The Bureaucracy Of Insanity

And Its Effects On the People of
Early Eastern Washington
Angel L. Rios

     It was early July of 1899 when Susan Glover first laid eyes on the room she would occupy for the next twenty-two years. The furnishings were meager, as were Glover’s possessions.[1]She had just two items, one was a well-traveled trunk containing Glover’s clothes. The second piece was an old chair.[2]It was, after all, a hospital for the insane, not a prison. Glover and the other patients at Eastern Washington State Hospital for the Insane were to receive the very best care modern medicine had to offer. But was Glover insane by the standards of her time? Or was she a victim of frontier Washington’s ill-equipped bureaucracy?

The original hospital built in 1890. Photo courtesy of Eastern State Hospital, Medical Lake, Washington. Creator: Eastern Washington State Hospital For the Insane. Date: 1890.

     At the time of Glover’s admission to Eastern Washington State Hospital, frontier Washington was awash with mental illness. Contemporary newspapers were filled with stories of insanity. When local stories were not enough, newspapers reported on cases found throughout the territory such as the condition of Ellen D. Conway of Vancouver, Washington Territory, who was known for her “wanderings.” Her condition deteriorated to the point that, in the spring of 1880, Conway was examined by a doctor and committed to an asylum.[3]

     National cases of insanity were also reported. Paul Murphy was allegedly driven insane by the shame of becoming a professional chess player. This national story was reported in Washington Territory. His illness manifested itself in Murphy claiming to be a lawyer and knowing nothing about the game of chess.[4]

     Washington newspapers even reported international news of insanity. When the actual stories were not enough to satisfy the public’s insatiable appetite for madness, the fictional serials provided an appetizer. 

     Insanity was also captured in objective documents, places including the census. Given the relatively little information census records recorded it is significant that insanity was deemed important enough to justify a column. In 1860, column fourteen read, “Whether deaf and dumb, blind, insane, idiotic, pauper, or convict.” The same description appeared in column eighteen in the 1870 census.

     Newspaper stories of insanity provided entertainment for a segment of the population and a profit for newspaper owners, the price of mental illness to the individual, their families, and the taxpayers was concerning. Mental illness was a temporary condition, an expensive epidemic that the citizens, hospitals and court system of territorial Washington was not prepared to handle. Close study of frontier newspapers as well as 32 insanity probate cases untangle the bureaucratic maze that led to the institutionalization of Susan Glover and others like her. Additionally, thirty-two probate cases (years 1808 – 1889) Walla Walla and what is now Spokane County were studied. Unlike civil cases, probate cases involving insanity do not contain the testimony of the person whose sanity was being determined. How patients felt or what they thought could not be ascertained through court documents; however, newspaper articles provided some insight into how the mentally ill may have viewed their treatment.

Washington Territory Before Institutions

     In the winter of 1855, a sailor believed to be named Edward Moore was found wandering a beach near Seattle. An unknown samaritan took Moore to town. A doctor amputated most of Moore’s frostbitten toes with an ax. Moore was kept at a hotel under the doctor’s care for several weeks during which time his physical injuries healed, but his mental health did not. Advocates for Moore arranged for him to be taken to Fort Steilacoom, an army fort in Washington Territory, where he would be under the care of Dr. P.M. Burns. Burns and the people of King County petitioned the territorial legislators for reimbursement for Moore’s care. The legislators denied their request.[5]

     The Washington Territorial government rejected reimbursement in Moore’s case for many reasons, not the least of which was the price, $1,659.[6]To put the cost into context, the territory’s income for the year was $1,200.[7]To pay Moore’s bill meant the territory would go into debt and set a precedent for the future reimbursement of ad hoc care for the mentally ill.[8]The legislators realized that doing nothing was not an option. The territory’s lawmakers recognize that Washington’s economy required a large number of sailors, like Moore, to function. They worked together and passed a resolution to request funds from Congress for the construction of a “marine hospital” with a separate psychiatric ward. The hospital was eventually built at Port Townsend.[9]

     Without reimbursement, Burns sent Moore back to Seattle. It was believed Moore had family in Boston. The people of Seattle arranged for a ship captain to take Moore to San Francisco and place him on a boat to Massachusetts to be reunited with his family. It is unclear what became of Moore after he set sail from Seattle.[10] 

     After Moore’s case, the territorial government did little to address the care of the mentally ill in Washington. They might have felt they could craft a solution later because the reported rates of insanity were low. In the years leading up to 1878 Washington Territory had only fifteen patients at the asylum, but an increase in patients in subsequent years outpaced the per capita population growth.[11]Given the devastating impact war has always has on survivors, it is not surprising to see an uptick in mental illness after the American Civil War.

     American doctors’ earliest understanding of what we now know as post-traumatic stress disorder came from Civil War soldiers.[12]In 1865, the public would read and see their loved ones in Walt Whitman’s “The Artilleryman’s Vision,” a poem told from the perspective of a soldier unable to shake the vivid memories of the battlefield:

     There in the room as I wake from sleep this vision presses upon me;

The engagement opens there and then in fantasy unreal…”[13]

     The American citizenry also suffered increased rates of mental illness after stressful situations. Even today, after disasters, psychological illness increases among the general population.[14] The actual number of Civil War volunteers from Washington Territory has been lost to history. Estimates place the number between just shy of 1,000 to just over 1,500. Also, Civil War veterans from elsewhere migrated to the territory. Fifteen Medal of Honor recipients migrated to territorial Washington after the war.[15]Some veterans, like James Gifford, even started small towns.[16]

     While the hospital at Port Townsend was one step closer to the mental health care that we see today, its treatment was limited to sailors. Slowly the people of Washington realized an asylum for the territory’s civilian, poor, mentally ill population was needed.

