community setting rather than in a remote, isolated, and

impersonal institution. . .

298

This change in thinking, plus the discharge of many military psychiatrists

into the medical community at the conclusion of the war in 1945, helped launch a

philosophical change in the way the mentally ill were treated. Contributing to that

change were several writers.

Writers Support Changes

In 1944, liberal journalist Albert Deutsch began investigating psychiatric

facilities. Over the next two years, he wrote several dozen articles exposing the

deficiencies and harsh realities of patient care in the nation’s mental hospitals. These

insufficiencies were echoed in state hospitals around the country as overcrowding

and understaffing took its toll on patients, such as those depicted by Deutsch in a

Detroit hospital:

Above the occasional shriek, the hysterical crying and senseless

laughter, the moaning and the muttered soliloquies—was the

oppressive crowding of the nervously sleeping inmates of the

depressing, dirty, dim-lit wards.

Out of Mind, Out of Sight

113

Cots and beds were strewn all over the place to accommodate the

289 mental patients packed into wards intended for 126. Cots lined

the corridors, with restless patients often strapped into them. (It

appeared that about one-third of all patients in the psycho wards

were under mechanical restraint that night—tied down to their beds

by leather thongs, muffs or handcuffs linked to chairs.) . . .

I had noticed, during the day, an unusually large number of women

patients in bed. An attendant, when I asked about this, replied that

there wasn’t enough clothing to go around . . . and it was necessary

to keep many in a bed to preserve some semblance of decency.

299

It was Mary Jane Ward’s 1946 autobiographical novel The Snake Pit,

condensed in Reader’s Digest and later made into a motion picture in 1948, that

generated the most eye-opening portrait of mental hospitals, softened only by the

potential found in psychoanalytic psychiatry.

In the movie, the heroine, who was committed to a hospital because of a

mental breakdown, was treated by a caring psychiatrist who employed

psychotherapy to help her gain valuable personal insight.

300

This portrayal of the

effective use of psychotherapy helped to promote its use as treatment.

With support for change converging from a number of sources, the country

underwent a major overhaul in its philosophical approach to mental health care.

Among those changes was the passing of the National Mental Health Act in 1946.

Theresa Walls in her article “The National Mental Health Act of 1946 and the

Establishment of NIMH: Ongoing Challenges,” noted that: “President Truman

signed this bill into law in the immediate post war period which heralded a dramatic

shift in the care of the mentally ill. This shift, primarily engineered through

education and research, would ultimately solidify the move from institutionally

based care (the asylum model) to community based care.”

301

The Act also provided for the creation of the National Mental Health

Advisory Council and the establishment of the National Institute of Mental Health

(NIMH) in 1949. NIMH’s stated mission was “to transform the understanding and

treatment of mental illnesses through basic and clinical research, paving the way for

prevention, recovery, and cure.” This mission was carried out in its headquarters in

Bethesda, Maryland, and multiple research offices across the country.

302

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114

Main Receiving Hospital. Photo courtesy of the Florida State Hospital.

Hospital Becomes a Small City

By the end of 1940, the Chattahoochee facility grew to become a sprawling

10,278-acre self-sufficient complex the size of a small municipality. Buildings

numbered 280 with a staggering 4,515 patients and 888 employees, 216 of which

worked the farm and were prisoners from the Florida State Prison at Raiford in

central Florida.

303

Covering 2,691 acres, the farm produced 2,147,969 pounds of

fresh vegetables a year along with thousands of pounds of Irish and sweet potatoes,

pecans, corn, pears, watermelons, and cantaloupes.

304

Dairy and poultry farms

provided meat, milk, butter, and cream.

Maintained by its own power, sanitation, and refrigeration plants, the

hospital complex also contained its own communications department, including

telephone, telegraph, and radio. The Mattress Factory, housed in the old arsenal

magazine, used surplus cotton and ticking to produce 1,801 cotton mattresses and

1,776 pillows. Adding to the compound’s self-sufficiency were support facilities

including a canning plant, carpenter shop, saw mill, foundry, garage, and broom and

mop factory.

305

Out of Mind, Out of Sight

115

Occupational therapy was conducted in the art room of the white female

department and incorporated creative and useful activities including basketry,

weaving, painting, wood-carving, rug hooking, knitting, crocheting, and embroidery.

These crafts, sold at a price high enough to pay for the materials, proved to be

particularly beneficial for some types of mental disorders.

306

Along with the School of Nursing, two new schools were added—Medical

Technology and Attendant’s Training. These schools graduated 22 nurses along with

77 aids and orderlies.

307

In the latter part of the decade, men were admitted to the

nursing school for the first time.

308

The Dental Department made great strides during this decade as well,

offering free dental service for employees with a nominal charge for materials. It

was described as “the most modern and completely equipped [dental] clinic of its

sort in any state maintained mental institution in the United States.” Ample

reception space for white patients and employees, separate reception-room,

operating-room and sterilizing facilities for the black patients and employees, were

its most outstanding assets.

309

On the clinical side, for the first time medical staff made progress notes on

the patients following admission—weekly for four weeks, monthly for five months,

and every six months thereafter.

310

While this greatly improved the ability to follow

a patient’s progress, in another arena physicians were functioning under a severe

handicap when overcrowding at the facility produced long delays in patient’s

admittance and led to unwillingness on the part of the patients to give accurate and

complete information concerning their mental illness.

311

To help alleviate the severe overcrowding and free up beds, patients were

furloughed to their families if the physician thought the patient had recovered

sufficiently. The furlough was for one year, at the end of which the patient would be

discharged by virtue of having been absent one year on furlough. If necessary,

however, the patient could return to the institution at any time during the year.

312

Using this method, thousands of patients were furloughed over the decade.

Unfortunately, as many as one-third of the patients, unable to “make it” on the

outside, were eventually returned to the institution.

Furloughs weren’t the only way patients separated themselves from the

hospital. Reports during this time indicate that hundreds of patients escaped,

including three who eloped with their husbands. As many as 78 percent of the

escapees were found and returned.

313

Sally J. Ling

116

Above: Woodworking shop. Below: Upholstery shop. Photo courtesy of the Florida State

Hospital.

Out of Mind, Out of Sight

117

Sam Cunningham, the hospital’s clinical psychologist for 38 years, recalled

the “unwritten” procedures that followed elopements during his tenure (1950-1988):

“It depended upon who broke out. If the patient had been there a while with good

contact with reality but no one to sign him out, they would go look for him but

wouldn’t call out the National Guard; however, if others eloped, they would go

through considerable efforts to find them. One time they went looking for nine and

found fourteen.”

314

As the hospital serviced not only the needs of the mental patients but staff

and their families as well, it was not unusual for the babies of staff and their families

to be delivered by hospital doctors.

315

Most newborns were sent home; however,

incidents included the death of several infants, a patient that escaped with her

newborn son, and other patients who gave birth.

Records do not indicate whether births by patients were due to the woman

becoming pregnant before or after admittance. In all the records reviewed, there was

no indication that sexual abuse by staff caused any patient pregnancies; however,

several biennial reports noted that some babies were adopted out when the hospital

was unable to locate relatives of the patient, or the relatives were unable or

unwilling to take the child.

316

Nine-Hole Golf Course Results in Joy and Controversy

In the 1940s, Dr. J.H. Therrell, hospital superintendent, headed an

association composed of doctors, hospital staff, and local townsfolk wanting to build

a golf course on hospital grounds. With minimal dues and fees to fund the

construction and operation of the course, it started with just a few holes; but, over

the years, other holes were added until the course expanded to nine holes. The

course was named Thronateeska, meaning “giving forth,” the name the Creek

Indians gave the Flint River (the Chattahoochee and Flint Rivers unite to form the

Apalachicola River at the Georgia/Florida State line).

According to Norman “Champ” Jones, the hospital’s utilities and

maintenance supervisor from 1973-1993, Jules “Jimmy” Terrell, a horticulturalist

and hospital grounds manager, knew folks in the golf course business in Marianna,

Florida, and visited several courses to collect sprigs of grass. The association then

built dirt mound greens, planted the sprigs, and assumed responsibility for weeding

and other maintenance as required.

317

Sally J. Ling

118

Hospital staff and local townspeople played the course and became most

fond of it. In fact, it was so popular that it underwent a redesign in the 1960s. The

facility fell into jeopardy in the 1970s when Health and Rehabilitative Services

officials started looking for a location to build a new forensic unit to house mentally

ill criminals. The preferred site was right in the middle of the existing golf course.

318

Upon learning that the forensic unit would replace their beloved golf course,

Chattahoochee citizens engaged in a spirited defense. A deal brokered by Senator

Pat Thomas and Representative James Harold Thompson ultimately allowed the

forensic hospital to be built with the caveat that another golf course would be funded

in the future. Several years passed, however, with no movement toward that end.

Then, during the 1983-1984 legislative session, $200,000 was appropriated. The

new Seminole Valley Golf Club, complete with driving range and restaurant, opened

in 1986.

Carved out of undulating woodland terrain in the northernmost section of

hospital grounds, the well-manicured course was extremely popular with locals,

state officials, and anyone else fortunate to know about this “well-kept secret.”

Concealed near the forensic unit, no signs directed golfers to the clubhouse and only

those who knew of its existence were able to find it. Even so, periodic tournaments

helped raise money for the hospital’s patients, local schools, and civic clubs.

319

Jim Baraneau, who worked at the hospital since 1986, retired in 2010, and

was intimately involved in the restoration of the old powder magazine, said that true

golfers loved the course because it was a shot maker’s course: “On the par five you

used a three iron off the tee. The number one tee was in Florida and, if you hit a

decent drive, your ball would land in Georgia. You played in Georgia until your

approach shot to the number nine green.”

320

All went well until 1993 when Jenni Bergal, a Sun Sentinel newspaper

reporter from South Florida, questioned why the Florida Department of Health and

Rehabilitative Services was running a golf course. In her article “Golf Might Be

Good for One’s Mental Health, but HRS Goes Too Far,” Bergal stated: “When you

play there, you make out your check to HRS. The staffers work for HRS. Even the

scorecard bears the HRS logo. How could this be? Why are social service

employees running a golf course on the grounds of a 1,002-bed mental hospital?”

321

Amid a growing scandal that took $49,000 a year out of the HRS mental

health budget to pay salaries and benefits for employees who worked at the course

and resulted in an over $7,000 annual deficit,

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HRS leased the golf course to a man

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from Albany who ran the facility until 1994. After a flood ruined the golf course and

the man lost his home in the same disaster, the lease was turned over to a second

individual who proved unsuccessful. It was subsequently leased to a third group

from Dothan, Alabama. Unfortunately their director, who was also the most

experienced in the golf business, suffered a debilitating stroke before the course

became operational. Unsuccessful in its attempts to attract others interested in

managing the course, the hospital returned the property to the Department of

Corrections.

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Today, if you consult Google Earth, you can clearly see the nine abandoned

holes of what once was the Seminole Valley Golf Course described by Bergal as “a

gorgeous place, with hilly woodlands and stone bridges that cross over clear

streams.”

324

New State Hospital Opens

In 1947, 759 patients from the Florida State Hospital at Chattahoochee were

transferred to the remotely located 2,173-acre Florida State Hospital No. 2 in

Arcadia,

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a small town in southwest Florida. Named the G. Pierce Wood State

Hospital after a north Florida legislator who lived in Arcadia, the facility was

intended to relieve overcrowding at Chattahoochee, service long-term patients, and

those patients coming from the southernmost part of the state.

Hospital facilities were built on two abandoned military airfields—

Carlstrom Field and Dorr Field. The fields were located seven miles apart and were

used by the Army to train pilots during World War I. Decommissioned at the end of

that war, the fields were abandoned and many of the buildings sold or demolished.

With the advent of World War II, the fields were chosen as the site for a

contract pilot training school run by the Embry Riddle Academy, a civilian

contractor. New facilities were built, and both fields opened in 1942. Mark Ball, a

flight instructor at Carlstrom Field from October 1942 to October 1943, noted that

Carlstrom Field trained British pilots while Dorr Field trained American pilots.

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Over 8,000 cadets trained at Carlstrom Field, and over 700 trained at Dorr.

327

At the

end of World War II, both Carlstrom and Dorr Fields were sold to the State of

Florida for a total of one dollar and their facilities converted into the G. Pierce

Wood State Hospital.

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Top view: Dr. J.H. Therrell, director of Florida State Hospital at Chattahoochee and Terry Lee,

coordinator of State institutions inspecting wards newly opened at the G. Pierce Woods Hospital

in Arcadia, Florida. Photo courtesy of the Florida State Archives.

The facility was divided into two sections, each with its own hospital, and

staffed by two doctors, including the Clinical director and two graduate nurses. The

men’s division at Carlstrom Field received 317 white male patients; Dorr Field

received 442 white female patients.

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Among the first female patients to arrive from

Chattahoochee was Theresa Castiglioni.

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Case History

Theresa Castiglioni (Admitted April 1932, Discharged 1974)

Born in 1901, in Canada of Czechoslovakian parents, at age 17, Theresa met

and became pregnant by Spartaco Castiglioni, a blue-collar worker of Italian descent

who was ten years her senior. Married to Spartaco, Theresa gave birth at age

eighteen to their first child, Ernest D. “Didier.” In 1920, the family emigrated to the

U.S. and took up residency in Orlando, Florida. During the next eight years, Teresa

gave birth to five more children.

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After the South Florida hurricane of 1928, the

family moved to West Palm Beach because Spartaco heard there was plenty of work

reconstructing homes.

On April 4, 1930, Gloria, the couple’s second youngest daughter who was

three and a half, was pronounced dead at the Good Samaritan Hospital in West Palm

Beach. The death certificate stated: “Burned 1st & 2nd degree 3/5 of body by fire.

Clothing caught fire by child playing with matches.”

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According to Gloria’s sister Isabel, their father Spartaco was a heavy

smoker who used pack matches to light his cigarettes. One day while cleaning, the

matches were swept out into the yard where Gloria found them. Wanting to cook

some cherries, the young girl lit a match that subsequently caught her clothes on

fire. While she survived a few days in the hospital, she eventually succumbed, due

to complications from the burns.

Theresa was so traumatized by the event that she cried all the time and

reverted back to speaking French (she was French Canadian), a language the

children could not understand. She also vehemently blamed her husband for having

the matches around in the first place.

In 1931, Spartaco had Teresa placed in a local hospital for treatment. Later,

on April 21, 1932, by order of Judge Cook, she was transferred from West Palm

Beach to the Florida State Hospital.

331

Her diagnosis was listed as “chronically

insane.”

332

Dr. Larry Annis, who at the time of his interview was Chief Psychologist at

the Florida State Hospital, stated that the term “chronically insane” was not a

clinical term, because diagnostic criteria weren’t firmly established in the 1930s and

1940s. He explained that basic insanity is not being able to tell the difference

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between right and wrong and not being able to conform to the accepted mores

because interpretation of what is normal is “off.”

333

According to Isabel, her father tried to visit Theresa but she flew into a rage.

She didn’t want to come back to him, and she blamed him for Gloria’s death.

334

Spartaco never visited Theresa again, nor did he speak of her, assist in her

rehabilitation, or try to get her released. In essence, her existence vanished from

family conversation. In 1935, Marjorie Barber, a family friend, moved into the

Castiglioni home to assist Spartaco in the care of the children. She subsequently

became his common law wife and assumed his last name.

After spending fifteen years at the Florida State Hospital at Chattahoochee,

in 1947 Theresa was “furloughed” (moved) to a the facility at the G. Pierce Wood

State Hospital in Arcadia, Florida.

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She stayed in the facility until 1974 when the

deinstitutionalization process swept the state. After 42 years in the Florida State

Hospital system, she entered a nursing home in West Palm Beach and later Lake

Worth. Her granddaughter Viki White stated: “Her neglect and being there [at the

hospital] so long had made it improbable that she could be released on her own.”

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Delores and Isabel continued to visit their mother until her death in 1989.

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Arcadia’s Last Years

By the end of 1954, the Arcadia facility had 1,228 patients and, like

Chattahoochee, the facility was self-contained with water, ice, and sewage treatment

plants, and a fire department. It also had recreational and occupational therapy

departments, beauty parlor, barbershop, and sewing rooms.

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Recreational activities took place in a large hanger formerly used by the

Aviation Corps and, along with board games, included volleyball and shuffleboard.

Softball was played three times a week, and weekly dances were held with patients

at both Carlstrom and Dorr Hospitals.

The facility operated until 2002, when the decision to close G. Pierce Wood

followed a series of incidents that ended in death and injury to several patients.

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Cited in a Civil Rights of Institutionalized Persons Act (CRIPA) proposed

investigation dated March 23, 1995, the incidents included suicide by hanging, an

unobserved patient who cut off both hands, and three patients that died in a single

week.

340

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While a federal judge ruled the hospital “adequate,” state officials decided

that closing the facility would save money and that community treatment programs

and patients living in supervised apartments would result in better care.

341

James K.

Green, a West Palm Beach lawyer who waged a 17-year legal battle to improve care

at the hospital noted: “This hospital, and a lot of other state hospitals like it, is a

dinosaur. The fact of the matter is, people get better, quicker, and cheaper care when

they’re closer to their home communities and families.”

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Community-Based Treatment Advocated

During the 1940s, hope laid the foundation for the next decade. Advances

made in psychiatry during the war helped augment the theory that community-based

treatment would be preferred over mental hospitals, and the infusion into psychiatry

of young military physicians that were trained in psychodynamic concepts helped

strengthen that theory. This, along with the formation of the National Institute for

Mental Health, laid the foundation for change. It was a start, but it would take years

before these organizations established tangible improvement in care for the mentally

ill.

While the next decade saw the discovery of a new psychotropic drug that

dramatically impacted patient treatment, commitment procedures were still quite

primitive; but, that was about to change. The commitment of Kenneth Donaldson to

the Florida State Hospital in the mid-1950s set wheels in motion that would

eventually alter patient rights and admission procedures on a national level—change

that was long overdue.

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125

Photo: Hospital kitchen. Photo courtesy of the Florida State Hospital.

Chapter X

Procedural Status Quo,

Medical Discoveries

and the Wind of Change

By 1952, Chattahoochee had 6,223 patients with the average cost to maintain each

running $2.02 per day.

343

The annual budget allocated salaries for 20 physicians, but

only 12 were on staff to treat thousands of patients as well as hospital employees

and their families. Reasons for the lack of an adequate number of physicians were

many. First and foremost, only a small percentage of physicians were actually

interested in psychiatry, and this decreased substantially when institutional work

was thrown into the mix. Second, even though salaries were combined with certain

perks, they fell far below that which would attract the average physician unless he

happened to have another source of income. Finally, the isolated location of

Chattahoochee proved unattractive to men with families.

344

Exacerbating the overcrowding of the hospital was the passing of House Bill

No. 926 on May 26, 1951. Known as the Child Molester Act, the bill was to

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“provide for the sentencing, commitment, treatment, parole, release and discharge of

persons convicted of certain sex offenses against persons under the age of 12

years.”

345

Under the provisions of the act, an offense included the following: rape,

attempted rape, sodomy, attempted sodomy, crimes against nature, attempted crimes

against nature, lewd and lascivious behavior, assault (when a sexual act was

completed or attempted) and assault and battery (when a sexual act was completed

or attempted).

346

Before sentence could be pronounced, however, the trial judge required an

examination and written report. The examination was to be conducted by two court-

appointed and licensed physiatrists with five or more years of practice in the

diagnosis and treatment of mental disorders. Written psych reports were to include

the following: social history, criminal record, circumstances of the offense, physical

and mental examination, and all the facts and findings necessary to assist the judge

in passing the sentence, including the likelihood of repetition of the offense.

Once sentencing was pronounced, it was the responsibility of the

Superintendent of State Hospitals and the Board of Commissioners of State

Institutions to assign psychiatrists, clinical psychologists, and psychiatric social

workers to diagnose and prescribe treatment that would either cure or rehabilitate

those committed under this act.

347

When the law took effect, the courts began sending persons convicted of

child molestation to Chattahoochee when prior to that they were sent to the State

Prison at Raiford.

348

While the transfer of these patients dramatically increased the

patient load of the physicians, it also came with an opportunity when Princeton

University Department of Psychology asked the hospital to participate in

standardizing the Tomkins-Horn Picture Arrangement Test.

349

The test, consisting of 25-sets of three pictures, had been used since the

nineteenth-century, primarily as an intelligence test to measure “consciously

controlled rational thinking.” The subject was to arrange the pictures in any

sequence that made sense and to write a brief explanation about each picture to

explain its arrangement. The results were expected to indicate social orientation,

optimism-pessimism, and the relative strength of thinking and thought to assist in

furnishing objective criteria for the effective handling of the problem created by sex

deviates. In addition, responses given by the criminals were believed to correlate

with significant features of mental illness.

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Dorce Fulghan Dean 194.? Photo courtesy of the Florida State Hospital.

An Inside Look at Psychiatric Nurses Training

By the 1950s, the hospital offered Psychiatric Nursing Education to nursing

students from outside programs. Attending classes at the Chattahoochee hospital

campus in 1954 was Jackie (Hogarth) Humes, a nursing student studying for her

Registered Nurse license from Riverside Hospital in Newport News, Virginia.

During her three months at the hospital, she lived in a dormitory on the campus with

nursing students from other facilities and was assigned to various wards in order to

gain knowledge of different psychiatric disorders, how they affected the patients,

and what current medications and therapies proved effective.

Humes explained that the students were taken on tours of areas they were

not allowed to work in, such as the Surgical Ward. While she didn’t observe any

surgeries, she was told lobotomies were sometimes performed. Other tours included

the ‘Back Wards’ where patients too severely mentally disabled to function in

society were housed as well as the ward for the criminally insane. In the latter,

Humes was introduced to a patient called ‘The Stomper,’ who acquired her name

because she had physically stomped 13 people to death. Isolated in an individual

cell, “The Stomper,” could only be viewed through the iron bars that surrounded

her.

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Part of Humes’ training involved her assistance in the administration of

electroshock therapy. To prepare for the therapy, 20 to 30 patients per session were

lined up in a long hallway with their heads facing the center of the hall. The

students, called staff assistants, were divided into teams of six with each team

surrounding a patient’s bed. Because the shock caused an immediate grand-mal

seizure, their job was to hold the patient in place to prevent jerking movements

during the procedure that could result in head injuries or broken bones from hitting

furniture or other objects. Just before the shock was administered, an assistant

placed a “bite block” in the patient’s mouth to prevent him or her from biting or

severing the tongue or lacerating the inside of the cheeks. Once staff and the bite

block were in place, the doctor determined the strength and duration of the electrical

current, set the machine accordingly, and an RN placed the paddles on the patient’s

temples.

As soon as that patient stopped seizing, the team moved past teams

stabilizing other patients and onto the next patient in line for therapy. After the

shock, the patient would be drowsy, inactive, and sometimes disoriented 24 to 48

hours. Another side effect was brief loss of short-term memory.

When nursing students were on rounds, the instructors stressed caution and

emphasized the practice of proper protocol. For instance, to administer medications,

nurses escorted patients to the nurse’s station; and, although at times nurses were

allowed to take medications to a patient, they could do so only if a staff person

accompanied them. Another protocol observed involved the use of keys that were

only to be visible when opening or closing a door. While this became routine,

Humes recalled that hearing locks click behind her took quite an adjustment.

Psychiatric nurses training also included the interaction of students with

patients in the sitting rooms where the nurses were required to write a paper

regarding the diagnosis, treatment, medications, response, status, and prognosis for

discharge of a patient. During these times, Humes observed a number of patients

suffering from a variety of mental illnesses. One of these was a German woman

who, to the casual observer, appeared normal. On occasion, however, she would

hear voices. Going to the window, she would point out individuals (persons invisible

except to her) who were using the radio connected to the window screen (also

invisible except to her) to spy on her and plan her murder.

Other patients observed were in catatonic states. Humes said these patients

were lifted from their beds and taken to the sitting room where they remained for the

day in whatever position the patient assumed when placed in the chair. Restraints

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Student nurses attend school. Photo courtesy of the Florida State Hospital.

were used to prevent them from falling, and pads were placed beneath both the

patient and chair to catch urine and feces until they could be taken for clean-up at

regular intervals.

Humes did not become a psychiatric nurse because she felt she did not

possess the ability to deal with the “hopelessness of the patient not being returned to

family or society as a normally behaving individual.” While she did observe many

sad situations at the hospital, she was unaware of patients being beaten, burned,

starved, imprisoned in dungeons, or otherwise abused as previously reported.

On a humorous note, Humes relayed an incident her family encountered

when arriving to pick her up at the hospital one day. As they drove toward the

parking area, they observed a male soldier dressed in khaki uniform wearing high

heels, makeup (including lipstick), and carrying a lady’s purse on his arm.

351

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Case Histories

The following case histories show the variety of patients who were admitted

to the Florida State Hospital at Chattahoochee during the 1950s:

Court Admission

Miss Dohna Lousie Bushong, an indigent from Okaloosa

County, admitted on November 2, 1959.

Her mother Mrs. Mabel Lousie Clements filed the petition

for inquisition of incompetency of this 16-year-old girl on 10/2/59,

stating that the nature of her disability was “mental.” She was put

before a committee of examination consisting of Dr. Robert W.

Wienecke, Dr. Arthur W. Brown, and Ronald C. Bounous. On

October 22, the committee determined that Dohna was incompetent,

the apparent cause being Adolescent Situational Reaction (Turmoil

State), which is chronic. Her propensities were: impulse acting out

though she did not require mechanical restraint. Relatives were

legally responsible for her support, but they were not able to pay in

full for her treatment at Florida State Hospital. She was ordered to

the facility on 10/29/59.

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Admission by Certification

Mrs. Evelyn Lucile Boone, from Gadsden County.

Admitted on November 14, 1959.

Lucile, 49, lived in Chattahoochee. Her husband petitioned

for an inquisition of incompetency on 11/12/50, stating that her

disability was mental incompetency (his address was FSH

Chattahoochee, and it is inferred that he worked at the hospital).

The examining committee reported on 11/13/5, that Lucile was

incompetent, the apparent cause being extreme depression. The

particular hallucinations were: she wanted death, was no good, and

would never be well. Considered a danger to herself, she required

mechanical restraint to prevent self-injury or violence to others. She

was destitute, as was her family.

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Upon recommendation of the examining committee, Evelyn

was declared temporarily incompetent. They felt, however, that

through specialized care and treatment, she would speedily be

restored to competency. She was ordered on 11/13/59, to be

certified to the director of mental health for admission to the state

hospital for intensive care, treatment, and observation for a period

not to exceed six months.

Criminal Court Admittance

Mrs. Lucille Mary Alice Barnett, from Hillsborough

County, was admitted on November 25, 1959. She was brought in

by Sheriff Henry B. Knabel.

On 7/3/58, courts charged Mary Alice with second degree

murder. The trial was held before Honorable L.A. Grayson, and

Mary Alice was acquitted by reason of insanity. Based on the

testimony of three doctors, the court ruled that she should not be

discharged and that allowing her to remain at large would be

considered by these doctors as manifestly dangerous to the peace

and safety of the public. The court ordered that she be committed to

the Florida State Hospital until further order of the court, and that

she not be released from the hospital without consent of the court.

