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Ahead of Its Time: The Stockton State Mental Asylum from the 1890’s to 1920’s
By Dave Smith and Justin Jones

 

It was early April; two men in a rowboat approached me while I was floating in the frigid Stockton Channel. As the two men approached, a look of astonishment came upon their faces as they saw I was floating on my back, fully clothed. The two men pulled me into the rowboat. As they dragged me in the boat I offered no resistance, but admitted I would rather stay in the water because I was looking for my sister. When the men asked me why I was looking for my sister in the Stockton Channel, I replied that my sister had drowned at a going away party in my honor before I left Boston. Not knowing what to do, the men took me to the local authorities.

As the examiner looked at me, I could see that his eyes were filled

 
   
  Entrance to the Stockton State Asylum's male department
Courtesy of the Bank of Stockton Historical Photo Collection
 
with disbelief. I told him that I was looking for my sister because she lived at the bottom of the pretty water in a beautiful house of pearls. The examiner then asked if my sister wanted me to live with her at the bottom of the water. I replied with great vigor that she was excited at the idea of me coming to live with her.

I later found that the examiner had consulted with other physicians, when they concluded that I possessed the symptoms of acute melancholia. Acute melancholia is a disorder in which a person suffers from depression due to a recently witnessed trauma. I was immediately admitted. The bed I slept on was made of straw and very uncomfortable, but I slept nonetheless.

I awoke the next morning in a horrific sweat, only to find that my experiences were not a dream, but reality. I was actually in the uncomfortable bed in an off-white room. The room was very dull in appearance with only the bed and a small table next to it. A window to my left had a view of a vast field, empty with the morning dew still covering the grass. An attendant came through the door assuring me that everything would be all right and that it was time for breakfast. Breakfast was a very foul tasting slop accompanied by cold coffee and stale bread. After breakfast I learned that it was my day to go out into the yard. The yard was a 10-acre field with gardens, flowerbeds, and a grove of oak trees. The attendant informed me that I was not to go beyond the limits of the hospital. It was at this instant that I finally realized I was a member of the Stockton State Mental Asylum.

At 12 o’clock noon dinner was served. Dinner consisted of soup, beans and potatoes. After dinner I returned to the yard until 5:45 p.m. The time in the yard was spent walking or occupied in the gardens. Under an oak tree I met a man with a most curious mania. He imagined that his head was made of glass and that by some unconscious movement, he might break his head. When he walked he carried his head in a very proper manner. When things were thrown at him, he fell into a most peculiar fright. In addition, the manner in which he took care of his head was most troubling indeed. At 6:00 p.m. supper was served, which was bread and tea. After supper, I was taken immediately to bed, back to the hard bed made of straw.1

According to existing manuscripts, daily experiences like the one articulated above, were typical of a patient who lived in the Stockton State Mental Asylum during the late 19th and early 20th centuries. However, not everyone living in insane asylums during this time period experienced the same conditions. Interpretations of the treatment regimen of the patients at the asylum vary from harmful and oppressive, to peaceful and tranquil: a day that was filled with simplicity. It was this simplicity on which the Stockton State Mental Asylum prided itself. The asylum served as a place for those deemed mentally unstable to live their lives as normal as possible, with the hopes of someday recovering and reentering society. The road to recovery was not just solely dependant on the patients, but rather included a complicated network of professionals both trained and employed by the state hospital.

At the top of the hierarchy of professional employees of the state asylum was the superintendent, the overseer of the hospital. In other words, nothing happened without his or her permission. The superintendent oversaw the building improvements as well as the care of the hospital’s patients. The superintendent was also in charge of dictating the different job descriptions throughout he asylum. For example, he or she would determine what the job of each attendant would entail. Most importantly, the superintendent had the final say as to whether or not a patient would be admitted. Along with the decisions of admittance came the superintendent’s log. The log was a biannual report submitted by the superintendent, which gave the specific happenings of the past two years. From the 1890’s to the 1920’s the Stockton State Asylum had a total of three superintendents by the names of Asa Clark, the founder, his son Fred Clark, and finally Margaret Smythe.2