     Adding to the rise in the number of cases of mental illness was a greater awareness of mental health as American medical schools began training students and treatment options expanded.[17]In Washington Territory, there was an attempt to increase awareness of mental health issues among the general population. Washingtonians read that the modern hospitals of 1874 were nothing like the “madhouses” remembered from a generation earlier. Most importantly not all patients were violent and mental illness was starting to be seen not as a character flaw but an illness like any other.[18]

     Seven years after Moore was placed on a ship to San Francisco, the territorial government’s interest in mental health increased and so did funding for the treatment of persons diagnosed with a mental illness. In 1862, the territorial government solicited bids for a contract to care for the territory’s low-income mentally ill, or “poor insane”, with the contractor being responsible for maintaining the facilities, employees, and all aspects of patient care, including housing and food. The Sisters of Charity in Vancouver Washington won the first contract with the lowest bid of $8 a week per patient. Four years later, a new contract was established with Monticello Hospital in Longview Washington. As the number of patients increased so did the cost of their care. In August of 1871 the land and buildings at Fort Steilacoom, by this time a former army camp, was ready to receive the territory’s poor insane. There were twenty-one patients.[19]In 1887, Fort Steilacoom was renamed Western Washington Hospital for The Insane.[20]The need for hospitalized care continued to increase and in 1891 Eastern Washington Hospital for The Insane opened.[21]The first patients admitted to Eastern were transfers from Western. From May to September of 1891, 122 patients were transferred from Western to Eastern.[22]

An Increase in Patients Yields an Increase in Bureaucracy

     While the overall cost of caring for the patients was now being covered by the territory, the expense of the judicial process was paid for by the county. In 1889, in the case of Daniel Collins, Walla Walla County saw an opportunity to recoup their expenses. Collins was from Whitman County. While in Walla Walla, Collins began suffering from delusions that someone was trying to kill him. Collins was a guest of the jail, the sheriff delivered summonses for witnesses to appear, and the legally required two doctors had a chance to evaluate his mental state. Collins was found to be suffering from mania; he was then sent to the hospital. Walla Walla probate court sent an itemized bill to Whitman county. Whitman county granted a guardianship claim for Collins. The probate court bill from Walla Walla was among the debts the guardian was required to settle for Collins’ estate.[23]No longer considered a mere health issue, mental illness diagnosis and institutionalization became part of the judicial system.

 

     An example of how law enforcement, judicial process and health care intertwined can be seen in the case of Mary Loy. Mary Loy was one of the patients who was resettled in Eastern Washington from Western Washington Hospital. On August 9th,1887 a writ of arrest for Loy on suspicion of insanity was signed by the Spokane County sheriff. She was quickly apprehended and evaluated in Spokane. The doctors determined the 50-year-old mother of six was suffering from mania. “The supposed cause of insanity” was menopause. At first, Loy was sent to Western Washington Hospital for The Insane. She was from Cheney, a town in Eastern Washington, and on July 18th, 1891 she was transferred to Eastern Washington Hospital. Loy died at the hospital on April 25th, 1892.[24]

     Both Western and Eastern hospitals faced periods of overcrowding. Mental illness in the nineteenth century, like today, could be temporary. The seemingly conflicting information of low insanity in Washington and the increasing need to care for the insane demonstrates that attacks of mental illness were fleeting. Mrs. Lucetta Durgin is an example of this paradox. Durgin’s sixteen-year-old daughter passed away from tuberculosis in 1870.[25]In 1871, Durgin was receiving treatment for “temporary insanity from which she was rapidly recovering.”[26]

Bureaucratic Oversight and Problems

     In 1867, in the Washington Territory, the employees of the Monticello Asylum were accused of the mistreatment of female patients.[27]The accusations included rape. At least one woman was thought to have been impregnated by her assailant. Additional allegations included refusal of medical assistance, and little or no food. The accusations were reported as, “a disgrace to our common humanity.”[28]The citizenry of the territory demanded reform.[29]Marshall Moore, the territorial governor, railed against the contractor system and championed the establishment of a permanent territory-run facility.[30]Due to a lack of documentation it is unclear if an investigation into the accusations was launched or what the findings where.

     In 1870 Fort Steilacoom was acquired by the territorial government for the establishment of a permanent hospital. The hospital was managed under a hybrid contract system. The facility’s superintendent was employed by the contractor and the psychiatrist was appointed independently.[31]The territory’s asylum continued to be scrutinized by past employees, journalists, the public and even investigative commissions. These investigations seem to have turned up very little in the way of abuse or mistreatment. 

     In 1875, Hill Harmon, Superintendent of Steilacoom, found himself at the center of a commission investigation into patient abuse under his watch. The five-day investigation on the Steilacoom grounds generated a report that found, “although in one or two cases, more force may have been used than was necessary…it was no more than may sometimes occur in any insane asylum, and in one or two instances a patient was abused, but against the express orders of Mr. Harmon.” The investigators also deduced that “a large majority of the citizens of the Territory are not as well fed, clothed, or cared for.”[32]Hill Harmon was exonerated and remained Superintendent of Steilacoom.

