American Psychosis (9 page)

Kennedy proceeded to tour Fort Atkinson for an hour, shaking hands and giving a brief talk. According to the newspaper, “he entered practically every business place, retraced his steps several times to greet persons he missed, and stopped traffic in the streets to shake hands with drivers.” And then he left, driving south to briefly stop in Whitewater, Elkhorn, and Lake Geneva, three nearby towns. He was not due in Kenosha (less than 50 miles away) until evening, so he had plenty of time. Leamer, who had access to the Kennedy family archives, simply said: “At the last moment the plans changed and Jack never saw Rosemary.” Did Kennedy change his mind? Was Rosemary too agitated? Did the campaign staff become frightened that the press would find out about Rosemary, thus introducing a campaign issue the Kennedys did not want introduced? It is not known. What is known is that Jack Kennedy personally called a local florist on Rosemary’s birthday each year to have flowers delivered. Rosemary thus seems to have hovered perpetually over her older brother, an unhappy apparition demanding expiation.
⁴

Following Kennedy’s election in November 1960, it became impossible to pretend that Rosemary did not exist. Immediately after the election,
Children Limited
, a publication of the National Association for Retarded Children (NARC), noted that “the President-elect has a mentally retarded sister who is in an institution in Wisconsin.” Because many leaders in the mental retardation community knew about Rosemary and resented the Kennedys for not acknowledging her, the article may have been an attempt to “out” them. The Kennedys immediately protested to NARC, which then sent a notice to its affiliates saying that “the family preferred not to have this [Rosemary’s retardation] mentioned, and we would respect their wishes in this matter as we would any other family’s wishes.”
⁵

By 1962 Rosemary’s condition had become common knowledge, and White House efforts to promote research on mental retardation were underway. The Kennedys decided that it was time to acknowledge the obvious, and in September Eunice authored an article, “Hope for Retarded Children,” in the
Saturday Evening Post
. She described her sister as having been mildly retarded in childhood. Later, however, Eunice wrote, Rosemary “was becoming increasingly irritable and difficult” and the doctors said that “she would be far happier in an institution.” Therefore, they put her in one where “she has found peace.” There was no mention of any mental illness and, of course, no mention of the lobotomy. As in all such matters, the ability of the Kennedys to deny inconvenient truths was noteworthy. As late as 1995 Eunice Shriver continued to deny any association between Rosemary’s condition and the Kennedy family’s interest in mental retardation. In an interview reported by the
New York Times
, Eunice “dismissed out of hand” the idea that her Special Olympics for retarded children “existed because of Rosemary.”
⁶

MENTAL HEALTH VERSUS MENTAL RETARDATION

Robert Felix and his colleagues were delighted with Kennedy’s election, viewing him as “the right person at the right time.” They were aware that “the essential ingredient in the creation of a national mental health program was the interest of the president,” and they were aware that he had read in its entirety the report of the Joint Commission on Mental Illness and Health. In July 1960, at the Democratic National Convention, Mike Gorman had even arranged to have a reference to their plan included in the Democratic national platform:

Mental patients fill more than half the hospital beds in the country today. We will provide greatly increased Federal support for psychiatric research and training, and community mental health programs to help bring back thousands of our hospitalized mentally ill to full and useful lives in the community.

Thus, by the time Kennedy took office on January 20, 1961, Felix et al. were ready to go forward with their national mental health plan.
⁷

The White House, however, informed them that mental retardation was going to have first claim on the administration’s attention. Eunice Shriver had also read the report of the Joint Commission on Mental Illness and Health and had been appalled. As she later recalled, “I didn’t even see the word mental retardation mentioned once. I thought that was awful, and I called up my father and I said to him, ‘Dad, would you be willing to let the foundation sponsor a nationwide conference on mental retardation, because this report has obviously nothing to say about the mentally retarded.” According to Eunice: “My father said we ought to create something like the Hoover Commission, and call it a Presidential Panel.” The Hoover Commission had been set up in 1947 by President Truman to recommend administrative changes in the federal government; former president Herbert Hoover had been its chairman.
⁸

