“The Diagnosis of Insanity in Immigrants” (1906)

This is one of two articles Salmon wrote while working at Ellis Island. Written for bureaucrats at the Public Health Service as part of the Ellis Island Annual Report, it provides a unique inside look into the views of psychiatrists regarding immigration.  

Salmon begins with the assertion that “it is a fact that foreign immigration alone is responsible for the high rate of insanity which prevails in the United States” (1). He continues to stress the scale of this issue by claiming that “the proportion of the population which is insane [in New York] is probably the largest in the world,” with a ratio of 1 mentally ill person for every 296.2 people in New York State, and 1 out of every 32.9 immigrants being institutionalized. He then launches into a discussion of the financial ramifications of these statistics. Claiming that most institutionalized patients spend on average 10 years at institutions, the cost for caring for the current number of patients in New York State could reach over $90,000,000 at a rate of $1,500 per patient for 150,151 patients.   

Salmon then turns to the role of immigration inspectors at Ellis Island. He claims the detention and deportation of 59 immigrants from 1904 to 1905 for cause of mental illness saved the public $88,500. Salmon builds on his economic claims with the assertion that “in no other disease is heredity so important an etiological factor, that the effects on society outweigh all other considerations” (2), implying that the “alien insane” not only constitute a financial drain in their current lifetimes, but also in the future through the assumed mental illness of their unborn children. 

Salmon states that he does not present his information to advocate for the outright restriction of certain immigrants into the US, but simply to contextualize the issues facing hospital administrators (3). He grounds these conclusions in the assertion that many immigrants come to American institutions with long histories of illness in Europe, identifying the lax standards of immigration officials and steamship companies as the core issue (4). His solution is the creation of a “psychopathic pavilion” at Ellis Island. This pavilion would function as an enhanced detention area for immigrants suspected of deportable mental illness, consisting of beds, a kitchen, and additional staff. Through enhancing psychiatric inspection capacity at Ellis Island, Salmon believes that psychiatrists can save the State vast sums of money, outweighing the appropriations needed to fund the construction of a psychopathic pavilion. He also thinks that this pavilion could rebound to the benefit of immigrants, many of whom he insists are left unstable from the journey and experience of new environments, offering them a place to rest and recoup, regaining confidence and sanity (5).