     In the summer of 1880, another investigation into the Superintendent and the Board of Trustees of Steilacoom was concluded. At the end of 1879, the hospital had seventy-five patients. Among the charges being investigated was an accusation that the superintendent had allowed female staff to remain employed even after discovering they had abused patients and had retained incompetent employees. Additionally, the superintendent had discharged patients prematurely. After three days of an on-site investigation that included interviews with board members and employees, the committee found that there was no evidence to substantiate the claims.[33]

Perceptions Of Mental Illness Influence Bureaucratic Processes

     In the ever growing and changing Washington Territory, mental illness was believed by the public to affect the classes differently. The poor were driven insane because of malnutrition, too much work, and exhaustion. The middle class was susceptible to insanity because of work-related stress, the harsh competitive business environment, and according to one journalist, “reckless abandonment to evil passions.” The upper-class were driven insane by a lack of self-discipline, poor life habits, and intemperance.[34] 

     The class differences had an impact on the treatment the mentally ill received. Though it was not intentional, doctors were not able to relate to their patients because their backgrounds were often very different.[35]Many of the patients in the Washington Territory were farmers or housewives of farmers.[36]The doctors and superintendents were well educated.[37] 

     Mrs. Glover had risen in class standing as a result of her husband’s business success, yet her standing in the community had not saved her from commitment to the asylum. As the door to Glover’s room at the hospital closed, she undoubtedly thought back on the events of the previous few weeks. Since returning to Spokane seven years earlier, Glover had rented various apartments.[38]In late June of 1899, she approached C.B. Strong to inquire about purchasing a house he had for sale on Ash Street. Glover agreed to a price. On the first of July, she hired movers to take everything, including her trunk of clothing and old chair, to the house on Ash Street. Later that evening Glover returned to the home to find all of her belongings outside on the sidewalk.[39]

     Undoubtedly shocked and confused, Glover walked around town until she became tired and sat down on the steps of a home owned by the McCrea family.[40]The McCreas sent for the police to remove the “ensconced” Glover. Officer Beals arrived on the scene. He offered to escort her home. But to what home? Glover had moved out of her apartment for a house she was locked out of. At that moment, she had no home. Perhaps she told herself she just needed a little time to think about what had happened and what to do next. But Officer Beals was insistent that Glover could not stay on the McCreas’ steps and eventually she was forcibly placed in a police wagon and taken to the county jail.[41]

Source: https://news.google.com/newspapers?nid=0klj8wIChNAC&dat=18990703&printsec=frontpage&hl=en. Creator: Spokesman-Review. Date: July 3, 1899.

     The Glovers had lived in Spokane before there was a jail. According to James Glover, Susan’s husband, he arrived May 11, 1873, in the area that would become Spokane. He had made the journey from Salem, Oregon with his friend and partner Jasper Manheny. In addition to Spokane Indians calling the area home there were already a few Euro-Americans living alongside the Spokane Falls. Glover and his partner Manheny bought out the Euro-Americans’ interest and began plans to build a city.[42]

     Before leaving for the Washington Territory Mr. Glover was married. Susan Glover, like her husband, had been part of the emigration to the Oregon Territory as a child. Both their families had settled in Salem. In 1874 the “pioneering” generation that settled the Coastal West was remembered, “for their physical and mental activity.” Their descendants struggled to understand why mental illness seemed so prevalent little more than two decades later.[43]

     A part of the generation of hardy mental health, Susan and James married on September 1, 1868. When Mr. Glover returned from purchasing the land for his town, he returned home to his wife, and the two left for their new home in August of 1873. It wouldn’t be until 1879, when some of her male family members moved to the town, that Mrs. Glover would see family again. In those early years, while her husband worked to build the city, letters from home would come with news, sometimes good, and other times sad. Her husband traveled for supplies, leaving Mrs. Glover by herself in a town that was little more than a few scattered wood buildings and dusty trails.[44]

     Glover left no record of her life from those early years in Spokane, but her experiences were probably very much like those of women who set out as the wives of farmers to cultivate the American West. Farming was the number one occupation in the Washington Territory.[45]Women of the time did not make decisions on behalf of the entire household, but many were participants in the process.[46]Glover, like many of the farmer’s wives at the time of their move, had no children.[47]When family were away from home, or the weather was terrible, women did experience temporary loneliness.[48]But the women were not entirely alone for very long as the continued interest in migrating West meant it was only a matter of time until new homes were constructed.[49]

     As Spokane Falls and Eastern Washington were growing, so were the number of cases of insanity. Legally, insanity fell into three categories: mania, melancholia, and dementia. In order for a person to be committed they had to fit into one of these categories. Insanity was a growing concern in the nation and in Washington. Nationally, six of the most common diagnoses in descending rates of affliction were, “mania,” “dementia,” “melancholia,” “epileptic,” “monomania,” and “paresis.”[50]Paresis is a form of dementia, usually accompanied by some form of paralysis, caused by the swelling of the brain routinely seen in the late stages of syphilis.[51]

     From 1850 to 1880 rates of mental illness in America more than doubled. Women made up 52 percent of patients, and the average age was forty-three-and-a-half.[52]The leading causes of mental illness in men was believed to be masturbation, and in women, the reason was thought to be heredity.[53]

     As rates of insanity increased so did the population of Washington territory, including Spokane. In 1880, the Glovers moved into a new home. The early half of the decade saw happy times for the Glovers as they socialized with a growing circle of friends and had opportunities to attend formal events in their expanding city. Their niece came to live with them; she would stay until the summer of 1885.[54]

A stained glass rendering of Susan Glover. This window is located above a doorway on the first floor of the Glover Mansion.