Dr. Asa Clark was the original superintendent of the Stockton
 
   
  Dr. Asa Clark
Courtesy of the Bank of Stockton Historical Photo Collection
 
State Mental Asylum and was also responsible for setting the benevolent precedent that would be followed for the rest of the asylum’s existence. “In reviewing the officials who have devoted their energies and best efforts to some particular department of the state government, there is no one who stands out more prominently than Dr. Asa Clark, the honored Superintendent of the State Hospital at Stockton.”3 In addition to being the first superintendent of the hospital he was also responsible for starting the Pacific Hospital, another local mental hospital that specialized in the care of the mentally ill through exposure to nature and comfortable surroundings. Not only did the Pacific State Asylum house the San Joaquin Valley’s mentally ill, but took on the daunting task of taking care of the mentally ill from Nevada and Arizona as well. Later on in Clark’s life, the Pacific State Asylum merged with the Stockton State Mental Asylum as Clark took over. In 1906, Asa Clark’s son, Fred Clark took control of the State Asylum as the superintendent. During Fred Clark’s reign as the superintendent he really made no innovations in the care of the mentally ill, rather, simply kept the asylum running the same way his father did.4 However, this was not the case when Margaret Smythe took over the facility in 1929.

Dr. Margaret Smythe was the first woman to be hired as a
 
   
  Dr. Margaret Smythe
Courtesy of the Bank of Stockton Historical Photo Collection
 
superintendent in the United States as a nationally recognized psychiatrist. “First Female Superintendent” was not the only “first” on Dr. Smythe’s resume. Dr. Smythe was also the first doctor to use insulin shots on patients as well as the first to eliminate the derogatory words “asylum” and “insane” from the name of her hospital. When Dr. Smythe retired from the superintendents position at the state hospital she was thought to have done more for the mentally ill and the field of psychiatric medicine than anyone in the past.5

Although the superintendents had an enormous workload, the assistant physicians had the closest doctor-patient relationship. The assistant physicians were each assigned a particular ward, either a building in the women’s ward or the men’s ward. The assistant physicians were responsible for the everyday care of their patients. The assistant physicians treated everything from mental illness to the common cold. The physicians were responsible for daily checkups on their patients as well as detailed reports that were turned in to the superintendent.6

Next in the hierarchy of employment were the attendants. The attendants were responsible for taking care of the practical needs of the patients. For example, they washed and dried patients’ clothing as well as bed garments. The attendants performed their duties by a simple motto: “do to others, as you would wish other to do to you.” By no right were the attendants allowed to strike or harm a patient; this was a direct result of the institutions strict policy on patient treatment. Attendants emphasized the nonviolent approach to patient care, which is not something one would quickly associate with psychiatric care during the time period. In addition to the code of non-violence, the attendants were to follow strict behavioral guidelines while they were on duty. These included things like no socializing. The rule of no socializing encapsulated the idea that an attendants time at the institution should be devoted to bettering the lives of the patients, not themselves. However, hospital employees were not the only people involved with the institution that had to follow strict rules.

Visitors were instructed to follow very strict rules. Visitors were not allowed to give anything to the patients for fear that they would give them some type of weapon or escape tool. In addition, the visitors were not allowed to touch any of the outside gardens or flowerbeds because they were for the use of the patients. The fact that the hospital had visitors, not to mention a set of rules for them highlights that the local community came and visited the mental asylum. In one surviving photograph, a local marching band came to play outside the men’s ward of the asylum.7 This fact indicates that the asylum was not frowned upon by the local community, but rather embraced. This embracing of the mentally ill was not just seen in the community, but rather in the actual ideology of patient care.

The state asylum adopted a sort of benevolence in asylum management. The goal for the asylum was to make life for the patients as peaceful and simplistic as possible. The ultimate goal for the state asylum was to rid the public of any negative connotations it had against asylums and their treatment of patients. “Everywhere there is an upward tendency toward improved comforts for the insane, and the emendation of the condition of those housed in asylums, and at the same time the distrust with which the public has heretofore viewed asylum management is fast passing away.”8 The aforementioned statement is an example of how much emphasis the asylum placed on taking care of its patients, for their sake and for the sake of the reputation held by the community. The idea of benevolence stemmed from the idea that those working at the asylum not only had a duty to the patients to run an upstanding institution, but also had a duty to themselves and their community.

