Memorandum from William A. White to Department of the Interior at Saint Elizabeths Hospital, May 23 1929
Dublin Core
Title
Memorandum from William A. White to Department of the Interior at Saint Elizabeths Hospital, May 23 1929
Subject
Letters (Correspondence)
Memorandums
Memorandums
Description
A memorandum from William A. White to the Department of the Interior regarding various options facing the future of the asylum, such as closure, renovations, and relocation.
Creator
William A. White; White, William A.
Source
State Archives of the South Dakota State Historical Society
Publisher
Copy from The National Archives
Date
5-23-1929
Contributor
Commissioner of Indian Affairs Department of the Interior Washington, D. C.; W. A. White, Superintendent Saint Elizabeths Hospital Washington, D. C.
Rights
government records, public domain
Text Item Type Metadata
Text
UNITED STATES
DEPARTMENT OF THE INTERIOR
SAINT ELIZABETHS HOSPITAL
WASHINGTON, D. C.
MEMORANDUM
in re
CANTON ASYLUM FOR INSANE INDIANS
The report of the inspection of this asylum by Dr. Silk shows a condition of affairs which quite obviously can not be permitted to continue. The question therefore immediately presents as to what remedy can be applied. Several propositions present themselves which I will discuss briefly as follows:
FIRST. The present institution might be abolished, in which case the problem would be how to care for the insane Indians which it is now housing. These might be cared for
(a) by contract with existing institutions that maintain a sufficiently high standard of care; or
(b) by being sent to Saint Elizabeths Hospital, in which case, however, it would be necessary first to build and equip additional accommodations.
SECOND. The institution may be maintained with such necessary changes in construction, methods of care and administration as are essential to bring it up to a proper standard.
THIRD. The institution might be entirely relocation.
With regard to these separate propositions, there are certain general principles which would govern in any case. In the first place, if the institution is to be maintained practically all of Dr. Silk’s recommendations will need to be carried out. Most of them, at least, are the ordinary routine methods of procedure here, and a proper standard of care could hardly be thought of unless these practices he recommends maintain. It is obvious that to put them into effect would involve a very considerable expenditure of money and a very considerable increase in the per capita cost of maintenance, and it is questionable whether such an ambitions program is warranted. In the first place, the unit is so small that the high per capita cost would probably have to be maintained indefinitely. But perhaps more serious than that is the fact that the location of the institution is such that it would be exceedingly difficult if not quite impossible to attract an efficient personnel who would stay there. It is hard to see, for example, how a capable psychiatrist could be induced to live in this isolated place with practically no contact with his profession or with his specialty. The tendency certainly would be to have the same thing that has already occurred repeat itself. He would ultimately be pretty apt to go to seed, and with him his institution.
If the institution is to be abandoned for the purpose of rebuilding in some other location, for the reasons given above, that location ought to be not only as accessible as possible to the population it serves but in addition it should be within easy distance, say five or ten miles, of some center of population, a city which offers a medical profession the individuals of which can be called on as consultants from time to time and that will form a group with which the medical officers of the hospital can find stimulating associations and a city in which there are reasonable opportunities for recreation for the personnel generally. Whether there is such a place I do not know.
If the patients are to be contracted for, presumably the most desirable thing to do would be to arrange with certain approved State Hospitals for their care at a per capita cost to be agreed upon. This is undoubtedly the simplest solution of the problem, provided it can be effected. All State Hospitals are overcrowded and whether they would be willing to take on this additional burden I do not know.
It is not recommended that any arrangement should be made with a private institution for their care as this would amount to subsidizing a private institution to build up the necessary units, and it would be much better for the Government to do this than to arrange for its doing in this way.
If the hospital is to be abandoned for another site or if it is decided that it would be desirable to send the patients to Saint Elizabeths, it must be appreciated that an interval of approximately three years must elapse before the actual transfer of the patients could take place. This is obvious because it would require, in the first instance, permissive legislation, and, in the second instance, appropriation, and, finally, construction, which would consume certainly over two years and probably three. In the meantime many of the changes recommended in Dr. Silk’s report would have to be carried out in order to correct glaring defects.
Aside, therefore, from which of the several policies above mentioned is to be carried out, and this of course rests with the Department, what shall be done now at the Canton Asylum depends upon whether the policy will be to maintain the institution, reconstructing it physically and administratively, or whether on the contrary it is decided to care for the patients elsewhere. In the former case a comprehensive scheme involving considerable expenditure, including building, seems to be necessary. In the latter case a great many things can be done that are largely administrative in type and do not require so much expenditure, and the leaving out of new construction will eliminate the major item of expense.
I think, therefore, that the main decision that needs to be arrived at at once is whether the asylum is to be retained or not. In either case it would seem to me that, having reached a decision on this point, the hospital should be visited and gone over very thoroughly by an engineer or an architect; and I think probably it might be well to arrange that this should be done in conjunction with Dr. Silk, and that at the time of that visit such changes as are recommended be inaugurated as are feasible, particularly with reference to the policy of the Department as to maintaining the asylum or otherwise.