     In 1889 the Glover’s moved into their mansion.[55]They had no children. However, some have speculated there may have been a miscarriage or stillbirth early in the Glover’s marriage, an event that left Susan melancholy. When a friend visited the Glovers in 1884, he couldn’t help but mention how happy Glover seemed to be with her life in Spokane. Years later, she was nearly an unrecognizable person.[56]

Changes in Treatment, but Not in Bureaucracy or Culture

     In 1888, Washington Territory was founding its asylums according to a new understanding of insanity in America. By the early nineteenth century, the French theory and practice of “moral treatment” had reached America. Moral treatment ended the use of chains and asked staff to treat the mentally ill as patients rather than criminals. Moral treatment outlined orderly, regimented activities, such as access to a library, as part of the patients’ individualized treatment plan.[57]Equally important as what it did was what it did not do. Among other things, it ended bloodletting, purgatives, emetics, and torturous hot and cold showers.[58]

     The way insanity was presented to the public was different from the way doctors captured mental illness for the probate courts. A person wasn’t reported as having been diagnosed with the mental illness of mania; instead, the person was described as a “maniac” based on their wild actions. The causes of mental illness in cases was often left out of the story or wildly speculated. In Pullman Washington, in 1894, a newspaper story about a mental health examination appears under the headline “Full of Dynamite.”

     A man identified only as Henager became highly agitated when his wife appeared in the courtroom to testify. He began throwing dynamite caps at her. The guards jumped Henager and removed him from the courtroom. After a search of his person, Henager was allowed to return to the courtroom. When his wife began to testify Henager produced two more dynamite caps that the guards had not found. Again, the guards subdued Henager and removed him from the courtroom. This time the man was strip-searched. The only explanation reported to the public was that Henager had once before been committed, was drinking heavily and jealous of his wife, and believed to be both homicidal and suicidal.[59]

     How people acted out as a result of their mental illness was nearly as varied as the causes. In the nineteenth century, just as today, personal economic hardship was a motivating factor for some suffering from mental illness to commit suicide. Financial problems drove an assistant postmaster in Spokane, George A. Silvey, to commit suicide. It was not until after his death that investigators discovered Silvey had embezzled $7,000. For years after his death residents of Spokane speculated that “women and gambling were his undoing.” Unrequited love was another factor in suicide. E. Ross Smith and Effie Clark, both from Spokane, were away at the same college. Clark rebuffed Smith’s romantic advances. Smith shot and killed Clark before turning the gun on himself.[60]

     Another murder-suicide gripped the Inland Empire in 1888 when the small community of Colfax was jolted by the shocking actions of David Yeater in early November. Newly married Yeater complained to friends about his marriage. One afternoon Yeater returned home to find his wife working on a sewing project with a female client. When the client left the room for a drink of water, Yeater pulled out a gun. When the woman returned she saw Yeater holding the gun to his wife’s head. The woman ran for help. By the time she returned with the sheriff it was too late. Yeater had killed his wife and himself. A macabre journalist spelled out the gruesome details for readers. Mrs. Yeater’s hair was drenched “in blood and her brains ooz[ed] from a large hole in the right temple.” Yeater’s self-inflicted gunshot wound to the head caused “a great stream of blood,” that went “nearly across the room.” He left two notes. In one, Yeater claimed to have been motivated to take action by his wife’s drug addiction. He worried that they would separate because of her drug use and “he could not bear to lose her.”[61]

     Not all homicidal individuals were suicidal. The prevalence of insanity was such that murderers used insanity as a defense in the courts. The public at large became suspicious that some killers were feigning mental illness to get away with their sinister crimes. One New Jersey murderess who drew the attention of those in the Washington Territory was Irene A. V. House. House had killed her husband. She was adjudged to be insane and sent to an asylum. Upon her release from the hospital, the newspapers commented: “it is a remarkable fact in pathology that murderers are cured of insanity quicker than any other class.”[62] 

     Dementia was another common illness that required hospitalization. Frequently the patient’s family and friends had noticed a decline in the person for many years. Usually an examination was a last resort, coming after everyone had done the best they could for the person. Those diagnosed with dementia were predominately over 45 years of age. Catherine Mack was such a case. According to Mack, one day in 1872 her husband, a dentist in Walla Walla, came home and told her to pack up her belongings and leave. Mack took her daughter and left. Three years later she sued for divorce. In her complaint Mack testified that her estranged husband had provided no support to her or their daughter. In 1883, at the age of 46, Mack was diagnosed with dementia. The cause was thought to be hereditary.[63]

     Patients like Mack deserved quality treatment in the hospitals. What was good enough for other asylums was not good enough for Washington. The theory of moral treatment seemed a possible solution. Those in charge of establishing the Eastern Washington State Hospital cherry-picked the best parts of moral treatment theory and left the rest behind. The fundamental course of treatment was isolation from family and friends, and that any non-disabled patient would work on the hospital grounds.[64]The use of restraints was extremely limited and had to be authorized by the doctor.[65]This re-tooled moral treatment was what Glover and others at Eastern Washington State Hospital received.

