American Psychosis (34 page)

What would be the role of the federal government in such experiments? The overall organization of experiments could be assigned to the NIMH or to the Institute of Medicine, with assessments contracted to universities or private groups such as the RAND Corporation. Beyond such tasks, the federal government should probably play little role.

* * *

So here we are, 50 years after the dream of Robert Felix crossed paths with the needs of the Kennedys to assuage their family guilt. In retrospect, it was a fateful encounter. At that time, the total funds being spent on mental health services in the United States was approximately $1.0 billion, which would be $7.6 billion today. As noted in
Chapter 7
, we are now spending approximately $140 billion on mental health services. Even allowing for the increase in population in the intervening years, we are now spending approximately 12 times more on mental health services than we were at that time. What we are purchasing with those funds is a disgrace.
⁵⁰

For the majority of people with serious mental illnesses, the situation is little better today than it was in 1947, when Frank Wright, in
Out of Sight, Out of Mind
, noted:

Throughout history the problem of the mentally ill has been dodged. We have continually avoided mental patients—we have segregated them, ostracized them, turned our backs on them, tried to forget them. We have allowed intolerable conditions to exist for the mentally ill through our ignorance and indifference. We can no longer afford to disregard their needs, to turn a deaf ear to their call for help. We must come face to face with the facts.

Isn’t it time to finally do so?
⁵¹

NOTES

Preface

1
. T. Vargas, “Disabled Man Found in Filth, Jury in Neglect Case Is Told,”
Washington Post
, March 13, 2007.

2
. President Kennedy’s message on Mental Illness and Mental Retardation, February 5, 1963, in Henry A. Foley and Steven S. Sharfstein,
Madness and Government: Who Cares for the Mentally Ill?
(Washington, DC: American Psychiatric Press, 1983), 165.

Chapter 1

1
. Michael R. Beschloss,
Kennedy and Roosevelt: An Uneasy Alliance
(New York: W. W. Norton, 1980), 190.

2
. Ibid., 164, 189.

3
. Doris Kearns Goodwin,
The Fitzgeralds and the Kennedys: An American Saga
(New York: St. Martin’s Press, 1987), 688–689; Peter Collier and David Horowitz,
The Kennedys: An American Drama
(New York: Warner Books, 1984), 117.

4
. Goodwin,
The Fitzgeralds and the Kennedys
, 689.

5
. Alfred W. Crosby,
America’s Forgotten Pandemic: The Influenza of 1918
(Cambridge: Cambridge University Press, 1989), 39–40; K. A. Menninger, “Psychoses Associated with Influenza, I: General Data: Statistical Analysis,”
Journal of the American Medical Association 72
, no. 4 (1919): 235–241; K. A. Menninger, “Psychoses Associated with Influenza, II. Specific Data, An Expository Analysis,”
Archives of Neurology and Psychiatry 2
, no. 3 (1919): 291–337; K. A. Menninger, “Melancholy and Melancholia,”
Journal of the Kansas Medical Society 21
(1921): 44–50; K. A. Menninger, “Reversible Schizophrenia: A Study of the Implications of Delirium Schizophrenoides and Other Post-influenzal Syndromes,”
American Journal of Psychiatry 78
, no. 4 (1922): 573–588; K. A. Menninger, “Influenza and Schizophrenia: An Analysis of Post-influenzal ‘Dementia Praecox,’ as of 1918, and Five Years Later: Further Studies of the Psychiatric Aspects of Influenza,”
American Journal of Psychiatry 5
, no. 4 (1926): 469–529.

6
. Crosby,
America’s Forgotten Pandemic
, 20; N. Takei et al., “Prenatal Exposure to Influenza Epidemics and Risk of Mental Retardation,”
European Archives of Psychiatry and Clinical Neuroscience 245
, no. 4–5 (1995): 255–259; W. Erikson, J. M. Sundet, and K. Tambs, “Register Data Suggest Lower Intelligence in Men Born the Year after Flu Pandemic,”
Annals of Neurology 66
, no. 3 (2009): 284–289; S. A. Mednick et al., “Adult Schizophrenia following Prenatal Exposure to an Influenza Epidemic,”
Archives of General Psychiatry 45
, no. 2 (1988): 189–192. In addition to her exposure to the influenza virus, Rosemary was said to have had a hard delivery, with her “head trapped in the birth canal.” This may have contributed to her subsequent mild mental retardation but is unlikely to have been a cause of her later psychosis, based on what is now known; see Edward Shorter,
The Kennedy
Family and the Story of Mental Retardation
(Philadelphia: Temple University Press, 2000), 30–31.