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Inquisition of Incompetency

James G. Burleson, from Bay County, was admitted on

November 30, 1959.

Mr. Lee Roy, father of this 16-year-old boy, petitioned for

an inquisition of incompetency on 11/16/59, stating that the nature

of his son’s disability was mental disorder. After examination on

11/17/59, the committee found James incompetent by reason of

acute compulsory sexually oriented psychosis. Mechanical restrains

were required to prevent self-injury or violence to others.

355

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132

Mr. James Alex Barnhill, an indigent from Sarasota County,

was admitted on September 9, 1959.

On 8/20/59, three citizens, Floyd G. Bowers, Jr., Ernest L.

Agnew, and William M. Boley, filed an Inquisition of

Incompetency alleging that this 51-year-old man’s disability was

mental illness. On the same date, the court entered an order to

summons a committee to examine Mr. Barnhill. The order claimed

that the disability was mental illness: disturbing the peace,

drunkenness, and attempts to kill three policemen. The committee

determined that James was incompetent with the cause being mental

illness: chronic organic brain syndrome, cause undetermined. While

Mr. Barnhill was considered homicidal, he did not require

mechanical restraint.

356

New Therapies Introduced

While the decade of the 1950s opened with new enthusiasm for what lay

ahead in the area of psychiatric treatment, ECT and insulin shock therapy were still

being used as primary responses in treating the mentally ill. Just around the corner,

however, were two new therapies—milieu therapy (therapeutic community) and

psychotropic drugs. According to Grob, “Milieu therapy had much in common with

early nineteenth-century moral treatment, namely, the belief that the environment of

the asylum could assist in the treatment of mentally ill persons and thus facilitate

their release into the community.”

357

Implementing this new therapy required a shift in philosophy, and while

some hospitals experimented with programs such as abolishing locked doors and

fences, and others included daytime care where patients returned to their homes in

the evening,

358

most hospitals weren’t quite ready to embrace such radical change.

Change was in the wind, however, and like the introduction of shock treatments and

lobotomies of previous decades, European physicians led the way.

Discovering a “Miracle” Drug

Looking for a way to reduce surgical shock in his patients, French surgeon

Henri Laborit used antihistamines (a compound used to fight allergies) to counteract

the chemicals in the brain that caused the shock. Administering strong doses, he

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133

discovered that his patients seemed less anxious about their impending surgery with

some even showing marked apathy. It struck Laborit that the effect of these drugs,

especially one called chlorpromazine (trade name Thorazine), might have

applications in psychiatry. While the psychiatric community had never used drugs

on the mentally ill and continued to avow the use of shock treatments, Laborit

doggedly touted his belief that the drug had great potential.

Psychiatrist Pierre Deniker heard of Laborit’s findings and tried

chlorpromazine on several of his most agitated and uncontrollable patients. He

reported stunning results: “Patients who had stood in one spot without moving for

weeks, patients who had to be restrained because of violent behavior, could now

make contact with others and be left without supervision.” Another psychiatrist

reported: "For the first time we could see that they were sick individuals to whom

we could now talk."

359

Meanwhile, in the U.S., Smith Kline, an American drug company, was

looking to expand its product line. Purchasing the rights to chlorpromazine in 1952

from the European company Rhône-Poulenc, Smith Kline introduced the drug into

the American market. Even though word had spread of the drug’s previously

successful use by Deniker on psychiatric patients in Europe, its debut remained

simply that of an anti-vomiting treatment.

Unsuccessful in its attempts to convince university psychology departments

and medical schools to test the new drug, Smith Kline persuaded Deniker to come to

the U.S. to help promote the product. Persuading physicians in private practice to

use the new drug fell dreadfully short of expectations, but state governments were

far more open when they learned that treating mentally ill patients with the new drug

could save money.

Testing soon commenced in state institutions with “miraculous results”

being reported on television and in other news media. Patients rapidly adjusted to

hospital society and life, there was an absence of fear of such drastic treatment as

electroshock, and there was the tendency of the tranquilizing drugs to make patients

much more willing to participate in psychotherapy.

360

These results prompted the

U.S. Food and Drug Administration to approve chlorpromazine in 1954, resulting in

its rapid spread throughout the country. The use of insulin shock (only on select

cases) and ECT waned, and patients who once had no hope were now being

discharged in record numbers.

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One of the practical aspects of the drug was the decrease in the number of

injuries patients inflicted upon themselves and in the destruction to hospital

property, including linens, mattresses, and clothing. This and other drugs weren’t the

only reason for improvement, however, as the combination of additional psychiatric

staff played a significant role.

362

For all its benefits, Thorazine was not without its side effects, some that

mimicked the uncontrollable shaking of Parkinson’s disease; still, its astonishing

benefits began a flood of research and development of new psychotropic drugs,

resulting in the virtual disappearance of psychosurgery. Grob noted that: “The

simultaneous development of milieu and drug therapies also helped to blur further

the traditional schism between biological and psychodynamic psychiatry, and thus

appeared to anticipate the reintegration of psychiatry into medicine.”

363

For all the promise milieu and drug therapies brought to state institutions,

commitment procedures, institutional practices, and daily care of patients lacked the

same advancement. It would take decades, along with a patient named Kenneth

Donaldson, to untangle the web of apathy.

Aerial view of the Florida State Hospital 1954. Photo courtesy of the Florida State Hospital.

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Kenneth Donaldson Sent to the Florida State Hospital

Born in 1908, in Erie, Pennsylvania, Donaldson briefly attended Syracuse

University, married, and had three children. Believing that people made derogatory

comments about him behind his back therefore rendering him the victim of slander

and harassment, he was committed to Marcy State Hospital for four months. Later

divorced and moving from town to town, in 1956, he was admitted to Philadelphia

General Hospital where he was treated for paranoid schizophrenia. After his release,

he traveled to Largo, Florida, where he visited his parents.

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It was there his

incredible saga began—one that lasted fifteen years.

It was December 10, 1956, when Kenneth Donaldson, 48, answered a knock

at his parent’s door. On the other side, law enforcement officials presented him with

papers signed by Jack White, Pinellas County Judge. The document, initiated by his

father William Donaldson, who believed his son to be potentially dangerous, called

for an “Inquisition of Incompetency.” The document stated that Kenneth Donaldson

was exhibiting signs of a persecution complex with “increasing signs of paranoid

delusions.”

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He was ordered to the Pinellas County Jail.

Donaldson’s Saga Begins

While in jail awaiting his hearing, Donaldson met Mable, a woman who

occupied a cell at the far end of the facility. Her story, like so many others, exposed

the gross injustice of the then existing laws that allowed individuals to be

incarcerated for unacceptable, yet innocuous, behavior.

According to Donaldson, Mable had sunbathed in the nude in her own back

yard that was shielded from her neighbors’ eyes. Yet, just knowing she was doing it

was apparently enough to justify her arrest. She was first sent to the St. Petersburg

jail where she was confined in a ‘strip cell’ without clothes, food, or water, and

where she caught urine in her hands to drink. Then, without a hearing, she was sent

to Chattahoochee.

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In another case, the police detained and searched the car of Aaron, a

locksmith, who had moved to Florida from New York. During the search, officers

found an unlicensed gun that Aaron claimed he needed for protection. Despite his

protests, he was taken to the Pinellas county jail. Once there, his objections became

so raucous and persistent the police suggested he belonged in Hollywood State

Hospital rather than jail (Hollywood State Hospital, known officially as the South

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Florida State Hospital, was part of the state hospital system). Now considered a

criminal, he, too, was sent to Chattahoochee.

367

Donaldson was housed in the Detention Ward of the Pinellas County Jail for

several weeks prior to his hearing. While there, he underwent a competency hearing,

engaged in numerous verbal and written appeals for his release, and was involved in

other discussions regarding his sanity and unlawful confinement; but, in the end, he

was sent to the Florida State Hospital at Chattahoochee where he was admitted on

January 15, 1957.

368

His state of mind at time of incarceration included delusions of

being persecuted and claims that “rich Republicans” were poisoning his food.

Doctors at Chattahoochee listed his diagnosis as “schizophrenic reaction, paranoid

type (Psychotic).”

369

Donald said of his situation: “In three months, I had come from the

supposedly free streets of Pinellas County to Coventry. I had appealed for justice to

many people. I was as important as a fly on a basketball hoop.”

370

During his fifteen years at Chattahoochee, Donaldson tenaciously tried to

convince doctors, and anyone else who would listen, that he was not insane and had

been denied a writ of habeas corpus. (A writ of habeas corpus is a judicial mandate

to a prison official ordering that an inmate be brought to the court so it can be

determined whether or not that person is imprisoned lawfully and whether or not he

should be released from custody. The petition must show that the court ordering the

detention or imprisonment made a legal or factual error.)

371

Eventually, Donaldson engaged the services of a competent attorney and

sued several prominent doctors at Chattahoochee. Events leading up to that lawsuit

and results of the hearing will be discussed in subsequent chapters, as this case had a

profound effect on the mental health care system in Florida and throughout the

country.

Dr. William DeWitt Rogers Appointed Superintendent

Dr. William DeWitt Rogers was one of the most dedicated and influential

men to serve at the Florida State Hospital. A native of Kensington, Georgia, he

graduated from the Medical College of Georgia in Augusta in 1933, and began his

practice at the Florida State Hospital in 1934. In 1940, he became clinical director

and served in that capacity until 1950, when he was named superintendent. He later

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Dr. W.D. Rogers, Superintendent, and J.C. Gissendaner. Photo

courtesy of the Florida State Hospital.

became the first director of Florida's Division of Mental Health in 1962, and served

there until his retirement in 1974.

During his service with the Department of Children and Families, he

established Florida's first statewide community mental health system and led the

effort to establish mental health treatment programs for children and the elderly

statewide. During his tenure as Director of the Division of Mental Health, he was

responsible for the administration at both the Florida State Hospital at

Chattahoochee and G. Pierce Wood Memorial Hospital in Arcadia. Additionally, he

was responsible for the development, implementation, and administration of the

South Florida State Hospital in Hollywood/Pembroke Pines and Northeast Florida

State Hospital at Macclenny. He was involved in the planning and first phase

construction of the Florida Mental Health Institute at Tampa and the establishment

of an Evaluation Center at Gainesville for mentally ill offenders.

372

Sally J. Ling

138

For his service, Rogers received numerous awards including the Allen

Morris award and the Most Effective State Administrator Award during 1957,

Meritorious Public Service Award, National Association for Mental Health

Distinguished Service Award, Florida Rehabilitation Association Professionalism

Award, and Mental Health Association of Florida Distinguished Service Award.

Along with his wife Mary and his two sons William DeWitt Rogers, Jr. and

John Bowen Rogers, he lived in what is now the William DeWitt Rogers

Administration Building. The Rogers family, the last to use the structure as a

residence (1950-1961), moved into their new home when the Florida Legislature

subsequently appropriated funding for its construction on hospital grounds. Their

former home was converted into the administration building. (See Appendix for an

interview with Mary Rogers.)

On September 14, 2007, over 100 people , including legislators, judges,

family, and friends of the late William DeWitt Rogers gathered outside the

administration building when Governor Charlie Crist dedicated the building in

Rogers' honor. (The William DeWitt Rogers Administration Building currently

houses hospital administration and is commonly referred to by hospital employees

as the "White House." See page 10.)

373

State Hospital System Expands

As Florida’s population grew, the Legislature realized that the Florida State

Hospital system needed to expand in order to alleviate overcrowding at

Chattahoochee and to become more accessible to patients throughout the state. At

the same time, they realized the need for a responsible group to oversee the system.

The Division of Mental Health began functioning in July 1957. It was charged with

the supervision of all state hospitals for the mentally ill.

374

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139

Chapter Photo: Outside the Administration Building at the South Florida State Hospital,

Hollywood, Florida. ca. 1960. Photo courtesy of the Francis Pou Collection.

Chapter XI

Two New State Hospitals Added

South Florida State Hospital/Hollywood

Hollywood, Florida, (between Fort Lauderdale and Miami) was tapped as the first

city where a new South Florida State Hospital would be built under the Regional

Hospital Plan because of the area’s rapidly expanding population (1,250,000 in

1956).

Like the hospital in Arcadia, the South Florida State Hospital was built

where barracks once stood on an old World War II military base—North Perry

Airfield. The U.S. Navy originally constructed the airfield in 1943 for use as a

satellite training facility of the Miami Naval Air Station. North Perry serviced flight-

training activities until the end of the war when it was decommissioned. Broward

County acquired the land in 1950. The airfield was renamed North Perry Airport and

continues to operate today as a general aviation airport dedicated exclusively to

private and light-plane business activity.

375

Sally J. Ling

140

The South Florida State Hospital covered three hundred acres west of the

airport and was constructed at a cost of over $5 million. The hospital was activated

on March 1, 1957, when 20 patients arrived from Chattahoochee while another 11

patients were transferred from the G. Pierce Wood Memorial Hospital in Arcadia.

Also admitted were patients from the surrounding counties of St. Lucie, Martin,

Palm Beach, Broward, Dade, Monroe, Collier, and Hendry.

376

Arnold H. Eichert,

M.D., became its first superintendent. (With the re-zoning of Hollywood’s city

limits in 1960, the hospital became located west of Hollywood in the newly created

city of Pembroke Pines.)

Similar to the overcrowding experienced by the hospital at Chattahoochee,

by the end of 1958 the Hollywood hospital housed 572 patients although current

buildings were designed to care for only 484. There was some good news though.

Because the hospital was located in an area with a large and growing population and

was close to the University of Miami’s teaching hospital, the South Florida facility

was able to fill its available positions with well-trained and capable personnel. In

addition, the hospital established teaching programs at the University of Miami

hospital in a variety of disciplines, including psychiatry.

377

A number of young adult patients necessitated the inclusion of schoolwork

into the hospital curriculum. Textbooks and school supplies were donated, and a

volunteer part-time teacher assisted with the teens’ education. To encourage female

patients to take a personal interest in their appearance and overall wellbeing, a

Charm School was added to the facility. Over 200 female patients benefited from

hearing guest speakers present a variety of topics on personal hygiene and social

etiquette. They also enjoyed the use of donated cosmetics and other supplies. To

better prepare the young men and women to deal with obtaining employment once

they were discharged, a business school was established with donated typewriters

and office equipment.

378

The hospital operated under the state’s care until the late 1970s, when

patient abuse, sexual misconduct by state employees, and lax security led to an

investigation by a Broward County grand jury and the U.S. Department of Justice.

The investigation branded the hospital a “warehouse for the mentally ill” with the

grand jury describing it as a “‘loosely knit conspiracy’ to turn the hospital’s staff

into a ‘haven for homosexuals. . .’” The conditions were so bad that one ward was

put under the oversight of a Broward County judge.

Shortly thereafter, Governor Bob Graham recruited Robert Burton, an

administrator with Jackson Memorial Hospital in Miami, to run the facility. Not

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141

wanting to become a state employee, Burton formed Amerimanage, Inc., and

received a two-year $1.1 million management contract in which an 11-person team

oversaw the 1,200 patients.

The contract was very controversial. First, it gave a private firm control of a

state institution; and second, the contract was awarded without competitive bidding.

After the first year, however, a grand jury report noted that, while the hospital was

“far from what it could be, or should be,” it had improved dramatically. This

prompted the state to renew the Amerimanage, Inc. contract and even to propose a

contract to help run the Northeast Florida State Hospital at Macclenny.

379

Amidst reports of group nudity, neglect, staff overload, and patients living

in terror, the state regained control of the hospital in 1987 as a cost cutting

measure.

380

Then, in 1993, under threat of a class action lawsuit, the state announced

plans to shut down the 349-bed hospital, citing that it would be a multimillion-dollar

investment to bring the institution up to higher standards.

381

The South Florida State Hospital continued to operate with state employees

until November 1998, when the state turned the hospital over to Atlantic Shores

Healthcare, later renamed GEO Care. As part of the company’s contract with the

Department of Children and Families, a new state-of-the-art hospital was built in

2001. Currently, the Boca Raton-based GEO Care, a mental health subsidiary of the

GEO Group, Inc., is under contract with the Department of Children and Families

(DCF) for the management and operation of the hospital.

382

Northeast Florida State Hospital/Macclenny

In 1955, the state legislature authorized the construction of the Northeast

Florida State Hospital (NEFSH) at Macclenny, Florida, 35 miles west of

Jacksonville. It wasn’t activated, however, until 1959, when the necessary funds

were appropriated. The purpose of the hospital was to relieve overcrowding at

Chattahoochee and to service patients in the northeastern portion of the state. J.T.

Benbow, M.D., then clinical director at the Florida State Hospital at Chattahoochee,

became its first superintendent. Similar to the Hollywood facility, Northeast Florida

State Hospital was able to attract and retain qualified staff because of its proximity

to a large population in Jacksonville.

On August 17, 1959, 74 patients from Chattahoochee transferred to

Macclenny that had the capability of 475 beds.

383

In its first 10 months of operation,

Sally J. Ling

142

the hospital admitted 879 patients; and by 1960, it had a population of 363.

384

Wards

were small, with no ward containing over 38 beds, and patients enjoyed the facility’s

open hospital policy that allowed them to have as much freedom on the grounds as

possible, based upon their mental condition.

385

Similar to patients at Chattahoochee and Arcadia, patients at the Hollywood

and Macclenny facilities were segregated by gender and race with each group

having its own kitchen, dining room, and therapy facilities.

386

Each of the new

hospitals was mostly self-contained, with its own support services, amenities, social

service department, and variety of therapy departments.

In March 1963, the hospital sent a registered nurse and a psychiatric aide to

the Veterans Hospital in Tuscaloosa, Alabama, to attend the formal training course

in “remotivation,” a program designed to inspire patients to get well. The course

sponsored by Smith, Kline & French Laboratories was presented under the auspices

of the American Psychiatric Association. When the two staff members returned,

they started a training course at the hospital, and, in June 1963, the program began

with a total of 47 aides and two RNs. The department took over an area that was

once a small canteen and converted it into a combination kitchen and library

equipped with kitchen equipment, a record player, and books. The remotivation

aides conducted two sessions a week with patient groups for a period of six weeks.

After consultation with psychiatrists and other team members, they then made

recommendations for selected patients to transfer to group therapy.

387

This program, which was originally designed to meet the need of a geriatric

as well as a chronically withdrawn group of patients in a State Hospital, was

expanded and modified to suit the hospital’s needs, and eventually became the

forerunner to formalized group therapy that introduced patients into group

interaction much more quickly.

388

In 1987, Governor Bob Martinez proposed turning the Northeast Florida

state hospital into a prison, a move that would necessitate the release of hundreds of

mental patients into the community. Legislators from across the area vehemently

opposed the plan. These included Representatives Corrine Brown (D-Jacksonville),

who called it, “. . . the worst thing I’ve ever seen,” and Representative Mike

Langton (D-Jacksonville), who remarked, “That is a high-security prison for the

mentally ill. They aren’t the kind of people you can release.”

389

Eventually, the

proposal died.

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143

Three years later, safety concerns at the facility surfaced prompting the state

to provide an additional $4.2 million to add 120 employees. Treating 575 patients at

any given time, the Northeast Florida State Hospital was the largest of the three state

hospitals that treated mentally ill patients committed through civil court

proceedings; yet, with 1,130 employees, it ranked last among the institutions in

number of staff. The addition of 10 psychologists and 10 nurses, along with

additional staff, was intended to reduce a patient’s length of stay which at the time

averaged around 18 months.

390

In the year 2000, the Northeast Florida State Hospital was the recipient of

the Governor's Sterling Award for Organizational Performance Excellence. It has

also been awarded numerous Davis Productivity Awards, and achieved accreditation

from the Commission on Accreditation of Rehabilitation Facilities (CARF).

391

In an effort to save money, privatization of the hospital by GEO Group was

under consideration in 2006. Over the next couple of years, however, opposition by

Florida legislators, Baker county leaders, as well as hospital staff and residents

picked up momentum, and by 2009 all negotiations were abandoned.

392

Today, Northeast Florida State Hospital serves Children and Families in 30

Florida counties by providing continuous service to persons with severe and

persistent mental illness. With 633 beds, it is the largest state-owned provider of

psychiatric care and treatment to civilly committed individuals in Florida and is the

largest single employer in Baker County. Referrals are based upon community and

district priorities for admission.

393

Chattahoochee Still in Dire Need

Although the new hospital at Macclenny afforded some much needed relief

to the hospital at Chattahoochee, the admission rate at Chattahoochee experienced

no appreciable decline. This was explained by the fact that the relief they expected

was offset by increased admissions due to Florida’s expanding population.

394

Steady

admissions weren’t the hospital’s only problem. Maintaining an adequate medical

staff continued to plague the institution, both in numbers, and in the quality of

training and adaptability to institutional standards. This was attributed to the fact

that the supply of physicians and psychiatrists had not kept pace with demand.

395

Sally J. Ling

144

Park Trammell Building. Photo courtesy of the Florida State Hospital.

Admissions by Certification

In 1959, the legislature authorized admissions by order of certification. This

allowed for the temporary hospitalization of mentally ill patients not to exceed six

months. If more than six months was needed, commitment by the County Court was

required. In addition, no longer were those who were senile, addicted to drugs or

alcohol, intellectually challenged, epileptic, a nonresident, or those subject to

pending criminal charges allowed to be certified to a state hospital.

396

While this helped reduce new admissions, unfortunately, it left those who

fell into one of these groups who were already committed to state hospitals,

especially the aged, vulnerable to longer stays. Housing a large number of elderly

non-mentally ill patients was just one of the problems plaguing the Chattahoochee

institution. Once again, rumors of patient mistreatment reached the Legislature, and

on February 1, 1961, an investigation of the allegations began.

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145

Chapter Photo: William Dewitt Rogers Administration Building. Photo courtesy of the Florida State

Hospital.

Chapter XII

Investigation and Changes

In 1961, the Committee on State Institutions was charged with conducting a

thorough study of the allegations of patient mistreatment at the Florida State

Hospital at Chattahoochee. Over the next three months, the institution was reviewed,

doctors, attendants and patients gave statements, and recommendations were made;

however, the final portion of the study—investigating the accuracy of the

statements—never took place. This, the Committee believed, was the responsibility

of the executive branch, not the legislative branch, so the Committee made all

reports available to the Governor’s office so it could further investigate the

allegations. There is no indication this ever occurred.

397

The Investigation

The Committee report indicated that, in general, the hospital had made great

improvement, noting that the overall atmosphere was relaxed, the wards spic and

span, no overcrowding existed and the doctors and nurses were able to provide

Sally J. Ling

146

adequate care to the patients. They did cite, however, the complete obsolescence of

the White Male and White Female Departments as possible contributing factors to

the allegations of patient mistreatment. The buildings housing many of these

patients were original to the arsenal (completed in 1839) and contained such

outmoded facilities as “toilet troughs” that were used in World War I. The main

concern, though, was with the white Male Department, as this was where most of

the complaints originated.

398

In this department, 1,000 patients were distributed among 10 crowded

wards, ranging from 82 to 192 patients each. There was virtually no segregation as

to type of mental illness, age, health, or charge patient (35 percent had been charged

with a crime). Thus, the feeble elderly were housed among teen-agers, psychopaths,

and criminals, ranging from forgers to rapists and even murderers.

Because criminals, some quite violent, were mixed with non-charge

patients, attendants believed their energies needed to be focused on maintaining

order among the charge patients rather than aiding and caring for the needs of all the

patients. This led to the implementation of strict security, more than what would

normally be required. In light of this, the Committee concluded that the wards were

operated more like detention facilities for inmates than hospital wards for the sick.

They recommended that charge patients be isolated from the non-charge patients

and that current structures be remodeled or replaced.

399

It wasn’t until the middle of

following decade, however, that a forensic unit to house the criminally mentally ill

was finally built.

Complaints from patients, corroborated by the testimony of dozens of

attendants, included: stolen packages, loss of mail, lack of medical treatment and

occupational therapy, teasing, physical violence such as choking and beating,

prolonged confinement in solitary “strip cells,” and the use of punitive wards such

as “the squad.”

“Strip cells” consisted of solitary unfurnished cells that were used to isolate

a patient who proved to be of danger to himself or others. The squad, on the other

hand, was a portion of Ward 8 that was set aside so attendants could more closely

supervise those who were highly disturbed or trying to escape. Testimony indicated,

however, that it was used for much more than that. These two areas alone were

responsible for a number of suicides.

400

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147

Testimony

Delbert Evans, a former patient of the hospital who lived in Tampa at the

time of the study, testified before the committee. Referring to himself as a “victim”

rather than a patient, he said the authorities had carte blanche to do “anything under

the guise of treatment no matter how inhumane.” He went on to tell the Committee

he had personally witnessed patients being given shock and ice pack treatments or

put in steel hand cuffs, some up to six months at a time, not as treatment but because

they had escaped or tried to do so. He also said that the squad was where most of the

beatings and brutal treatment occurred.

One former patient Guy W. Hoagland even wrote a letter to President John

F. Kennedy to complain about the brutality, lack of medical treatment and

rehabilitation programs, unpalatable food, and violation of Federal laws regarding

mailing privileges for inmates in state institutions. He concluded that widespread

graft had permeated the hospital administration.

401

Other non-charge patients expressed feelings of total despair over ever

being released from the institution. These were patients who felt trapped because

they did not have anyone on the outside to accept responsibility for them, so they

continued to languish in the facility for years, even though they were able to be

treated or cured and eligible for release.

402

Thirty-three white and black, male and female patients gave testimony to

the Committee, as did 18 attendants. Many of the attendants were reluctant to speak,

fearing physical retribution or the loss of their jobs. Because of this, Committee

Aide John J. Parker met with attendants off hospital grounds where they more freely

shared their experiences. Those that gave statements indicated that the low morale

among attendants was due, in part, to believing they were receiving only subsistence

wages. The average take home pay of an attendant at the Florida State Hospital was

$1,700 per year whereas other institutions, such as the Appalachee Correctional

Institution, paid their attendants $600 to $1,200 more per year. This forced most

Chattahoochee attendants to supplement their incomes with outside jobs, some

working on area farms.

403

Attendants seemed well aware of patient mistreatment, with almost all of

them having either heard of or having witnessed firsthand the common restraint

technique of “choking out a patient.” Not surprisingly, few confessed to having used

it themselves. They did, however, describe some of the conditions at the hospital

that led to such abuse.

Sally J. Ling

148

Jeff R. Spooner, an attendant, explained that he felt there weren’t enough

attendants to look after the needs of the patients and that the hospital was “one big

mass of family ties,” leading to the opportunity for patients to be easily framed. He

had knowledge of attendants who permitted homosexual acts among the patients,

times when medical attention was withheld, and intimated that administrators,

including Dr. Rogers, seemed disinterested in addressing these issues.

Attendant Alvin Mercer addressed the fact that patients weren’t getting the

treatment they deserved, citing his observation that there were some patients who

hadn’t seen a doctor for months. He also noted that there was neither a doctor nor

nurse on the floor after 3:00 p.m.

The doctors assigned to the white Male Department were Dr. Wilfred J.

Char and John Gumanis. These two doctors, along with the attendants, were entirely

responsible for the care and treatment of the 1,000 patients. No nurses were assigned

to the ward.