     Moral treatment seemed to facilitate recovery, among some patients.  In 1884 Elizabeth Goth, of Walla Walla, a 33-year-old mother of three was committed for what today would be identified as postpartum depression. Goth’s condition became noticeable after the birth of her youngest child, five months before her court date. The complaint noted Goth’s behaviors included, “wandering around,” and “neglecting family.” The physician’s certificate warned the probate court that Goth was a danger to her children. Goth was sent to the hospital on April 19, 1884, where she recovered and was released on June 22, 1885.[66]

     Glover was not so lucky. When Officer Beals put Glover into the back of the police wagon, she was 56 years old, the prime age for admittance into the hospital. However, there was a process. First Glover had to be evaluated by two physicians and then have her day in court.

     Territorial laws allowed for anyone to call a charge of insanity against any other person. If the person charged with insanity was found to be sane the person who made the accusation was responsible for all the fees associated with the case.[67]An example of this is seen in the Campbell case. In the summer of 1867 Fannie Campbell’s brother, Harrison Campbell, claimed Fannie (a minor) was insane because she wanted to “depart and live in a state of adultery.”[68]Fannie was found to be sane. Had she been found insane the fees would have come out of her assets, if she had any. If she was insolvent, like poor toeless Moore had been, the county would have been legally required to cover the costs, not only for her court case but also for her institutionalization.[69] 

     Regardless of assets, anyone suspected of insanity received the same evaluation. State law required two physicians conduct the “inquiry and examination.” The superintendent at Eastern Washington Hospital complained, in 1892, that the evaluations and accompanying paperwork were completed carelessly. This accusation was alarming because in some instances sickness that could have had a direct impact on a person’s behavior, was not documented. Additionally, the forms contained contradictions. The examining physicians would state that the patient was not a risk to themselves or the safety of others, but then say the opposite on the next page. Sometimes the evidence that a person was insane was answered with, “his antics.” The superintendent asked that the local doctors conducting the evaluations be better trained.[70]

     Two doctors would have evaluated Mrs. Glover before her probate case. Glover’s ex-husband and others were called upon to testify at her hearing. According to the Spokesman-Review, friends said, “within the last year her mental affliction has been growing worse and that at times she became almost abusive.”[71]It is likely some friends gave testimony that closely resembled these claims. After all the evidence was delivered to the court, the judge committed Glover into the care of Eastern Washington State Hospital for the Insane. Ten days later a friend of Mrs. Glover’s convinced Jules L. Prickett to become her guardian. Pickett was appointed as Glover’s legal guardian to manage her finances. Prickett likely had no idea he would handle Glover’s funds for the next twenty-two years as there was some, though not high, hope of Glover’s recovery and release.[72]

     Appointment of a guardian had been the law of the territory since the early 1850s. Once the patient had recovered from insanity they would regain control of their finances. If the person died, the guardian would turn the estate over to the next of kin.[73]This indicates there was an expectation that people could or would recover from their illness. Insanity was legally viewed as being a temporary state.

     In addition to the aforementioned case of Mrs. Lucetta Durgin, the case of Franklin J. Wentworth, apprehended in Walla Walla County in 1882, is an example of recovery. Wentworth went to the Hospital For The Insane Of Washington Territory on December 2, 1882. Adjudged and committed for mental derangement, Wentworth spent just a few months at the hospital. On March 13, 1883, the hospital superintendent sent a letter to the Walla Walla Probate court that Wentworth had been discharged.

     Though Susan Glover’s decades of commitment might seem rear, another case of guardianship for an extended period is that of Noah Isham. Isham of Walla Walla was evaluated and found to be insane in 1868. In 1870 the court granted O.P. Lacy guardianship. Lacy was to take care of Isham’s financial affairs. Isham spent the next twelve years at the asylum in Monticello.[74]In May of 1880 the Walla Walla County Probate Judge was notified of Isham’s death, “an indigent patient committed to this hospital from Walla Walla County.”[75]Isham and Glover were not the only institutionalized patients to live out the rest of their lives in a hospital.

     The superintendent of the hospital was the only person with the authority to determine whether or not a patient was ready to be released from the institution. As mentioned earlier, there were only two doctors on staff at Eastern Washington State Hospital, one of whom was the superintendent. In the first full year of the hospital’s operation, the average daily population was just over 149 patients.[76]The number of people committed steadily increased. The average daily population of 218 in 1894 grew to 240 in 1895.[77]With the hospital’s patient caseload growing there was no way for the superintendent to become personally acquainted with each of the patients under his care. The concern of overcrowding was in the hospital’s first biennial report.[78]

     Unable to personally see each patient, the superintendent relied on the vague information provided in the paperwork his staff of attendants completed each day.[79]The attendants oversaw between 40 and 50 patients, worked 12 hour days and lived in the same ward as their patients. To keep the cost of care low, attendants were paid very low wages. Doctors and attendants did not have much time for patients.[80]This lack of personalized treatment fell short of the state’s intent; however, patients still recovered and were released.There were five categories for discharge; “recovered,” “improved,” “unimproved,” “not insane,” and “dead.” All five groups were used from 1891 to 1895.[81]It is worth noting that in the hospital’s first six years of operation only eight people were found not to be insane. All of them were men.[82]

Paperwork from a probate case file.

     The old saying, “an ounce of prevention is worth a pound of cure,” was applied to mental health. As mentioned earlier two of the three economic classes were thought to have mental illness brought on by too much work or the worry over work. The idea of being “overworked” grew in popularity. M. Maurice, a doctor, said: “we need less work, but we need it to be wisely directed.” The doctor cautioned readers against trading sleep for anything.[83]The idea of resting became popular. A midday nap, for homemakers, was recommended in one 1891 paper.[84]

     Mr. Henager, the dynamite-cap-throwing-man mentioned earlier, was not the only person to be recommitted to the hospital. It was not unheard of for people to recover from their illness only to be committed again. Many patients were in and out of the hospital. It was reported on April 19, 1899, that Kenneth Bellairs was held in jail awaiting a mental health examination. On May 2, 1899, Bellairs was committed to Eastern Washington State Hospital for the Insane. Over the course of the next year he was released. But on August 24, 1900, Bellairs once again was held in jail for examination. On the fifth of September, he was declared insane by the probate judge and sent back to the hospital. [85]

     At Eastern Washington State Hospital, men made up a higher percentage of the population. At Eastern, male patients were hospitalized at more than twice the rate of females.[86]Nationally, men and women were institutionalized at roughly the same rate.[87]However, on the frontier men outnumber women by nearly 2:1.[88]In the first year Eastern avoided overcrowding male patients by using a portion of the women’s ward. The superintendent’s report predicted that expansion was necessary as the number of female patients was likely to increase over the next two years.[89]The elderly faced institutionalization at a higher rate between 1891 and 1896.[90]  

The Bureaucracy of Recovery

     At the time of Glover’s commitment to the hospital, she was 56 years old. Because of her age Glover would have been considered, by the hospital’s superintendent, as having “almost no hope of recovery.” Patients considered “aged persons” would be expected to die of natural causes “at an advanced age” in the hospital.[91]This despite the constant reporting of insanity in the territorial newspapers that kept the issue of mental illness in the forefront of the minds of the reading public. As instances of insanity increased across the territory, the citizenry strove to hold the superintendents accountable and provide the best opportunity for recovery to all patients.

     Moral treatment became the standard of care in Washington just as it was falling out of favor in the rest of the nation. The failure of moral treatment was its promise to cure most patients.[92]The high cost of humane treatment and the added pressure to cure patients led to dishonest bookkeeping. Cure rates were based on the number of patients discharged, and hospitals used the word “recovered” loosely, which led to patients being readmitted and discharged repeatedly.[93]While there were cases of patients being readmitted in Eastern Washington, the rate suggests relapse in the person’s mental health condition, rather than the superintendent attempting to put a positive spin on the hospital’s program.

     Over the course of just two decades worth of moral treatment, with its high cost and lack of promised results, the treatment plan lost favor with multiple state legislatures and began losing funding.[94]Except in Washington Territory, where advocates for mental health treatment saw the progress moral treatment had made.[95]Not until the beginning of World War II was a clear change in treatment seen. After the Second World War, Sigmund Freud’s theory was put into practice with the implementation of group and one-on-one counseling.[96]Another advancement in treatment came from psychotropic medications that became available at Eastern in 1954.[97]  

The Case of Susan Glover

     In the past, like today, mental illness was a largely temporary condition, as seen in the cases of recovery. It could also be a recurring illness, as seen in the cases of recommitment. Mental illness affected hundreds of Washingtonians at a cost that the territorial government was not prepared to handle.

     The cases recounted here raise an interesting question; would these people be considered insane today? It’s difficult to say with certainty because many of the probate case files lack specific detail and patient medical records remain sealed. However, classifications and treatments have changed.

     Elizabeth Goth, the 33-year-old mother of three, who spent 13 months at the hospital for her postpartum depression very likely had depression rather than the more advanced psychosis, because, according to the Mayo Clinic, postpartum psychosis could require medications not available in the 19th century.[98]Goth’s illness, as well as the others discussed in this article, can be found in the Diagnostic and Statistical Manual of Mental Disorders, the book published by the American Psychiatric Association and used for the classification of all types of mental disorders. Therefore, it is likely that the men and women in these pages, by today’s standard, would be diagnosed with a mental illness. 

     There has been a change in the standard of care patients receive. Age is no longer the deciding factor in determining a patient’s chances of recovery from mental illness. In early Eastern Washington, older patients were often institutionalized for dementia. The most common form of dementia seen today is Alzheimer’s disease for which there is still no known cure. However, according to the Alzheimer’s Association, some types of dementia can be cured because they are brought on by “thyroid problems and vitamin deficiencies.”[99]Although these forms of dementia are rare and the likelihood of a 19th-century patient recovering because the foods served at the hospital contained the vitamins they needed is low, the one undeniable fact remains that if a senior had recovered, then their age would have made it nearly impossible for them to be released.

     Looking back once more to Glover alone in her room at Eastern Washington State Hospital, one wonders, was she mentally ill or had she just had a dreadful day? Forgetfulness is a symptom of dementia.[100]Glover’s age makes this the most likely diagnosis; however, the symptoms do not seem to manifest themselves in the known accounts of her actions. Glover had not forgotten to hire movers. She had not gone to her old address and become upset about her belongings not being there. Glover had become upset after she had gone to the new address and found her belongings outside, indicating she remembered she had moved.[101]Even if Glover had been ill enough for hospitalization, if she had been 20 years younger, she would likely have only spent a few weeks, or a few months at most, in the hospital.

     Goth had been ruled a danger to her children and spent just 13 months in the hospital. Because Glover was more than 20 years older than Goth, and had very little personal interaction with the facility’s doctors she spent 22 years, the last 22 years of her life, in the hospital.  

     These cases offer a window into Eastern Washington’s history of mental illness. On America’s frontier doctors, lawmakers, family and friends were attempting to understand an illness, cope with the expense of care, treat patients with dignity, and hopefully cure some people along the way. Some were helped and released, others required recommitment to the hospitals, and a few may have been unfairly committed for life.

