“Immigration and the Prevention of Insanity” (1914)

This article, presented at the Illinois Mental Hygiene Society’s annual Conference, is Salmon’s last on immigration and came in response to pending immigration legislation. In 1914, immigration restrictionists successfully passed a bill in Congress requiring a literacy test as part of a suite of new immigration qualifications. President Woodrow Wilson, seeing a literacy test as politically controversial, promptly vetoed the bill, throwing a wrench in the movement to restrict US immigration.

In a departure from his 1911 position, Salmon rejects the value of certificates of health in assessing immigration qualifications, citing the example of politically-persecuted immigrants such as Carl Schurz, who could not have reasonably secured a certificate from governments abroad. He also rejects heredity, in a departure from his 1906 position, as a bearing on mental health, claiming “our knowledge of the effect of heredity upon the production of mental disease is hardly definite enough to base such an arbitrary administrative measure upon.” (1)

Salmon’s solutions, as before, mostly center on allocating more resources to immigrant examination and detention, this time through hiring more examination staff and by placing American psychiatrists onboard steamships. Salmon turns his focus onto the steamship companies, highlighting how their desire for profit in transporting immigrants leads them to invest little into mental examinations and the quality of living space onboard steamships. For the first time, Salmon also explains that the “New Immigration” is motivated by economic concerns, which in turn compels the steamship companies to cast an ever wider net in soliciting passengers.

This article also contains no figures or extensive statistical analysis for the first time since Salmon started writing about immigration 8 years earlier. This, alongside the softening of his views around heredity and restrictive measures, suggests a growing distance from the subject, and some dissipation of the urgency which gripped his analyses in 1906, 1907, and 1911.

At the core of Salmon’s writing is the presumption that a proper examination of immigrants can prevent their future institutionalization in America. While Salmon pays attention to the trauma inflicted by the process of immigration, including from the journey, from conditions in detention facilities on Ellis Island, and from adjusting to life in America, Salmon’s solution is primarily to prevent detainees from ever embarking upon their arduous journey to America. Salmon’s application of these preventative measures mirrors his growing concern with preventive medicine, or the intervention of medical professionals to prevent the onset of disease before it happens.

Salmon’s interest in preventative medicine aligned with the interests of Clifford Beers, a former asylum patient-turned-psychiatric activist. He would join Beers in the development of a new organization which would revolutionize conversations around psychiatric facilities: The National Committee for Mental Hygiene.