Both physicians felt overwhelmed by the workload and recommended hiring

another doctor and adding nurses. They also recommended that charge patients

(patients charged with a crime) be removed from the hospital. Aside from the fact

that Gumanis noted some patients had not been outside in three months, neither

doctor indicated they had knowledge of physical abuse of the patients.

404

Recommendations

One of the most important recommendations made by the Committee was

for the establishment of a Personnel Department and the hiring of a personnel

director who would be directly responsible to the hospital superintendent. This

department would establish job descriptions and hire employees based on

qualifications and experience. Other recommendations included: establishing pay

scales, removing charge patients from the hospital, adding more attendants, male

nurses and medical assistants, establishing an occupational therapy program,

refurbishing antiquated facilities, and segregating patients by conditions of health.

405

Aged Patients Overwhelm System

By 1962, patients aged 65 and older represented 26.1 percent of patients in all state

hospitals in Florida, an increase of over ten percent over 1952.

406

By 1964, that

number had risen to 27.6

407

percent, as the hospital increasingly became the

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149

Pearl Trammel (left front), black female Aides, 192?. Photo courtesy of the Florida State Hospital.

repository for those suffering from senile brain disorder—Alzheimer’s and

dementia-related conditions. (Dementia is a continually declining disease where no

rehabilitation is possible. Some dementia symptoms can be caused by medications

that can be adjusted, but dementia is a deteriorating disease.)

Like many Floridians, Robert B. “Bob” Williams, former Florida State

Hospital administrator (1978-1980, 1981-1987, 1993-1999), had a grandmother who

suffered from Alzheimer’s. While the family cared for her at home for many years,

eventually they were no longer able to do so, and the family placed her in the

Florida State Hospital because there was, “simply no alternative for people in her

situation.”

408

She died in the hospital in 1967.

To counter this explosion of elderly into the mental health care system, a

pilot program was initiated by the State Welfare Department to place the elderly in

approved Foster Homes.

409

Unfortunately, the program didn’t catch on. Records

indicate that from 1962-1964, only two patients were released on Foster Home

Care,

410

but the lack of success didn’t dampen the state’s increasing emphasis on

rehabilitation and returning patients to the comfort of their homes.

Sally J. Ling

150

White male yard, 1950s. Photo courtesy of the Florida State Hospital, Florida State News

Bureau, Tallahassee.

With 30.5 percent of the patients 65 years or older by 1966, the State

Welfare Department assigned 23 welfare personnel to the hospital in hopes of

reducing the elderly population through suitable placement in select nursing

homes.

411

In addition, amendments to the Social Security Act in 1965 made it

possible for assistance payments to persons 65 or older residing in mental hospitals.

Overseeing this program were the new employees of the State Welfare

Department.

412

The Courts and Medicare

During the 1960s, courts around the country began to hear legal cases

relating to the mentally ill. In response to questions presented during these

procedures, “Courts defined the right to treatment in the least restrictive

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151

environment; shortened the duration of all forms of commitment and placed

restraints on its application; undermined the sole right of psychiatrists to make

purely medical judgments about the necessity of commitment; accepted the rights of

patients to litigate both before and after admission to a mental institution; and even

defined a right of a patient to refuse treatment under certain circumstances.”

413

With the passing of Medicaid in 1965, states shifted care of elderly persons

with behavioral symptoms from mental hospitals to chronic care nursing facilities;

yet, many of the facilities had no psychiatric care, resulting in an increased death

rate. Nevertheless, this proved to be a popular alternative because the federal

government incurred a large percentage of the cost of care.

414

By the late 1960s, the population of geriatric patients at Chattahoochee and

other state hospitals in Florida began to reach critical levels. To deal with the

problem, a special Task Force on Geriatrics was commissioned by the Secretary of

State, Chairman of the Cabinet Committee on the Division of Mental Health. The

task force was to work with the Division of Mental Health and State Department of

Public Welfare to study the situation in detail and propose a solution.

Operation Hope

The Task Force suggested “Operation Hope” in 1968, a pilot project

designed to achieve two goals. First, it was to reinforce the premise that most

geriatric patients could be better cared for in nursing homes, boarding homes, foster

homes, and sometimes, independent living in their own homes. Second, it was to

devise an innovative and improved statewide system of evaluating geriatric patients

in their local communities in order to eliminate unnecessary admissions to the State

hospitals.

415

While it was anticipated that Operation Hope would reduce overcrowding in

state hospitals, the bigger hope was that this project would eliminate those who, in

the past, were admitted with physical ailments (epilepsy, senility, etc.), and only

admit those who were actually suffering from some type of mental illness.

416

Financing for the project was approved by the Board, and up to $100,000 was

budgeted from the Division of Mental Health Trust Fund (monies from existing

revenues allocated to the Division of Mental Health and the Welfare Department).

The joint project by the Division of Mental Health and the Department of

Public Welfare located in Orange, Seminole, Brevard, Osceola, and Volusia

counties, limited the program to the 100 persons already in the state hospitals or

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152

those whose commitment proceedings had already been initiated. In 1969, there

were 78 referrals, 36 complete placements, and nine ready to be placed.

417

Florida Division of Mental Health

By authority of the 1965 Florida Legislature, the Division of Mental Health

with Dr. William Rogers at its helm assumed the responsibility for the Community

Mental Health programs formerly administered by the State Board of Health. Beside

the challenge of organizing the new department, the primary mission was the

implementation of the federal Community Mental Health Centers Act that allocated

matching funds for the construction of community mental health centers.

418

The Division prepared a State Plan for Construction of these centers; and,

by July 1, 1966, eight new construction projects had been accepted. This positioned

Florida among the first states in the country to institute this type of program and

proved a major step toward providing Florida residents a comprehensive

community-based mental health care program, one that included the dispensing of

psychiatric drugs.

The program began on January 1, 1966, and allowed outpatient clinics and

Public Health Officers all over the state to dispense psychiatric drugs to indigent

patients released from the state hospitals. As the drug distribution program needed to

be overseen by a registered pharmacist, the pharmacy of the Florida State Hospital

at Chattahoochee was selected to distribute the drugs. While the State Board of

Health restricted the drugs to only those patients released from the state mental

hospitals, a plan was immediately put into place to expand the program to include all

indigent patients receiving treatment for mental disorders. The plan was also

extended for the next two years.

419

ECT Gives Way to Drug Therapy

While changes were made outside the hospital, procedures inside the

hospital were evolving as well. ECT, still used in select cases of agitated depression,

acutely disturbed patients, and patients with suicidal tendencies, gave way to drug

therapy that soon became the primary treatment with remarkable results. Coupled

with new techniques and programs, the use of these drugs was highly effective in

reducing the length of hospitalization.

420

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153

As noted earlier, the use of drugs also proved exceptionally valuable in

rendering the patient receptive towards psychotherapy and other related therapies.

One of those therapies was Industrial Therapy, the placing of patients in various jobs

throughout the hospital.

Industrial Therapy Initiated

A total of 649 patients were placed in various occupational areas throughout

the hospital at Chattahoochee under the Industrial Therapy program. Some were

trained as dental and laboratory assistants while others worked on the grounds and at

the homes of staff living on the hospital campus. Attending psychiatrists referred

patients to the program, and those who worked were paid a stipend by the hospital

with some money set aside for patient use after discharge.

421

Of those participating

in the program, 438 were released into the community.

422

Assigned to the home of Clinical Psychologist Sam Cunningham was a

black patient from St. Louis, Missouri, named Eulish Pratt. A chronic alcoholic, he

became delusional when he drank, but, once diagnosed, he received appropriate

treatment and remained at the hospital until he was able to control his drinking.

423

A handyman with no education, Pratt reported to the Cunningham home

three mornings a week to perform odd jobs. Cunningham recounted that one time

his wife gave him a wheelbarrow that had all the pieces but wasn’t put together. One

morning Pratt came in and assembled it without an ounce of trouble. He also played

with the Cunningham children and told them stories.

When Pratt was discharged, the hospital sent him on his way with a small

amount of money and a bus ticket. Wishing him well, the Cunningham family

accompanied him to the bus terminal. The last thing they remember is Pratt’s head

stuck out the window and waving a fond goodbye. Cunningham recalled “it was

very touching.”

424

Unfortunately this particular program, which proved so valuable to the

patients, was terminated after only a few years because some saw it as

discriminatory since most of those in the program were African Americans.

425

New Buildings and Programs

The hospital at Chattahoochee continued to undergo physical improvement

as many of the old and outdated buildings that previously housed patients

426

gave

Sally J. Ling

154

Construction Department, 1950s. Photo courtesy of the Florida State Hospital.

way to new ward buildings to accommodate over 900 men. Future plans called for a

new kitchen and dining room, renovation of the General Kitchen, construction of an

Administration Ancillary Services Building, and additional staff housing.

The Department of Nursing Education now included a course in Psychiatric

Nursing for student nurses enrolled in six basic schools of nursing. In addition, the

hospital provided clinical facilities for learning experiences in psychiatric nursing

for a four-year collegiate nursing program, and for two two-year associate nursing

programs.

427

After the sudden death of two supervisors and the loss of another by

resignation, the Horticultural Department merged with the Sanitation Department.

The results of this six-month trial proved most satisfactory. Propagation of plants—

especially azaleas, camellias, viburnum, boxwood, philodendron, lilies, and other

decorative plants

428

—was initiated. As a result, the hospital grounds blossomed into

an oasis of beauty among the scrub pines and Spanish moss covered oaks, especially

in the spring.

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155

Two major changes occurred simultaneously during the 1960s. The first was

total integration of the state hospitals, both in patients and personnel.

429

The second

was the establishment of a Personnel Department to oversee the 2,269 authorized

positions. With an average turnover rate of 17 percent, personnel staff had their

hands full terminating the services of 693 employees and filling 947 positions.

430

One of those positions was for a new Superintendent. As Rogers moved on to his

new position as director of Florida’s Division of Mental Health, Dr. J.B. O’Connor

became the Superintendent. He would go on to play an important role in Kenneth

Donaldson’s struggle for justice.

Kenneth Donaldson Continues His Fight

During his confinement at Chattahoochee, Kenneth Donaldson observed and

experienced the worst the hospital had to offer. After years of mistreatment—bread

with “spots of mold, as big as a silver dollar,” patients beaten, others given incorrect

and debilitating medicine, and patient deaths from abuse—a fellow inmate of

Donaldson’s suggested a patient riot. Quelling the undercurrent of discontent,

Donald convinced the patients that exposing hospital conditions in public court

would accomplish far more than risking the lives of attendants and patients if a riot

were to take place.

Throughout his ordeal, Donaldson continued his campaign to obtain a writ

of habeas corpus

431

by documenting, in code, his experiences and writing letters to

Superintendent O’Connor, Director Rogers, the chief justice of Florida, and

Governor Farris Bryant. When his petitions failed, he wrote, “As nothing ever

developed to help me after the pleas by Congressman Rodino and Governor Bryant,

and as my follow-up letters went unanswered, is it any wonder that I thought there

must be something sinister about the ‘sound barrier’ I could never quite

penetrate?”

432

Superintendent O'Connor, who served during most of this period, refused to

release Donaldson, even though the hospital staff had the power to do so. O'Connor

stated that, “Donaldson would have been unable to make a ‘successful adjustment

outside the institution,’” although at the eventual trial O'Connor could not recall the

basis for that conclusion.

433

Because of his persistence in obtaining justice and the “heat” he was taking

for it from administrators to attendants, Donaldson was transferred from ward to

ward. On each, a different doctor evaluated his condition and treated him

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156

accordingly, even if the treatment plan differed greatly from that of the doctor on the

previous ward. In one such incident, Donaldson described his experience with

Thorazine:

A 50-mg tablet of Thorazine three times a day was the dosage. I

held the first tablet under my tongue until I could spit it into the

toilet. At the second meal, attendants threatened me with the needle

if I spit out another. The Thorazine caused a narrow purple ring

beneath each eye by the second day. The third day it covered both

eye sockets and a spot on the left nostril. I sent word to the doctor

but was not called.

My hopes were at an all-time low. This was how Carter and Vittorio

had been taken care of [other patients at the hospital].

Then, again, a miracle. On the fifth morning, I went to sickbay and

the pill man took me in to Hanenson. The doctor discontinued the

medication. That was Thursday, and the spots were gone by

Saturday.

434

As Donaldson’s struggle moved through the 1960s, the national political

and medical landscape regarding psychiatric hospitals began to change.

New Perspective on Institutionalized Mental Health Care

In The Mad Among Us, Grob noted that the mental health system had

undergone a series of dramatic postwar changes. Emerging from this change was the

belief that community care and treatment of the mentally ill was far superior to

confinement in remote custodial mental hospitals; however, this new philosophy

failed to become the panacea it was intended to be. Stated Grob: “The unmet needs

of severely and persistently mentally ill would force a fundamental reevaluation of

mental health policy after 1970 when new demographic factors and a different social

and political environment combined to transform both the nature of the problem and

the context in which policy was formulated.”

435

Little did Donaldson or the Florida State Hospital know that they would

soon take center stage in changes that would come to pass in this arena, both in

Florida and the U.S. during the 1970s.

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Chapter Photo: Front of the Forensic Admissions building. Photo courtesy of Joe Blanton, Florida

State Hospital.

Chapter XIII

Landmark Changes Come to Florida

The national trend, prior to 1970, was to confine the mentally ill to state institutions

where their care and treatment was centralized and their numbers invisible to the

community at large. But, in the decades that followed, that trend gave way to

deinstitutionalized mental health care services. This allowed hospitals to discharge

large numbers of patients into community-based programs—a system in its infancy.

Young adults who had spent extended periods in mental hospitals suddenly

found themselves discharged without the functional and adaptive skills to cope on

the outside. Alcoholism and drug abuse became rampant within their populous and

their explosive and defiant behavior

436

only intensified the problem as these young

adults became the decade’s homeless. For all the help available in community-based

clinics to these young adults and those newly diagnosed as mentally ill, there were

countless other patients in the state institutions and at Chattahoochee who still

fought for release.

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158

Donaldson’s Struggle Nears the End

Donaldson struggled for decades with every fiber of his being to get his day

in court. Now, with the engagement of a competent attorney, his case moved, though

decidedly slowly, through the Florida courts. A legal brief, dated March 24, 1971,

presented to the United States District Court, Northern District of Florida,

Tallahassee Division, was a three-part petition filed by Dr. Birumbaum on behalf of

Donaldson. It sought Donaldson’s release through habeas corpus, asked for

$100,000 in damages, and was filed as a class action “in favor of all other

involuntary patients in Chattahoochee, asking for a declaration that Florida

commitment statutes were unconstitutional, and asking for an injunction barring the

hospital staff from holding patients without adequate treatment.”

437

Before the case was heard, Dr. Walls, who became acting superintendent

when Dr. O’Connor retired, called Donaldson into his office for a chat. He described

to Donaldson his frustration with the role that Chattahoochee and other state mental

hospitals played in the care of the mentally ill:

These hospitals should not be trying to be everything. I have

watched it over the last ten years. First, it was OT [occupational

therapy], then industrial training and education. If a man can’t read

and write, it should be the job of his home county and not that of

Gadsden. Similarly, if he wants to be an auto mechanic, some other

unit of state government should teach him. It should not be the job

for a hospital. We need to get down to fundamental questions. What

is the purpose of this hospital? It should not be a dumping ground

for every county in the state for their geriatrics and morons. They

don’t belong in a psychiatric facility. And we shouldn’t have to

have guards to keep criminals from escaping. This can’t be a cure-

all. It’s gotten to be a third-grade college. It should be limited to

psychiatric cases if it is to be a hospital. Say, keep 25 percent of the

ones here. Then we could have something we could manage and do

something for.

438

For all of Wall’s frustrations, and those of the patients who were still in the

hospital, there was no relief; however, in 1971, Donaldson was finally discharged. It

was believed, however, that this was permitted as a hedge against the pending legal

action.

439

Out of Mind, Out of Sight

159

His case eventually arrived on the steps of the Tallahassee courthouse—a

suit filed against Florida State Hospital Drs. O’Connor and Gurmanis. As Dr.

O'Connor presented his defense, he asserted that he acted in good faith in confining

Donaldson “since a Florida state law, which had since been repealed, had authorized

indefinite custodial [to protect and maintain confinement] of the 'sick' even if they

were not treated and their release would not be harmful . . .’"

440

This defense, however, did not hold up. The jury found for Donaldson and

awarded him $5,000 each in punitive damages against Drs. Gumanis and O’Connor,

and compensatory damages of $17,000 against O’Connor and $11,500 against

Gurmanis. Donaldson was a free man, but the battle wasn’t over. He was plagued

for years by the trauma of his stay at Chattahoochee.

Eventually moving to Pennsylvania, Donaldson got a job as a hotel clerk

and lived on his own. Of that time he wrote:

Psychic shock erased simultaneously as physical health improved,

so that I could not see any separation of the two. My brain was

stunned, simply bruised so much that it halted normal activities

where possible until the fouled-up blood from fifteen years of

beatings drained away. I could read newspapers twice as fast the

second year, four times as fast this year . . . I have told of the death

of emotions, which I noticed during my last years in Chattahoochee.

A full complement of feelings has returned gradually over the years

of freedom. During the long fight for vindication, anger has waned

and friendships have grown.

441

Donaldson’s case was appealed to the Court of Appeals for the Fifth Circuit.

While the original ruling was affirmed, Dr. O'Connor appealed the decision all the

way to the U.S. Supreme Court. On June 26, 1975 in a nine to zero decision, the

Supreme Court of the United States upheld the decision of the lower courts and

established three important rulings:

First, it established that mental illness alone does not justify confining a

person against their will for an indefinite period of time.

442

Second, the court

affirmed that state hospital officials could be held liable for damages if “their actions

were carried out ‘maliciously . . . or oppressively’ and with the knowledge that their

actions violated a person’s constitutional rights.” And third, the court acknowledged

that the rights of the mentally ill should be protected, but it did not clarify whether

the mentally ill have a constitutional right to treatment if they are hospitalized.

443

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160

Chatt-a-gram, the Florida State Hospital newspaper that started in 1975 as

an informational service for patients and staff of the Chattahoochee hospital,

commented on the Supreme Court decision in the Donaldson case. An article stated

that the case was of “great concern” to all and that the hospital was currently

developing guidelines to aid the units in implementing proper treatment programs.

444

Sam Cunningham, Florida State Hospital Clinical Psychologist (1950-1988)

who performed diagnostic testing on Donaldson to see if he recovered from his

schizophrenia, stated that Donaldson was never quite together mentally and that his

family was afraid of him because he had made threats against them. Said

Cunningham, “I can’t say he recovered from his mental illness. He varied from

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161

Dust Jacket from Insanity Inside Out. Photo

courtesy of author.

being quite pleasant to being obstructive. He was never bad and never did anything

to harm anyone. The main thing was that he wasn’t a danger to himself or others.

You have to learn to tolerate these people.”

445

Donaldson’s experience at

Chattahoochee and his subsequent

fight for justice were described in his

book Insanity Inside Out, published in

1976. During the late 1970s, he toured

the U.S. promoting his book and

championing the rights of mental

patients. He died in Arizona in

1995.

446

“Chattahoochee,” a movie

based upon fellow inmate Emmett

Foley’s similar experience at the

Florida State Hospital, was released in

theaters in 1991. This saga portrayed

the story of Foley, a Korean War

veteran, who was depressed and

shattered by continual unemployment.

Shooting up his neighborhood, he

hoped police would gun him down so

his wife Mae could collect the

insurance money. Instead, he was sent

to Chattahoochee where the shocking conditions at the hospital resulted in him

becoming dispirited.

Encouraged by a friend, he drew upon his anger to write letters to

authorities protesting the sub-human conditions in the mental facility. His efforts

resulted in a state commission formed to investigate conditions at Chattahoochee,

and an opportunity for him to tell the world through his movie of the horrible

conditions.

The Baker Act

While Donaldson’s case moved through the courts (some suggest perhaps

even because of it), on July 1, 1972, history-making legislation came before the

Sally J. Ling

162

Florida Legislature that would bring about a comprehensive revision of Florida’s 97-

year-old mental health care law. It would also strengthen the due process and civil

rights of persons in mental health facilities.

447

From the inception of Florida laws back in the late 1800s that governed the

treatment of the mentally ill, residents could be committed if affidavits were signed

by three persons and secured the approval of a county judge. The law further stated

that any destitute person considered “mentally ill” was to be placed in the Sheriff’s

care until he or she could be transported to the state hospital. Restrictions allowed

only one individual with whom the patient could correspond, and the individual

could be confined for an indefinite period of time before a judge would review the

case.

448

The 1972 bill before the Florida Legislature would make a dramatic change

in that law.

The Act, commonly referred to as the “Baker Act,” was named after Maxine

Baker, former State Representative from Miami who sponsored the legislation after

serving as chairperson of the House Committee on Mental Health. According to

Cunningham, Baker was a tiny lady who insisted the Legislature became more

interested in mental health issues.

449

An advocate for the mentally ill, she wanted Chattahoochee to have an

atmosphere that was decidedly home-like. Cunningham described Baker’s reaction

to a patient’s artistic expression when she visited the hospital:

After the forensic unit was built, we had a patient on one of the

wards who was quite an artist. There were blank walls to the right

and left as you entered the ward, and he said he would like to do a

mural. He painted a woman on a sofa—very nude—with her arm

up, but he did it very well. Of course it was larger than life. Then he

said, “Men should have equal treatment,” so he painted a man on

the other side.

One day Ms. Baker decided she wanted to tour the hospital

unannounced. She came in and stopped inside the door and took in

the picture of the woman for a lengthy time. Then she turned and

looked at the man. “Now this is what I mean by home-like

atmosphere,” she announced. I thought, “Sister you are really with

it.”

450

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163

State Representative Maxine Baker. Photo courtesy of the

Florida State Archives.

Baker Act Brought Changes

The Baker Act barred the indiscriminate admission or retention of persons

without just cause to state institutions. It also mandated court-appointed attorneys to

represent each person for whom involuntary placement was sought, and provided for

independent reviews every six months of all involuntary placements The new law

established a patients’ bill of rights, protecting persons’ rights to communicate with

whomever they wished, to receive and send unopened mail, to use their own

possessions, and to vote, as well as many other rights. The law also prohibited the

placement of persons with mental illnesses in jails unless they had committed

criminal acts.

451

When enacted, the Baker Act had a profound effect and was considered by

many throughout the country as landmark legislation. While it has undergone a

number of revisions, these reflect the evolution of the mental health care system and

the way it evaluates and treats the mentally ill, while continuing to protect their

rights.

Sally J. Ling

164

Reflections of a Former Administrator

Bob Williams, former administrator, remarked that three things happened

within a short time of each other that changed Chattahoochee forever: Thorazine

was used on schizophrenics, the Community Mental Health Act created the capacity

in communities and throughout the nation for the establishment of community-based

clinics, and the Baker Act, for the first time, established some fairly rigorous criteria

regarding whom should be served in a state hospital and how long they should stay.

But nothing happened instantaneously, leaving the Baker Act’s substantive

improvements to evolve over time.

452

When Williams came to the hospital in 1978, he was asked to reorganize the

institution and to move it from a departmentally structured heavily medical

organization into broader psychiatric rehabilitation [holistic care]. Upon his arrival,

he found many more challenges—some as old as the hospital itself.

The first major event I found out was there were horrendous abuses

in geriatric wards, including the heating of keys and pressing them

it into the flesh of the elderly. Others included driving patients

down the hallways with their pants around their ankles for baths and

mealtimes. I took a strong position and terminated several staff.

There were challenges to those terminations, but they were upheld.

Those abuses stopped, but there were others in the geriatric units.

Anytime you have a large facility there is a certain small element

that will try to abuse people. I don’t know if we ever completely

eliminated it.

453

During Williams’ tenure, the hospital was reorganized, a move that allowed

the professionals to work as a team to evaluate the patient both physically and

mentally, and prescribe treatment that looked at the patient holistically.

454

New Forensics Hospital Opens

In 1973, the original Thronateeska golf course gave way to the new forensic

hospital, built to accommodate those criminals who were ruled Not Guilty by

Reason of Insanity. Sam Cunningham was the clinical psychologist at

Chattahoochee who received some of the first patients. At 5’ 11” and weighing just

119 lbs., he was just recovering from a heart attack when some of the most difficult

Out of Mind, Out of Sight

165

patients from the South Florida State Hospital in Hollywood arrived at

Chattahoochee:

They couldn’t handle the patients and sent them all in leg and hand

restraints. They marched them into a 36-person ward with

psychiatric aids, so I got them together and removed their restraints.

They sat there looking shocked. I picked out the biggest, meanest

one, and to keep order during the meeting once a week, designated

him as Sergeant at Arms. I told them, “You elect a chairman, and

somebody you trust. Every day I’ll contact him to see what the

complaints are.” They turned out to be regular pussycats. It was

really funny. I told them, “I’ll be reasonable with you if you are

reasonable with me or we won’t keep you on the ward.” The big

tough man grew flowers by his bed, and they were all very

attentive. They were more court cases than mental cases and had

acted like they were more in jail then a hospital. When they were

treated like human beings, they acted like them.

455

State Wide Deinstitutionalization a Challenge

In a draft of a concept paper submitted by the Mental Health Program Office

on February 17, 1978, an overview was presented of the many challenges facing the

state in implementing a deinstitutionalization program. These included: the image

of “State hospital patients locked in slovenly, prison-like settings, suffering from

neglect, over-medication, and abuse by staff and other patients; the image of ex-

patients living in inner city slums, untreated, isolated, starving and exploited by

those around them; and the image of ex-patients disrupting an otherwise tranquil

environment with crime and violence, all come to the fore with the mere utterance of

the word ‘deinstitutionalization.’”

456

Yet, despite these concerns, deinstitutionalization became a reality, and

community-based treatment centers were established throughout the state. This led

to the gradual phase down of state hospitals leaving them to treat forensic patients

and the chronically mentally ill.

Reorganization Creates Department of Children and Family Services

The Department of Health and Rehabilitative Services (HRS) began

reorganization in 1991. This created new agencies to serve clients previously served

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166

by HRS. The Legislature created the Department of Elder Affairs in 1991, the

Agency for Healthcare Administration in 1992, the Department of Juvenile Justice

in 1994, and the Department of Health in 1996. In 1996, HRS officially closed, and

the Department of Children and Family Services (DCF) was created. Since then, the

Florida State Hospital has operated under its jurisdiction.

457

Florida Today

Today, seven mental health treatment centers serve Florida’s population.

Three are operated by the state: Florida State Hospital (Chattahoochee), Northeast

Florida State Hospital (Macclenny), and North Florida Evaluation and Treatment

Center (Gainesville). Four others are managed privately: South Florida State

Hospital (Pembroke Pines), South Florida Evaluation and Treatment Center (Florida

City), Treasure Coast Forensic Treatment Center (Indian Town), and West Florida

Community Care Center (Milton).

The Florida State Hospital at Chattahoochee currently serves 2,000 people a

year and consists of two institutions in one—the Forensic facility and the Civil

facility. Capacity for both facilities is 1,042.

The Forensic facility contains 528 beds and serves those committed by the

court as Not Guilty by Reason of Insanity or Incompetent to Proceed. Located in

two different sites on hospital grounds, Forensic Services residents are housed in the

Admission and Evaluation Service (Units 23 and 24), and the Central Forensic

Service (Units 21 and 25).