However, the Stockton asylum’s exercise of benevolence and non-violence was not commonplace in the rest of the nation’s treatment of the mentally ill. In 1900, a man by the name of Clifford Beers was admitted to a private Connecticut insane asylum where his treatment was very different. “At the mercy of untrained, incompetent attendants, he was subject to degrading treatment and mental and physical abuses.”9 For its time, the Stockton State Mental Asylum was a progressive institute that sought to truly serve the best interests of its patients in contrast to other institutions around the world. After Beers was released in 1908, he started a movement to change the face of mental illness and the care of the mentally ill. He had three goals in mind: 1) to improve attitudes toward mental illness and the mentally ill, 2) to improve services for the mentally ill, and 3) to work for the prevention of mental illness and promote mental health.10 The novelty of the Stockton asylum can largely be attributed to the early Progressive movement during this time period, a time of reform and change for the better. The Progressive movement was especially strong in California and sought social reform through temperance and awareness.11 Ironically, all three of these ideas had been implemented at the Stockton State Asylum since its creation, again highlighting the progressive nature of the asylum.

During this time period, the ratio of those deemed insane to those who were sane was 1 in 370 people. One may ask who was determining whether or not someone was insane, or more importantly, how was one diagnosed. When undergoing the admittance process there were generally two questions that had to be answered. First, was the person insane? Secondly, was the case of insanity a danger to the prospective patient or the community? If both of these questions were answered in the affirmative then another series of questions began to determine the exact disease and cause from which the patient suffered. However, simply being diagnosed with some type of dementia or mania was simply not enough to be admitted. If one was diagnosed with a mania or type of dementia, there had to be proof of danger to society. This notion says a great deal about the responsibility the hospital had to the surrounding community. The hospital had a great deal to do with keeping the community of Stockton safe from potentially harmful people, a relationship that was greatly appreciated by the Stockton public. As Dr. Asa Clark stated, “No case of idiocy, imbecility, simple feebleness of intellect, or old case of harmless dementia, or of any class of incurable and harmless insanity, or of delirium tremens, shall be sent to the asylum.”12 Clark’s statement touches on the fact that the prime concern for the institution was to make sure a person was not harmful to society. If that person was deemed harmless, then he or she was released to society. Once a person was admitted, there were a number of treatments that one could undergo.

The asylum in Stockton was progressive for the time, but remained limited by the lack of medical and diagnostic technologies. Psychopathology was the overarching practice at the State Asylum in Stockton during the late 1800’s and the early 1900’s. Psychopathology is the behavioral study of mental illness. Behavioral study was virtually all that was available due to the lack of medical technology available at the time. In addition to psychopathology, hydrotherapy was often used inside the Stockton asylum for patient care and rehabilitation. Hydrotherapy is by definition the treatment of a patient through the use of water of differing temperature. Patients were soaked in water in order to alleviate their pains and symptoms. Although the water did very little for the actual disease itself, it helped the patients to relax, a healing technique heavily used by the institution. Along with hydrotherapy, music therapy was also used a great deal by the state asylum. Music was often playing in the institution to create a very peaceful environment, one that evoked simplicity. Quite often, the Masonic Temple band would come and play at the institution as seen in a number of the institutions photographs.13 The band would start at the entrance of the asylum and play while walking around the grounds. Not only did music come from outside the institution, but also patients were encouraged to take up the playing of instruments. This provided the benefits of music therapy for patients but also gave them something to do with their spare time. The constant playing of music by outsiders, as well as those inside the institution, was encouraged and highlights that fact that the physicians in charge of the institution had enormous confidence in the music therapy approach to curing mental illness. Finally, the most common form of therapy for the patients in the mental asylum was work. “The chief aids in the restoration to mental health,” argued Clark, “are occupation and diversion. Daily confinement in the wards and yards with nothing to occupy the mind is tedious in the extreme.”14 Thus, the head physicians at the hospital encouraged their patients to work daily, whether it was in their rooms or in the gardens. In fact, the heads of the hospital ideally wanted the institution to be a self-sufficient entity: all clothes, food, and other necessities would come from the hospital grounds, made largely by the patients. Thus, work gave the patients something to occupy themselves and at the same time helped administrators run the hospital more economically and efficiently. Most of the gardens were located near the wards to prevent the patients from running off, however, the heads of the hospital ultimately wanted the entire plot of land, all remaining 10-acres, to be cultivated, thus assuring the self-survival of the institution and its members. In addition, the constant work by the patients would help them later on if re-admittance to mainstream society were in their future.15 In essence, the hospital was benefiting itself through employment of its patients but also benefiting society by turning out productive citizens. This idea of citizenship leads us to the relationship the hospital had with the surrounding community.