7
. Laurence Leamer,
The Kennedy Women: The Saga of an American Family
(New York: Ballantine Books, 1994), 143; Goodwin,
The Fitzgeralds and the Kennedys
, 414–415; Collier and Horowitz,
The Kennedys
, 68.

8
. Leamer,
The Kennedy Women
, 170; Goodwin,
The Fitzgeralds and the Kennedys
, 415.

9
. Leamer,
The Kennedy Women
, 173, 212–213; Goodwin,
The Fitzgeralds and the Kennedys
, 576–577.

10
. Leamer,
The Kennedy Women
, 237–238; Goodwin,
The Fitzgeralds and the Kennedys
, 422; V. Dawson, “Eunice Shriver and the Power of the Possible,”
Washington Post
, August 3, 1987; Shorter,
The Kennedy Family
, 32.

11
. Leamer,
The Kennedy Women
, 239; Goodwin,
The Fitzgeralds and the Kennedys
, 420, 577; Robert Dallek,
An Unfinished Life: John F. Kennedy, 1917–1963
(Boston: Little, Brown, and Company, 2003), 72.

12
. Leamer,
The Kennedy Women
, 267–271, 284–285; Will Swift,
The Kennedys amidst the Gathering Storm
(New York: HarperCollins, 2008), 82; Goodwin,
The Fitzgeralds and the Kennedys
, 630.

13
. Goodwin,
The Fitzgeralds and the Kennedys
, 415, 704; Beschloss,
Kennedy and Roosevelt
, 197; Leamer,
The Kennedy Women
, 312–313.

14
. Ronald Kessler,
The Sins of the Father: Joseph P. Kennedy and the Dynasty He Founded
(New York: Warner Books, 1996), 217; Leamer,
The Kennedy Women
, 316.

15
. Beschloss,
Kennedy and Roosevelt
, 221, 209; Seymour M. Hersh,
The Dark Side of Camelot
(Boston: Little, Brown, and Company, 1997), 39; Alonzo L. Hamby,
Liberalism and Its Challenges: FDR to Reagan
(New York: Oxford University Press, 1985), 184.

16
. Collier and Horowitz,
The Kennedys
, 132; Leamer,
The Kennedy Women
, 319.

17
. Goodwin,
The Fitzgeralds and the Kennedys
, 741; Leamer,
The Kennedy Women
, 240; Collier and Horowitz,
The Kennedys
, 133.

18
. Goodwin,
The Fitzgeralds and the Kennedys
, 741–742; Leamer,
The Kennedy Women
, 335–336; Shorter,
The Kennedy Family
, 32. Shorter cites as his reference for this fact Leamer,
The Kennedy Women
, 318–319, but I do not find that information there; it thus may have come from the private records to which he had access.

19
. Doris Drummond, John F. Kennedy Library Foundation, letter to the author, October 18, 2010; Kessler,
The Sins of the Father
, 250; Rose F. Kennedy,
Times to Remember
(New York: Doubleday, 1974), 286; Bertram S. Brown, interview by John F. Stewart for the John F. Kennedy Library, August 6, 1968, 11; V. A. Morgan et al., “Intellectual Disability Co-occurring with Schizophrenia and Other Psychiatric Illness: Population-Based Study,”
British Journal of Psychiatry 193
, no. 5 (2008): 364–372; P. Nettelbladt et al., “Risk of Mental Disorders in Subjects with Intellectual Disability in the Lundby Cohort 1947–97,”
Nordic Journal of Psychiatry 63
, no. 4 (2009): 316–321.

20
. Beschloss,
Kennedy and Roosevelt
, 42; Collier and Horowitz,
The Kennedys
, 38, 7.

21
. Aaron J. Rosanoff,
Manual of Psychiatry and Mental Hygiene
(New York: John Wiley and Sons, 1938), 526; E. Fuller Torrey and Judy Miller,
The Invisible Plague: The Rise of Mental Illness from 1750 to the Present
(New Brunswick, NJ: Rutgers University Press, 2001), 239. Some of the excess psychiatric hospitalization of Irish immigrants was later found to be due to demographic differences, such as more young people among the immigrants.