This was the origin of the President’s Panel on Mental Retardation, created in October 1961 with 27 members, including basic brain researchers, educators, and representatives of NARC and other parent organizations. The panel’s charge was to create a plan to combat mental retardation within 1 year. Predictably, there was little agreement among the various factions regarding what should be done with “the science-oriented ‘researchers’ squared off against the education-oriented caregivers.” The panel, ultimately divided into six task forces, held a series of public meetings, and visited mental retardation facilities in Europe to gather ideas. In October 1962, it issued a 200-page report with 95 recommendations, including something for everyone.
⁹

At the same time that the President’s Panel on Mental Retardation was deliberating, plans also proceeded to create a new institute within the National Institutes of Health
(NIH) to focus research attention on mental retardation. The federal Department of Health, Education, and Welfare (DHEW) and James Shannon, the NIH director, both opposed the idea but were overruled by Ted Sorensen, one of Kennedy’s key advisors, and by Kennedy himself. The new institute was initially going to be called the National Institute on Mental Retardation, but that was considered to be too narrow a mandate, so it was called the National Institute of Child Health and Human Development. President Kennedy proposed the new institute in a message to Congress on February 27, 1962, and by September the necessary legislation had been passed. The recommendations of the President’s Panel were divided into two sets of legislation. The first provided funds from Social Security to provide better care for pregnant women and newborns; the second established 18 university-affiliated clinical facilities for mental retardation. Both pieces of legislation were passed by Congress and signed into law in October 1963.
¹⁰

It should be added that the driving force behind these mental retardation initiatives was Eunice Shriver. In March 1961 her husband became the director of the Peace Corps, and in December 1961 Joe Kennedy had a stroke, effectively disabling him. Eunice, therefore, took command and, using her brother to remove obstacles, made things happen. Crucial to her efforts were Myer “Mike” Feldman and Wilbur Cohen. Feldman worked for Ted Sorensen in the White House, and within the White House he was “the chief force for action on mental retardation.” Cohen, who had an undergraduate degree in economics from the University of Wisconsin and had worked on Franklin D. Roosevelt’s New Deal programs, was the Assistant Secretary for Legislation at DHEW. As early as May 1961, 5 months before the President’s Panel on Mental Retardation had begun discussions, Eunice had begun regular meetings with Feldman, Cohen, and Dr. Robert Cooke to plan the mental retardation legislation. According to Shorter’s history of this legislation, Eunice Shriver “acquired the authority to give orders to Mike Feldman, who in turn gave orders to Wilbur Cohen.” Eunice’s authority came, of course, from the president, whom she pestered persistently. Bobby Kennedy later joked that Jack used to say: “Let’s give Eunice whatever she wants so I can get her off the phone and get on with the business of government.”
¹¹

Although Eunice recognized that legislation would ultimately be proposed by the Kennedy administration for both mental health and mental retardation, she was determined to make the latter paramount. As Shorter noted, Eunice “shared the general loathing of the parents’ [of mentally retarded children] group for psychiatrists.” Eunice’s key advisor, Dr. Robert Cooke, similarly remembered that “the feeling [among mental retardation advocates] . . . against psychiatry was just enormous and that these people had done very little.” Dr. Bertram S. Brown, assigned by the National Institute of Mental Health as a liaison to the President’s Panel because of his previous writings on mental retardation, also claimed that “there was hatred of psychiatry because mental retardation was more acceptable to them.”
¹²

Some of the animosity between the mental retardation and mental health advocates arose from the fact that each group felt superior to the other. As described by one historian of these events: “The mental-health groups assumed a superior attitude because mental illness can be a temporary condition from which people recover, while the retarded will always be intellectually inferior.” On the other hand, “the mentally retarded group thought, or believed, that mental illness was more of a stigma and didn’t want to be identified with it.” Their family members may be intellectually slow, they said, but at least they weren’t crazy.
¹³

