By Elizabeth Kane Buzzelli
Northern Michigan Asylum
By William A. Decker, M.D.
Arbutus Press, $50
Northern Michigan Asylum: A History of the Traverse City State Hospital by William A. Decker, M.D., is a sad story despite Dr. Deckers attempt to keep this history to facts and figures, and keep the human equation to a minimum. I dont mean sad in the attempts made to upgrade the care of asylum patients, but sad that weve come full circle, back to the lack of mental health care that the people of Michigan found unacceptable in the mid-1800s.
Built in 1885, the present-day site of Building 50 and the Grand Traverse Commons was first called the Northern Michigan Asylum for the Insane. Later the name was sanitized to the Traverse City State Hospital, and then Traverse City Regional Psychiatric Hospital.
HOSPITAL ON A HILL
Before the 1850s, mentally ill citizens of the state were confined in almshouses and jails, subjected to abuse and taunts, and kept in chains that bound them to the floors or the walls of their places of confinement.
Prodded by Dorothea Dix, an early advocate of humane care and treatment for the afflicted, the Michigan legislature set aside money for asylums. In 1885, one of these care and treatment facilities was built in Traverse City, chosen due to the presence of pure spring water in the hills and the presence of artesian wells. With a little pressure from Perry Hannah, known as the Father of Traverse City, the hospital on the hill was built and opened its doors to take in the first patients.
Building 50, of Victorian-Italianate architecture, was designed by Gordon W. Lloyd of Detroit to what was called the Kirkbride Plan which meant a center administrative section with wings on either side. This bat-wing plan separated male and female wings, with additional cottages for more patients.
From early beliefs that mental illness was caused by supernatural powers, a struggle between the forces of good and evil, light and darkness, God and Satan, leading to the horrors of Bedlam Prison in England where the citizenry paid a fee to stare at the poor wretches confined there, to this countrys Salem witch trials, the study of lunacy, insanity, mental illness moved toward humane care and new therapies which eventually led to the deinstitutionalization of many of the formerly ill. Still, it wasnt until 1949 that the Michigan legislature got around to naming the affliction mental illness rather than insanity.
Buried here, in lists of statutes and rules for admission and release of patients presumed to be insane/mentally ill, lie some terrible injustices obscured by legal language. Consider Public Act 164 (1859), where The commissioner was empowered if he concluded that the person was insane at his discretion without the benefit of a hearing to order the admission of the person to the asylum.
In 1903: County superintendents of the poor or a supervisor of a city or town could petition the probate court for admission of a person they believed to be insane. Even senility was a cause for admission, along with being a rapist or a child molester.
Public act 285 of 1923 provided for sterilization of mentally defective persons.
And Public act 281 of 1929 added epileptic persons, moral degenerates and sexual perverts to the list of the mentally ill, along with the feeble-minded.
This history of the Traverse City Hospital is more, or certainly as much, about the progression of care of the mentally ill as about a single hospital. For this alone, the book is invaluable. The only thing I missed in this book was any element of the human side of this huge and sometimes ugly equation. There are no stories of patients or families of patients. None of the emotions that have to haunt these buildings. No stories of triumph, of hope, of sadness. Buildings with the past of the Traverse City Hospital are not simply buildings with numbers of bricks and size of rooms and numbers of rooms and numbers of people. They are repositories of our people and our past. I suppose that is for another book but I hope it is written soon, before too many of the people who were committed there or worked there are gone.
MENTAL HEALTH TODAY
The last patient left the hospital on September 29, 1989. In a way there is triumph in that and yet a new sadness. From a state that noted the abysmal care of the mentally ill in the 1800s and moved to correct the problems with an infusion of money, buildings, new therapies, and well-trained personnel today, its a different story.
As Dr. Decker notes in Chapter 20, Back to the Almshouses and the Jails, weve moved backward from those early, hopeful days. After the closing of the mental hospitals patients were left to be cared for . . . in a more expensive psychiatric ward in a general hospital or in a free-standing psychiatric hospital. Other available alternatives to hospital treatment included the confinement to prisons and jails of mentally ill individuals. It is estimated that nationally 20-30% of prison inmates are mentally ill. In Michigan, it is estimated that approximately 20% of its prison inmates are mentally ill.
And this isnt even touching those turned out on to the streets to care for themselves, to become homeless, to live in tent cities, and under overpasses.
Really, beneath all the facts and figures presented, this is largely a story of ultimate failure or, more hopefully, a story ending with a momentary lapse in Michigans judgment.
Dr. Deckers book offers an impressive look at the facts and dates behind the institution, including a brick count (8,000,000 white bricks for the first buildings); a personnel count, legislative initiatives, doctors who ran the asylum, numbers of patients, dates for every event at the asylum, a compendium of diseases of the brain (real and not so real), therapies, and date after date after date. I would put this book up there as the most comprehensive history of a Michigan hospital that has ever been, or will ever be, written.
Dr. William Decker wrote the award-winning, Asylum for the Insane: A History of the Kalamazoo State Hospital in 2009. He served with the Michigan Department of Mental Health for nearly 34 years. For 13 years he was Medical Superintendent of the Kalamazoo Regional Psychiatric Hospital. He continues to practice his specialty of psychiatry.
Elizabeth Kane Buzzellis fourth book in the Emily Kincaid mystery series, Dead Dogs and Englishmen, will be published soon by Midnight Ink.