 Admission and Evaluation Service (Units 23 and 24): Units 23 and 24

are admission and treatment sites. Each unit in this maximum security

facility contains 100 beds for male forensic commitments. Primary

activities are assessment of new admissions, short-term treatment, and

competency restoration for defendants Incompetent to Proceed, and

behavior stabilization for persons committed as Not Guilty by Reason of

Insanity. Unit 23 also administers a medical complex with an infirmary

and dental clinic.

 Central Forensic Service (Unit 21): Unit 21 in Central Forensic provides

longer-term treatment for male residents. This 160-bed unit primarily

serves a seriously and persistently mentally ill population of male

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defendants who are Incompetent to Proceed or Not Guilty by Reason of

Insanity.

 Central Forensic Service (Unit 25): Unit 25 in Central Forensic includes

four living areas for women and two for men. This 168-bed unit admits

and treats women who have been committed as Incompetent to Proceed

or Not Guilty by Reason of Insanity. The unit also provides longer-term

treatment for male residents.

 Forensic Admissions and Rehabilitation Services: Coordinates all

Forensic admissions in conjunction with the Mental Health Program

Office, coordinates intra unit transfers, works with the Office of Social

Services in the coordination of interstate transfers, maintains resident

records, and provides therapeutic activities which include Arts and

Crafts, Music, Computer Classes, Substance Abuse, Self-Image, and

Competency Education within the secure perimeters of Forensic

Services.

458

In addition to the Forensic facility, the Civil facility serves those individuals

who have been released from the Forensic unit and those who have been Baker

Acted (under evaluation according to the Baker Act). It also serves those who are

intellectually challenged and have a mental illness. Scattered throughout the state,

other Florida Department of Children & Families Mental Health Treatment

Facilities serve the mentally ill in a variety of capacities.

In 2009, the Florida State Hospital at Chattahoochee received its first three-

year accreditation certification from the Commission on Accreditation for

Rehabilitation Facilities (CARF). It received its second certification in 2012.

459

Three years is the maximum achievable length of time for accreditation.

460

Role of the Mental Health Professional at Chattahoochee

According to Larry Annis, who retired at the end of 2010 after 28 years of

service at the hospital and who served as Chief psychologist for the last 20 years of

his service, when a prisoner was admitted to the Florida State Hospital, he or she

was moved from “inmate” to “resident” status and treated as a patient. He cautioned,

however, that the patients came to the facility with high risk: “Most of the people we

see are dangerous. They are killers, or would be killers if they had shot a little more

to the left or they got their knife out in time.”

461

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168

Ellen E. Resch, PhD., Dialectical Behavior Therapy & Substance Recovery

Director and Psychology Training Director, who has served the hospital for over 30

years, stated that once the prisoner became a resident, the interdisciplinary mental

health team took over. This process involved review of the “admission paperwork to

determine the exact legal stage of proceedings, the Court's order as to nature of

evaluation and due date, the mental health issues identified as problematic, the

health records at the previous place of residence, the mental health and social history

of the person, etc.”

462

Annis noted that if the resident had mental health issues, those

typically surfaced before the crime, and there was usually something in the record.

Personal interviews, observations, psychological testing, and medical testing

are then performed to assess the individual, whom Annis described as “typically

uncooperative.” During the personal interview, the evaluator usually asks questions

that range from global to specific, establishes who the evaluator is, and what the

restrictions are on privacy. Then, the evaluator attempts to engage the person in

conversation and develop rapport. The clinician also looks at the resident’s response

style, and in the evaluation, asks about specific issues and why the resident is

there.

463

Once the evaluation is concluded, a treatment plan is devised. This plan

takes into account the legal basis for commitment, the assessed nature of the

problems or the diagnosis, the person's risk factors and all their safety/security

needs, and the person's motivation or interest in taking part in the services. At the

conclusion of the assessment, team members discuss their observations and findings,

and each is then assigned specific responsibilities for assessment or treatment that is

consistent with their expertise. Throughout the resident’s stay, his or her progress is

documented, discussed, and used to adjust the service plan as needed.

According to Resch, specific focus on the person's clinical/legal competency

issue is the responsibility of the psychology staff that is trained to understand the

forensic mental health evaluation process. Eventually, the psychologist and team

reach a decision that, from a clinical perspective, achieves the purpose of the Court's

commitment.

At the conclusion of the evaluation and treatment process, the team's

findings are sent in a report to the committing Judge. Copies of the report are also

distributed to the defense counsel, prosecution, Clerk of Court, and other parties as

necessary. The resident is then discharged from the hospital, and the Court orders

him or her transported to the next setting where the legal sequence of events

resumes.

464

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Hospital Receives Awards

In 1999, the Florida State Hospital at Chattahoochee received the

prestigious Governor's Sterling Award for Organizational Excellence, based

upon the Baldrige criteria. A national public-private partnership, the Baldrige

Program helps U.S. organizations improve their performance by:

 Helping organizations achieve best-in-class levels of performance

 Identifying and recognizing role-model organizations

 Identifying and sharing best management practices, principles, and

strategies

465

Despite the award, the hospital still had its challenges.

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170

Out of Mind, Out of Sight

171

Chapter Photo: Maximum security (1930 or earlier). Photo courtesy of the Florida State Hospital.

Chapter XIV

Risk and Reward

Patient Rights VS Staff Rights

In September 2006, the death of a staff member at the Florida State Hospital at

Chattahoochee drew attention to the risk faced by employees at the forensic unit

when James Smith, 52, suffered a heart attack after a patient attacked a co-worker. A

treatment and rehabilitation specialist, Smith collapsed while monitoring the violent

patient after his injured co-worker was taken for treatment.

In an incident a year later, Kelvin Haywood’s left bicep showed an arc of

teeth marks and a scar on the right side of his neck—each an indication of the

dangers of the job. Even Joe D’Agostino, a psychologist, fell victim to the violence

on the forensic wards when a gash on his head from a patient wielding brass

knuckles required seven staples to close. In fact, many of the workers bore scars and

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172

told of frequent threats, fights, gangs, and homemade knives or cudgels, known as

“locks in socks.” These incidents were among many that occurred in the unit since

its inception. Although the unit was not understaffed at the time of the incidents, a

Department of Children and Families inspector general’s report noted that at times

units were often unmanned for minutes or even hours at a stretch. The report also

highlighted several security issues.

Between April 2004 and April 2006, Unit 23 had a 145 percent increase in

aggressive behaviors, with Unit 24 at an 87-percent increase. Overall, the increase in

aggressive behaviors for both units stood at 116 percent; yet, the report pointed out

that during that same time period there had been little or no increase in staff.

466

This

left the staff at risk. At issue were the rights of patients versus those of the staff, as

well as equal pay, and acquisition of the same protections and reinforcements given

prison guards.

Forensic patients charged with murder, assault, rape, and other major

offences for which a competent defendant would be charged with a felony, arrived

at the Florida State Hospital in chains; but, once they entered the facility, they were

referred to as “residents” who were there for treatment. Disruptive residents were

given an appropriate 15-minute time out, with handcuffs or strapping down being

acceptable for short durations. If the resident required further discipline, he or she

was sent into seclusion—quarters with concrete floors, metal doors with an opening

for passing meals, and a plastic chair. A mattress was brought in at night for

sleeping.

Jim Baiardi, who at the time was president of the Police Benevolent

Association correctional-officer chapter that represented the security staff,

corroborated remarks made by attendants and security officers who told legislators

they thought some patients were faking mental illness or deficiency to spend their

time in an atmosphere preferable to the prison system.

There existed a delicate balance between the rights of the patient and those

of the staff. Attorney Kathryn Dutton-Mitchell, manager of the institutional

conditions team at the Advocacy Center, represented seven mentally challenged

residents who were held in seclusion for more than a week because of an earlier

mêlée. The incident started when a lieutenant and security officer accompanying a

nurse delivering medicines entered a ward of intellectually disabled residents. One

patient refused to take his medicine, and another was stopped when he wanted to

leave to use the phone. The patients were forced back into the ward and began

kicking the door held shut by the security officers. When a supervisor entered the

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173

ward, a resident attacked him, hitting him in the right cheek with his fist and

knocking out three of the lieutenant’s teeth.

Both the Chattahoochee Police Department and the Gadsden County

Sheriff’s Department were called. Upon arrival, they found the wards increasingly

unmanageable. A resident who appeared to be the leader was subsequently sprayed

with mace after which the disturbance was quelled by the police officers.

Representative Marti Coley of Marianna County conceded that patients had

rights but noted that employees have a right to a safe work environment.

Representative Curtis Richardson of Tallahassee agreed: “If we focus too much on

the rights of patients, we’re not going to have any staff to serve them.”

467

In order to insure the safety of employees, residents, and visitors, Diane

James, former hospital administrator, stated that the Hospital remains proactive by

providing “the best training and tools available to be able to identify and manage the

rare occasions when urgent circumstances occur.” This includes training and

education in conflict resolution, crisis response, gang recognition, and safety

awareness. In addition, annual training classes are required in myriad subjects under

such headings as: employee and resident safety, hospital policies, policies specific to

Forensic Services, and environmental and work practice controls.

468

Hospital Break Out

Injuries to staff were only one concern of hospital administrators. Attempted

escapes, though quite rare, were another, especially when they involved help from

the inside. In February 2008, Donald Ray Moore, 22, an employee of the hospital,

was fired in the middle of his probationary period after authorities found a hacksaw

blade in the trash. The blade, it was later learned, was supplied by Moore to two

forensic residents who attempted an escape.

In the escape attempt from a secure unit, the residents, who were found unfit

to stand trial for their crimes, were found on the roof of Pod F after having escaped

through the window of their room. Placing dummies in their beds to make it look

like they were sleeping, the two removed glass from the bedroom window that they

subsequently hid under a bed. After crawling out the window, they made it to the

roof where they remained about 15 minutes before being discovered by hospital

staff who called police after noticing their absence from the secure unit. The men

were found wearing two layers of clothes.

469

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174

Hallway of the Behavioral Isolation Unit (BIU). The BIU area closed many years ago. The

philosophy of utilizing "isolation" as a treatment modality changed, and efforts have since been

focused on the reduction of the use of seclusion and restraint (S/R). With this change in focus, any

need for the use of S/R (which is low) is now handled on the resident's home unit. Photo courtesy

of Joe Blanton, Florida State Hospital.

Since neither resident had exhibited any previous behavior problems, the

escape attempt was most unexpected. According to James, after the escape attempt,

each resident was clothed in a jumpsuit and placed in seclusion on 1:1 special (1:1

special means one staff person to one resident at arm’s length at all

times). Visitation was suspended, and hospital security escorted the residents when

they moved from seclusion. Charges were also filed against both residents.

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Competency and Death Row Inmates

Over the decades, the Florida State Hospital has been home to thousands of

criminals deemed incompetent to stand trial, but the most notorious of them all have

been death-row inmates. Sent to Chattahoochee to receive evaluation and treatment,

the hope was they would emerge competent enough to return to the county courts to

continue the trial process or be returned to the Florida State Prison at Raiford to

serve out their sentence until their scheduled execution either by Florida’s electric

chair, known as Old Sparky, or lethal injection. A U.S. Supreme Court ruling in

1986, based upon a case involving an inmate at the Florida State Prison, however,

changed all that. The ruling allowed dozens of prisoners to remain on death row for

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decades, some even indefinitely, even though they were convicted and sentenced to

die.

Here are the stories of three Florida death row inmates who experienced

mental illness and were intimately connected to the Florida State Hospital. Like

Kenneth Donaldson in the 1970s, Alvin Bernard Ford’s case went all the way to the

U.S. Supreme Court and won a significant ruling—one that affected states

nationwide. The other two inmates spent time at the Florida State Hospital during

some part of their incarceration on death row.

Alvin Bernard Ford

The case that changed the face of death row across the country started in

Florida with Alvin Bernard Ford. He was only 20 when, on July 21, 1974, he and

three others planned and executed an armed robbery at a Red Lobster restaurant in

Fort Lauderdale. While the crime was in process, two people from the restaurant

were fortunate enough to make their getaway. This prompted the robbers to believe

they would contact police who would soon be dispatched to the restaurant. In light

of this, all the robbers, except for Ford, fled the scene. Not realizing his accomplices

had left, Ford remained behind and snatched approximately $7,000 from the

restaurant's vault.

Officer Dimitri Walter Ilyankoff responded to the police dispatch and

arrived on the scene by himself, only to run into Ford in the parking lot. Ford shot

the officer twice in the abdomen. Looking for his accomplices and realizing they

had abandoned him, Ford ran to the parked police car intending to make a fast

getaway. When he found no keys in the ignition, he returned to the wounded and

struggling police officer and demanded the keys. Without results, Ford then shot

Ilyankoff in the back of the head at close range, grabbed the keys, and escaped in the

officer’s cruiser.

Police apprehended Ford at his mother’s home in Gainesville. Said to be

suffering from depression and drug addiction at the time of the robbery, he was

charged with murder and held for trial. Convicted of first-degree murder in Circuit

Court, Broward County, Florida, the jury recommended the death penalty, and the

trial judge pronounced the sentence on January 6, 1975. During the first six years of

his incarceration while waiting for his appeal, Ford’s physical and mental health

appeared normal, and on November 4, 1981, Governor Bob Graham signed his

death warrant. Ford’s execution was scheduled for December 8, 1981.

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As his execution date neared, Ford began developing delusions and

hallucinations. Just 14 hours before he was to be executed, the Eleventh Circuit

Court of Appeals in Atlanta granted him a stay of execution. Ordered to undergo

psychiatric evaluation, Ford was examined by three psychiatrists in the courtroom at

the Florida State Prison where the doctors spent 30 minutes interviewing him.

Afterward, they, along with an attorney from the governor’s office, correctional

officers, two paralegals, and two defense attorneys spoke with correctional officers.

They also examined Ford’s cell, reviewed his medical records, and discussed his

condition with the medical staff. Under separate reports to the governor, one

psychiatrist described him as “severely disturbed” and the two others described him

as “psychotic;” however, each determined that Ford understood he had been

sentenced to death for his crime.

Ford was subsequently found competent for execution, and the Governor

signed a second death warrant on April 30, 1984. An execution, date of May 31,

1984, was set. Just as before, with only 14 hours to go, he was granted a second stay

of execution. At issue now was whether the execution of an inmate who was

considered “incompetent” fell under the U.S. government’s definition of cruel and

unusual punishment. Up to this time, the Eighth Amendment argument had been

used to determine method and amount of punishment, but Ford’s case argued that

execution of the insane was cruel and unusual.

Ford’s case was brought before the United States Supreme Court, which

ruled on June 26, 1986, that “the Eighth Amendment prohibits states from inflicting

the death penalty upon prisoners who are insane and found that Florida's procedures

for determining sanity had failed to adequately protect Ford's rights.” While the case

did not decide Ford’s sanity, capital punishment experts Kent S. Miller and Michael

L. Radelet wrote about the impact this decision had on the treatment of mentally ill

prisoners on death row: "Alvin Ford made history as the man who forced the

criminal justice authorities, lawyers, judges, politicians, mental health professionals,

and a host of others to seriously debate the question of what types of mental illness

should exempt condemned prisoners from execution and how (and by whom) these

life-and-death determinations should be made."

Up until this time, no clearly defined protections shielded the mentally ill

from execution. This ruling took the final decision out of an individual governor's

hands through clemency hearings and placed it in the court system.

In 1989, Ford was evaluated again and found competent for execution.

Another appeal was about to take place when, on February 2, 1991, he was found

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dead in his cell at age 37 of adult respiratory distress syndrome associated with

“fulminant acute pancreatitis.”

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Aftermath of the Ruling

The Ford case was analyzed in an article published in 2008 by Amnesty

International Magazine which concluded that: “Justice Lewis Powell drew his own

line, reasoning that the Constitution protected only those who are so insane that they

are ‘unaware of the punishment they are about to suffer and why they are to suffer

it.’ Justice Powell concluded that Florida could execute Ford if he became sane

again, presenting a cruel irony: death row inmates who become insane must remain

insane to avoid execution. Moreover, the Ford decision left the determination of

sanity up to each state and herein lies the heart of the problem.”

The article also noted that of more than 1,700 death row inmates at the time

of the ruling, over a dozen had insanity assertions made on their behalf. The article

further noted that the American Civil Liberties Union estimated that up to ten

percent of the more than 3,400 inmates on the nation's death rows had serious

mental illnesses. Regardless of the numbers, the article stated that mental health

experts agreed that many mentally ill prisoners would never have made it to death

row in the first place if they had been able to find treatment when they were free.

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The U.S. Supreme Court ruling in Ford’s case would eventually affect Gary

Alvord, another Florida death row inmate.

Gary Alvord

Gary Alvord, alias Paul Brock, who was convicted and sentenced to death

for the 1973 triple homicide of a family of women, still sits in his cell on Death Row

awaiting execution—one that may never come. Deemed incompetent by reason of

insanity, Alvord gained his reprieve because of the Ford ruling that does not permit

the execution of a person deemed incompetent.

On June 18, 1973, Hillsborough County homicide detectives were called to

a residence in reference to a triple homicide. They found the body of Georgia Tully,

53, in the back bedroom of her house; Ann Herrman, 36, daughter of Georgia Tully,

in the hallway between the living room and the kitchen, and Lynne Herrman, 18,

granddaughter of Georgia Tully, in the kitchen. All three women died of

strangulation with a nylon cord, and sperm was discovered in the vaginal tract of

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Lynn Herman. Time of death was estimated sometime between Saturday, June 16,

1973, and 1:30 p.m. on Monday, June 18, 1973.

Police identified Paul Brock as the suspect who had skipped town with his

girlfriend and her son. A week later, the sheriff’s office received a call from Brock’s

girlfriend who told them Brock had confessed to murdering the three women and

that his real name was Gary Alvord.

Alvord’s family had a history of mental illness, and he, in fact, had mental

health problems of his own. He claimed his mother was treated and hospitalized off

and on for schizophrenia. After his birth, he said she had a complete breakdown and

was immediately hospitalized. He also claimed his father blamed him for her

breakdown and became abusive toward him. At age 11, he was placed in a number

of foster homes where foster parents continued the cycle of abuse.

Institutionalized in Northville Hospital in Michigan at age 12, Alvord

received a number of diagnoses including Sociopathic Personality Disorder, Passive

Aggressive with underlying Schizophrenia. It was also noted that his behavior could

be described as psychotic.

He escaped numerous times and, while out, participated in violent behavior

including a shooting that involved his brother-in-law. In 1963, Alvord was sent to

the maximum-security hospital for the criminally insane at the Iona State Hospital in

Michigan where he was diagnosed with Schizophrenic Reaction, Paranoid Type.

After another escape, he was arrested for the kidnapping and rape of a 10-

year-old girl. Subsequently tried for the crime in 1970, he was found not guilty by

reason of insanity. In 1971, he escaped again but was quickly apprehended. In 1973,

despite his history and classification as a “dangerous offender,” he was granted

leave from the hospital. It was during this time that he traveled to Florida. He was

on “escape status” when he committed the murders of Tully, her daughter, and

granddaughter.

Throughout the trial, Alvord’s attorneys alleged that he was not competent

to be executed; and in 1973, while his trial was in process, he was transferred to the

Florida State Hospital to determine his competency. Dr. Daniel J. Sprehe found him

competent, and Alvord was returned to the Florida State Prison at Raiford.

Governor Graham, who didn’t want to sign the death warrant before

allowing for a competency hearing, appointed three physiatrists who traveled to the

prison to evaluate Alvord who refused to cooperate. After several delays, the

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Governor signed the second Death Warrant on November 2, 1984, and ordered

another competency hearing. Alvord was transferred to the Florida State Hospital

where he remained for three years before being transferred back to death row. He

was eventually found “incompetent” by a panel of psychiatrists appointed by the

governor.

At the time of this publication, he remains on death row. He has been there

for almost forty years.

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John Huggins

In August 2009, the Florida State Hospital hosted another death-row inmate.

John Huggins, 47, was twice convicted in 1998 for strangling Orlando resident Carla

Larson, 30, after she left work. Her partially buried body was found near Disney

World.

After taking her daughter to daycare on the morning on June 10, 1997, Carla

Larson went to work. Around lunchtime, she left to go to the grocery store to pick

up food for an afternoon meeting. She never returned.

Witnesses stated they saw a white Ford Explorer matching Larson’s vehicle

parked in a wooded area off the Osceola Parkway. Two days later, witnesses led co-

workers to the spot in the woods where they had seen the parked vehicle. It was

there Larson’s body was discovered; she had been strangled. Her vehicle was

missing, as well as her jewelry, clothing, and purse.

The day Larson disappeared, John Huggins, his wife Angel, and their five

children were visiting the Orlando area. That same day, Fay Blades, Huggins’

mother-in-law, stated that when she came home from work, she observed a strange

SUV parked in her carport. A week later neighbors stated the vehicle was painted

black.

Sixteen days after Larson’s disappearance, police got a call to investigate a

burning black truck in a vacant lot in Cocoa Beach. It was determined to be Larson’s

SUV. The very next day, Huggins and his sister-in-law, with whom he had begun an

affair, fled Florida. Several days later, Angel Huggins was watching America’s

Most Wanted, which, coincidentally, was featuring Carla Larson’s murder.

Suspecting her husband of being the killer, she called police.

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Left: Outside a room in the Behavioral Isolation Unit. (BIU). Right: Inside a room in the BIU.

(This unit is no longer used.) Photo courtesy of Joe Blanton, Florida State Hospital.

Officers searched Blades’ home several times but found no tangible

evidence. Convinced Huggins was guilty, Blades subsequently conducted a search

of her own. In her shed, she uncovered jewelry identified as belonging to Larson.

Initially convicted and sentenced to die, Huggins, who had a criminal

history of robbery with a deadly weapon in 1979, to grand theft in 1995, was granted

a second trial when it was determined that prosecutors had withheld potentially

helpful evidence from the defense in the first trial. The conviction and sentence were

set aside, and a new trial was ordered. The second trial resulted in the same

conviction, and for a second time Huggins was sentenced to death.

In the post-conviction phase, Huggins was determined to be incompetent to

assist his council and was sent to the Florida State Hospital at Chattahoochee in the

hopes that his competency could be restored. He was placed in solitary confinement

in a building that serves as a medical services building for other inmates. Huggins

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was separated from them by a heavy metal door containing a small, shatter-proof

window. The cell contained only a bed and toilet. A guard at the console controlled

the door electronically.

After two months, Huggins appeared before Orange-Osceola Circuit Chief

Judge Belvin Perry where a psychologist who evaluated Huggins stated that the

convicted killer was competent to proceed. Huggins, now 48, was subsequently

returned to the State Prison at Raiford;

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however, his fate still appeared in

question.

In October of 2010, Tampa psychologist Richard Carpenter determined that

Huggins “demonstrated signs of mental illness” and was thought by his defense

team to be “delusional with a sense that there is a vast conspiracy by others against

him.” The conspiracy included federal agents and the Dixieland Mafia who he

believed were framing him.

At the time of this writing, Judge Perry was deciding how to proceed in the

Huggins case as Huggins repeatedly refused to cooperate with his defense team and

filed papers to have his legal team removed.

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He continues to sit on death row, and

his fate is yet to be determined.

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AFTERWORD

The history of the Florida State Hospital’s physical plant—from federal

arsenal to Freedman’s Bureau, from state prison to state mental institution—is as

fascinating as it is remarkable; and, preservation of the historic buildings is a most

commendable endeavor. It is, however, the human drama within the facility played

out in decades that gave us the most compelling reason for this story.

Thousands of Florida’s mentally ill entered the confines of the Florida State

Hospital at Chattahoochee with the hope of being cured. From Betsey Yulee,

Chattahoochee’s first mentally ill inmate, to Kenneth Donaldson’s 15 year struggle

for freedom, to death row forensic patient Alvin Ford, each displayed the diverse

face of mental illness, a disorder that in any given year affects an estimated 26.2

percent of Americans ages 18 and older, over 57 million Americans.

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Some may wonder why an account of the obscure facility at Chattahoochee,

its staff, and patients as set against a history of mental health care in Florida, is

important. The answer lies in its dual role as historic physical facility and evolving

mental institution that, when combined, paint a poignant portrait of Florida—its

history, its laws, and its people. It is incumbent upon historians to preserve this

picture—the good, the bad, and the ugly—for generations to come.

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Eleanor “Lolo” Woodham Tomlinson. Photo courtesy of Rebekah Tomlinson Mendoza..

POSTSCRIPT

Living with Lolo

Thus far, the reader has had an inside look at the evolution of the Florida State

Hospital at Chattahoochee as set against the evolution of institutionalized mental

health care throughout the nation and Florida; and, the reader has heard the voices of

those who lived the experience, whether they were doctors, patients, or staff. It

would be a grave disservice if this story did not include another perspective—that of

a family who lived with a mentally ill patient that was sent to Chattahoochee.

For that, we turn to Rebekah Tomlinson Mendoza, whose mother Mrs.

Eleanor “Lolo” Woodham Tomlinson, was initially committed to the Florida State

Hospital in 1956, and who, for the next 18 years, was admitted and discharged

multiple times, finally being released into foster care in 1974. She died in December

2008 at the age of 93, never having been fully free from her disease.

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Rebekah, who is retired from both Chrysler Financial Corporation and Rose

Printing Company, now lives in Tallahassee, Florida. Before returning to

Tallahassee in 1969, she was a photographer in the U.S. Navy. This is the story of

her family, the profound affect her mother’s mental illness had upon them, and her

recollection of her mother’s time at Chattahoochee.

The Early Years

The Woodham family was Scotch-Irish, and by trade, a very industrious and

successful lot—mostly farmers and merchants. They arrived in this country in the

late 1600s and early 1700s and initially settled in the Virginia and Maryland area.

Hearing the silent call to move south, they briefly moved to Old Dobbs County,

North Carolina, before relocating to Darlington County, South Carolina, where they

laid down family roots.

After nine years of marriage, Sullivan and Lalla Woodham welcomed their

first child, a daughter whom they named Eleanor. During the first six years of her

young life, she cherished being the only child and became very close with her

parents, especially her father. A second child, Sara Martyn, arrived six years later

and became Eleanor’s playmate and lifelong friend. It was little Sara Martyn who

called her big sister “Lolo,” pronounced La-La, when she couldn’t quite grasp her

longer name.

At first, Sullivan ran a grocery in town, but when Martyn was only a few

months old, he gave up the grocery business to move the family of four out to the

country where he managed a small farm of about 75 acres.

Growing up on a farm in rural South Carolina required the entire family,

including the girls, to share in the household and farm chores. The girls fed the pigs

and chickens, picked vegetables and fruit, and shelled peas and beans. Under the

tutelage of their mother, they learned how to make cornbread and biscuits; but, their

domestic chores never interfered in their learning the “proper” things of life—

etiquette and manners. After all, they were Southern Belles—well-bred and well

educated.