From the hospital’s beginning the community and hospital interacted with each other. For example, the frequent visits of the Masonic Temple band indicates that not only did community members feel safe at the asylum, but also that they went out of their way to help those inside. In addition, the minutes of the meetings of the hospital’s Board of Directors were printed in the Stockton Independent. For example, a decision on what type of coal to use for heating and other purposes was printed on May 8, 1888, which indicates that the community was interested in the decisions being made internally at the hospital.16
 
   
  The Pacific Hospital, 1871
Courtesy of the Bank of Stockton Historical Photo Collection
 
In addition, the doctors mentioned in the transcripts at Holt-Atherton were well-respected physicians in the community because of their work inside the insane asylum. Community support of the hospital was not only programmatic, but also came through infrastructure. There were several roads, for example, that led to the asylum, which would indicate that carriages as well as electric cars maintained by the city frequented the asylum. Maintenance of these access roads and electric car tracks required a fair amount of money, underscoring an important commitment to the asylum by the city and the citizens. However, the local community was not the only one involved with the Stockton State Asylum. As mentioned before, the mentally insane from Nevada as well as Arizona were housed at the state asylum indicating there was a west coast cooperation of states for the care of the mentally insane. However, the most apparent example of the asylum’s responsiveness to community came in 1906. That year was the year of the San Francisco earthquake and fire, during which the mental hospital in San Francisco was completely destroyed. After the earthquake, all of the surviving members of the San Francisco asylum were transferred to the asylum in Stockton. This event not only signifies the community of trust embodied in the asylum but the willingness of the asylum to take on the care of the mentally ill from other communities. Although the admittance of nearly 100 new patients caused overcrowding in the asylum, there was still the attempt to take on the challenge.

The aforementioned ideas are all positive reflections of the Stockton State Asylum; there were however, negative beliefs as well. The notion of overcrowding was a huge concern taken on daily by the heads at the Stockton State Mental Asylum. During the late 19th century the asylum had taken on more that its maximum patient capacity. The asylum’s capacity was 1,150 and in 1888 the asylum housed some 1,647 patients, 497 patients greater than the stated capacity. This number was largely due to the over abundance of incoming patients, many of whom were not necessarily insane, but kept on the premises because of requests by family members or friends. Analyst John R. Sutton of the University of California, Santa Barbara argues that the overpopulation of insane asylums during this time period was not a result of an increase in the number of those diagnosed insane, but rather the inability of the government to deal with those in poverty. He argues that legislation restructured the requirements for admittance to these institutions so that they were able to take care of the elderly, poor and incapable, not necessarily just the insane.18 Consequently, places like the Stockton insane asylum ultimately ended up caring for such individuals. The superintendents often argued against overcrowding. As Clark stated, “To overcrowd the insane is to impair the usefulness of the asylum and subvert good management.” Employment of its patients and methods of curing were deeply affected by overcrowding the asylum. With all the new patients, there were less jobs and fewer patients and ways for patients to achieve the tranquility and simplicity that made the Stockton Asylum so favored and respected. In addition, some argued that overcrowding led to neglect of the well being of the patients, even resulting in mistreatment, either by staff or simply because of absence of adequate food and water.

In 1888, the San Francisco Examiner, a well-respected newspaper on the West Coast, sent an undercover reporter in to the Stockton State Mental Asylum under the fictional diagnosis of lunacy. The reporter was to find out the truth about the asylum and the alleged mistreatment
 
   
  "Asylum Gang"
Illustration by Ralph O. Yardley, a local artist and historian of Stockton
Courtesy of the Bank of Stockton Historical Photo Collection
 
of its patients. He was admitted and spent several weeks in the asylum getting to know its structure and behavior, both its patients and its employees. However, when the reporter was inside, he found that none of the stereotypes believed by the public were actually true; in fact, the asylum was well run and well kept. “During my stay at the asylum I heard of only two cases of actual cruelty,” he wrote, “…both of these acts were in direct and flagrant violation of the rules of the asylum, which provide that, “a blow or a kick is never to be inflicted on a patient by any employee under any circumstances. Any violation of this rule will subject the offender to instant dismissal.”19 The report underscores the strict rules and regulations of the asylum and underlines that the reporter was impressed when he left the asylum, because he had only witnessed two brutalities when the general public, himself included, had imagined a place of shear cruelty. As far as cleanliness was concerned the reporter also found his prior beliefs of dirty and unsanitary conditions to be false. “The asylum in appearance is a model of cleanliness. The floors are swept and scrubbed every morning by some of the patients, under the direction of the attendants. This service is not compulsory, only such patients performing it as volunteer…the doctor dwelt strongly on the importance of some properly adapted form of occupation as a means of cure and the evil of the opposite condition of utter idleness.”20 The reporter entered a skeptic and left a believer. He had been impressed by the actions of both the staff and the patients at the Stockton State Mental Asylum during his visit.