Faced with accusations of neglect, Robert Felix and his psychiatric colleagues privately “cried bitterly that they hadn’t shortchanged mental retardation.” Felix also “protested loudly that he was the first to push for attention for the area of mental retardation,” although he had difficulty citing specific examples. The psychiatrists felt that the Kennedys were being disingenuous in giving priority to mental retardation, as Rosemary was both mentally retarded and mentally ill. Bertram Brown later characterized this Kennedy lack of candor “the biggest mental health cover-up in history.”
¹⁴

Nevertheless, the mental health advocates said little publicly, because they did not want to offend the Kennedys or the mental retardation advocates. Mike Gorman had tested the waters in Congress and found that joint legislation, covering both mental health and mental retardation, stood a better chance of being enacted than legislation on mental health alone. Thus, Gorman proposed an alliance with the mental retardation group. However, “the retardation groups not only did not want such a coalition, they also wanted any new appropriations to be directed primarily to mental retardation programs.”
¹⁵

The real battle, like most Washington fights, was about budgets. Presidential interest in a program inevitably means more money, the ambrosia of the Potomac. Felix correctly perceived that Eunice Shriver was not going to allow the National Institute of Mental Health to keep the mental retardation program. In exchange for giving up the program, Felix and his colleagues attempted to extract more concessions for their national mental health program.

SHAPING A NATIONAL MENTAL HEALTH PLAN

Once President Kennedy had gotten the mental retardation planning efforts underway, he turned his attention to mental illness. Unlike with mental retardation, however, no Kennedy family member offered to take a leadership role as Eunice had done, and the president was uncertain what to do. He therefore did what most American presidents have done in similar circumstances, and on December 1, 1961, he appointed a committee to make recommendations.

To chair his Interagency Committee on Mental Health, Kennedy asked Anthony Celebrezze, the Secretary of the Department of Health, Education, and Welfare (DHEW). Celebrezze in turn asked Boisfeuillet Jones, a lawyer who was his special assistant, to do the actual work and chair the committee. Jones had been a dean and vice president at Emory University and had previously served on the National Advisory Mental Health Council, so he had a special interest in these issues. Other members of the Interagency Committee were Daniel P. Moynihan, a sociologist, representing the Department of Labor; Robert Atwell, an economist, representing the Bureau of the Budget; Rashi Fein, an economist, representing the Council of Economic Advisers; and Robert Manley, an administrator representing the Veterans Administration. Dr. Felix, representing NIMH, was, of course, a member, and in a 1972 interview Felix claimed that he had had input on the selection of the other committee members. The committee was asked to make recommendations on future mental illness services in state hospitals versus community mental health centers, on federal versus state funding for the enhanced services, and on possible ways to increase the pool of mental health professionals to staff the enhanced services. What was clear to everyone was that President Kennedy was committed to some kind of new mental illness program. Jones recalled in a 1972 interview that Kennedy made it clear that he wanted a new program but did not specify the details of such a program.
¹⁶

As the only mental health professional on the Interagency Committee, Felix inevitably dominated the proceedings. In later interviews, both Jones and Moynihan verbalized great deference to Felix. Fein recalled that “a lot of time was spent hearing Felix extol the medical approach.” Felix was assisted in his committee efforts by two other NIMH psychiatrists: Stanley F. Yolles and Bertram S. Brown. Brown was especially well placed to be useful to Felix, as he was also serving as the NIMH liaison to the President’s Panel on Mental Retardation. Yolles would succeed Felix as director of NIMH in 1964, and Brown would succeed Yolles in 1970. Thus, from 1946, when NIMH was created, until 1977, when Brown left NIMH, the official mental health policies of the U. S. government were dominated by these three men.
¹⁷