(Signature) William A White
Superintendent
May 23, 1929
WAW-LMD
DEPARTMENT OF THE INTERIOR
SAINT ELIZABETHS HOSPITAL
WASHINGTON, D. C.
MEMORANDUM
in re
CANTON ASYLUM FOR INSANE INDIANS
The report of the inspection of this asylum by Dr. Silk shows a condition of affairs which quite obviously can not be permitted to continue. The question therefore immediately presents as to what remedy can be applied. Several propositions present themselves which I will discuss briefly as follows:
FIRST. The present institution might be abolished, in which case the problem would be how to care for the insane Indians which it is now housing. These might be cared for
(a) by contract with existing institutions that maintain a sufficiently high standard of care; or
(b) by being sent to Saint Elizabeths Hospital, in which case, however, it would be necessary first to build and equip additional accommodations.
SECOND. The institution may be maintained with such necessary changes in construction, methods of care and administration as are essential to bring it up to a proper standard.
THIRD. The institution might be entirely relocation.
With regard to these separate propositions, there are certain general principles which would govern in any case. In the first place, if the institution is to be maintained practically all of Dr. Silk’s recommendations will need to be carried out. Most of them, at least, are the ordinary routine methods of procedure here, and a proper standard of care could hardly be thought of unless these practices he recommends maintain. It is obvious that to put them into effect would involve a very considerable expenditure of money and a very considerable increase in the per capita cost of maintenance, and it is questionable whether such an ambitions program is warranted. In the first place, the unit is so small that the high per capita cost would probably have to be maintained indefinitely. But perhaps more serious than that is the fact that the location of the institution is such that it would be exceedingly difficult if not quite impossible to attract an efficient personnel who would stay there. It is hard to see, for example, how a capable psychiatrist could be induced to live in this isolated place with practically no contact with his profession or with his specialty. The tendency certainly would be to have the same thing that has already occurred repeat itself. He would ultimately be pretty apt to go to seed, and with him his institution.
If the institution is to be abandoned for the purpose of rebuilding in some other location, for the reasons given above, that location ought to be not only as accessible as possible to the population it serves but in addition it should be within easy distance, say five or ten miles, of some center of population, a city which offers a medical profession the individuals of which can be called on as consultants from time to time and that will form a group with which the medical officers of the hospital can find stimulating associations and a city in which there are reasonable opportunities for recreation for the personnel generally. Whether there is such a place I do not know.
If the patients are to be contracted for, presumably the most desirable thing to do would be to arrange with certain approved State Hospitals for their care at a per capita cost to be agreed upon. This is undoubtedly the simplest solution of the problem, provided it can be effected. All State Hospitals are overcrowded and whether they would be willing to take on this additional burden I do not know.
It is not recommended that any arrangement should be made with a private institution for their care as this would amount to subsidizing a private institution to build up the necessary units, and it would be much better for the Government to do this than to arrange for its doing in this way.
If the hospital is to be abandoned for another site or if it is decided that it would be desirable to send the patients to Saint Elizabeths, it must be appreciated that an interval of approximately three years must elapse before the actual transfer of the patients could take place. This is obvious because it would require, in the first instance, permissive legislation, and, in the second instance, appropriation, and, finally, construction, which would consume certainly over two years and probably three. In the meantime many of the changes recommended in Dr. Silk’s report would have to be carried out in order to correct glaring defects.
Aside, therefore, from which of the several policies above mentioned is to be carried out, and this of course rests with the Department, what shall be done now at the Canton Asylum depends upon whether the policy will be to maintain the institution, reconstructing it physically and administratively, or whether on the contrary it is decided to care for the patients elsewhere. In the former case a comprehensive scheme involving considerable expenditure, including building, seems to be necessary. In the latter case a great many things can be done that are largely administrative in type and do not require so much expenditure, and the leaving out of new construction will eliminate the major item of expense.
I think, therefore, that the main decision that needs to be arrived at at once is whether the asylum is to be retained or not. In either case it would seem to me that, having reached a decision on this point, the hospital should be visited and gone over very thoroughly by an engineer or an architect; and I think probably it might be well to arrange that this should be done in conjunction with Dr. Silk, and that at the time of that visit such changes as are recommended be inaugurated as are feasible, particularly with reference to the policy of the Department as to maintaining the asylum or otherwise.
(Signature) William A White
Superintendent
May 23, 1929
WAW-LMD
Citation
William A. White; White, William A. , “Memorandum from William A. White to Department of the Interior at Saint Elizabeths Hospital, May 23 1929,” Honoring the Dead: A Digital Archive of the Insane Indian Asylum, accessed May 6, 2024, https://honoringthedead.omeka.net/items/show/20.