THE State Psychopathic Hospital. — Michigan has the distinction of being the first state to establish a psychopathic hospital in connection with its state university. In 1901, due in no small measure to the efforts of Dr. William J. Herdman, who was at that time Head of the Department of Nervous and Mental Diseases at the University (see Part V: Department of Neurology), the legislature passed an act (No. 161) to provide for the construction and equipment of a so-called "Psychopathic Ward" on the hospital grounds at the University. The stated purpose of this act was to establish an institution for the study and care of persons who were mentally diseased.
It was considered essential that there should be close co-operation between this psychiatric unit and the state "asylums." At the same time, it was felt necessary that the Psychopathic Ward should be an integral part of the University Medical School and Hospital. It was so organized that it might receive patients from any part of the state and that, when necessary, patients might be transferred between it and the other state hospitals. A sum of $50,000 was appropriated by the 1901 legislature for the purpose of building this unit. Before the building was completed, certain changes were made in the control of the institution by another legislative act (P.A., 1905, No. 140). This act provided that a joint board of trustees, composed of members from the boards of trustees of the "Asylums for the Insane" and from the University Board of Regents, should control the new institution and should employ an experienced investigator in clinical psychiatry as its superintendent. His duties were outlined as follows:
… To conduct clinical and pathological investigations and to direct the treatment of such patients as are inmates of the ward, as well as to guide and direct the work of clinical and pathological research in the several asylums of the State, and to instruct the students of the Medical Department of the University in the diseases of the mind.
This act also provided for the establishment of a clinical laboratory of research in which investigations should be continuously carried out with a view of determining the nature and causes of insanity and of developing means of prevention and cure of mental diseases.
The first meeting of the Board in Control of the State Psychopathic Hospital was held on August 9, 1905. At the second meeting, on September 13, formal organization of the Board was completed, with Chauncey F. Cook as chairman, F. S. Case and C. J. Linton, of the asylum boards, and Regents Charles D. Lawton, Loyal E. Knappen, and Henry W. Carey. This committee appointed Dr. Albert M. Barrett as head of the new institution. He began work on January 1, 1906, and the institution was formally opened February 7, 1906, by the transfer of thirty-seven patients from the institutions at Kalamazoo and Pontiac. By further legislation in 1907, the Psychopathic Ward became the State Psychopathic Hospital at the University of Michigan. Its control was vested in a Board of Trustees composed of eight members, four of whom were to be chosen from the boards of trustees of Page 327Michigan asylums, and four from the Board of Regents of the University.
Dr. Barrett remained in charge of the State Psychopathic Hospital from the day he began his duties on January 1, 1906, until his death on April 2, 1936. Animated by a passion for research, possessed of a scientific rectitude unexcelled by anyone in his field, and gifted with extraordinary administrative ability, Dr. Barrett organized the State Psychopathic Hospital at the University of Michigan, directed its medical research activities, guided its clinical and pathological research program in the several asylums of the state, and maintained a fine spirit of co-operation between the state institutions for the insane and the State Psychopathic Hospital. In his capacity as pathologist for the state hospitals and Professor of Psychiatry in the Department of Medicine and Surgery of the University, Dr. Barrett devoted the best years of his life to the administration of his institution, extensive programs of research, medical education, and care of the mentally ill. He created an epoch in the progress of psychiatry which will not fail of lasting recognition in the history of Michigan. At the time of his death in 1936, he was President of the American Neurological Association, a signal honor which comes only to those who have made very important contributions to neurology or psychiatry.
From time to time the legislature made certain changes in the control and function of the State Psychopathic Hospital. In 1929 it appropriated $330,000 for the construction of a new building and for the repair of the existing structure. The financial depression, with its attendant need for economy, resulted in subsequent repeal of this appropriation. In 1935, the control of the State Psychopathic Hospital was changed and was vested solely in the Board of Regents of the University.
Following the death of Dr. Barrett in April, 1936, Dr. Harley A. Haynes was made Acting Director of the State Psychopathic Hospital until the appointment of Dr. Raymond W. Waggoner as Director on January 1, 1937.
The Neuropsychiatric Institute of the University Hospital. — In 1937, by legislative action, the Neuropsychiatric Institute of the University Hospital of the University of Michigan was brought into being to replace the former State Psychopathic Hospital. Certain changes, primarily concerned with the admission of patients, were made in the functioning of the new unit, although its purpose remained the same as that which had been so well stated in the original enabling act of 1901. At the same time an appropriation of $400,000 was made for the construction of a new unit directly attached to the University Hospital. With this change, a larger number of yearly admissions to the hospital and a larger out-patient service were made possible. The physical connection with the University Hospital has facilitated co-operation and co-ordination with the activities of other hospital departments and has thereby benefited both institutions.
The purpose of the Institute is best defined by an extract from the statute which brought it into being. The adoption of Act No. 85 of the Public Acts of 1937 transferred to the Board of Regents of the University of Michigan all the properties of the State Psychopathic Hospital, on condition that the Regents maintain a neuropsychiatric institute as a part of the University of Michigan Hospital, to be devoted to the prevention, diagnosis, and treatment of mental disorders. The act provides (sec. 4):
The neuropsychiatric institute of the University of Michigan shall be open so far as facilities are available, and under rules and regulations to be prescribed by the board of Page 328regents of the university, for the care and treatment of persons suffering from mental disorders, but who have not been committed by the probate courts as insane, feeble-minded, or epileptic. It is the further purpose and intention to establish a clinic for the study of prevention of mental illness, and for the conduct of training and research in all phases of mental disease. With the approval and under the rules of the board of regents, there shall be maintained as a part of the neuropsychiatric institute a neuropathological laboratory, which shall be a central laboratory for the Michigan state hospitals for mental disease.
Its functions are as follows:
To study and develop methods of treatment of mental disease and pursue research in the field of psychiatry.
To serve as a center for the diagnosis and treatment of incipient mental disease in an effort to stress particularly the great importance of prevention.
To render special service to mentally ill children and to those who exhibit behavior abnormalities. The establishment of a children's ward provides for the segregation of children under conditions which will greatly facilitate careful examination, observation, and treatment of those who have shown mental symptoms.
To serve as a training center for physicians, nurses, and persons engaged in the study of psychiatry and charged with the duties of serving those who are mentally ill.
To provide a center for both clinical and laboratory research in the field of neuropsychiatry.
Every patient who is to be admitted to the Neuropsychiatric Institute must bring a letter from a referring physician or must come to the hospital with an order of conveyance issued under one of the public acts of Michigan authorizing hospitalization.
Patients may be detained in the Institute during a period of observation pending possible commitment to a state hospital.
Patients may also be transferred to the Neuropsychiatric Institute from other state hospitals on the approval of the superintendent of the hospital concerned and the State Hospital Commission.