Remembering the past, celebrating the future

JOE KLINE/ IDAHO STATE JOURNAL Tracey Sessions, administrator of the State Hospital South in Blackfoot, stands in front of a few old dormitory buildings being demolished at the campus in Blackfoot. To see a photo gallery from this story or to purchase Journal photos, go to idahostatejournal.com.

State Hospital South marks 125 years

BY KENDRA EVENSEN
kevensen@journalnet.com

There are more than 900 unmarked graves at the State Hospital South cemetery in Blackfoot. Tracey Sessions, administrator of the 125-year-old hospital — once called the Idaho Insane Asylum — said many of the unmarked graves belong to former patients who had no family to speak of, or at least no family members who knew their lost relatives were buried there. And she and her staff have decided to do something about it.
As part of the hospital’s 125th anniversary celebration, they are trying to build headstones to place on the graves of the individuals who died there.
“It’s about dignity and respect,” Sessions said of the former patients — once called inmates.
The headstones, which will be made of the granite from two 79-year-old dormitories that are currently being demolished on campus, is a connection between the present and the past, and a physical symbol of the changes that have occurred in mental health treatments and perceptions over the past century.
“It’s a full circle we’ve come to (regarding the) dignity and treatment that we’re so proud to provide now,” Sessions said.
Few people understand and appreciate those changes more than Ella Tam, who served as the hospital’s director of nursing in the ’40s and early ’50s and played a role in changing those perceptions and treatments in Idaho.
Tam was a young mother raising two children when she was offered a job at the hospital. She took it because she needed the $180 a month plus room and board that the job came with.
“I went, but I hated it,” she said, although she started trying to make the most of it from day one. “It was what I was going to do to support my children, so I decided to make it something I could be proud of.”
But that wasn’t easy, particularly for a woman ahead of her time in believing that the illness didn’t make the person.
“I wanted them treated as people, not as the condition,” said Tam, who to this day dislikes it when individuals are referred to as “the mentally ill.”
When she began working at the hospital, the conditions were much different than they are today. People didn’t really know how to help those with mental illnesses back then, and the drugs and other treatments we use today were not available.
Many of those who were sent to the hospital remained there for years, if not the rest of their lives. A Biennial Report of the Board of the Directors of the Idaho Insane Asylum for the years 1903-1904, illustrates the situation:
“The patients remaining in the asylum are coming to be more and more of the feeble-minded and helpless class of the old who require increased care. There are a number of patients here who have been insane for more than 20 years and a still greater number who have been insane for 10 or 15 years. All hope of recovery has passed in these cases and whatever of the joy and comfort of living remain for them must be had in the asylum.”
Because many of the patients stayed on, the hospital population grew from 36 in 1886 to roughly 800 when Tam was working there. She said the conditions at that time were deplorable compared to today’s standards.
The bedrooms were only equipped for about 20, but 60 or more sometimes had to sleep in the rooms due to the large population and lack of facilities, she said. And treatment of the patients was often harsh.
“If they made a disturbance in the night, they were taken into a side room,” she said, adding that they would be strapped to a thin mattress and left there. “They couldn’t get up to go to the bathroom, and if they yelled and hollered, they were mistreated until they got frightened enough to settle down.”
There were some employees they called bug-housers, many of whom would stay at a state hospital until they were fired for abusing patients or other causes, and then they would move on to the next one, Tam said, adding that they often made life even more difficult for the patients.
Some of the more able patients were allowed to work on the hospital’s farm, which included a large variety of fruits and vegetable crops, along with chickens, cows and honeybees at times. The food supply supplemented the patient’s diets, and surplus was shipped to other state facilities.
Some patients were also able to help build bricks for buildings, and performed other jobs at that time, Sessions said, adding that the activity was one way of trying to help the patients with their illnesses.
Although some of the workers were abusive towards the patients, there were others who treated them with whatever courtesies were possible and called them Mr. or Mrs. when they addressed them, Tam said.
In particular, there was Dr. J.O. Cromwell, who came to oversee the facility while Tam was working there. She said he didn’t believe in restraining patients unnecessarily, and he wanted to help find better treatments for the patients with the hope of returning them to society.