Lolo was a natural at the family’s piano. Taking lessons, she became quite

accomplished, surpassing even her teacher’s expectations. Winning numerous

awards for her musical prowess, she went on to study at Coker College, a liberal arts

college in Hartsville, South Carolina. During her junior year she suffered a “nervous

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Eleanor “Lolo” Woodham Tomlinson

and Rebekah. Photo courtesy of Rebekah

Tomlinson Mendoza.

breakdown” and took the year off to rest; nevertheless, she graduated in 1937, and

went on to briefly play a concert tour.

During this time, Benjamin Tomlinson entered Lolo’s life, and she realized

traveling to play the concerts would separate them. To be closer to Ben, she gave up

the tour in favor of a teaching position with the Manning Public School system. This

position proved short lived, however, because she and Ben married in November

and settled in Georgetown.

Lolo Experiences Tragedy

Ben and Lolo’s first child, David, was born in 1940 and quickly became the

apple of Lolo’s eye. When she became pregnant just seven months later, however,

things began to change. Unable to handle her second pregnancy, she sent David to

live with his grandparents and aunt on the farm about a hundred miles away. After

she and Ben welcomed Rebekah into the family in 1941, David returned home.

Their bottom floor apartment in the

spacious Victorian home in the historic

district of Georgetown was now feeling

cramped, so Ben built the family a three-

bedroom concrete block home on Duke

Street. He later added a double car detached

garage that he used as a workshop, fenced

in the yard, and built a chicken coop where

the family raised about 40 chickens. What

eggs the family didn’t use, Lolo sold to the

neighbors.

In the front of the house was an

extra-large room where Lolo had her piano

and music cabinet. She gave private piano

lessons in her home, played the organ for

the local Baptist church, and performed at

various social functions. While she

functioned reasonably well, two traumatic

events soon threw her world into a tail spin.

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The first came in 1942, when Lolo had a hysterectomy, ending her ability to

conceive more children. As no hormone replacement therapy was then available, she

had a difficult time coping both physically and emotionally with the distressing

event. Showing signs of mental instability, she was sent for shock therapy; however,

she was given only one treatment as it was thought any more could cause permanent

brain damage.

During this time, Lolo’s behavior was beginning to take its toll on Rebekah:

“I was told many years later that I also had to see a psychiatrist. Daddy told me that

after one quick visit, the doctor thought it best to send me to the farm to stay a while

and that nothing was really wrong with me. Apparently I had a child’s reaction to

the way Mother was doting on my brother and not giving me what I felt was my

share of attention. She wasn’t bad in any way, just totally absorbed in trying to make

up for David being away from her as a little tot. I was told that I thought I had a

snake inside of my belly, and they couldn’t get me to wear any real clothes–only a

long loose gown. I was also told that within a week’s time at the farm, I was as

normal as any little child could be. I have absolutely no memories of any of these

events.”

For many years, Lolo functioned quite well and enjoyed family vacations to

nearby beaches, including Pawley’s Island, the mountains of North Carolina, and St.

Augustine. There were even times when David and Rebekah would stay with their

grandparents on the farm while Lolo and Ben took trips by themselves.

Unfortunately, the second traumatic event lurked just around the corner.

In 1947, Lolo’s father died of bladder cancer. Along with her inconsolable

grief, she suffered terrible guilt that affected her ability to deal with the everyday

decisions of running a household and raising children. According to Rebekah, Lolo

maintained a continual feeling of guilt because she never got the chance to pay back

her father for all the hard work he did over the years to make sure she had a college

education and proper musical training. The guilt and her inability to accept his loss

rendered the pain of his death overwhelming.

Believing a change in scenery would do the family good, Ben moved the

family to Tallahassee, Florida, in 1952. Lolo gave private piano lessons in the house

on Grace Street and gave organ lessons to people in their homes; but, her teaching

became sporadic and soon ended. While she functioned fairly well in many ways—

continuing to drive and take care of the house—her mental problems became worse,

and she began to exhibit behavior totally out of character. Opening up cereal boxes

to let the cereal breathe was just one example of her bizarre behavior.

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Rebekah, now old enough to experience some of her mother’s inexplicable

behavior, recalled that one recurring problem had to do with sewing: “She would

take clothing apart and put it back together again in a slightly different way by hand

. . . She couldn't be trusted with scissors because she would cut all her clothes into

pieces. Later she would also cut her hair . . . She would walk into the room and say

things out of the blue then leave the room again. She would roam around the house

and make sort of grunting sounds or heavy breathing.”

Ben realized Lolo needed immediate professional help when one day, after

bringing the children home from school, he found a bowl full of wooden hammers

she had broken out of the piano. Said Rebekah: “She had turned on the one thing she

most loved–music. She had already lost interest in current events and I’m pretty sure

she was no longer a ‘wife’ to my father.”

Lolo Enters the Florida State Hospital

Two doctors declared Lolo incompetent due to chronic schizophrenia; and,

on June 26, 1957, she was committed to the Florida State Hospital at Chattahoochee.

Discharged after only a couple months of treatment, she returned home where she

remained for about a year. Rebekah recalled that at times her mother thought “they”

were trying to get the family to eat White House applesauce by talking about politics

on TV. The invisible “they” were always around, even though no one knew who

“they” were.

On one occasion, Lolo accused Rebekah of flirting with her father. Another

time, she sold several pieces of furniture and replaced it with what Rebekah

described as “some really weird stuff.” While Ben managed to get most of the

transactions reversed, Rebekah felt it must have been horribly embarrassing and

difficult for her father. Lolo went back to the hospital.

On most weekends while Lolo was in the hospital, Ben, Rebekah and David

visited her. Rebekah remembered the white buildings that housed the patients at

Chattahoochee and the waiting rooms where most of their visits occurred:

They were clean and neat and I don’t remember any

objectionable smells like real hospitals sometimes have. I do

remember talking to some other patients – some really

“interesting” folks. People padded around in slippers and

housecoats and many had “spacey” looks. I remember one time

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in a visiting room on the second floor looking down on a

courtyard where a number of patients and attendants were sitting

and walking around. One lady with very stringy hair was

standing facing the building toward me. She just stood there

constantly wringing her hands. To someone my age (about

twelve maybe), that was really bizarre. I also remember someone

who suddenly took off running from one side of the courtyard to

the other. Two attendants grabbed her, put a straitjacket on her,

and dragged her inside. They didn’t seem to be cruel, just firm

with the task at hand. That was probably the most bizarre thing I

had ever seen; and, of course, I’ve never forgotten it.

There were visits where Mother was as normal acting as anyone

I knew. Other times she seemed hyper or drugged. Even at my

tender age, I could tell that where she was housed at the hospital

was different each time she went back, and each change put her

in a less “sane” place. She had progressed from the really

hopeful area, the “going to go home soon” area, to the custodial

care section. The buildings were progressively older and less

inviting.

Lolo was furloughed back to her home, but by this time her behavior was

taking its toll on Rebekah, who was now in college. Rebekah said she couldn’t study

at home or spend the necessary time at the Florida State University library. She

changed her major to make it easier to get a degree, but said “it just wasn’t fun

living at home with Mother and trying to go to college at the same time.”

In 1960, Rebekah joined the Navy—her way of running away from home

and her Mother. When she returned to Tallahassee in 1961 to get married, Ben

decided to send Lolo back to Chattahoochee. This time, there was little hope of her

ever returning home to live a normal life as wife, mother, and grandmother. In 1964,

Ben divorced Lolo and later remarried.

Rebekah returned to Tallahassee with her daughter in 1969 after her own

divorce, and took over Lolo’s care from her father. On her visits to Chattahoochee,

Rebekah would typically take Lolo for drives off hospital grounds and to a local

restaurant for lunch and for talks.

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Lolo Returns to the Family Farm

In 1972, when the Florida State Hospitals began transitioning patients into

foster care programs, Lolo was released to the care of her sister Martyn who lived

on the old family farm in South Carolina. With this move, everyone had high hopes

that Lolo’s being back in familiar surroundings with her family would prove of great

benefit. Martyn, however, had never really understood the depth of Lolo’s mental

problems and, in fact, had placed much of the blame for them on Ben.

Misunderstanding the instructions the hospital doctors gave her for Lolo’s

care, Martyn discontinued her sister’s medication. It wasn’t long before Lolo

relapsed. This forced Martyn to acknowledge the severity of her sister’s condition

for the first time.

Martyn begged Rebekah to come get Lolo because she was making life

miserable for the family by being bossy, belligerent, and pacing the floors. In

addition, Lolo insisted that neither Martyn nor the children play the piano. This

proved a major problem because Martyn played for Hebron Methodist Church and

needed to practice. When Rebekah picked up Lolo, Martyn implored her to please

tell Ben she didn’t blame him anymore and was very sorry for thinking he had been

the cause of Lolo’s mental condition.

Once Lolo’s condition stabilized, she was furloughed again, only this time

she went to the private home of Mrs. Clyde Gilbert in Quincy, Florida. The small

home worked out well until Gilbert’s failing health required Lolo to be moved to

another facility. Again, failing health on the part of the caregiver forced Lolo to

move a third time to Ruby Varnum’s house (Varnum's Rest Home, as it later

became known) where Ruby cared for several other ladies. Lolo was with Ruby for

over 20 years.

Of her Mother’s time in foster care, Rebekah noted that Lolo still exhibited

abnormal behavior: “She cut out things from magazines and saved them, then gave

them to me. This started when she was in hospital but continued for a number of

years in foster care. We're talking about an entire grocery sack full of pictures and

ads—mostly about food or beauty products. There were times she didn't want to

wear shoes (she would wear socks) because she thought they were bad for her feet.”

Rebekah became Lolo’s legal guardian in 1984; and, while Ben allowed

Rebekah to make all decisions regarding Lolo’s care, he was always concerned

about her. He made sure that Rebekah always had enough money to provide Lolo

with decent clothing and meet her other needs. He also planned for her funeral

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Eleanor “Lolo” Woodham Tomlinson. Photo courtesy of Rebekah

Tomlinson Mendoza.

expenses if she died before he did. Until Ben’s death in 1988, of a heart attack at age

75, he and Rebekah visited together every few days and always discussed Lolo’s

care and progress.

Lolo’s Last Days

Macular degeneration, two broken hips, and dementia slowed Lolo in the

end, but her bright outlook never dimmed. Even when told that her sister had died,

Lolo simply replied, “I'll cry later.”

She spent the final year of her life at Blountstown Health and Rehabilitation

with her last week under the care of Covenant Hospice. Rebekah read Psalms to her

just before she left this world on Monday, December 1, 2008, at the age of 93. Later,

when friends and family gathered to say their final goodbyes at Hebron Church in

South Carolina, Lolo looked lovely in her pale pink gown with dainty floral

embroidery at the neckline and a matching robe. A small white Bible rested in her

hands along with a few photographs of her family.

Lolo was laid to rest in Hebron cemetery beside her beloved sister in the

“bosom of the Woodham family heart” while one of her favorite hymns, “Jesus

Loves Me,” wafted on a breeze. The Reverend Julius Haddon officiated at the

graveside service while Reverend Ed Wilkes, dressed in full Scottish regalia, played

“Amazing Grace” and “Going Home” on his bagpipe.

Out of Mind, Out of Sight

193

The Rest of the Story

One might think that would be the end of Lolo’s story, but it’s never that

simple when one lives with a mentally ill family member. It wasn’t until decades

later, with the help of therapy, that Rebekah was finally able to recognize and cope

with the anger she harbored as a result of feeling abandoned by her mother at such

an early age: “Mother left me (yes, she was ill and not her fault) . . . Anyway, I

discovered I was angry with her even though I loved her very much. I suppose

knowing that helped me. I don't think it affected the way I acted when I was with her

- don't think I ever displayed any ill feelings towards her.”

Many who live with a loved one who is mentally ill wonder if they will

suffer the same fate. Rebekah wondered that too: “The thought has, of course, come

to mind, but I've never seriously dwelled on it. I think I've feared the most that it

might skip a generation or two and show up in my daughter or one of the

granddaughters. However, my daughter is mentally healthy.”

477

Sally J. Ling

194

Out of Mind, Out of Sight

195

APPENDIX

TIMELINE

1814-1817 First Seminole War

1817 Scott Massacre

1821 Spain Cedes Florida to the U.S.

1823 Gadsden County is established

1828 First Post Office established at Mount Vernon

1830 Indian Removal Act

1832 Captain Hills surveys land at Mount Vernon

1834 Mount Vernon name changed to Chattahoochee

Apalachicola/Chattahoochee Arsenal begins construction

1834-1842 Second Seminole War

1839 Arsenal opens

1855-1858.1 Third Seminole War

1861 Florida Cedes from the Union

1861-1865 Civil War

1865 Arsenal becomes Freedman’s Bureau

1868 Florida State Prison established at Chattahoochee

Malichi Martin becomes first warden

Calvin Williams becomes first prisoner

1870 Betsey (Betsy) Yulee arrives at state prison as first insane resident

1877 Prisoners moved to work camps

Prison becomes Asylum for the Indigent Insane (Lunacy Law)

Sally J. Ling

196

1886 Name changed to Florida Hospital for the

Insane

1900 Name changed to Florida State Hospital

1905 Asylum Scandal of 1905

1910 Hydrotherapy established as standard treatment for mentally ill

patients

1919 Opening of Nurses Training School

1921 First Epileptic Colony established in Gainesville

1926 Influenza Epidemic

193? Dr. Marynia Farnahan Inspection and Survey

1930s Introduction of Fever Therapy, Insulin Shock Therapy, Metrazol

Shock Therapy, and Electroconvulsive Therapy (ECT)

1934 Dr. William DeWitt Rogers arrives at FSH

1935 Prison Camp established at Florida State Hospital

1936 Dr. Walter Freeman and Dr. James W. Watts perform first

lobotomy in U.S.

1937 Dr. James G. Lyerly performs first lobotomy at Florida State

Hospital

1940s 9-hole Thronateeska golf course built at Florida State Hospital

Groundwork laid for community-based treatment

1940 Dr. William DeWitt Rogers becomes clinical director of FSH

1941 Rosemary Kennedy receives lobotomy

1946 Dr. Freeman performs first “ice pick” lobotomy

National Mental Health Act passed

1947 G. Pierce Wood State Hospital in Arcadia opens

1949 National Institute of Mental Health established

1950 Dr. William DeWitt Rogers becomes superintendent of Florida

State Hospital

1951 Child Molestation Act passed

1955 FDA approves use of chlorpromazine (Thorazine)

Out of Mind, Out of Sight

197

1956 Kenneth Donaldson sent to Florida State Hospital

1957 Establishment of Florida Division of Mental Health

1958 Opening of South Florida State Hospital in Hollywood

1959 Opening of Northeast Florida State Hospital/Macclenny

Admission by order of Certification established

1960s Integration of Florida State Hospitals

1961 Committee on State Institutions conducts investigation of Florida

State Hospital

Dr. William DeWitt Rogers becomes director of Florida's Division

of Mental Health

1970s Move to deinstitutionalize mental health care

1972 Baker Act established

1973 Forensic hospital opens at Florida State Hospital

1975 Kenneth Donaldson wins U.S. Supreme Court Case

1976 Florida State Hospital establishes mortuary

Kenneth Donaldson’s book released – Insanity Inside Out

1986 Seminole Valley Golf Club opens on Florida State Hospital grounds

U.S. Supreme Court rules that the Eighth Amendment prohibits

states from inflicting the death penalty upon prisoners who are

insane

1991 Movie “Chattahoochee” released in theaters

1995 Seminole Valley Golf Course closes amid scandal

1996 Department of Children and Family Services (DCF) established

1999 Florida State Hospital receives Governors Sterling Award for

Organizational Excellence

2002 G. Pierce Wood State Hospital in Arcadia closes

2009 & 2012 Florida State Hospital at Chattahoochee receives three-year

accreditation

Sally J. Ling

198

UNUSUAL CAUSES OF DEATH AND NOTEWORTHY

CIRCUMSTANCES - 1933

Name

Date

Death

Duration

admission

Admission

Diagnosis

Age/

Race/

Gender

Cause of Death

Isabelle

Miranda

1/19/3

22 y, 1 m

Main Dep.

Psychosis

62 white

female

Gangrene arm-

Diabetes Mellitus

– Ludwig’s Ang

Henrietta

Henne

1/19/3

1 y, 7 m

Manic Dep.

Psychosis,

Menopause

49 white

female

Self-inflicted

hanging

Mathew

Carlton

1/19/3

12 years

Feebleminde

d with

psychosis.

Deteriorated

54 white

male

Fracture of skull;

accidental

Lizzie

Dixon

1/21/3

34 y, 1 m

Epilepsy

with

psychosis

70 white

female

Pul. Tb. Chronic

amoebas & colitis

Henry

Lee

1/30/3

39 y, 8.5 m

Dementia

Praecox

62 black

male

Influenza.

General

Septicemia.

Ludwig’s Ang.

Minnie

Davis

2/3/33

19 y. 1 m.

Dentia

Praecox

45 black

female

Died suddenly –

cause

undetermined

Richard

Edwards

3/1/33

18 y, 10.5

Dementia

Praecox

42 black

male

Cerebral

hemorrhage

Jimmie C.

Johnson

3/13/3

35 y., 11 m

Feebleminde

84 white

male

Chr. Nephritis.

Crh. Myocarditis,

Cardiac

Decompensation

Laura

Snow

4/24/3

31 y., 7 m.

Senile

Dementia

84 white

female

Chr. Myocarditis,

Arsenical

Dermatitis

Out of Mind, Out of Sight

199

Mamie

Lumley

6/4/33

20 y., ½ m.

Dementia

Praecox

43 white

female

Inf. With

gangrene thigh –

general debility.

Ysolina

Noa

7/23/3

4 y., 1½ m.

Dementia

Praecox

28 white

female

Died suddenly,

cause

undetermined

Barbara

Arbeau

7/25/3

2 y., 4 m.

Menopause

with

psychosis

44 white

female

Bronchial

pneumonia,

Pellagra

Marion H.

Hammock

7/30/3

37 y., 4 m.

Dementia

Praecox

73 white

male

Acute Catarrhal

Jaundice

Gus

Rathers

8/15/3

10 minutes

Undetermine

31 black

male

Undetermined

Mary

Hawkins

9/5/33

39 y., 10 m.

Feebleminde

d Senility

w/Psy.

62 black

female

Cere.

Hemorrhage

William

Fuller

10/8/3

16 y. 2 m.

Feebleminde

66 black

male

Pul. Tuberculosis

Ellison

Cleveland

10/9/3

1 day

Mental

Exhaustion

43 black

male

Exhaustive

psychosis

Rueben

Wilson

10/15/

22 y., ½ m.

Epilepsy

w/psychosis

31 black

male

Pul.

Tuberculosis, Pul.

Thrombisis

Julia A.

Jones

10/28/

17 y., 6 m.

Epilepsy

51 white

female

Status

Epilepticus

H.N.

Carter

11/12/

4 y., 6½ m.

Cer. Spi.

Syphilis

44 white

male

Fractured Skull

Sally J. Ling

200

1933 Child Admissions under the age of 15.

None discharged.

478

 Floriene Peterson, 10 year-old black female, admitted by

court order on 4/15/33 with admission diagnosis of “Feebleminded.”

Discharge book shows she was discharged 6/13/33, “Unimproved.”

 A. H. Bracewell, Jr., 7 year-old white male, admitted by

court order on 6/16/33 with admission diagnosis of “Congenital Iddicy.”

(sic)

 Raymond Moore, 7 year-old black male, admitted by court

order on 6/6/33 with admission diagnosis of “Observations” (Probably

Traumatic Psychosis/Epilepsy).

 Irvin Albert Ingraham, 14 year-old black male admitted by

court order 6/19/33 with admission diagnosis: “Idiocy.”

 Ruth Davis, 12 year old black female admitted 7/4/33 with

admission diagnosis: “Feebleminded.”

 Sammie McKee, 14 year-old white male admitted on

10/1/33 with admission diagnosis: “No Psychosis.”

Out of Mind, Out of Sight

201

FLORIDA STATE HOSPITAL

STATISTICS 1878-1968

Year

Patients

Adm

Fur

Disch

Died

Escaped

Empl

1878

1884

157

1887

183

1890

239

Jan-00

N/A

1892

272

104

N/A

1893

277

106

Jan-00

N/A

1894

306

132

Mar-00

N/A

1895

288

N/A

1896

373

171

Mar-00

N/A

1897

443

175

3/unknown

N/A

1898

491

230

3/unknown

N/A

1899

561

221

Unknown

3/unknown

N/A

1900

612

219

Unknown

N/A

1901

640

274

Unknown

113

118

N/A

1902

697

286

126

102

N/A

1903

734

237

Unknown

104

6/unknown

N/A

1904

747

305

Unknown

133

146

13/unknown

N/A

1905

752

248

57 (included

in total # of

patients)

142

N/A

1906

802

257

85 (included

in total # of

patients)

109

1/unknown

N/A

1907

730

318

113

128

134

Aug-00

N/A

1908

794

298

126

119

2-Apr

N/A

1910

929

329

145

119

120

3-Aug

Approx.

180

Sally J. Ling

202

1912

1,107

381

280

194

12/unknown

N/A

1914

1,336

590

154

212

202

5/unknown

Approx.

200

1916

1,482

563

101

288

238

N/A

1918

1,403

659

146

233

475

17/9

294

1920

1,538

669

234

154

241

64/41

N/A

1922

1,910

698

149

104

240

74/43

N/A

1924

2,266

891

219

130

386

83/55

N/A

1926

2,490

974

322

156

413

108/63

N/A

1926-1928

2,973

2,271

796

281

851

209/138

N/A

1928-1930

3,407

2,597

858

485

892

372/203

N/A

1930-1932

3,706

2,540

1,008

483

845

244/162

N/A

1932-1934

4,011

2,352

985

392

893

183/118

Approx.

700

1934-1936

4,012

1,575

804

261

663

169/94

800+

1936-1938

4,268

1,782

849

194

583

108/65

848

1938-1940

4,613

1,608

786

164

599

115/70

888

1940-1942

5,015

2,086

1,202

142

638

126/65

950

1942-1944

5,203

1,833

1,239

132

830

131/102

793

1944-1946

5,390

1,858

1,295

110

799

101/74

865

1946-1948

5,243

2,359

1,405

139

796

113/78

944

1948-1950

5,729

3,161

1,402

133

768

104/82

1,123

1950-1952

6,223

3,286

1,616

158

728

107/66

1,481

1952-1954

6,490

3,524

1,865

175

727

100/66

1,634

1954-1956

6,521

4,231

2,399

321

897

83/45

1,763

1956-1958

6,680

4,457

2,514

390

957

104/63

1,859

1958-1960

6,396

4,397

2,936

641

899

77/51

1,919

1960-1962

6,106

4,468

2,732

872

960

99/66

1,941

1962-1964

5,929

4,166

2,331

947

896

128/70

2,269

1964-1966

5,646

4,605

2,618

1,155

942

149/92

2,303

Out of Mind, Out of Sight

203

1966-1968

5,309

4,318

2,373

1,091

1,025

115/77

2,430

NOTE: No records were available after1968.

Sally J. Ling

204

INSPECTION REPORT OF THE

FLORIDA STATE HOSPITAL 193-?

The following is a condensed version of an inspection of the Florida State

Hospital made by Dr. Marynia Farnhan sometime in the 1930s

The full report may be found online at:

http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm.

General Overview

The organization of the Florida State Hospital included several

divisions made up of: administration, maintenance, receiving and treatment hospital,

tuberculosis infirmary, dental infirmary, general infirmary for the chronically

disabled among the white patients, and four units that housed the white female,

white male, colored female and colored male patients.

Averaging 100 admissions per month, patients entered

Chattahoochee via the receiving hospital where they were held for 30 to 60 days

before being assigned to general wards. The receiving and treatment hospital itself

consisted of wards to care for the acutely ill of both colors and sexes along with an

operating room, laboratories and x-ray department. During admittance, four

attending physicians, registered nurses and nurses in training conducted thorough

examinations to determine the patient’s mental and physical condition. Histories, if

available, were obtained from the patient or relative, and a diagnosis, both physical

and mental, was made. This was followed by an appropriate treatment plan that was

outlined before the patient was transferred to a ward.

479

After examination, patients were assigned to wards that were divided by sex

and ethnicity. Letters or numbers, in ascending order, further divided each ward and

patients were assigned to these as determined by their “symptomatology,” or level of

physical and mental competency.

Wards consisted of individual rooms with from two to four beds apiece and

a communal porch for gathering. In most wards however, beds replaced space on the

porches because of the severe overcrowding. Generally, the patients seemed well

cared for and the number of nurses sufficient. The general appearance was one of

“cleanliness and order and every effort is made to give the patients proper and

considerate treatment within the limitation of the institution itself.”

480

Out of Mind, Out of Sight

205

Additional wards servicing both sexes and colors included those devoted to

malarial treatment of central nervous system syphilis. Under the direction of Dr.

Mark Boyd of the Malarial Experimental Station that was operated by the

Rockefeller Institute, patients were inoculated with a variety of malaria treatments.

Because no treatment was available in the general wards for patients who

were in the most seriously disturbed and violent mental condition, the receiving and

treatment hospital accepted and housed these patients. This resulted in those with

acute physical illnesses and acute maniacal phases of mental illness being placed

together. On the day Farnhan made her the preliminary visit, she reported that six

seriously mentally disturbed patients were causing pandemonium in the white

woman’s ward of the receiving hospital. So disruptive were their screams that the

other patients, many of whom were recovering from surgery or convalescing from

illnesses, were unable to get any rest, thus extending their recuperation.

481

Besides the wards being overcrowded and the mix of patients within each

ward less than ideal, privacy in the wards was nonexistent. In the white female ward,

dressing, undressing and bathroom needs were all performed in one common area

with no privacy at all, a condition that pervaded each ward in the hospital. Five

communal showers located just a few feet from the washbasins and toilets, some

with no seats, forced patients to bathe while others used the facility. Concrete floors

were damp and hard to keep clean, and showerheads and water pipes leaked causing

the pipes to rust.

482

In this ward, as throughout the hospital, beds were so close together that a

patient trying to reach his or her bed would find it impossible without either moving

the entire line or crawling over those in the way.

Patients who could work were assigned duties according to their

capabilities. Those who were more disturbed and unable or unwilling to work were

allowed outside in a fenced yard. On inclement days they spent time on the porches,

lay in their beds, on the floor under their beds or curled up and scattered throughout

the ward.

Attendants were, for the most part, untrained yet it was noted that

throughout the visit that there was never any evidence of mistreatment of the

patients here and none showed any evidence being afraid of the attendants.

483

Sally J. Ling

206

Tuberculosis Hospital

It was widely known that blacks were particularly susceptible to

tuberculosis and common sense would have dictated that patients in the “colored

wards” who had this disease would have been quarantined in order to control its

spread. At Chattahoochee, however, that was not the case. In fact, it was quite the

opposite.

In the tuberculosis ward of the Receiving Hospital, Farnhan reported that

the porches in the “colored wards” only had simple screen doors to separate

tuberculosis patients from the general population and no provisions to quarantine

those near death into separate rooms. And because there were so many infected

black patients, the remainder were scattered throughout the wards to spread the

infection throughout the general population.

484

Wards

As noted before, wards were segregated by ethnicity, at the time an

acceptable practice in every medical or mental hospital in the country. And

generally the treatment black patients received was inferior to that of white patients.