22
. Walter Freeman, “Psychosurgery,” in
American Handbook of Psychiatry
, vol. II, ed. Silvano Arieti (New York: Basic Books, 1959), 1528; Jack El-Hai,
The Lobotomist: A Maverick
Medical Genius and His Tragic Quest to Rid the World of Mental Illness
(New York: John Wiley and Sons, 2005), 168.

23
. Goodwin,
The Fitzgeralds and the Kennedys
, 742. John White is quoted in Collier and Horowitz,
The Kennedys
, 133–134.

24
. Kessler,
The Sins of the Father
, 75.

25
. El-Hai,
The Lobotomist
, 151–154.

26
. Ibid., 106, 227, 163–164.

27
. In
The Patriarch: The Remarkable Life and Turbulent Times of Joseph P. Kennedy
(New York: Penguin Press, 2012), 535, author David Nasaw claimed that the lobotomy was done between November 12 and 28, based on the Kennedy correspondence to which he had access. Kessler,
The Sins of the Father
, 242–246.

28
. Collier and Horowitz,
The Kennedys
, 134 (the quotation is from Timothy Shriver, Eunice Kennedy Shriver’s son); Kessler,
The Sins of the Father
, 255; Collier and Horowitz,
The Kennedys
, 69; Leamer,
The Kennedy Women
, 338.

29
. Kessler,
The Sins of the Father
, 255; Swift,
The Kennedys
, 514; Leamer,
The Kennedy Women
, 342, 390.

30
. Amanda Smith, ed.,
Hostage to Fortune: The Letters of Joseph P. Kennedy
(New York: Viking, 2001), 515–516; Goodwin,
The Fitzgeralds and the Kennedys
, 745.

31
. Leamer,
The Kennedy Women
, 433, 712, 795; G. Zielinski, “A Life Outside the Spotlight: Rosemary Kennedy Lived Quietly for Decades as Her Family Made History,”
Milwaukee Journal Sentinel OnLine
, January 9, 2005,
http://nl.newsbank.com/sites/mwsb/
; Nasaw,
The Patriarch
, 628.

32
. Edgar Allan Poe,
The Raven
(New York: J. K. Wellman, 1845); Kessler,
The Sins of the Father
, 247; Nasaw,
The Patriarch
, 536, 629–631; El-Hai,
The Lobotomist
, 174.

33
. Laurence Leamer,
The Kennedy Men
(New York: William Morrow, 2001), 170.

Chapter 2

1
. R. H. Felix, “Psychiatry in Prospect,”
American Journal of Psychiatry 103
, no. 5 (1947): 600–606. Felix’s original 1942 master’s thesis on the organization of a national mental health program is no longer available, according to officials at the Johns Hopkins School of Public Health. Felix’s many published papers on this subject from 1945 to 1949 presumably reflect his earlier ideas.

2
. F. J. Braceland, “Robert Hanna Felix, Eighty-Ninth President, 1960–61: A Biographical Sketch,”
American Journal of Psychiatry 118
, no. 1 (1961): 9–14.

3
. Henry A. Foley and Steven S. Sharfstein,
Madness and Government: Who Cares for the Mentally Ill?
(Washington, DC: American Psychiatric Publishing, 1983), 18; G. N. Grob, “Creation of the National Institute of Mental Health,”
Public Health Reports 111
, no. 4 (1996): 378–381; G. N. Grob, “Government and Mental Health Policy: A Structural Analysis,”
Milbank Quarterly 72
, no. 3 (1994): 471–500; A. D. Miller, “Hindsight in Retrospect: Learning the Lessons of History,”
Psychiatric Quarterly 62
, no. 3 (1991): 213–231; Bertram S. Brown, interview by author, October 15, 2010;
Mental Illness and Retardation
,
Hearings on S. 755 and 756, Before the Subcomm. on Health, Comm. on Labor and Public Welfare
, 88th Cong. 193 (1963).

4
. Grob, “Government and Mental Health Policy.”

5
. Murray Levine,
The Theory and Politics of Community Mental Health
(New York: Oxford University Press, 1981), 16; John A. Talbott,
The Death of the Asylum
(New York: Grune and Stratton, 1978), 17; Grob, “Government and Mental Health Policy”; E. M. Gruenberg
and J. Archer, “Abandonment of Responsibility for the Seriously Mentally Ill,”
Milbank Memorial Fund Quarterly/Health and Society 57
, no. 4 (1979): 485–506.