The progressive attitude towards the treatment of the Stockton Asylum’s patients was what made it so special, especially for the late 1800’s and early 1900’s.
 
   
  The Masonic Temple Band marching and playing outside of the Stockton State Asylum
Courtesy of the Bank of Stockton Historical Photo Collection
 
In fact, the asylum was not only progressive for its time but was years ahead of some of its peers, like the asylum in Connecticut. The asylum in Stockton not only instilled a sense of community in its members but also welcomed the support of the surrounding community outside the hospital. The community was involved on a superficial level (in terms of tolerance of the hospital and its patients) and at a very personal level (as seen in the photographs of the Masonic Temple band). In addition, the asylum in Stockton was not only a reflection of the community, but rather a model of what was going on during the time on a national basis, both politically and economically embodied by the Progressive movement. As we have seen, many of the social and political norms of the time, such as social awareness, were well represented in the asylum during the 1890’s and the 1920’s.

  

Bibliography

 

1. San Francisco Examiner, no date available, Oullahan Scrapbook, MS 194, Box 15, (Holt-Atherton Special Collections. University of the Pacific), 1.

2. “Asa Clark,” History of the New California Its Resources and People, Volume 1, Retrieved from the World Wide Web on October 26, 2002,
http://www.usgennet.org/usa/ca/state1/biographies/aclark.html.

3. “Asa Clark,” History of the New California, Retrieved from the World Wide Web on October 26, 2002,
http://www.usgennet.org/usa/ca/state1/biographies/aclark.html.

4. Ibid.

5. “NMHA and the History of the Mental Health Movement,” National Mental Health Association,
http://www.nmha.org/about/history.cfm.

6. Stockton Insane Asylum, Rules and Regulations of the Stockton Insane Asylum at Stockton, CA, (Sacramento, CA: Office of State Printing, 18880.

7. Photograph Courtesy of the Bank of Stockton Archive.

8. Dr. Asa Clark, Biennial Report of the Directors and the Thirty-Ninth and Fortieth Annual Reports of the Superintendents of the Insane Asylum of the State of California At Stockton for the Two Years Ending June 30, 1882, (Sacramento, CA: Office of State Printing, 1882), 14.

9. “NMHA and the History of the Mental Health Movement,” National Mental Health Association,
http://www.nmha.org/about/history.cfm.

10. “NMHA and the History of the Mental Health Movement”

11. James J. Rawls and Walton Bean, California: An Interpretive History, (Boston, MA: McGraw-Hill, 1998).

12. Dr. Asa Clark, Biennial Report of the Directors and the Thirty-Fifth and Thirty-Sixth Annual Reports of the Superintendents of the Insane Asylum of the State of California At Stockton for the Two Years Ending June 30, 1888, (Sacramento, CA: Office of State Printing, 1888), 14.

13. Photograph Courtesy of the Bank of Stockton Archive.

14. Dr. Asa Clark, Biennial Report of the Directors and the Thirty-Ninth and Fortieth Annual Reports of the Superintendents of the Insane Asylum of the State of California At Stockton for the Two Years Ending June 30, 1882, (Sacramento, CA: Office of State Printing, 1882), 14.

15. “NMHA and the History of the Mental Health Movement,” National Mental Health Association,
http://www.nmha.org/about/history.cfm.

16. Stockton Independent, May 8, 1888, 3.

17. John R. Sutton, “The Political Economy of Madness: The Expansion of the Asylum in Progressive America,” American Sociological Review, Vol. 56, No. 5, (Oct., 1991), 665-678.

18. Dr. Asa Clark, Biennial Report of the Directors and the Thirty-Fifth and Thirty-Sixth Annual Reports of the Superintendents of the Insane Asylum of the State of California At Stockton for the Two Years Ending June 30, 1888, (Sacramento, CA: Office of State Printing, 1888), 14.

19. San Francisco Examiner, no date available, Oullahan Scrapbook, MS 194, Box 15, (Holt-Atherton Special Collections, University of the Pacific).

20. San Francisco Examiner, no date available, Oullahan Scrapbook, MS 194, Box 15, (Holt-Atherton Special Collections, University of the Pacific).
 

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