This policy did not change until desegregation during the mid-1960s, as noted later

in this book.

White Female Wards

The white female population of 1, 670 was housed in an old frame building

with sprinklers but no fire escapes. Attendants worked 12 hours a day, six days a

week for a wage the report called “pitifully inadequate.” Yet the workers appeared

caring and of generally high character despite the fact that none of them had been

trained, except for what they acquired on-the-job in the Wards.

All the Wards were quite similar in physical layout with dormitory style

sleeping arrangements, attached sanitary facilities and a porch that could be

accessed from all parts of the wards. Outside, a large grassy area surrounded by a

fence contained various sized shelters with benches. These were available for the

patients when weather permitted, however, during the summer patients were only

allowed outside during early morning or late afternoon due to the relentless heat.

Severe overcrowding existed in all the wards with some beds only four to six inches

Out of Mind, Out of Sight

207

apart. In many cases, this required the patients to climb over several beds in order to

reach their own.

485

Patients in Ward A had the best physical condition, were the least disturbed

and the most cooperative. Those who were able to work did so with assignments in

the dining, linen and art rooms, industrial shop, outside yard or other general

housekeeping duties such as bed making and cleaning.

486

A moderately sized

attractively furnished day room with books, writing space and comfortable chairs

was shared by patients from Ward A and J.

As the letter of the ward got higher, the patients’ mental and physical ability

showed less capability. Ward F, for example, housed many patients who could not

control their bodily functions. On the day of the inspection, mattresses being aired

were described as extremely filthy with odors commensurate with the soiled

bedding.

487

In Ward G five attendants cared for 105 severely declining patients who

needed constant attention. Included among this group were seriously deteriorated

epileptics who could not maintain body cleanliness or control excretory functions.

This required attendants to change their clothes up to five times per day. Other

patients were destructive to furnishings and clothing and were constantly restrained

by camisoles or tied to chairs or beds except for exercise twice a day.

488

Farnahan noted that the epileptic patients in this ward were of the most

seriously deteriorated type. Here, patients spent a large portion of their time in

restraints, were fed, sometimes forcibly, soiled themselves as well as their clothing

and surroundings, and continuously inflicted injury on themselves and others if

given the slightest opportunity. Other less disturbed patients were subjected to

frequent attacks by those who were more disturbed if they were not closely

watched.

489

Ward L contained 48 patients commonly referred to as “maniacs.” These

were the seriously disturbed patients with dementia praecox and manic-depressive

behavior. These patients constantly screamed, attacked the furniture or were violent

toward other patients. This resulted in many being placed in restraint or sedated

during violent episodes. Farnhan described the disturbance in this ward as intense

with a loud buzz, punctuated by frequent shouts and screams, that could be heard a

considerable distance from the building.

In this ward “frightening brutality” between patients was

commonplace and was met with equal brutality by the attendants. Some of the

Sally J. Ling

208

violence witnessed included patients attacking each other with the attendants having

to drag the offender off by the hair in order to control her until placed in a camisole.

This, the report noted, was because there were too few attendants to make anything

else possible.

490

Two hundred physically debilitated patients were housed in Wards O, S, and

T including those with cerebral hemorrhages (strokes), hypertrophic arthritis and

other chronic incapacitating diseases associated with later life. While some of these

patients were unclean, uncooperative, and sometimes violent, many were in

wheelchairs. These patients, the report stated, could have been cared for in boarding

homes or by family members at home had there been the desire and/or facilities to

do so.

491

While most of Farnhan’s findings were somewhat expected given a facility

of this type, she was most stunned to find a normal male child of three living in a

white female ward among the acutely physically ill and several intensely violent and

disturbed patients.

The mother, who was pregnant at the time she was brought to the hospital

for treatment by the father, was taking care of the child since locating the father had

been unsuccessful. According to the hospital, the toddler was there only after every

effort was made to place him elsewhere and the child’s county of resident refused to

take responsibility.

492

Colored Female Wards

Numbers C-10 to 22 were used to designate the colored Female Wards that

housed a total of 671 patients. Four wards each were housed on three floors, with

each floor being considered a unit. The report stated that despite the wards being

fairly clean, immediately upon entering these wards it was apparent that the

handling of the “colored” female patients was inferior to that of the white female

patients, and that attendants were inferior as well. Twenty-eight day attendants and

15 night attendants cared for the patients with many on “detail duty,” taking patients

to and from outside work, and to and from treatments. This reduced the number of

attendants who were actually on the floor at any given time.

These wards did not have a recreation room but they did have a yard, though

it was less adequate and notably less pleasing than that of the white Female Wards.

Clothing worn by the colored Female Patients was of decidedly poorer quality than

Out of Mind, Out of Sight

209

that issued to the white females, with many patients wearing “ragged and patched

clothes and some being extremely dirty.” This, it was explained, was because it was

“impossible to keep some patients clean, regardless of the efforts . . .”

493

Wards C-11 to 14 contained 196 women, many of who were pellagra

patients and had a deficiency in niacin (vitamin B3). These patients were not

allowed outside and were given special pellagra diets. Also on this floor was a nine

year old feeble-minded child who had been on the ward since infancy.

494

Wards C-15 to17 contained the poorer class of patients who were more

deteriorated. As in the white Female Wards, the higher the ward the more

deteriorated the patient with the exception of C-10. This ward, housed in the

basement, was reserved for the physically incapacitated and senile patients, many of

whom were untidy and entirely helpless, requiring constant care.

495

White Male Wards

Patients in the white Male Wards numbered 1,183. Wards one to 10 were

configured similarly to those of the female wards where again, overcrowding was

severe. With no beds on the porches, however, this left no space between the beds

but only a center aisle. The men had two yards—one for the better class of patient

and one for the more deteriorated and violent patients. These yards were decidedly

less pleasing in appearance with shacks scattered here and there as shelter from the

sun. Steep downhill slopes were hazardous and the fence surrounding the yard was

inadequate to prevent escapes, which appeared to be rather routine.

There was no recreation area and only one small sitting room on the main

floor for visitors. During inclement weather the patients weren’t allowed outside and

simply sat about where ever they could find space. Several hundred of the patients

worked on the farm, or in the kitchens, laundries, mattress factory or various

maintenance shops, always accompanied by an attendant. Use of restraints was

liberal and at the discretion of the Chief Attendant.

496

A physician, in attendance on the ward at all times, was responsible for the

care and treatment of minor illnesses and injuries. Answering correspondence and

examining patients about whom there has been an inquiry was the responsibility of a

second physician.

497

Sally J. Ling

210

Colored Male Wards

The colored Male Wards, numbered 1-11, had a population of 740. Of

those, 297 were employed in various capacities throughout the hospital—laundry,

construction and building repairs, engine and boiler rooms of the heat and power

plants, kitchens, dining rooms and other maintenance of the hospital. The housing

was especially deteriorated with floors sagging and two side wards showing signs of

collapsing inward, and although these wards held fewer patients, they were no less

crowded than those of the white Male Wards.

498

The old and feeble were housed in

ward 11. Also called “the nursery,” this ward housed 11 young children, all of

whom were feeble-minded with “several of the idiot grade.”

Restraint, in the form of leather cuffs as well as chains, was widespread in

these wards due to so few attendants. Although Farnhan saw no evidence that the

patients suffered more from the use of chains than leather cuffs, she was very much

opposed to their use believing that the psychological effect of using chains was

demoralizing and correlated to prison and punishment.

499

The attendant in charge of the nursery was also in charge of an adjoining

ward containing 23 criminally insane patients. Here, restraint was used liberally;

but, an additional method of discipline was also included, one reminiscent of the old

prison—a sweatbox. While there was no sweating, unmanageable patients were

locked in this container where it is impossible to lie down.

Unlike the other wards, certain patients in the “Colored” Male wards were

allowed to wander the grounds with almost entire freedom. One patient with

dementia praecox (schizophrenia) who was in charge of the institution’s coal

burning did not finish his work until 10 or 11 at night but was allowed to come and

go freely from his job without an attendant, even though he was considered

“dangerous and unfit for discharge.”

There was no physician assigned to this ward, however one of the doctors

did make daily rounds to check on patients who were ill and requested interviews. A

small inadequate treatment room serviced minor illnesses and/or injuries, a number

that was unusually large.

500

The Infirmary

This facility was a two-story frame building with porches on all sides. It

housed both male and female white patients who required constant care but did not

Out of Mind, Out of Sight

211

require hospitalization. These patients included those who were paralyzed and who

were unable to feed or dress themselves or had late stage cancer or severe diabetes.

Two “feeble-minded” children were found in this ward, neither of which was

psychotic. Attendants, under the direction of a registered nurse, rendered care.

While there appeared to be ample room to keep beds inside in the male ward

year round, during winter months the beds were moved to the porches so patients

could sit inside. In the summer, this situation was reversed. As temperatures during

winter could drop down to freezing, it seems odd that the beds would be positioned

outside during these months; however, there is no indication to the contrary.

Bathrooms were inadequate with two tubs for the women and two showers

for the men. Bedridden patients in the male ward had to be transported into the

showers via wheelchairs and bathed accordingly as there were not enough attendants

to do it any other way. Meals were brought in from the kitchens, but there were no

provisions to keep the food warm and it was described by Farnhan as unpalatable.

501

General Administration and Management

The hospital operated under the direction and supervision of a

Superintendent who was not a physician and did not have any former experience in

a similar facility. The superintendent managed all areas from operation of the 8,000-

acre farm to purchasing and patient work assignments. Everything was under his

direction supervision except for matters of patient care. That he deferred to the Chief

Physician and his staff of doctors.

Farnhan found the Superintendent’s nonmedical background and the

emphasis he put on fiscal operations detrimental to the curative nature of the

institution. Though she acknowledged he was considerate of the patient’s welfare

and happiness, she felt that his lack of medical training and knowledge of mental

illness failed to provide the skills necessary to give effective direction to the

institution.

502

She was also critical of the program that allowed patients to work in various

capacities around the hospital, believing it was a two-edged sword. The staff, she

suggested, would be reluctant to discharge patients who performed work essential to

the operations of the hospital, a feeling also expressed by the patients. And she

believed the patients could become dependent upon institutional life and would be

reluctant to accept the challenges of a normal community.

Sally J. Ling

212

Farnhan’s goal was not to eliminate the program but to move it under the

direction of a physician instead of the Superintendent. She emphasized that: “Since

it should be regarded as a portion of the patient's treatment, it should inevitably be

undertaken under the direction or delegated direction of the physician in charge of

that patient.”

503

Another area found to be of concern was the food, which she called inferior

grade and without proper balance. Meals, planned by a steward, approved by the

Superintendent and then passed onto the Chief Physician for review, were found to

have excessive use of starches and syrup while almost devoid of fresh fruits. One

menu she cited included beef stew, Irish potatoes, grits, macaroni, light bread and

syrup.

Because some types of mental illness caused a reduction in appetite and it

took great tact and persuasion by the attendants to encourage the patients to take an

interest in their food, Farnhan noted that making sure the menus were balanced was

paramount to maintaining the patient’s best health. But food selection wasn’t the

only problem. Service in the dining room was called “extremely bad” with food

being served in the “crudest and most revolting fashion by being slopped onto

battered tin trays.”

504

Medical Care and Supervision

Under the direction of the Chief Physician, nine physicians, including the

Chief, performed all the duties at the hospital for the almost 4,000 patients and 1,000

employees. Farnhan called the ratio of physician to patient “clearly ridiculous,” and

blamed this for the reason many patients could not be seen for years at a time.

Looking at the responsibilities of these men, one can only agree:

Chief Physician – Oversees all patient care; performs or directs all major

surgeries; supervises 11 attendants and nurses; provides medical and surgical care to

those who are not mentally ill but who have been admitted to the hospital.

 Physician A – Assigned to the white female patients in the receiving

hospital, the general and tuberculosis hospitals; conducts clinics regarding

the treatment of venereal diseases to the white female patients; cares for the

white female employees; instructs the nurses.

Out of Mind, Out of Sight

213

 Physician B – Assigned to the white male patients in the receiving and

general hospital; manages the clinics for white male patients; cares for white

male employees; treatment of white male convicts.

 Physician C – Assigned to the colored female patients in receiving and

general hospital; care of black female employees; care of patients in the

colored Female Wards and correspondence regarding those patients; all

minor surgery and fractures of all patients of both sexes and colors;

conducts clinics in the treatment of syphilis for the colored female patients;

emergency surgery among convicts and employees as well as citizens

brought in off the highway due to automobile accidents. (The hospital was

the only one in the area.)

 Physician D – Assigned to the colored male patients in receiving and

general hospitals; care of colored male patients in the wards as well as

employees; correspondence regarding patients; care of 40 colored convicts

from the State Prison Farm, urological work for all patients of both sexes

and colors; conducts syphilis clinics for colored male patients.

 Physician E – Routine treatment of white female patients in wards and

correspondence; care of white female attendants, nurses and nurses in

training; assists Chief Physician in all major surgery; physical exams for all

new white female attendants and nurses; assists in all urological work.

 Physician F – Charge of correspondence regarding white male patients;

general supervision of the white male wards; care of white male convicts;

administers all general anesthetics in the hospital; operation of the X-ray

department; camp physician for 42 white male convicts located at the

hospital prison camp.

 Physician G – Specialist in diseases of the eye, ear, nose and throat of all

patients of both sexes and colors; performs routine duties when other

physicians are off.

 Physician H – Continuous attendance at the white male wards and treatment

of minor illnesses and injuries; examines all new white male attendants,

white kitchen and dining room workers.

In addition to the physicians, dentists provided care to the patients,

employees and 440 boys at the Industrial School at Marianna.

505

Sally J. Ling

214

Despite the overloaded schedules the report praised the physicians for their

dedication and ability to medically care for the patients under such difficult

circumstances. Farnhan noted, however, that there was a clear lack of accurate and

continuous patient record keeping. This resulted in an incomplete picture of the

individual patient’s condition and led to the patient not being adequately

evaluated.

506

While the Florida State Hospital was primarily designed for the treatment of

the mentally ill, it evolved into more of a medical hospital, as according to Farnhan

treatment of the mentally ill was almost nonexistent, except for an inadequate

hydrotherapy set-up for the white male patients. Occupational therapy, previously

mentioned as part of acceptable treatment, was also inadequate and lacked direction.

Psychotherapy, key to patient recovery and discharge, was also noticeably

lacking, though Farnhan did acknowledge that the physicians’ schedules didn’t

permit adequate time for this. And even if time was available, the hospital lacked

sufficient private space for these sessions to take place. This left the patients to

muddle their way alone, resulting in delayed discharges that cost the State a tidy

sum.

507

Recommendations

In spite of the deficiencies noted in the report, Farnhan concluded that the

institution was relatively clean and maintained a certain amount of order. The

patients were treated kindly but medical supervision was insufficient for the

physicians to become familiar with a patient’s state of mind or in any way contribute

to his/her recovery and possible discharge. She felt the staff was most conscientious

but worked under “crippling handicaps” that resulted in their being unable to render

the type and amount of care needed to assist the patient in his/her recovery.

Farnhan completed her report with a list of recommendations and hoped the

Legislature would provide the necessary funds to upgrade the facility and attract

qualified personnel who could help the state’s mentally ill citizens return to

productive lives. Her recommendations included:

Physical Facility - An aggressive building program to provide more

housing, reorganizing the units to better accommodate those patients who

are disturbed, new hydrotherapy equipment, office space for physicians for

psychotherapy, larger, more pleasant outdoor areas and new laundries

Out of Mind, Out of Sight

215

Personnel – Additional personnel hired in all areas, enough

physicians to allow physician/patient ratio to become 1/150, increased

wages, hiring of physician specialists and psychologists, hiring of a

recreational director, hiring of a hospital record historian

Superintendent – Employment of a physician as Superintendent of

the Hospital who has at least five years of experience in the care of the

mentally ill, moving the current Superintendent into a Business Manager

position

Occupational Therapy – Establish an Occupational Therapy

department with a director and staff trained in this area

Social Services – Establish a Social Services department with

director and staff

Diets – Meal planning should be placed under the direction of a

dietitian

Medical Library – Establish a medical library

508

Sally J. Ling

216

INTERVIEW WITH

MRS. MARY ROGERS

This interview with Mary Rogers, 92, wife of Dr. William Rogers after

whom the William DeWitt Rogers Administration Building was named, was

conducted in Mrs. Rogers’ home in Chattahoochee by Florida State University

intern and research assistant Tara Benton Newman in 2009. Rogers was staff

physician from 1934-1940, chief physician from 1940-1950, superintendent from

1950-1962, and director of the Division of Mental Health for the State of Florida

from 1962-1974.

Q. Where are you from originally?

A. Cantonment, Florida, but I graduated high school in Waycross, Georgia,

when I was 16. I lied about my age to get into nursing school at age 17. I was going

to be a teacher; passed a teacher’s examination but couldn’t afford to buy a car to

drive myself back and forth to school. My sister Luta was already in nursing school

at the Florida State Hospital, so I applied to nursing school there, too. I attended

nursing school from 1932-1935 and graduated with my nursing class of five in 1935.

I was the highest scorer on the board exams from my class and received a trophy for

highest achievement. My sister had also graduated at the top of her nursing class.

Q, How did you meet Dr. Rogers?

A. He was a doctor at the FSH and was one of my instructors. I met back up with

him a few years later when working in Tallahassee or when working in Jacksonville

as a nurse [she couldn’t remember exactly]. He was a very good teacher and I

learned a lot from him but never dated Dr. Rogers at all while a student at the

hospital.

Q. What did you think of Chattahoochee? Where did you live when you first

arrived?

A. I liked it but didn’t know many people outside of the hospital. As a student

nurse, I lived just across the street from the main hospital (in Landis Hall) in a

dormitory for all the student nurses, and maybe some off-duty employees. Life was

Out of Mind, Out of Sight

217

different for us then. The laundry operated on site and we sent out our uniforms for

cleaning. The nursing students and nurses always wore their uniforms for work,

unlike today when some nurses wear street clothes. Back then there was also medical

care available for all the nurses right there on grounds of the hospital.

Q. What was nursing school like?

A. We treated doctors with total respect, and learned a lot from them. If the

doctor walked in the room, the nurses would all stand up. The nursing program had

very strict rules and some of the other girls in the program would come to my room

to sneak out, because I had a corner room on the bottom floor. But I never did such a

thing myself! We could date in school, but if we got married, we were out of the

program. [Her class started out with 15 or 20 girls, but only five of them graduated.]

Q. What did you do after you graduated nursing school?

A. I had a job working for a doctor in Thomasville for a short while, then

worked for a doctor in Tallahassee. My older sister (Luta) had been working for a

doctor in Marianna, and he taught her about anesthesia. Luta wanted to get further

advanced in that field, so she talked me into going to Philadelphia and taking an

anesthesia course. We were up there for about nine months and when the term was

up, Luta had a job at the Florida State Hospital. After that course, I got a job with St.

Vincent’s Hospital in Jacksonville, and that’s when my romance with Dr. Rogers

started up again. We got married in 1937 and moved right onto the grounds of the

hospital; I never worked professionally again.

Q. Tell me about the house(s) where you lived on the grounds of the Florida

State Hospital. Am I correct that you lived in what is now the administration

building from 1950-1961?

A. There were some houses for medical doctors and we lived in one of those

two-stories for a while. We moved into the superintendent’s house (the

administration building) in 1950 and lived there until 1961. Dr. Rogers had the idea

to move into the superintendent’s house because he felt he deserved it since he had

moved up in authority.

Sally J. Ling

218

Our bedroom was in the upstairs of the superintendent’s house. My mother

and our kids lived on the downstairs of the house. My mother had a stroke and

Rogers put her in the hospital here. Then she moved downstairs and we put a buzzer

in and she stayed there in that house with us until she died. The rooms in that house

today are pretty much as they were when we lived there.

The building was not air conditioned at first. The first room to be air-

conditioned was our bedroom. We were the last family to live in the

superintendent’s house before it was converted entirely into administration offices.

Both of our boys were born while we lived in that house: William, Jr. in 1944 and

John in 1947. I drove them to school every day and they would fight about who got

to sit in the front every day. They went right through high school here in

Chattahoochee. The boys were big sports players, mostly basketball. I’m a big sports

enthusiast and enjoy football, basketball, baseball, and playing golf.

There was a rumor that there was a big tunnel underneath the

superintendent’s house, and I remember that every time a kid came to play with my

boys they would try to find the big tunnel under the house, but they never found it.

That house also shared space with business offices, so Dr. Rogers’ office

was literally right next to the residence portion of the house, and he came home for

lunch most days. The house and the offices shared a porch.

In 1961, we moved out of the superintendent’s house into a new house we

had built on the hospital grounds. Towards the ‘70s, Dr. Rogers started thinking

about where we were going to live once he retired, so he built my home here,

modeled exactly on the home we lived in after the superintendent’s home on the

hospital grounds.

I didn’t miss living on the grounds after we moved to our private residence

when Dr. Rogers retired. When we moved to the new house, we still kept our help

[paid by the State] until Dr. Rogers retired in 1974.

Q. What was the hospital like when you first arrived?

A. We were assigned different areas of the hospital to work when we were in

nursing school with graduate supervisors who were in charge of the students who

were doing the care of the patients. I dealt with mostly older patients, long-term [not

necessarily mentally ill patients].

Out of Mind, Out of Sight

219

When I was working there, there was only one main hospital – the majority

of the sick patients were there. Ms. Kirkland was in charge of most of the white

female patients who were not medically sick.

Most of the buildings were heated with steam pipes underground. William

Jr. came home one day saying his feet were hot and it turned out it was because he

had been walking in those steam tunnels. I forbid him from ever going back into

them. In the old days, they would carry people out of the medical building into the

morgue or the TB ward using those tunnels, when it was too cold or for some other

reason they didn’t want to go outside.

Q. Did you have much contact with patients throughout your time there (i.e.,

any working for you? Around the house? Around the grounds?)

A. Not really. I had a cook and a housekeeper employed by the State. Other

employees that lived on the grounds had patients working in their homes, but I never

did. The only time I really ever saw patients was if one accidentally wandered into

the house instead of the business end of the building. [The business offices were

housed in the same building as their home while they lived in the superintendent’s

house.]

I wasn’t afraid of them but never had too much contact with them. [She

does have some things that were made by patients—some lovely pale blue dishes

with white ornamentation on them that were made at the occupational therapy

department, under the supervision of Mary Harvard. Mrs. Rogers loves the dishes,

but they spelled her name wrong on the underside (Rodgers). They were a Christmas

gift, and are dated 12/25/54.]

The occupational therapy department was for patients who were

mentally capable of accepting that work. They made our dining room chair covers

[embroidered silk]. I also have a table that an employee built us - Jaybird Freeman

[deceased]. Other furniture in the superintendent’s house on the grounds [two twin

beds, and some other furniture, and dishes] was also made at the hospital.

We had fresh milk and veggies delivered every day from the garden. I

could go to the kitchen that cooked for the dining hall and get a chicken or whatever

we needed. Staff left food for us on a daily basis in a big cattycornered room off the

house that had an ice chest. The iceman came every day.

Sally J. Ling

220

Q. What was Dr. Roger’s job like? Did he work long hours?

A. In the early days, he was always home at night. Then when he became state

administrator, he was gone some, but it wasn’t too different for me. I always had

help in the kitchen and around the house [cook and housekeeper] and I had the boys,

so it was never any trouble or lonely when he was gone for work.

Q. What were his biggest concerns?

A. Patient concerns were his life’s work and that was definitely his biggest

concern. He would take trips all over the state, once he became the Division of

Mental Health director, to look in on and work with the other hospitals that housed

mental patients.

Q. What did Dr. Rogers used to wear?

A. White men’s jackets, just like today. I sent his jackets to the hospital

laundry. He also wore white linen suits. Patients worked at the laundry but they had

a supervisor. We could send our clothes and bed linens to the laundry but I did some

of my own laundry.

Q. Did you entertain a lot?

A. We didn’t entertain a lot, but when I did I always had help to fix the meals.

Ida O’Connor was my next-door neighbor and we were close. Dr. O’Connor was the

clinical director. After Dr. Rogers went to Tallahassee for his director job, Dr.

O’Connor was the superintendent at FSH. My friend Eleanor’s husband was a

purchasing director for the state and Eleanor and I played golf together.

The hospital had a golf course. Several friends and I decided to get a group

of golfing women together after all the men took off for their golf games every

Sunday. For a while, we went over to Quincy and took lessons from a pro. I played

once a week or more if anyone was ready to play, particularly after the boys got big

enough to go to school. After Emily Hart came, she played a little, but there weren’t

a lot of women players. My golfing buddies didn’t necessarily all live on the

grounds. Jean didn’t live on the grounds all the time – but that was when we played

at the [Seminole Valley] country club.

Out of Mind, Out of Sight

221

We used to have Easter egg hunts all along the lawn of the administration

building. They were for the whole community. Also, the Harry Shepherd orchestra

played at the hospital’s weekly dance [Harry Shepherd was head of finance for the

hospital]. There was also a weekly dance for patients. Sometimes the doctors would

go.

The interview ended as Mrs. Rogers was tired and needed to rest.

Sally J. Ling

222

Out of Mind, Out of Sight

223

At the time of researching and writing this book, the referenced websites were active.

While the author makes every effort to be as accurate as possible, websites change and

evolve over time. Because of this, the author cannot vouch for the accuracy of the websites

at time of publication.

Dale Cox, The Early History of Gadsden County, Florida, 2008, p. 91

Ibid, 89-90.

Richard W. Scott to Edmund P. Gaines, November 28, 1817, American State

Papers,

Military Affairs, Volume 1, p. 688.

Cox, p. 91-94.

Seminole Tribe of Florida, History – “Introduction,”

http://www.semtribe.com/History/Introduction.aspx.

Cox, p. 94.

Ibid.

General Gaines to John C. Calhoun, December 4, 1817, ASP, Military Affairs, Volume 1,

p. 688.

Ibid.

Turnage, Grady, “From Mount Vernon to Chattahoochee,”19??, p. 3.

John C. Calhoun to Andrew Jackson, December 26, 1817, ASP,

Military Affairs, Volume 1, p. 690.

Seminole Indian Tribe of Florida, History, “Indian Resistance and Removal.”

http://www.seminoletribe.com/history/IndianRemoval.aspx. (1/5/2013)

Turnage, p. 8.

“Indian Removal Act,” Twenty First Congress, Sess. I. Ch. 148. 1830, Chap. CXLVIII, pp.

411-412.

Cox, p. 157.

Ibid, p.158.

Turnage, pp. 4, 8, 32.

Ibid, pp. 4-6.

Boyd, Mark F., “The Apalachicola or Chattahoochee Arsenal of the United States,” 1958,

p. 35, M93-4, Box 4, Tallahassee Historical Society Records.

Ibid.

Anonymous, “Two Days in Chattahoochee,” Tallahassee Floridian, December 5, 1935,

p.3.

ENDNOTES

Sally J. Ling

224

Turnage, p. 6.

Boyd, p. 36.

Cox, p. 162.

US History, “Second Seminole War,” http://www.u-s-history.com/pages/h1139.html.

(1/5/2013)

Cox, p. 163.

Apalachicola Gazette, quoted in the Vermont Phoenix, June 21, 1839,

p. 3.

