Origination of Asylums
Institutional housing in asylums gained popularity in the nineteenth century as an alternative to care for people with mental illness. Prior to asylums, families and small communities cared for their dependent members, but rapidly expanding urban centers increasingly found dependents homeless, in jail, or in almshouses.
Dorothea Dix, famed mental health reformer, fought for new laws and greater government funding to improve the treatment of people in asylums during the mid- nineteenth century. Dix was a supporter of the “moral treatment” approach to care, which maintained that a daily routine of exercise, social contact, and other structured activities in conjunction with a well-balanced diet, adequate rest, and attention to physical health could restore sanity.
However, by the end of the nineteenth century, asylums had become neglected, overcrowded, and in disrepair. As cost considerations overrode ideals,1 “moral treatment” techniques devolved into dispassionate institutional routines within a rigid, authoritarian structure.
Not long after the Hogg Foundation for Mental Hygiene was established in 1940, Texas was swept up in the growing movement to reform these neglected state asylums.
Much of the Hogg Foundation’s early advocacy centered around disseminating modern mental health concepts to all Texans by funding seminars, academic studies, and expert speakers who gave public lectures across the state. The foundation also worked with state officials and agencies to improve training for hospital staffers, and formed strategic partnerships with other mental health organizations such as the Texas Society for Mental Hygiene and The Texas State Board of Control.
Texans were becoming increasingly aware and upset about overcrowded and rundown mental hospitals, in part due to the foundation’s public education efforts. However, despite incremental improvements in mental health care, the Hogg Foundation and fellow reformers felt that they needed to amplify their case to the public.
The public awareness campaign grew to include:
- funding for an eight-part series of journalistic exposés on the poor conditions in state hospitals titled “The Shame of Texas (1949)”;
- funding for a twelve-part narrative series titled “My Brother’s Keeper (1953),” describing the experiences of individuals working or living in the state hospitals, from their own points of view;
- production of a thirty-minute documentary film titled “In a Strange Land (1956),” that dramatically portrayed the life of people with mental illness, both inside and outside the state’s mental hospitals;
- publication of “The Opening Door (1958),” written by foundation officer Bert Kruger Smith, assessing both the gains achieved and the work remaining to be done;
- testimony from Hogg Foundation staff members before legislative committees;
- facilitating legislators’ visits to mental health facilities; and
- inviting William Menninger, the nation’s best-known advocate for mental health reform, to address a joint session of the Texas Legislature. His lecture, titled “Brains Before Bricks,” consisted of an urgent plea to focus on “buying brains” before “buying bricks” in legislative appropriations, or in other words, emphasizing treatment over institutional custody.
These efforts led to:
- an increase in taxes on oil and gas revenue to raise funds for the operating budgets of state-run mental health hospitals and special schools, new building construction, and new professional staff positions (1950);
- a new constitutional amendment allowing the waiver of a criminal jury trial for commitment to a mental hospital (1955); and
- the landmark Texas Mental Health Code (1957), the first legislated statute that defined the state’s responsibility for mental health services and established patients’ rights to visitation, religious freedom, communication, confidentiality of their clinical records, and a right to release.2
For two decades, the Hogg Foundation and fellow reformers supported ongoing public education and organized awareness campaigns to improve services in state-run mental health hospitals in Texas. Robert Sutherland, president of the Hogg Foundation, reflected on the cause of their successes to William Menninger in a letter written in 1957:
“Probably the best achievement is the growing interest on the part of the legislators in this problem. The lesson we have learned is that next time all of the citizens’ efforts should center directly in the legislature, and, of course, now is the time to begin that. I am looking forward to much more substantial achievement next time.”
The Hogg Foundation’s educational mission includes documenting, archiving, and sharing its history, which is not only an important part of the history of mental and public health in Texas, but also the evolution of mental health discourse nationally and globally. Archival information about the foundation is available at The Dolph Briscoe Center for American History at The University of Texas at Austin, and includes, but is not limited to, the Ima Hogg Photography Collection and the Robert Sutherland Papers. We also have a robust collection at the foundation office. Research questions and appointments to view the collections can be made by contacting our archivist at firstname.lastname@example.org.