National Committee for Mental Hygiene (NCMH)
In 1900, Clifford Whittingham Beers entered a psychiatric asylum. Suffering immense mistreatment in dilapidated, outdated facilities, Beers used self-teaching and guidance to improve his condition, in spite of psychiatric staff. Upon being discharged, Beers decided to write about his story and the general decay in mental asylums, publishing A Mind that Found Itself in 1908. This book became an immediate bestseller and spawned a new movement in psychiatry: “mental hygiene”.
Beers was not a psychiatrist by trade, nor did he have any medical training. A banker on Wall Street and a Yale graduate, he had access to influential people in New York and New Haven. Determined to change the conditions in psychiatric hospitals, Beers partnered with Adolf Meyer, the eminent psychiatrist and theorist of the relationship between personality, life circumstances, and mental illness, to create the National Committee for Mental Hygiene (NCMH) in 1909. The term “mental hygiene” was invented by Meyer for this context, although neither he nor Beers were quite sure what exactly it meant clinically (1). In practice, the NCMH would focus its activities on advocating for better facilities and management practices in psychiatric hospitals, conducting statistical studies of hospital conditions, and lobbying the public for increased awareness of mental illness.
Underlying the NCMH’s work was one core assumption: mental illness could be caused by problems in upbringing and environment, not just heredity. Therefore, mental illness could be both prevented and cured in the right environment. The psychiatric hospital, then, should tend towards an environment most likely to induce a cure, while society as a whole should avail itself of psychiatric knowledge to create environments that prevent outbreaks of mental illness.
In drumming up support for expanded psychiatric facilities, the NCMH also utilized eugenic frameworks, operating under the principle that the influence of heredity on mental health could be scientifically identified and regulated. Some members of the NCMH, such as Lewellys F. Barker, with whom Salmon kept up a decades-long professional correspondence, were ardent eugenicists. Barker and other eugenicsts further promoted legislation that would mandate segregation of the "mentally unfit" and their medical sterilization, although the NCMH did not take an official position in favor or against segregation and sterilization (2). At the same time, other psychiatrists involved with the NCMH, such as Adolf Meyer and Wiliam A. White, rejected deploying eugenic reasoning in health policy, reflecting a lack of consensus among American psychiatrists more generally (3).
“Mental hygiene”, like the concept of the “alien insane”, offered psychiatry both a way to professionalize itself, by standardizing and improving conditions in psychiatric facilities, and a way to improve its standing among medical professionals and society, by bestowing upon itself the power to reorder society and potentially eliminate mental illness. In its encouragement of social engineering, “mental hygiene” proved particularly appealing to non-psychiatrists, especially social workers and philanthropists.
Coming into prominence at the height of the Progressive Era, the NCMH would take advantage of the expanded relevance of “mental hygiene” to partner with philanthropic organizations like the Rockefeller Foundation and Commonwealth Fund.
The NCMH would continue to exist beyond Beers’ death in 1943, eventually transforming into Mental Health America.