They replaced bughousers with local employees, and began trying new treatments on the patients.
Tam said that Cromwell was willing to try anything that had worked on a patient in the past, so they instituted several new types of treatments, including lobotomies.
“The other nurses were afraid to do it, but I was the boss so I had to do it,” she said, adding that she helped perform several of the surgeries.
She said some of the procedures did seem to help the patients, including a girl who had been abused by her father and brothers when she was young and had become aggressive and combative when she got older.
After the surgery, she was eventually able to return to the community and get a job with the railroad, Tam said.
“That was one of our biggest lobotomy successes, but even if it just made them better citizens on the unit we felt the lobotomy was worth it,” she said, adding that she was driven to help the patients get better and return to society. “Just enough really outstanding things happened to keep you going.”
They also tried hydrotherapy, a technique in which they placed a patient in a covered tub of water that was kept at body temperature. That helped to calm agitated patients, she said.
Numerous changes at the hospital had taken place by the time Dr. August Miller started working summers there as a premedical student during the mid 1950s.
“The treatment of mental illness was just entering a new era. In 1954 there were no tranquilizers and no antidepressants. Severe depression was treated with a planned series of seizures — convulsions — triggered either by a controlled overdose of insulin, or by electric shock through electrodes held to the side of the head,” he said, adding that as a young man, it took him a while to get used to the procedures, but they did make a difference for some of the patients.
They also started using new medicines as part of the treatments, and patients responded to them.
“Agitated or combative patients were overwhelmed as gently as possible (tackled if necessary), restrained and sedated with medicines like Phenobarbital,” Miller said. “This seemed like a daily occurrence (at first). One year later we had our first tranquilizers — Thorazine and Serpasil — and I only witnessed three or four donnybrooks the entire summer,” he said.
The hospital campus had also changed a lot by the time Miller started working there.
“Patients with minor medical conditions lived on ‘open wards,’ and moved freely about the hospital grounds during daytime hours,” he said. “The more severely disturbed patients were housed in locked wards, and occasionally escorted from building to building, in restraint, through a vast network of tunnels that interconnected the entire hospital campus.”
Once medical breakthroughs started helping the patients at the hospital, it still took some time for them to be accepted by the outside world, Tam said.
She remembers a time when the community commonly referred to the hospital as the “nuthouse,” and the patients and even some of the hospital staff were looked down upon for their affiliation with the facility.
“No one would come near them. They were afraid of the patients,” she said.
Cromwell and other staff members, including Tam, worked hard to educate the public to help them better understand mental illnesses at that time.
And over the years, those perceptions have changed.
Thanks to many modern day advances, things are very different at State Hospital South today.
The hospital can accept only 135 adult and adolescent patients at a time now, and most of the patients are able to return home within 40 days, Sessions said.
Patients participate in various types of modern-day treatments depending on their needs, and maintaining patient dignity is a key part of that treatment, she said.
Most of the released patients are able to go on and get help from community counseling services after their time in the hospital.
But there are still challenges; the economy has hampered some of those outside programs, and it’s not always easy for those in need of help to find or pay for the services they require after they leave the hospital.
Still, there are many reasons to celebrate the advances that have occurred since the hospital opened 125 years ago.
Although she’s now retired, Tam still continues to aid those with mental illnesses through volunteer work to help them transition back into society and find funding for the medicines they take. And she said she’s proud to have been a part of the changes that have taken place over the years.
“I’m real happy to see how things are (today) at the State Hospital. It’s more like they are going into a rest home — a place to get away from all their frustrations of life, and get the treatments to fix what’s wrong with them and help them get back to their jobs,” she said. “I’m proud of what I did to help them become citizens rather than someone who has to be taken care of.”
But Tam knows there are still more advances that lie ahead.
“I listened in on a (hospital) staff meeting last week and heard their philosophies. They’ve made leaps and bounds since I was there and they will do even better with the leadership they have now,” she said.

PHOTO COURTESY OF STATE HOSPITAL SOUTH A vintage image of State Hospital South in Blackfoot.