Minnesota Prairie Roots

Writing and photography by Audrey Kletscher Helbling

Book review: A closer look at mental health care reform in Minnesota from 1946-1954 September 19, 2019

AS A WRITER, hearing other writers share insights into their work always interests me. That includes listening to Susan Bartlett Foote talk about her book, The Crusade for Forgotten Souls—Reforming Minnesota’s Mental Institutions, 1946-1954, at the Owatonna Public Library on Tuesday evening. Foote’s book won the 2019 Minnesota Book Award in nonfiction. It’s a well-deserved honor for a book which shares the powerful, and previously untold, story of reform in Minnesota’s mental health care system some 70 years ago.

Despite the four years Foote invested in researching and writing, she is quick to credit another woman for this story. Engla Schey. Foote dedicated her Minnesota Book Award to this activist and aspiring writer whom she calls the first mental health advocate in Minnesota. Schey worked initially as an attendant in several state mental health hospitals, or “insane asylums” as they were called back in the day. She witnessed first-hand the neglect, abuse, inhumane treatment, poor living and working conditions…all documented in her diaries. Foote read those diaries, in the possession of Schey’s great great niece.

The result is a deeply personal story about one ordinary woman’s efforts to change “a cynical and secretive system.” Schey’s insider perspective, Foote notes, allowed her to upend the whole structure. At the time, some 15,000 people lived in the state’s seven mental health hospitals with 80 percent of them committed and 35 percent senile/elderly. