N.D. State Hospital's history marked by politics, reform
By Janell Cole
The Forum - 10/24/1999

On a hill overlooking the James River Valley and the Stutsman County seat is one of the two oldest state institutions in North Dakota, its sturdy buildings and tunnels belying the fierce gales of change it has withstood for 116 years at the hands of politicians and revolutions in social policy.

The North Dakota State Hospital at Jamestown is one of two state institutions that predate statehood. Its location and mission as a "hospital for the insane" was authorized by the Dakota Territorial Legislature in 1883 and it opened on May 1, 1885, accepting its first two patients from Morton County.

(The University of North Dakota is the other territorial institution; it also was authorized in 1883 and opened in September 1884. Both were later authorized again by the state constitution in 1889.)

Fifty-eight patients whose addresses were in what eventually became North Dakota were moved to Jamestown from the Dakota Hospital in Yankton (now South Dakota). The first superintendent was Dr. O. Wellington Archibald, who had been an assistant surgeon at Fort Abraham Lincoln south of Mandan.

By the end of 1886, the average daily census was 106 patients.

Sally VanBeek, a longtime registered nurse at the hospital (now retired), writes in her 1974 history of the hospital that "with the writing of the 1886 biennial report (came) what was to become the chronic cry of the hospital ... the hospital cannot adequately care for the patients on the monies appropriated by the Legislature." The 18-month-old hospital was already crowded.

Praise for new hospital

Nevertheless, VanBeek writes, it was considered a model institution by some out-of-state observers. In a Pennsylvania newspaper, an unnamed reporter talks of visiting "several of the pretty towns of Dakota," including Jamestown, where a proud citizen drove the reporter's party to the new hospital for a look around.

"To state that we were astonished is putting it mildly," the newspaper writer gushed. "I have visited many 'insane asylums' as we call them in the effete east, but nothing like the home-appearing (Jamestown facility). As we made a tour of the place, pleasant surprises never ceased, from the discovery that there was not a single horrifying prison-like grated door or bar or heavy bolt, down to the systematic manner in which a large number of the patients were engaged in doing light housework!"

The reporter said the contrast between the jail-like asylums of the eastern states and the "happy" North Dakota institution "was indeed a revelation."

Crowded conditions

But by 1892, conditions at the hospital were so crowded that attics were used for sleeping rooms and even then, patients had to sleep two to a bed, VanBeek wrote. Archibald warned the Legislature that if it didn't appropriate more money for adequate care, the hospital would be closed and each county would have to care for its own insane. He left the hospital in 1894.

By 1904, the census had risen to an average of 401 and still there were no additional buildings. Two buildings had been started in 1903 but construction was halted when the funding process was found unconstitutional, wrote VanBeek. When the state began enforcing laws that allowed it to collect fees from patients' families or their home counties, the construction started again and the two new buildings were completed. Staff was increased so that patients would not have to be locked in their rooms at night or restrained during the day.

The census continued to rise, leaping from 538 in 1908 to 819 in 1912 and then to 1,288 by 1920, wrote VanBeek.

In 1914, the hospital was almost closed down because of a smallpox epidemic.

Also in 1914, the hospital began to routinely sterilize its "inmates," due to the common belief that their "deficient and degenerate mentality" would be handed down to any progeny. Sterilization was carried out on female patients for many years.

Policies were adopted in the 1920s that were designed to relieve overcrowding by improving patient care. It was hoped the changes would lead to shorter stays and more discharges. The policies included plans for after-care and preparing patients' families for release.

Still the census went up, reaching 1,486 in 1929.

Corrupt politics

Then came the turbulent 1930s.

VanBeek's history is virtually silent on this tumultuous time in the hospital's - and state's - history, which saw Gov. William Langer elected, thrown out after a criminal conviction, then elected again a few years later, after his conviction was overturned.

In 1937-38, during Langer's second term, the controversial state Board of Administration that had got Fargo in an uproar over the firing of the president of the Agricultural College (NDSU) also caused havoc at the State Hospital, according to The Fargo Forum's coverage.

On Jan. 30, 1939, The Forum printed all or most of special examiner Clyde Duffy's report to the Legislature of the political shenanigans affecting the hospital administration, staff and patients.

Headlined "Asylum Inquiry Report Reveals Politicization Major Factor in Breakdown of Institution's Work," The Forum's repetition of Duffy's findings reveal an atmosphere of corrupt Non-Partisan League cronyism, nepotism, employee shakedowns, blatant politicking and flat-out interference.

(It should be noted that The Forum and Langer were bitter enemies; nevertheless, the 1939 article appears to be a verbatim printing of Duffy's report)

The problems started in June 1937, when Langer dismissed Dr. J.D. Carr as hospital superintendent and appointed Henry G. Owen.

Owen promptly purged the hospital of 75 percent of its staff, most of whom were "faithful and efficient" employees and had no reason to be fired. Employees were told to rat on each other and if they didn't produce the expected dirt, they themselves were terminated. The tactics also included the hiring of an undercover agent and an ex-con to gather evidence used to fire employees.

New employees were hired strictly on the basis of their contributions to the Non-Partisan League. Duffy dug up numerous letters in which county NPL chairmen recommended party contributors for jobs or in which prospective employees tout their party positions in seeking a post a the hospital.

In one case, Bank of North Dakota manager Frank Vogel - who had no authority over the hospital - wrote to a crony in the hospital administration and directed the crony to "send back to the farm" a couple employed there who "were against us in the last campaign."

A new hospital superintendent, Dr. F.O. Lorenzen, was appointed by Langer and ratified by the Board of Administration, in October 1937.

"According to Dr. Lorenzen, the governor told him that he was to run the institution and that no politics were to be connected with it," wrote Duffy. "Dr. Lorenzen apparently took this enunciation seriously." He told the employees the purging and politicking were over.

Not so.

Lorenzen's attempts to run the hospital were frustrated by ongoing political activity and interference by C.A. Miller, secretary-treasurer (business manager) of the hospital, who was hired after Lorenzen.

"Mr. Miller appears to have been given considerable power with reference to the administration of the hospital and the hiring and firing of help but Dr. Lorenzen does not appear to have been advised of this fact," Duffy wrote.

Under the direction of Miller and the Board of Administration, employees at the hospital were required to do political work, including collecting of mandatory contributions. They were sent out to do NPL campaign work on hospital pay. NPL caucuses and fund-raising dances were held at the hospital, with the hospital paying the bills for food served.

The hospital ran over budget in the 1937-38 biennium and Duffy found a disregard for sound business practices. One reason was that 75 more employees had to be hired in addition to the ones fired, because the new, politically connected employees didn't know how to do their jobs.

"Some latitude may be given to political appointments and political assessments," Duffy wrote, "But when a hospital for the care of the insane is made a hot bed of political activities, it is carrying the subject beyond all reason."

Politics affect care

During 1937-38, the disorganization, the ongoing politicking, mass firings and inexperienced employees had a detrimental effect on the patients. Patients cried when longtime care givers were suddenly fired and gone.

Duffy quotes an employee: "The new employees didn't know how to treat the patients. They called them bad names, cussed and swore at them. Some said they would run away and some did run away."

It's unclear what happened as a result of Duffy's report to the 1939 Legislature, but by then Langer was out of office. Lorenzen's tenure also was short, though the hospital history doesn't say exactly when he left.

Continuing struggles

During the 1940s, the hospital census continued to rise, reaching 2,027. It was so crowded that VanBeek writes that the institution went through a Dark Ages period, with treatment stifled by the conditions, lack of qualified staff and "general hospital-wide disorganization."

The Forum reported that the American Psychiatric Association was brought in to inspect the hospital in 1949. Inspectors made many expensive recommendations, which reached the 1951 Legislature. It's not clear what was done in 1951, but in 1953, the next session increased hospital appropriations, The Forum reported

Then came a period of great reform, under Dr. R.O. Saxvik, who was "loaned" to the hospital from the state Health Department for six years, beginning in 1953. When he took the position, the census was 2,136 and he found chaotic administration, employee confusion, overworked staff and unrest, VanBeek writes.

Together with the blessings of Gov. Norman Brunsdale and the Legislature, Saxvik reorganized the hospital, hired more staff and increased salaries.

By 1956, Saxvik had positive news in his biennial report.

"In three years time one can see and feel the difference," he wrote. "Gone are the cages, strait jackets, leg irons, stern guards, malnutrition, windowless seclusion rooms, unorganized departments, the sixty-hour work week, the naked despondent patient on a back ward, the odors from wards crammed with untidy and helpless men and women, the tuberculosis patients in disorganized treatment areas, the neglected surgical problems and the bedlam of disturbed units," he wrote in one breathless sentence.

The Forum reported that in the 1950s, the hospital began widespread use of tranquilizers on patients to relieve their anxiety and stress.

Under Saxvik, the census dipped to 1,886. The 1957 Legislature appropriated money to raze two old buildings, The Forum reported.

As reforms continued, the hospital received a full three-year accreditation from the Joint Commission on Accreditation of Hospitals in 1961. An adolescent unit was founded in 1963.

One of the best known superintendents, Dr Hubert Carbone, stayed for 16 years, resigning in 1979.

By that time, the state had begun moving toward a treatment model that continues today, in which long-term placement in the hospital is discouraged in favor of outpatient treatment in the patients' home areas through the services of the regional human service centers, the use of advanced psychotropic drugs and the regional intervention services. In 1974, the census was 557 patients and the average stay was 60 to 90 days.

The VanBeek history, updated through 1998 by Nancy Schulz, does not give much history of the development of the physical plant, but the campus continued to grow, with many buildings added or replaced, as recently as the 1980s, when the secure forensic unit and Lahaug buildings were dedicated.

Meanwhile, the population continued to dip - down to 270 in 1989 - and wards in many of the older building were closed.

By 1997, with many of the hospital's buildings empty or nearly empty and the State Penitentiary in Bismarck fairly bursting at the seams with excess inmates, the Legislature appropriated money to turn three State Hospital buildings into the James River Correctional Center, a medium-security prison on the grounds of the hospital.

The two institutions are co-existing on the hill south of Jamestown today.