Turnage, p. 10.

Yulee, C. Wicliffe, “Senator David L. Yulee,” Florida Historical Quarterly, 1909, Vol. 2,

No.2, p. 13-14. 1909.

Cox, pp. 201-204.

Boyd, p. 40.

Boyd, p. 40, 41.

Freedman’s Bureau Online, http://freedmensbureau.com. (1/5/2013)

Boyd, p. 41.

Fryman, Mildred L., “Career of a ‘Carpetbagger’ Malachi Martin in Florida”, The Florida

Historical Quarterly, Vol. 56, No. 3, Jan 1978, p. 322.

Ibid.

Turnage, p. 12.

“Report of M. Martin,” Florida Senate Journal, 1970, Appendix, p. 93.

Florida House Journal, 1873, Warden’s Report, pp. 135-136A.

Ibid.

Fryman, Mildred L., “Career of a ‘Carpetbagger’: Malachi Martin in Florida,” Florida

Historical Quarterly, Vol. 56, No. 3 (Jan., 1978), p. 319.

Ibid.

Florida State Penitentiary Record Book 1868-?. ( lost or destroyed)

Powell, J.C., The American Siberia Or Fourteen Years' Experience In a Southern Convict

Camp, p. 8.

Ibid, p. 17.

Florida Corrections: Centuries of Progress, ttp://www.dc.state.fl.us/oth/timeline/1868-

1876.html, 1868-1876.

Martin, Malichi, Annual Report of the Adjutant General of the State of Florida for Year

Ending December 31, 1874, p. 130.

Reports of the Adjunct General and Warden State Prison Years 1869-1888, p. 144.

Ibid, pp. 144-145.

Ibid, p. 131.

Reports of the Adjunct General and Warden State Prison Years 1875-1876, State Journal

1877, p. 162.

Tingley, Charles, email to Sally J. Ling, 2010.

Find a Grave, Betsy Yulee, http://www.findagrave.com/cgi-

bin/fg.cgi?page=gr&GSln=yulee&GSfn=betsy&GSiman=1&GScid=2225761&GRid=23083

088&. (1/5/2013)

Fryman, p. 329.

Ibid, p. 331.

Ibid, p. 333.

Out of Mind, Out of Sight

225

Turnage, p. 12.

Kline, R. & Puerzer, Ellen, West Gadsden County Historical Society,

http://www.octagon.bobanna.com/FL.html. (1/5/2013)

Biennial Report of the State Prison, Commencing March 4th, 1877, and Ending December

1st, 1878, p. 6.

Powell, p.7.

Ibid, pp.8, 10.

Martin, M., Reports of Adjutant General and Warden State prison Years 1969-1888, p. 92.

Powell, p. 8.

Ibid, p. 9.

Ibid, p. 15.

Ibid, pp. 9-10.

Ibid, pp. 50-51.

Ibid, p. 9.

Dr. Hankins, J.S., “Report of Surgeon of Convict Camps,” Senate Journal 1879, p. 241.

In 1913, an 18,000-acre tract of land near Ocala known as "Marion Farms" was purchased

“as the location for a new central prison hospital for aging, crippled and infirm inmates,”

prisoners who could not be leased to private businesses. It was named Raiford State

Penitentiary and was also referred to as the "State Prison Farm," "Raiford Prison" and

"Florida State Prison." Ten years later, Governor Cary Hardee discontinued the convict lease

system and all state prisoners were transferred to Raiford.

http://www.dc.state.fl.us/oth/timeline/1900-1919, and 1922-1924.html.

Gerald N. Grob, The Mad Among US, A History of the Care of America’s Mentally Ill,

Harvard University Press, Cambridge, Massachusetts, London, England, 1994, p. 10.

Ibid, p. 11.

Ibid, p. 5.

Merriam-Webster Dictionary, http://www.merriam-webster.com/dictionary/lunatic.

(1/5/2013)

Grob, p. 6.

Kristen A. Graham, A History of the Pennsylvania Hospital, The History Press, 2008, p.

40.

Ibid, p. 18.

Ibid, p. 20.

Ibid, p. 21.

Ibid, p. 39.

Soreff, Dr. Stephen M. and Bazemore, Dr. Patricia H., “Confronting Chaos,” Behavioral

Healthcare, June 2006, p. 18.

Medieval Medicine, The Humors; http://www.intermaggie.com/med/humors.php.

Personalities, theories, types and tests, The Four Temperaments, The Four Humors,

http://www.businessballs.com/personalitystylesmodels.htm#four temperaments four

humours. (1/5/2013)

Benjamin Rush, http://www.ushistory.org/declaration/signers/rush.htm. (1/5/2013)

Bloodletting and the Four Humors;

http://www.collectmedicalantiques.com/bloodletting.html. (1/5/2013)

Soreff, pp. 16-17.

Sally J. Ling

226

Ibid, p. 17.

Ibid.

Graham, Kristen A., A History of the Pennsylvania Hospital, pp. 40, 42.

Soreff, p. 17.

Hydrotherapy, Alternative Medicine,

http://altmedicine.about.com/od/therapiesfrometol/a/hydrotherapy.htm (1/5/2013)

Hicks, David W. and Opsahl, Stephen P, “The Warm Springs of the Southwest Georgia

Piedmont,” http://www.sherpaguides.com/georgia/flint_river/sidebars/warm_springs.html.

(1/5/2013)

Harmon, Rebecca Bouterie, PhD, “Hydrotherapy in State Mental Hospitals in the Mid-

Twentieth Century,” Issues in Mental Health Nursing, 2009, 30:491.

Ibid.

Hubbard, L.D., MD, “Hydrotherapy in the Mental Hospital,” The American Journal of

Nursing, Vol. 27, No. 8, Aug. 1927, pp. 642.

Harmon, p. 492; Hubbard, p. 642.

Ibid.

Harmon, p. 493.

Hubbard, p. 643.

Soreff, p. 17; Hubbard, p. 643.

100

Soreff, p. 18, Hubbard, p. 644.

101

Hubbard, pp. 642-643.

102

Ibid, p. 644.

103

James W. Trent, Jr., “Moral Treatment,” Disability History Museum,

http://www.disabilitymuseum.org/dhm/edu/essay.html?id=19 (1/5/2013)

104

Grob, p. 20.

105

Graham, pp. 39-40.

106

Ibid, p. 42.

107

James W. Trent, Jr., “Moral Treatment,” Disability History Museum,

http://www.disabilitymuseum.org/dhm/edu/essay.html?id=19 (1/5/2013)

108

Grob, p. 55.

109

Geller, Jeffrey L., and Harris, Maxine, Women of the Asylum, Anchor Books, 1994, p. 34.

110

Ibid, p. 35.

111

Ibid, p. 39.

112

Florida Health Notes, Vol. LII, No. 10 (Jacksonville: published by the Board of Health,

1960), p. 193.

113

State of Florida, Acts of the Legislative Council, 1832, p. 110.

114

Weiser, 53; Richard Chardkoff, “Development of State Responsibility for the Care of the

Insane in Florida, 1830-1850” (MA Thesis, 1964), 3.

115

Florida Senate Journal, 1850, Attorney General’s Report in the Appendix, p. 10.

116

Florida Senate Journal, 1852, pp. 137, 195.

117

Acts and Resolutions, 1852, p. 157.

118

Florida Senate Journal, 1854, pp. 304-306.

119

Ibid, p. 316

120

Florida House Journal, 1855, pp. 23-24.

121

Florida Senate Journal, 1855, p. 124.

Out of Mind, Out of Sight

227

122

“General Presentment of the Grand Jury of Leon County for the Fall Term of 1856,” The

Floridian and Journal, Nov. 1, 1856, Vol. VIII, No. 44.

123

The Floridian and Journal, Tallahassee, Florida, Dec. 13, 1856, Vol. VIII, No. 50.

124

Laws of Florida, 1856, Ch. 792, Sec. 26.

125

Ibid.

126

Florida House Journal, 1858, pp. 24-25.

127

Acts and Resolutions, 1858, p. 135.

128

Reports of Comptroller Treasurer and Trustees of Internal Improvement Fund, 1874,

(Tallahassee: Dyke and Carlisle, 1874), p. 116.

129

Florida Senate Journal, 1874. Report of Comptroller in the Appendix.

130

Eighth Census:1860, p. 98.

131

Report of the Comptroller, 1878, pp .9-10A.

132

Laws of Florida 1877, Ch. 3035, Sec. 95.

133

Senate Journal, 1879. Tallahassee, Fl: C.E. Dyke, Sr., State Printer.

134

Senate Journal, Tallahassee, Florida, 1879, p. 234.

135

Ibid, p. 236.

136

Chardkoff, Rickard B., “The Development of State Responsibility for the Care of the

Insane in Florida, 1830-1950,” Thesis, April 1964, p. 43.

137

Ibid.

138

Ibid.

139

Report of the Adjutant General of the State of Florida, 1877-1878, pp. 9-10.

140

Senate Journal, Tallahassee, Florida, 1879, pp. 239-240.

141

Nelson, Dave, “More of a Prison than an Asylum: Florida Hospital for the Indigent Insane

during the Progressive Era,” School of Social Sciences, V. XVI 2009, No. 3 & 4, Fall/Winter

2009, p. 8.

142

Geller/Harris, p. 110.

143

Ibid, p. 83.

144

Ibid, 139.

145

Ibid, 163.

146

Ibid, pp. 164,165 (Charlotte Perkins Gilman).

147

Ibid, p. 126 (Ada Metcalf).

148

Senate Journal, Tallahassee, Florida, 1879, p. 239.

149

Geller, Harris, pp.112-113

150

Messages and Documents, 1893; Report of Superintendent of State Insane Asylum, p.5.

151

Fleming, E.B, and Fleming, Agustin, Three Years in a Mad House, Donohue, Hennebery

& Company, 1893, p. 21, John, P. McGovern Historical Collections and Research Center,

http://mcgovern.library.tmc.edu/data/www/html/texascoll/Psych/TYM/TYMContents.htm.

(1/5/2013)

152

From the Governor’s Message, House Journal, 1879, Tallahassee, FL: C. E. Dyke, Sr.,

State Printer, pp. 32-33; Division of Historical Resources, Drew Mansion.

153

Journal of the Proceedings of the Assembly of the State of Florida, 1881, (Tallahassee:

Charms A. Finley, State Printer, 1881), pp. 252-253.

154

Florida House Journal, 1887, Report of Superintendent of the Asylum, p. 40.

155

Grob, p. 117.

156

Report of the Superintendent of the Florida Insane Asylum, for the period Beginning

January 1, 1891 and Ending December 31, 1892, p. 5.

Sally J. Ling

228

157

Report of the Superintendent of the Florida Insane Asylum, for the period Beginning

January 1, 1890 and Ending December 31, 1890, pp. 3-4.

158

Ibid, p. 5.

159

Perugi G, Akiskal HS, Rossi L, Paiano A, Quilici C, Madaro D, et al. Chronic mania.

Family history, prior course, clinical picture and social consequences. Br J Psychiatry

1998;173:5148.

160

Report of the Superintendent of the Florida Insane Asylum, for the period Beginning

January 1, 1891 and Ending December 31, 1892, p. 9.

161

Trammell to David Lang, 11 February 1896, Florida Hospital for the Insane

administrative files, 1885-1914, Box 1, folder: “Patients, 1885-1897,” FSA.

162

Find a Grave: Florida State Hospital, http://www.findagrave.com/cgi-

bin/fg.cgi?page=cr&CRid=2225761. (1/5/2013)

163

“Florida State Hospital cemetery: efficient, anonymous,” St. Petersburg Times, August

16, 1976, 8B.

164

Analysis of new arrivals in 1901, Biennial Report of the Superintendent of the Florida

Hospital for the Insane, 1901-1902, p. 33.

165

Messages and Documents, pp. 23-24; Superintendent’s Report 1897, pp. 16-22.

166

Lang to Mr. J.N. Bradsh, Clerk of Board of County Commissioners, Orange County, 3

August 1896, Commitment Records, 1893-1973, Letter Book Volume 3, 1894-1897, FSA.

167

Ibid.

168

Lang to Hon. James Hill, Marion County, 10 August 1896, Commitment Records, 1893-

1973, Letter Book Volume 3, 1894-1897, FSA.

169

Messages and Documents, 1894, p. 5.

170

Cutler, H.G., History of Florida (Chicago: Lewis Publishing Co, 1923), Vol. I. p. 255.

171

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1901-1902,

pp. 13-15.

172

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1905-1906,

p. 11.

173

House Journal, 1905, pp. 1164-1165.

174

“Florida State News,” The Weekly True Democrat, May 26, 1905, p. 5.

175

House Journal, 1905, p. 2142.

176

Ibid, p. 1204.

177

Ibid, p. 2195

178

Ibid, p. 1204.

179

Ibid, p. 1204-1205.

180

Ibid, pp. 2132-2135.

181

Ibid, p. 1167.

182

Ibid, p. 1166.

183

Ibid, p. 1164.

184

“The Insane Hospital: State Press Opinions on the Investigating Committee’s Report,”

The Weekly True Democrat, June 2, 1905, p. 7.

185

“House Adopts Hospital Report,” The Weekly True Democrat, May 26, 1905, p. 1.

186

“What the State Newspapers Say,” The Weekly True Democrat, June 9, 1905, p. 1.

187

Ibid.

188

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1905-1906,

pp. 16, 19.

Out of Mind, Out of Sight

229

189

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1907-1908,

pp. 1-31

190

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1909-1910,

pp. 7, 9.

191

While the use of cribs was eliminated in previous administrations, they were brought back

in subsequent administrations.

192

Superintendent’s Report, 1913, pp. 19-20.

193

Ibid, 1913-1914, p. 30.

194

Ibid, 1913, p. 17.

195

Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1913-1914,

pp. 1.

196

Superintendent’s Report, 1917-1918, p. 9.

197

Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years

1914-1916 (Tallahassee: T.J. Appleyard, State Printer).

198

H.G. Cutler, History of Florida (Chicago: Lewis Publishing Co., 1923), Vol. I, p.256.

199

Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years

1921-1922, p. 39.

200

Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years

1919-1920, p. 256. Physician’s Report, 1919, pp. 32-33.

201

Superintendent’s Report, 1919-1920, pp. 256-257. Physician’s Report, 1919, pp. 20-21.

202

Physician’s Report, 1923-1924, pp. 34-35. Physicians Report, 1925-1926, p. 34.

203

Physician’s Report, 1925-1926, pp. 12-18.

204

Superintendent’s Report, 1928-1930, pp. 7, 8, 11.

205

Series 1063, Carton 85, File Folder 1, Florida State Archives.

206

Series 1063, Carton 85, Folder 99, Florida State Archives.

207

Mendoza, Rebekah, via emails 2010.

208

Superintendent’s Report, 1932-1934, p. 8.

209

Superintendent’s Report, 1934-1936, pp. 11-17.

210

Ibid, pp. 31-32.

211

Page: 84

Ibid, pp. 36-39.

212

Florida State Hospital Chattahoochee, Biennial Report for the Period 1934-1936, p. 56.

213

Ibid, p. 45.

214

While extensive research was done to try to find additional information on the wild life

preserve, no state or county records were found.

215

Laws of Florida, 1935, Ch. 2, Sec. 104.

216

Superintendent’s Report, 1934-1936, p. 83.

217

Ibid, pp. 10, 59-60.

218

Ibid, pp. 87.

219

Ibid, pp. 18-19.

220

Ibid, p. 46.

221

Ibid, p. 48.

222

Ibid, p. 109.

223

Farnahan, MD, Report of Inspection and Survey of Florida State Hospital Chattahoochee,

p. 1.; http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm

Sally J. Ling

230

224

Letter from C.M. Wiggins to Board of Commissioners of State Institutions, April 29,

1938, Box from 1938, Record Group 841, Series 1063, FSA.

225

Information Blank for Florida State Hospital, Percy A. Graham, May 2, 1938 Box from

1938, Record Group 841, Series 1063, FSA.

226

Admittance form, May 4, 1938,Box from 1938, Record Group 841, Series 1063, FSA .

227

Letter from Mrs. Lean Graham to Ralph E. Stephens, M.D., The Florida State Hospital,

July 24, 1938, Box from 1938, Record Group 841, Series 1063, FSA.

228

Notes of Staff Conference, August 8, 1938, Box from 1938, Record Group 841, Series

1063, FSA.

229

Letter from Ralph E. Stevens, MD to Mrs. Lena P. Graham, August 18, 1938, Box from

1938, Record Group 841, Series 1063, FSA.

230

Western Union telegram from the Florida State Hospital to Lena Graham, October 22,

1938, Box from 1938, Record Group 841, Series 1063, FSA.

231

Letter from Ralph E. Stevens, MD to Mrs. Lena Pl Graham, October 22, 1938, Box from

1938, Record Group 841, Series 1063, FSA.

232

Report of Inspection of Body and Undertaking of Deceased Patient Prepared for Burial or

for Shipment, Box from 1938, Record Group 841, Series 1063, FSA.

233

Grob, p. 178.

234

Ibid, p. 180.

235

Ibid, pp. 180-181.

236

Ibid, p. 181.

237

Huskey, Dr. A.L., “Insulin Shock Therapy at Florida State Hospital,” Journal of the

Florida Medical Association, Vol. XXV, No. 6, November 1938, p. 231.

238

Ibid, p. 232.

239

Sabitini, Renato M.E PhD, “The History of Shock Therapy in Psychiatry,”

http://www.cerebromente.org.br/n04/historia/shock_i.htm#meduna. (1/5/2013)

240

Huskey, pp. 232-233.

241

Sabitini, Renato M.E PhD, “The History of Shock Therapy in Psychiatry,”

http://www.cerebromente.org.br/n04/historia/shock_i.htm#meduna. (1/5/2013)

242

Ibid.

243

Grob, p. 185.

244

“Use of Electroconvulsive Treatment for Residents of State Mental Health Treatment

Facilities,” State of Florida Department of Children and Families Tallahassee, August 1,

2008, CFOP 155-40.

245

Grob, p. 182-183.

246

http://science,jrank.org/pages/5576/Psychosurgery-History.html

247

Manjila, S., Rengachary, S., Xavier, A., Parker, B., and Guthikonda, M. “Modern

Psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt.” Journal of

Neurosurgery, July 2008 Volume 25, Number 1-

http://thejns.org/doi/full/10.3171/FOC/2008/25/7/E9.

248

Manjila S, Rengachary S, Xavier AR, Parker B, Guthikonda M. “Modern psychosurgery

before Egas Moniz: a tribute to Gottlieb Burckhardt,” Neurosurgical Focus 2008; 25(1):E9.

249

Jansson, Bengt. “Controversial Psychosurgery Resulted in a Nobel Prize.” Oct. 29, 1998.

http://nobelprize.org/nobel_prizes/medicine/articles/moniz

250

Freeman, III, Walter (Son of Walter Freeman), “The Lobotomist.” American Experience,

PBS.

Out of Mind, Out of Sight

231

251

“The Lobotomist.” American Experience, PBS.

252

Sullivan, Edward, M.D., personal interview.

253

“The Lobotomist.” American Experience, PBS.

254

Ibid. Edward Shorter, Medical Historian.

255

Weil, Martin. “Rosemary Kennedy, 86; President's Disabled Sister,” Washington Post,

January 9, 2005, p. B06.

256

Kessler, Ronald, “Rosemary Kennedy’s Inconvenient Illness,” Newsmax.com, Tuesday,

June 17, 2008.

257

Weil, p. B06.

258

Kessler, Ronald, “Rosemary Kennedy’s Inconvenient Illness,” Newsmax.com, Tuesday,

June 17, 2008, http://www.newsmax.com/RonaldKessler/Rosemary-

Kennedy/2008/06/17/id/324146. (1/5/2013)

259

Ibid.

260

Ibid.

261

“History of Neurosurgery and Neurology in Jacksonville,” James G. Lyerly, Jr., M.D., pg.

262

Sullivan, Dr. Edward, personal interview 2009.

263

Ibid.

264

Lyerly, James G., Sr., “Transsection of the Deep Association Fibers of Prefrontal Lobes

in Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 431.

265

Ibid, p. 432.

266

Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical

Journal, Sept. 1952, pp. 798.

267

Lyerly, J.G, M.D., “Prefrontal Lobotomy in Involutional Melancholia,” The Journal of

the Florida Medical Association, Vol. XXV, Number 5, p. 226.

268

Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in

Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 432.

269

Ibid, p. 427, 428.

270

Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical

Journal, Sept. 1952, pp. 795.

271

Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in

Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 433.

272

Ibid.

273

Ibid, p. 433-434.

274

Ibid.

275

Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical

Journal, Sept. 1952, pp. 795-796.

276

“History of Neurosurgery and Neurology in Jacksonville,” James G. Lyerly, Jr., M.D., pg.

277

Sullivan, Dr. Edward, personal interview, 2010.

278

Ibid.

279

Ibid.

280

Lyerly, Dr. James G., Jr., personal interview 2009.

281

Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in

Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 511.

Sally J. Ling

232

282

Forrester, Angelene, daughter of patient. “The Lobotomist.” American Experience, PBS.

Program transcript, p. 1.

283

“The Lobotomist.” American Experience, PBS, Program Transcript.

284

Ibid..

285

El-Hai, Jack, “The Lobotmist,” The Washington Post Magazine, February 4, 2001.

286

“Remembering the Tragedy of Lobotomies,” Psychosurgery,

http://www.psychosurgery.org/about-lobotomy/ (2010)

287

Swayze II, Victor W., M.D., Frontal Leukotomy and Related Psychosurgical procedures

in the Era Before Antipsychotics (1935-1954): A Historical Overview,” American Journal of

Psychiatry, 152:4, April 1995, p. 511.

288

Ibid, p. 509-510.

289

El-Hai, Jack, “The Lobotmist,” The Washington Post Magazine, February 4, 2001.

290

“The Lobotomist.” American Experience, PBS, Program Transcript.

291

Ibid.

292

Lyerly, M.D., James G., “Results of Lobotomy in Mental Disorders,” Southern Medical

Journal, Sept. 1952, Vol. 45, No.9, p. 795.

293

Ibid, p.794.

294

Sullivan, personal interview, 2010.

295

Lyerly, Dr. James G., Jr., personal interview, 2010.

296

Florida State Hospital Biennial Reports, RB 841, Series 1071, 1940-1942, p. 18.

297

Ibid, p. 21.

298

Ibid, p. 191 and 195.

299

Ibid, p. 203-204.

300

Ibid, p. 206.

301

Walls, Theresa, "The National Mental Health Act of 1946 and the Establishment of

NIMH: Ongoing Challenges," Scattergood Ethics,

http://www.zoominfo.com/CachedPage/?archive_id=0&page_id=-

1670095225&page_url=//www.scattergoodethics.org/?q=node/1146&page_last_updated=20

11-01-14T17:23:49&firstName=Theresa&lastName=Walls. (1/5/2013)

302

Drug rehab wiki, National Institute of Mental Health,

http://www.drugrehabwiki.com/wiki/National_Institute_of_Mental_Health. (1/5/2013)

303

Florida State Hospital Biennial Report, 1938-1940, pp. 5-6.

304

Ibid, pp. 13, 24.

305

Ibid, p. 13.

306

Ibid, p. 31.

307

Florida State Hospital Biennial Report, 1938-1940, p. 44.

308

Florida State Hospital Biennial Report, 1946-1948, p. 36.

309

Ibid, p. 44.

310

Florida State Hospital Biennial Report, 1938-1940, p. 40.

311

Florida State Hospital Biennial Reports, 1948-1950, p. 31.

312

Florida State Hospital Biennial Report, 1938-1940, p. 40.

313

Florida State Hospital Biennial Reports, 1940-1948.

314

Cunningham, Sam, Clinical Psychologist 1950-1988, personal interview 2009.

315

Florida State Hospital Biennial Reports, 1942-1944, p. 51.

316

Florida State Hospital Biennial Report, 1938-1940, p. 54.

Out of Mind, Out of Sight

233

317

Jones, Norman “Champ,” Utilities and Maintenance Supervisor 1973-1993, personal

interview 2010.

318

Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”

Sun Sentinel, July 26, 1993, 7A.

319

Ibid.

320

Baraneau, Jim, personal interview 2010.

321

Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”

Sun Sentinel, July 26, 1993, 7A.

322

Ibid.

323

Baraneau, Jim, personal interview 2010.

324

Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”

Sun Sentinel, July 26, 1993, 7A.

325

Florida State Hospital Biennial Report, 1946-1948, p. 77.

326

Freeman, Paul, “Abandoned and Little Known Airfields,”

http://members.tripod.com/airfields_freeman/FL/Airfields_FL_FtMyers.htm#dorr.

(1/5/2013)

327

“Aviation and Southwest Florida - History Of Florida Aviation,”

http://sites.google.com/site/donbrowne/aviation. (1/5/2013)

328

Florida State Hospital Biennial Reports (1948-1950), RG 841 Series 1071, p. 80-81.

329

Fifteenth Census of the United States, 1930.

330

Florida State Board of Health Bureau of Vital Statistics, State File No. 6656.

331

Admittance Record, Florida State Hospital, DCF.

332

Florida State Hospital Records, Master Patient Index.

333

Annis, Dr. Larry, personal interview, 2009.

334

Isobel Castiglioni Gately, personal interview, March 2010.

335

Admittance Record, Florida State Hospital, May 4, 1938.

336

White, Viki, (granddaughter of Spartaco and Teresa Castiglioni), personal interview,

March 2010

337

Florida Department of Vital Statistics, Death Notices, Gloria Castiglioni.

338

Florida State Hospital Biennial Reports (1952-1954), RG 841 Series 1071, p. 9, 57-67.

339

Krueger, Curtis, “State mental hospital shuts down,” St. Petersburg Times, February 9,

2002.

340

CRIPA Investigation, Memorandum, March 23, 1995;

http://www.clearinghouse.net/chDocs/public/MR-FL-0001-0001.pdf.

341

Ibid.

342

Krueger, Curtis, “State mental hospital shuts down,” St. Petersburg Times, February 9,

2002.

343

Florida State Hospital Biennial Reports 1950-1952, RB 841, Series 1071, p. 9.

344

Ibid, p. 23.

345

House Journal, 1951, p. 1200.

346

Ibid, p. 1198.

347

Ibid, p. 1198-1199.

348

Florida State Hospital Biennial Reports 1950-1952, RB 841, Series 1071, p. 24.

349

Florida State Hospital Biennial Reports 1952-1954, RB 841, Series 1071, p. 30.

Sally J. Ling

234

350

Journal of Nervous and Mental Disease, “The Tomkins Horn Picture Arrangement Test,”

http://journals.lww.com/jonmd/Citation/1958/01000/The_Tomkins_Horn_Picture_Arrangem

ent_Test.16.aspx.

351

Letter from Jackie Humes to Sally J. Ling, Dec. 9, 2010.

352

Commitment Records, S1062, Carton 183, Box description: B 4/1959-9/1959; 9/1959-

6/1960, Florida State Archives.

353

Ibid.

354

Ibid.

355

Ibid.

356

Ibid.

357

Grob, p. 226

358

Ibid, p. 228.

359

“People and Discoveries,” PBS,

http://www.pbs.org/wgbh/aso/databank/entries/dh52dr.html.