     On October 11, 1921, Glover died of pneumonia. Eastern Washington Hospital for the Insane had a private patient cemetery on their grounds. It is there that Glover was buried in a grave marked only with a number.[102] 

The “Eastlake” building as it appears today on the grounds of the Eastern Washington State Hospital.

[1]Barbara F. Cochran, Seven Frontier Women and the Founding of Spokane Falls, ed. Suzanne Bamonte and Tony Bamonte, (Spokane: Tornado Creek Publications, 2011), 58.

[2]Cochran, Seven, 57.

[3]“Gone To the Asylum,” The Vancouver Independent(Vancouver, Washington), May 20, 1880, page 5, column 2, accessed November 4, 2017https://www.newspapers.com/image/71083507.

[4]“Ashamed,” The Washington Standard(Olympia, Washington), Jul 18, 1879, Page 6, column 3, accessed November 4, 2017, https://www.newspapers.com/image/337490804. 

[5]Thomas W. Prosch, The Insane in Washington Territory(Seattle: Northwest Medicine, 1914), 2-5, accessed November 4, 2017, https://www.sos.wa.gov/legacy/images/publications/SL_proschinsane/SL_proschinsane.pdf.

[6]Prosch, Insane in Washington, 5.

[7]Prosch, The Insane in Washington,6.

[8]Prosch, The Insane in Washington, 6.

[9]Prosch,The Insane in Washington, 5-6.

[10]Prosch, The Insane in Washington, 2-5.

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[12]Walter E. Barton, The History And Influence Of the American Psychiatric Association, (American Psychiatric Press, Inc., 1987), 53.

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[14]Walter E. Barton, The History And Influence Of the American Psychiatric Association, (American Psychiatric Press, Inc., 1987), 53.

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[19]Prosch, The Insane in Washington, 8. 

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[22]First Biennial Report Of the Board Of Trustees Of the Eastern Washington State Hospital For the Insane(Olympia: O.C. White, 1892), 8.

[23]Daniel Collins, Original Case file 4558, Frontier Justice, Walla Walla County, Original Case file 196, Frontier Justice, Whitman County, Washington State Archives, Eastern Washington Branch, Cheney, Washington.

[24]Mary Loy, Original Case file 161, Probate, Spokane County Clerks Archives, Spokane, Washington.

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[27]Russell Hollander, “Mental Health Policy in Washington Territory,1853-1875,” The Pacific Northwest Quarterly, 71, No. 4 (Oct.,1980), 155, accessed November 16, 2017, http://www.jstor.org/stable/40490079.

[28]“The Insane Asylum,” Walla Walla Statesman(Walla Walla, Washington) October 18, 1867, page 2, column 1. 

[29]“The Insane Asylum,” Walla Walla Statesman(Walla Walla, Washington) October 18, 1867, page 2, column 1. 

[30]Hollander, “Mental Health,”155.

[31]Hollander, “Mental Health,”155.

[32]“Report of the Investigation Committee,” The Washington Standard(Olympia, Washington), January 16, 1875, page 2, column 4, accessed November 4, 2017, https://www.newspapers.com/image/337474129. 

[33]“Insane Asylum Investigation,” The Seattle Post-Intelligencer(Seattle, Washington) July 13, 1880, page 4, column 1-2, accessed November 4, 2017https://www.newspapers.com/image/333579224. 

[34]“Insanity And Its Causes,” The Washington Standard, (Olympia, Washington), November 23, 1878, page 4, column 2, accessed November 4, 2017, https://www.newspapers.com/image/337480908.

[35]Gerald N. Grob, Mental Illness, and American Society, 1875-1940, (Princeton: Princeton University Press, 1983), 22.

[36]First Biennial Report Of the Board Of Trustees Of the Eastern Washington State Hospital For the Insane(Olympia: O.C. White, 1892), 24.

[37]Gerald N. Grob, Mental Illness, and American Society, 1875-1940, (Princeton: Princeton University Press, 1983), 22.

[38]Lisa Waananen Jones, “Facing History: The Story That James Glover Didn’t Want You To

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[40]Cochran, Seven, 55.

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[42]J. William T. Youngs, The Fair And the Falls; Spokane Expo 74(Cheney; Eastern Washington University Press, 1996), 3-11.

[43]“Insanity and Its Causes,” The Washington Standard (Olympia, Washington) Nov 23, 1878, page 4, column 2, accessed November 4, 2017. https://www.newspapers.com/image/337480908.

[44]Cochran, Seven, 26-33.

[45]1860 and 1870 U.S. Census and 1885 and 1887 Spokane County Census.

[46]Sarah Brooks Sundberg, “Picturing the Past: Farm Women On the Grasslands Frontier 1850-1900, Great Plains Quarterly, 30 no. 3 (Summer 2010), 205, accessed October 15, 2017, http://www.jstor.org/stable/23534505.

[47]Brooks Sundberg, “Picturing the Past,” 207.

[48]Brooks Sundberg, “Picturing the Past,” 210.

[49]Brooks Sundberg, “Picturing the Past,” 208.

[50]Grob, Mental Illness, 8.

[51]“Paresis,” Dictionary.com, accessed November 11, 2017, http://www.dictionary.com/browse/paresis?s=t.

[52]Grob, Mental Illness, 8.

[53]First Biennial Report), 25-6.

[54]Cochran, Seven, 33-4, and 43.

[55]Cochran, Seven, 48.

