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“Meeting on The Same Errand”—Origins of Mental Hygiene

A former mental patient.
A renowned psychiatrist.
A common dream.

Photos courtesy of The Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions and others

The leading American psychiatrist of his day, Adolf Meyer wanted to move psychiatry off the couch and into the community.

They were an unlikely pair: the asylum messiah and the taciturn, Swiss-born psychiatrist.

Clifford Whittingham Beers, a former mental patient, did not seek treatment from Adolf Meyer when they met in the fall of 1907. Instead, Beers wanted the esteemed psychiatrist to review an 80,000-word manuscript he’d written called A Mind That Found Itself. The book described Beers’ two-year odyssey through the primitive and brutal insane asylums of the day.

At their meeting, each had his own agenda: Beers was crusading for institutional reform; Meyer wanted to broaden society’s approach to mental health by treating and possibly preventing disorders on a community-wide basis.

“…you are the man for the cause… you should be given the support of the ablest and most influential persons of this country…”—Meyer to Beers, Dec. 6, 1907

Their brief collaboration would draw unprecedented public attention to mental health and launch a national organization. Ultimately, their ideals, and particularly Meyer’s vision, would inspire others to found the Department of Mental Hygiene at the School and place mental hygiene on the public health agenda.

“We both felt equally keenly the opportunity of the hour,” Meyer would later write. “Active psychiatry and public sentiment seemed to be meeting on the same errand.”

Clifford Beers’ 1908 book about his inhumane treatment in mental asylums catapulted him to national prominence.

Born to middle-class Connecticut parents in 1876, Beers graduated from Yale and worked in a New York City insurance office. Increasingly obsessed with his epileptic brother’s death, Beers suffered a breakdown in 1900 and returned to his parents’ New Haven home. On June 23, in a half-hearted suicide attempt, he dropped himself feet-first from his fourth-floor bedroom window. He landed in front of the dining room window as his family was eating lunch. “Naturally that dinner was permanently interrupted,” Beers wrote.

Shuttled from one asylum to another as his parents struggled to pay for his care, Beers suffered inhumane treatment by “typical eighteen-dollar a month attendants.” His book details how he was  laced so tightly into a straitjacket that he suffered intolerable pain and had difficulty breathing; locked in an airless and filthy padded cell; and choked, knocked down, and cursed regularly.

It would be difficult to find someone more different from Beers than Meyer. Born in 1866, in Nieder-weningen, near Zurich,  Meyer studied medicine at the University of Zurich and wrote a thesis on the reptilian forebrain. He arrived in the United States in 1892.

“I want you to know that I have valued you as an adviser more than any other person because of your Gibraltar-like qualities.”—Beers to Meyer, April 1, 1909

Small in stature, with a direct, clear gaze and thinning black hair, Meyer wore a bushy goatee and spoke heavily accented English. Trained as a neurologist and a neuroanatomist, Meyer worked at the University of Chicago, the Worcester (Mass.) State Hospital—where, among other things, he studied patterns of alcoholism among the Irish—and at the New York State Hospitals for the Insane at Wards Island. Meyer believed that clues to the reasons for psychotic reactions could be found in a thorough review of a patient’s history, community, and environment—the patient’s life experience. “To Dr. Meyer, this was not just an intellectual insight; it was a burning conviction and a practical program of action,” recounted Hopkins psychiatrist John C. Whitehorn in a 1950 tribute to Meyer.

By 1930, the mental hygiene movement had reached a global audience: more than 3,000 people attended its first international meeting.

In Beers, Meyer found a man overflowing with life experience and the desire to share it. Beers, Meyer recalled, was “a man with a vivid appeal and a fervid devotion to a cause.” He could also be useful in Meyer’s quest for greater acceptance of the concept of mental hygiene.

Meyer was an early advocate of looking at the individual within the context of his or her home and social environment, and, on the flip side, looking to that community as a potential source of mental disorders. He believed that psychiatrists should work with community leaders and organizations to promote mental health. The concept was labeled “mental hygiene” (see facing page).

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