360

Florida State Hospital Biennial Reports, 1954-1956, RG 841, Series 1071, pp. 32-33.

361

“People and Discoveries,” PBS,

http://www.pbs.org/wgbh/aso/databank/entries/dh52dr.html.

362

Florida State Hospital Biennial Reports, 1954-1956, RG 841, Series 1071, pp. 33.

363

Grob, p. 229.

364

Kenneth Donald Paper. Manuscripts and Archives, Yale University Library.

365

Donaldson, Kenneth, Insanity Inside Out, Crown Publishers, N.Y., 1976, pp. 13-14.

366

Ibid, p. 7.

367

Ibid, p. 96.

368

Ibid, p. 67.

369

Ibid, p. 70.

370

Ibid, p. 66.

371

Habeas Corpus,” The ‘Lectric Law Library, http://www.lectlaw.com/def/h001.htm.

372

James, Diane, Hospital Administrator, Florida State Hospital, e-mail 2/22/2010.

373

Florida's "Father of Mental Health" Immortalized at Florida State Hospital; Florida

Department of Children and Families press release, http://www.dcf.state.fl.us/news/9-14-

07FSHBuildingDedication.shtml. (2010)

374

Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, p. 6.

375

Broward County History,

http://www.broward.org/Airport/NorthPerryAirport/Pages/NorthPerryNo1.aspx. (1/5/2013)

376

Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, p. 84.

377

Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, pp. 84, 85

378

Florida State Hospital Biennial Reports, RG 841, Series 1071, 1958-1960, pp. 91, 92.

379

Shannon, Paul, “State to Take Over Hospital, Change would Cut Costs,” Miami Herald,

March 26, 1987.

380

Germer, Fawn, “Report: Abuse Continues at SFSH ‘No Evidence’ of Treatment,’” Miami

Herald, October 6, 1988.

381

Witt, April, “S. Florida Mental Hospital to Close, Shutdown of 349-Bed Facility will take

2 to 3 Years,” Miami Herald, May 22, 1993.

382

Paez, Pablo E., Director of Corporate Relations, The GEO Group, Inc., personal email,

July 26, 2010.

383

Florida State Hospital Biennial Reports, RG 841, Series 1071, 1958-1960, p. 106.

Out of Mind, Out of Sight

235

384

Ibid, pp. 108, 118.

385

Ibid, p. 106.

386

Ibid, pp. 113, 123.

387

Report of the Director, Division of Mental Health, Covering Activities of Florida State

Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Floirda State

Hospital, Hollywood; Northeast Florida State Hospital, Macclenny. For the period July 1,

1962-June 30, 1964, p. 125.

388

Ibid, p. 127.

389

Page: 142

AP, “Legislators to Fight Prison Proposal Martinez Plan to Convert Mental Hospital –

Dangerous, Lawmakers Say,” Orlando Sentinel, February 21, 1987.

390

Strobbe, Mike, “A healthy hike: State to add 120 staffers at Macclenny mental hospital,”

The Florida Times-Union, January 11, 1998.

391

About Northeast Florida State

Hospital, http://www.dcf.state.fl.us/facilities/nefsh/about.shtml.

392

Cotterell, Bill, “Mental Hospital Won’t be Privatized,” Tallahassee Democrat, May 1,

2009, p. A4.

393

About Northeast Florida State Hospital,

http://www.dcf.state.fl.us/facilities/nefsh/about.shtml. (1/5/2013)

394

Report of the Director, Division of Mental Health, Covering Activities of Florida State

Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State

Hospital, Hollywood; Northeast Florida State Hospital, Macclenny, For the period July 1,

1962-June 30, 1964, p. 30.

395

Ibid, p. 31.

396

Change in Report. Report of the Director, Division of Mental Health, Covering Activities

at the Florida State Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia,

The South Florida State Hospital Hollywood, Northeast Florida State Hospital Macclenny,

For the Period 1962-1964, p. 6.

397

Final Report of the General Findings of the Committee on State Institutions Relating to

the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,

1961, pp. 1-2,

http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm

(1/5/2013)

398

Ibid, p. 2.

399

Ibid, pp. 3-4, 7.

400

Ibid, p. 5.

401

Testimony from Present and Former Patients at Florida State Hospital,

http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/patient-test.htm.

402

Final Report of the General Findings of the Committee on State Institutions Relating to

the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,

1961, p. 5,

http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm

(1/5/2013)

403

Ibid, pp. 7-8.

Sally J. Ling

236

404

Testimony from Present and Former Patients at Florida State Hospital,

http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/patient-test.htm.

(1/5/2013)

405

Final Report of the General Findings of the Committee on State Institutions Relating to

the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,

1961, pp. 11-13,

http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm

(1/5/2013)

406

Report of the Director, Division of Mental Health, Covering Activities at the Florida State

Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida

State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1960-

1962, pp. 6, 31.

407

Report of the Director, Division of Mental Health, Covering Activities at the Florida State

Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida

State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1962-

1964, p. 7.

408

Williams, Bob, personal interview, 2010.

409

Ibid.

410

Report of the Director, Division of Mental Health, Covering Activities at the Florida State

Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida

State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1962-

1964, p. 52.

411

Report of the Director, Division of Mental Health, Covering Activities at the Florida State

Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida

State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1964-

1966, p. 31.

412

Ibid, p. 36.

413

Grob, pp. 288-289.

414

Ibid, pp. 289-290.

415

Minutes, Board of Commissioners, State Institutions, Florida. Volume 6, 1968-1971, p.

20.

416

Ibid.

417

Ibid, pp. 191-192.

418

Report of the Director, Division of Mental Health, Covering Activities of Florida State

Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State

Hospital, Hollywood; Northeast Florida State Hospital, Macclenny For the period July 1,

1964-June 30, 1966, p. 7.

419

Ibid, p. 8.

420

Report of the Director, Division of Mental Health, Covering Activities of Florida State

Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State

Hospital, Hollywood; Northeast Florida State Hospital, Macclenny For the period July 1,

1964-June 30, 1966, p. 7.

421

Cunningham, Sam, former hospital Clinical Psychologist, personal interview, 2009.

422

Report of the Director, Division of Mental Health, Covering Activities at the Florida State

Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida

Out of Mind, Out of Sight

237

State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period July

1, 1962-June 30, 1964, p. 39-40.

423

Ibid.

424

Ibid.

425

Cunningham, Sam, former hospital Clinical Psychologist, personal interview, 2009.

426

Biennial Report of the Division of Mental Health for the Period 1962-1964. Covering

activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial

Hospital Arcadia, The south Florida State Hospital Hollywood, pp. 39-40.

427

Ibid, pp. 42-43.

428

Ibid, p. 48.

429

Biennial Report of the Division of Mental Health for the Period 1964-1966. Covering

activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial

Hospital Arcadia, The south Florida State Hospital Hollywood, p. 31.

430

Biennial Report of the Division of Mental Health for the Period 1962-1964. Covering

activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial

Hospital Arcadia, The south Florida State Hospital Hollywood, p. 44.

431

Donaldson, Kenneth, Insanity Inside Out, Crown Publishers, N.Y., 1976, pp. 144-147.

432

Ibid, p. 159.

433

O’Connor v. Donaldson, http://www.enotes.com/supreme-court-drama/o-connor-v-

donaldson. (1/5/2013)

434

Donaldson, pp. 243-244.

435

Grob, p. 278.

436

Ibid, p. 297.

437

Donaldson, p. 304.

438

Ibid, p. 295.

439

Kenneth Donaldson Papers, Manuscripts and Archives, Yale University Library.

440

O’Connor v. Donaldson, http://www.enotes.com/supreme-court-drama/o-connor-v-

donaldson. (1/5/2013)

441

Ibid, pp. 325-326.

442

Donaldson, p. 329.

443

O’Connor v. Donaldson: Supreme Court Drama, http://www.enotes.com/supreme-court-

drama/o-connor-v-donaldson. (1/5/2013)

444

Chatt-a-gram, 7/3/75.

445

Cunningham, Sam, personal interview, 2009.

446

Kenneth Donaldson Papers, Manuscripts and Archives, Yale University Library.

447

The History of the Baker Act, www.dcf.state.fl.us/programs/mentalhealth/laws/histba.pdf.

(2011)

448

Ibid.

449

Cunningham, Sam, personal interview, 2009.

450

Ibid.

451

The History of the Baker Act, www.dcf.state.fl.us/programs/mentalhealth/laws/histba.pdf.

(2011)

452

Bob Williams, personal interview 2010.

453

Ibid.

454

Ibid.

455

Cunningham, Sam, personal interview.

Sally J. Ling

238

456

“Deinstitutionalization Concept Paper” (Draft), February 17, 1978, Mental Health

Program.

457

House of Representatives Staff Analysis, h1703.fff.doc, March 23, 2004, p. 2.

458

Forensic Hospital at Chattahoochee,

http://www.dcf.state.fl.us/facilities/fsh/forensic.shtml. (1/5/2013)

459

McClellan, Melanie, Administration Assistant II, Florida State Hospital, email, January

22, 2013.

460

Florida Department of Children and Families,

http://www.dcf.state.fl.us/facilities/fsh/about.shtml. (1/5/2013)

461

Annis, Larry, personal interview, 2010.

462

Resch, Ellen, email, December 27, 2010.

463

Annis, Larry, personal interview, 2010.

464

Resch, Ellen, email, December 27, 2010.

465

Baldrige Performance Excellence Program,

http://www.nist.gov/baldrige/about/what_we_do.cfm. (1/5/2013)

466

Cotterell, Bill, “Hospital death shows threat that many face, Tallahassee Democrat,

Tallahassee, Fla: September 11, 2006, p. B1.

467

Cotterell, Bill, “Ward workers fear violent inmates: Rights of patients overshadowing

protection of staff,” The News Press, Fort Myers, Fla.: April 9, 2007, p. B3; Cotterrell, Bill,

“Hospital fight highlights problems,” Tallahassee Democrat, Tallahassee, Fl: March 13,

2007, p. A1.

468

James, Diane, email to Sally J. Ling, January 5, 2011.

469

Corbett, Nic, “Mental patients break out,” Tallahassee Democrat, Tallahassee, Fla: Feb.

21, 2009, p. A1.

470

James, Diane, email to Sally J. Ling, January 5, 2011.

471

M.E. Grenander Department of Special Collections and Archives, Archives of Public

Affairs and Policy, “Finding Aid for the Alvin Ford Collection, 1965-1995,” APAP-159,

http://library.albany.edu/speccoll/findaids/apap159.htm#history (1/5/2013); Zenoff, Elyce

H., “Can an Insane Person be Executed?,” HeinOnline, 1985-1986 Preview U.S. Sup. Ct.

Cas., pp. 465-467.

472

Malone, Dan, “Cruel and Inhumane, Executing the Mentally Ill,” Amnesty International

Magazine, Winter, 2008, http://www.amnestyusa.org/node/87240. (1/5/2013)

473

Alvord, Gary Eldon, The Commission on Capital Cases,

http://www.floridacapitalcases.state.fl.us/case_updates/041482.doc (1/5/2013); Gary Alvord,

Florida Death Row, http://crime.about.com/od/deathrow/ig/Florida-Death-Row-

Inmates/Gary-Alvord.htm (1/5/2013); Corrections Offender Network, Florida Department of

Corrections,

http://www.dc.state.fl.us/ActiveInmates/Detail.asp?Bookmark=1&From=list&SessionID=68

1150493

474

Corrections Offender Network, Florida Department of Corrections,

http://www.dc.state.fl.us/ActiveInmates/Detail.asp?Bookmark=1&From=list&SessionID=68

1135141; “Death row inmate moved to FSH,” August 26, 2009, By Staff Report:

http://www2.jcfloridan.com/news/2009/aug/26/death_row_inmate_moved_to_fsh-ar-62444/;

Montaldo, Charles, “John Huggins, Florida Death Row Inmate,”

http://crime.about.com/od/deathrow/ig/Florida-Death-Row-Inmates/John-Huggins.htm

(1/5/2013); Corrections Offender Network, Florida Department of Corrections.

Out of Mind, Out of Sight

239

475

Colarossi, Anthony, “Judge sets special meeting with death row inmate John Huggins,”

October 8, 2010, Orlando Sentinel.

476

“The Numbers Count: Mental Disorders in America,” National Institute on Mental

Health, http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-

in-america/index.shtml. (1/5/2013)

477

Mendoza, Rebekah Tomlinson, “Eleanor Rebecca Woodham,” “Lolo’s Story,” and

personal emails to the author, January 2010.

478

“Hospital Records: First Admissions – 1933,” Federal Census for Public Mental Hospital

Reports, Florida State Hospital, RG 841 Series 1068-00001, Florida State Archives.

479

Farnhan, MD, Report of Inspection and Survey of Florida State Hospital Chattahoochee,

http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm. (1/5/2013)

480

Ibid, p. 3.

481

Ibid, p. 2.

482

Ibid, p. 7.

483

Ibid, p. 6.

484

Ibid. p. 4.

485

Ibid, pp. 10-11.

486

Ibid, p.11.

487

Ibid, p. 13.

488

Ibid, p. 12.

489

Ibid, p. 6.

490

Ibid, pp. 13-14.

491

Ibid, p. 15.

492

Ibid, p. 3.

493

Ibid, p. 19.

494

Ibid, p. 18.

495

Ibid, p. 19.

496

Ibid, pp. 21-22.

497

Ibid, p. 22.

498

Ibid, pp. 23-24.

499

Ibid, p. 24.

500

Ibid, p. 25.

501

Ibid, pp. 26-27.

502

Ibid, pp. 28-29.

503

Ibid, p. 30.

504

Ibid, pp. 30-33.

505

Ibid, pp. 33-35.

506

Ibid, pp. 36-37.

507

Ibid, pp. 37-39.

508

Ibid, pp. 43-48.

Sally J. Ling

240

Out of Mind, Out of Sight

241

INDEX

1877 Lunacy Law, 56

Allison, Dr. H.H., 60

Alvord, Gary, 179, 180, 181

Alzheimer, Alois, 43, 149

American Civil Liberties Union,

179

Amerimanage, 141

Amnesty International Magazine,

179

Annis, Dr. Larry, 121, 169, 170

Arcadia, 119,122, 139, 142

Arsenal, 8, 19, 20, 21, 22, 23, 24,

25, 30, 56, 57, 73, 114, 146

Asylum for the Indigent Insane,

Ayers, Preston, 83, 86

Baker Act, 164, 165, 166, 198

Baker, Representative Maxine,

143, 164, 165, 198

Baraneau, Jim, 118

Bergal, Jenni, 118, 119

Bini Dr. Lucio, 93

Birumbaum, Dr., 160

Black Seminoles, 16

Bloodletting, 40

Bloxham, Governor William D.,

Bond, Dr. Thomas, 38

Bowlegs, Chief Billy, 22

Brickle, Adriana P., 60, 62

Broward, Governor Napoleon

Bonaparte, 71, 74, 139

Bryant, Governor Farris, 155

Burckhardt, Dr. Burckhardt, 98

Bureau of Refugees, Freedmen,

and Abandoned Lands, 24,

Calhoun, John C., 16, 17, 224

Carlstrom Field, 119, 120

Castiglioni, Theresa, 120, 121

Cerletti, Dr. Ugo, 93

Chaires, Benjamin, 20

Char, Dr. Wilfred J., 148

Chatt-a-gram, 162

Sally J. Ling

242

Chattahoochee, 7, 8, 11, 16, 19,

20, 21, 23, 24, 25, 26, 27, 28, 29,

30, 31, 32, 34, 35, 36, 37, 56, 60,

62, 63, 64, 65, 69, 71, 75, 79, 81,

86, 89, 105, 114, 117, 118, 119,

120, 122, 125, 126, 127, 133,

134, 135, 136, 138, 140, 141,

142, 143, 144, 145, 147, 151,

152, 153, 155, 159, 160, 161,

162, 163, 165, 166, 168, 169,

170, 175, 176, 182, 187, 188,

191, 192, 193, 196, 198, 205,

207, 217, 219, 224

Chattahoochee Arsenal, 19, 29

Chattahoochee, the movie, 163

Child Molester Act, 125

Chlorpromazine, 130, 131, 197

Christie, Dr., 72, 73

Christofoli, Peter, 80

Civil War, 23, 30, 43, 196

Coley, Representative Martin,

175

Continuous Tub Therapy, 44

Crawford, William, 54, 55

Cunningham, Sam, 117, 153,

162, 163, 164, 166

Dade, Major Francis, 21

Department of Children and

Families, 94, 134, 141

Deutsch, Albert, 112

Dickison, J.J., 36, 59, 60

Dix, Dorothea, 54

Donaldson, Kenneth, 11, 123,

132, 133, 134, 155, 156, 157,

160, 161, 162, 163, 164, 177,

198

Dorr Field, 119, 120

Drew, Governor George, 32, 63

Dry Wraps, 48

Dully, Howard, 108

ECT, 10, 92, 93, 94, 102, 130,

131, 152, 197

Embry Riddle Academy, 119

Eugenics Law, 86

Farnhan, Dr. Marynia, 86, 205,

206, 207, 208, 209, 211, 212,

213, 215

Fever Therapy, 89, 197

First Florida Infantry, 23

First Seminole War, 18, 196

Fleming, E.B., 62

Florida Division of Mental

Health, 152, 198

Florida Penitentiary, 25

Florida State Hospital, 8, 10, 11,

14, 19, 21, 30, 37, 57, 67, 70, 81,

84, 86, 88, 91, 92, 94, 101, 105,

108, 109, 111, 119, 121, 122,

123, 132, 133, 134, 135, 138,

139, 140, 143, 145, 147, 149,

152, 157, 160, 162, 163, 166,

168, 169, 170, 173, 174, 176,

Out of Mind, Out of Sight

243

177, 181, 182, 187, 191, 197,

198, 202, 205, 215, 217, 218

Florida State News, 72

Florida State Prison, 114, 177,

181, 196

Folmar, Dr., 78

Ford, Alvin Bernard, 177, 178,

179, 181

Foreman, Dr. W.B., 60, 66

Fort King, 21

Four Humors, 39, 43

Franklin, Benjamin, 38, 39

Freedmen's Bureau. See Bureau

of Refugees, Freedmen, and

Abandoned Lands

Freeman, Dr. Walter, 98, 99,

100, 101, 105, 106, 107, 109,

197, 220

G. Pierce Wood State Hospital,

119, 197, 198

Gadsden County, 16, 18, 19, 23,

31, 55, 136, 160, 175, 196, 224

Gaines, Major General Edmund

P., 14, 16, 17, 224

GEO Care, 141

Gilcrist, General, 74

Gilman,Charlotte Perkins, 61

Graham, Governor Bob, 178,

181

Graham, Percy A., 88, 89

Grob, Gerald, 37, 65, 94, 112,

130, 131, 156

Gumanis, Dr. John, 148, 161

Gwynn, Dr. V.H., 71, 72, 73

Hand Irons, 39

Hardee, Governor Cary A., 78

Hart, Ossian, 31, 221

Hills, John, 19, 21

Hills, Lieutenant John, 19,

Hogue, Attorney General D.P.,

Hollow Wheel, 41

Holt, General Joseph, 23, 29

Homathlemico, Red Stick Chief,

HRS, 118, 167

Hubbard, Dr. L.D., 44, 47, 48

Huggins, John, 181, 182, 183

Humes, Jackie Hogarth, 127,

128, 129

Huskey, Dr. A.L., 91, 92

Hydrotherapy, 43, 44, 197

Ilyankoff, Officer Dimitri

Walter, 177

Indigent Insane, 28, 36, 56, 63,

196

Insanity Inside Out, 11, 163, 198

Insulin Shock Therapy, 91, 197

Sally J. Ling

244

Jackson, Andrew, 14, 17, 18, 19,

224

Kalinowski, Dr. L.B., 93

Kennedy Shriver, Eunice, 101

Kennedy, Joseph P., 100

Kennedy, President John F., 147

Kennedy, Rosemary, 100, 197

Kirkbride, Dr. thomas Story, 50

Kneipp, Father Sebastian, 43

Kraepelin, Emil, 43

Laborit, Dr. Henri, 130

Leg Locks, 39

Leucotome, 98

Lincoln, Abraham, 23, 188

Live Oak, 32, 34, 35, 36, 72

Lobotomies, 94, 97, 101, 109

Lobotomy, 89, 94, 97, 99, 100,

101, 102, 103, 104, 105, 107,

109, 197

Lolo, 187, 188, 189, 190, 191,

192, 193, 194, 195

Lunacy Law. See 1877

Lyerly, Dr. James G., Jr., 105,

109

Lyerly, Dr. James G., Sr., 101,

102, 103, 104, 105, 108, 109,

197

Macclenny, 134, 141, 142, 143,

198

Mad-Shirts. See Straitjacket

Mallory, Stephen Russell, 23

Martin, Colonel Malachi, 26, 27,

28, 31, 32, 33, 34, 35, 196

Martin, Governor John W., 78

Martin, Weil, 100

Martinez, Governor Bob, 142

Mather, Cotton, 37, 38

Mendoza, Benjamin Alva, 81

Mendoza, Rebekah Tomlinson,

187, 188, 189

Metcalf, Ada, 61

Metrazol. See Metrazol Shock

Therapy

Metrazol Shock Therapy, 92, 197

Milton, Governor John, 23

Moniz, Dr. Antonio Egas, 98

Mount Vernon, 19, 196, 224

Mozely, W.D., 64, 65

Muhlenburg, Major Peter, 15

National Mental Health Act in

1946, 113

Neamathla, Creek Indian Chief,

Nine-Hole Golf Course, 117

North Perry Airfield, 139

Northeast Florida State Hospital,

134, 141

Out of Mind, Out of Sight

245

O’Connor, Dr. J.B., 155, 160,

161, 221

Operation Hope, 151

Osceola, Chief, 21, 181

Pennsylvania Hospital, 38, 49

Perry, Circuit Judge Belvin, 118

Perry, Governor Madison Starke,

23, 55

Plunge-Baths, 51

Pollock, Horatio M., 94

Pound, Dr. J.H., 83

Powell, J.C., 27, 32, 33, 34, 35

Powell, Justice Lewis, 179

Pratt, Eulish, 153

Prison Camp, 35, 84, 214

Public Works Administration, 85

Purging, 39, 41

Puusepp, Dr. Ludvig, 98

Raiford, 79, 114, 126, 177, 181,

183

Randolph, Dr. J.H., 63, 64

Rebekah. See Mendoza, Rebekah

Tomlinson

Reed, Governor Harrison, 24

Reid, Robert Raymond, 29

Reil, Johann, 41, 43

Resch, Ellen E., Ph.D., 169, 170

Restraint, 41, 87, 211

Richardson, Representtive

Curtis, 175

Rodino, Congressman, 155

Rogers, Dr. W. D., 8, 57, 134,

135, 148, 152, 155, 197, 198,

217, 218, 219, 220, 221

Roosevelt, President Franklin, 43

Rush, Dr. Benjamin, 41, 42, 49

Sabitini, Dr. M.E., 92

Sakel, Dr. Manfred, 91

School of Nursing, 115

Scotch Douche, 48

Scott, Lieutenant Richard W., 14,

15, 16, 17, 196, 224

Scull, W. J., 28

Second Seminole War, 21, 196,

224

Seminoles, 16, 17, 18, 19, 22

Shedd, Tirzah F., 61

Shower Baths and Needle

Sprays, 47

Sitz Bath, 46

Smith Kline, 131

Smith, James, 54, 55, 65, 66,

131, 142, 173

South Florida State Hospital,

134, 139, 141

Spiers, Dr. W.H., 78

St. Augustine Record, 74

Sally J. Ling

246

St. Vincent’s Hospital, 105, 218

State Board of Health, 152

Stearns, Marcellus, 31

Stone, Elizabeth T., 51

Straitjackets, 39, 41, 49

Sullivan, Dr. Edward, 101, 105,

109

Sun Sentinel, 118

Supreme Court of the United

States, 161

The Indian Removal Act, 19

The Mad Among Us. See Grob,

Gerald

The Seminole Valley Golf Club,

118

The Snake Pit, 113

The Southern Surgeon, 103

Third Seminole War, 21, 22, 196

Thompson, Wiley, 21, 118

Thorazine, 109, 130, 131, 156,

165

Three Years in a Mad House. See

Fleming, E. B.

Thronateeska, 117, 166, 197

Todd, Ferris, 79

Tomkins-Horn Picture

Arrangement Test, 126

Tomlinson, Eleanor "Lolo"

Woodham, 187

Trammell, J.W., 66, 67, 69, 70,

71, 75

Tranquilizer chair, 42

Transfusion, 40

Twirling Devices, 42

U.S. Supreme Court, 161, 177,

179, 198

Utica Crib, 41, 45, 65. 75

Virginia Eastern Asylum, 49

von Meduna, Dr. Ladislas, 92

Wagner-Jauregg, Julius, 89, 90

Walls, Dr., 113, 160

Watts, Dr. James, 98, 99, 100,

101, 107, 197

Wet Sheet Wraps or Packs, 45

Whitner, B.F., 71, 74, 75

Williams, Bob, 149, 165, 166

Williams, Calvin "Cy", 26, 27,

135, 196

Wilson, Dr. J.G., 28, 88, 89, 200

Wise, Major, 35

Women of the Asylum, 61

Woodham, Sara Martyn, 188,

193

Young Guards, 23

Yulee, Betsey, 28, 29, 30

Yulee, David Levy, 23, 29, 30,

196

Out of Mind, Out of Sight

247

Sally J. Ling

248

ABOUT THE AUTHOR

ally J. Ling, Florida’s History Detective,

is an author, speaker and historian. She

writes historical fiction and nonfiction

and specializes in little known stories of

Florida history.

As a special correspondent, Sally wrote for

the Sun Sentinel newspaper for four years and

was a contributing journalist for Boca Raton,

Gold Coast, Delray Beach, Boca Life, Jupiter and

Palm Beacher magazines.

Based upon excerpts from her book Run the

Rum In, Sally appeared in two TV

documentaries (“Gangsters” - the National

Geographic Channel, and “Prohibition and the

South Florida Connection” - WLRN, Miami).

She served as associate producer on the latter production.

She has been a guest on South Florida PBS TV and radio stations, guest

presenter at the Lifelong Learning Society at Florida Atlantic University and

Future Authors of America, and guest speaker at numerous historical societies,

libraries, organizations, and schools.

Sally lives with her husband, Chuck, and her cat, Kitty, and splits her time

between Deerfield Beach, Florida, and Wolf Laurel, North Carolina.

Out of Mind, Out of Sight

249

ally’s books include:

Nonfiction

Out of Mind, Out of Sight: A Revealing History of the Florida State Hospital at

Chattahoochee and Mental Health Care in Florida

Run the Rum In: South Florida during Prohibition

Small Town, Big Secrets: Inside the Boca Raton Army Airfield during World

War II (First and Second editions)

A History of Boca Raton

Fund Raising with Golf

Fiction

The Cloak: A Shea Baker Mystery (Volume I)

Phillip’s Great Adventures: Spies, Root Beer and Alligators (Children’s Novel)

For information on Sally’s current projects, to become a Preferred Reader, or to

engage her as a speaker, please visit her website at:

sallyjling.com

Sally J. Ling

250

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