About

The project examines the mid-twentieth-century case of Morningside Hospital, a private, federally funded mental institution in Portland Oregon. The history of Morningside illustrates debates over psychiatric diagnosis and practices of mental health care in the mid 20th-century. We are particularly interested in tracing the contested roles of the state and the public in determining the moral and medical boundaries of mental healthcare as well as the role of understandings of mental health and illness in furthering the aims of the nation-state. Tracing these debates and public narratives through archival materials, we can see how the history of mental healthcare shapes the history of nation-state formation, as Alaska becomes a state in the context of the controversies surrounding Morningside Hospital’s federal contract; the fraught relationship among state, territory, and national government entities; and the use of land grants to fund public health treatment, which was part and parcel of the Alaska Mental Health Act (passed after much debate in 1958). 

In order to explain the complex meanings of this understudied history, we conduct interviews and examine archival materials written from a range of perspectives: psychiatrists in Oregon and elsewhere; senators and representatives from Oregon and Alaska; bureaucrats in the U.S. Department of the Interior; journalists covering the controversy; patient families and communities; and members of civic organizations in Los Angeles, Chicago, and New York who became interested in the Morningside-Alaska connection. Each of these perspectives shows a different understanding of mental illness and health and the role of psychiatry and the state in their treatment. 

In the early 20th century, a contract was struck between the directors of Morningside Hospital, the Federal Government’s Department of the Interior, and the Territory of Alaska. This agreement justified the existence of Morningside Hospital on the one hand and legitimized the state-sanctioned forced displacement of Alaska Natives and other Alaska residents in the name of mental health on the other.   

This research project asks what the mid-twentieth-century history of Morningside has to tell us about the role of the nation-state in displacement, community, and mental health past, present, and future, in the Pacific Northwest as well as globally. How did social processes such as land loss, political instability, and cultural upheaval threaten mental health and simultaneously delineate the possibilities for mental health care? How did medical authority justify the separation of patients from families in the name of treatment and diagnosis of mental illness? How were mid-twentieth-century treatments such as insulin shock therapy, “moral treatment,” electroshock, and lobotomy understood and represented in both medical documents and popular accounts? 

Even after the AMHA (Alaska Mental Health Act) was passed and management of Alaska public mental health was returned to more local control, Morningside Hospital continued to operate, largely because the lack of public mental healthcare alternatives meant that aging and ill inpatients had few options for community-based care. Thus, tracing the apex and the decline of Morningside as deep history to Reagan-era shuttering of state mental institutions also allows us to explore the history of the asylum and the incomplete project of community mental healthcare that continues into the present day. 

What Morningside Tells Us About American Psychiatry 

By exploring the history of Morningside Hospital, particularly its rise and demise during the 1950s and early 1960s, we can discover how the discipline of American Psychiatry responded to debates over professional power, diagnostic uncertainty, treatment controversies, and patient care, consolidating its role as both arbiter of medical practice and mediator of competing political demands in the mid-century USA. The project uses a historical window to look at these questions provided by the Morningside Psychiatric Hospital, an inpatient ‘insane asylum,’ which operated in Portland, Oregon from the 1883 to 1968. 

 The hospital was administered by a private, family corporation through a federal contract, an arrangement that came under increasing scrutiny as allegations of fraud and waste emerged in the 1940s. While patients came to Morningside from across the Pacific Northwest, a substantial number were transferred to the hospital from the then-territory of Alaska, which at the time lacked public institutions of mental health care. By the early 1950s, patient care at Morningside was under a great deal of public scrutiny from federal regulators, professional associations, and citizen groups, and eventually became the subject of Congressional hearings. In response to these controversies, the American Psychiatric Association commissioned a series of external evaluations of patient care at Morningside, leading to recommendations for improvements in patient care. Throughout this period, patients continued to be admitted to the hospital, voluntarily and involuntarily, and psychiatrists continued to provide them with treatment and care, even as these professionals struggled to manage both the limits and the power of their practice. Psychiatrists at Morningside at midcentury were utilizing the First Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a volume which itself reflected what Tanya Luhrmann has termed the “two minds” of American Psychiatry through the varied influences of psychoanalytic and biomedical approaches. This project thus contributes to psychiatric anthropology and medical history by interrogating a critical moment in American psychiatry when the tensions between the neurochemical and psychoanalytic approaches to mental health and illness were clearly visible, but when it was not yet clear which tendency would come to dominate the field.  

 Morningside and Deinstitutionalization 

We show in our research collaboration that scrutiny of clinical and financial practices at Morningside prefigured the deinstitutionalization of U.S. mental health care in the latter half of the 20th century. Coming under increasing criticism from outraged citizens, legislators, and Alaska politicians, Morningside Hospital was forced to close. One key player in the closure of Morningside was Congresswoman Edith Green, Oregon’s Representative in Congress from 1955-1974. Rep. Green became a pivotal actor in investigating abuses of patient care at Morningside, representing the concerns of patients and family members from Oregon, Alaska, and throughout the Pacific Northwest. One of Rep. Green’s key concerns was the role of federal financing paid to a private hospital corporation, revealing deep-seated tensions in public-private contracting of health care services and institutional care that persist to this day. Allying with stakeholders in Alaska, including the Territory’s non-voting Representative E.J. Bartlett, Green introduced legislation that eventually became the AMHA, granting a large track of federal land to finance the development and operation of a psychiatric hospital. By shifting land to local control in this way, the AMHA set in motion the broader push for Alaskan statehood. 

Since the inception of this project, in 2017, we have received the generous support of the following entities, which has been essential to the development of this project:
Oregon Humanities Center
Center for the Study of Women in Society
Office of the Vice Provost for Research and Innovation
UO Mellon Library-Museum Collaborative Faculty Fellowship

We also owe many thanks to community members in Oregon and Alaska who have partnered with us on the project, including:

Ellen Ganley

Karen Perdue

Dennie Brooks

Jim Gottstein

Steve Langdon

Libby Rascon

David W. Oaksd

Arlene Schmuland