[56]Waananen Jones, “Facing History,” accessed 12, 2017, https://www.inlander.com/spokane/facing-history/Content?oid=2336047.

[57]Albert Deutsch, The Mentally Ill in America; A History of Their Care And Treatment From Colonial Times (Garden City: Doublebleday, Doran & Company, Inc.),91-2.

[58]Deutsch, Ill in America, 77-83.

[59]“Full of Dynamite,” Pullman Herald (Pullman, Washington), Dec 7, 1894, page 1, column 5, accessed November 8, 2017, https://www.newspapers.com/image/194816640.

[60]Durham,History of the City of Spokane, vl. 1, 452-3.

[61]“The Colfax Tragedy,” Pullman Herald(Pullman, Washington), Nov 3, 1888, page 1, column 5, accessed November 8, 2017, https://www.newspapers.com/image/143914742.

[62]The Washington Standard(Olympia, Washington) Nov 10, 1877, page 7, column 1, accessed November 4 2017, https://www.newspapers.com/image/337471239.

[63]Catherine Mack, Original Case files 1081, 4497, 4244, and 4246, Frontier Justice, Walla Walla County, Washington State Archives, Eastern Washington Branch, Cheney, Washington.

[64]Blaine Wickham, “Not Dead Yet,” 75, 82, 87.

[65]First Biennial Report, 11.

[66]Elizabeth Goth, Original Case file 4451, Frontier Justice, Walla Walla County, Washington State Archives, Eastern Washington Branch, Cheney, Washington.

[67]Errin R. Edlin, “Washington Territory Insanity Laws,” Frontier Justice: Walla Walla During the 1860s, accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_doc3.html. 

[68]Harrison Campbell testimony, Frontier Justice, Walla Walla County, Washington State Archive, Cheney, Washington, quoted in Errin R. Edlin, “Insanity Cases in Walla Walla County: 1860s,”accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_essay2.html.

[69]Errin R. Edlin, “Insanity Cases in Walla Walla County: 1860s,” Frontier Justice: Walla Walla During the 1860s, accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_essay2.html.

[70]First Biennial Report, 15-6.

[71]“Susan T. Glover Is Insane: Found In A Demented Condition And Placed In Custody,”

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[72]Cochran, Seven, 56-8.

[73]Errin R. Edlin, “Washington Territory Insanity Laws,” Frontier Justice: Walla Walla During the 1860s, accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_doc3.html.

[74]Errin R. Edlin, “Insanity Cases in Walla Walla County: 1860s,” Frontier Justice: Walla Walla During the 1860s, accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_essay2.html.

[75]Letter from Hospital For the Insane, May 20, 1880, Frontier Justice, Walla Walla County, Washington State Archive, Cheney, Washington, quoted in Errin R. Edlin, “Insanity Cases in Walla Walla County: 1860s,” Frontier Justice: Walla Walla During the 1860s, accessed November 4, 2017, http://www.narhist.ewu.edu/frontier_justice/disease_essay2.html.

[76]First Biennial Report, 8.

[77]Third Biennial Report Of the Board Of Trustees Of the Eastern Washington State Hospital For the Insane(Olympia: O.C. White, 1896), 3.

[78]First Biennial Report, 8.

[79]Blaine Wickham, “Not Dead Yet,” 82.

[80]William Stimson, Edgar Stimson, Patti Stimson, William Beck, and Laurel Nelson,The History of Eastern State Hospital 1891 – 1991, (Medical Lake, Washington: Eastern State Hospital Centennial Committee, 1990), 9.

[81]First Biennial Report, 8; Third Biennial Report, 6.

[82]Third Biennial Report, 21.

[83]“The Age Of Overwork,” Pullman Herald(Pullman, Washington) Nov 1, 1890, page 5, column 6, accessed November 8, 2017, https://www.newspapers.com/image/143792109.

[84]“Women And Home,” Pullman Herald(Pullman, Washington) Aug 14, 1891, page 7, column 1, accessed November 8, 2017, https://www.newspapers.com/image/143774648. 

[85]Spokesman-Review Index, Volume 4, H-L, 1887-1900, Northwest Room, Spokane County Library, Spokane Washington.

[86]First Biennial Report, 8; Third Biennial Report, 6.

[87]Gerald N. Grob, Mental Illness, and American Society, 1875-1940, (Princeton: Princeton University Press, 1983), 8.

[88]“Center For the Study of the Pacific Northwest,” University of Washington, accessed November 24, 2017. http://www.washington.edu/uwired/outreach/cspn/Website/Classroom%20Materials/Pacific%20Northwest%20History/Lessons/Lesson%209/Census%20Data.html.

[89]First Biennial Report, 9.

[90]Third Biennial Report, 9.

[91]Third Biennial Report, 7.

[92]Blaine Wickham, “Not Dead Yet: The Persistence of Moral Treatment at the Eastern Washington Hospital for the Insane, 1891-1896″(masters thesis, Eastern Washington University, 2010), 11.

[93]Deutsch, Ill in America, 150, 155-6.

[94]Blaine Wickham, “Not Dead Yet,” 6.

[95]Blaine Wickham, “Not Dead Yet,” 75.

[96]William Stimson, History of Eastern State Hospital, 14.

[97]William Stimson, History of Eastern State Hospital,16.

[98]The Mayo Clinic Staff, “Postpartum Depression,” Mayo Clinic, updated April 11, 2015, accessed November 18, 2018, https://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/tests-diagnosis/con-20029130.

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[102]Cochran,Seven, 58.

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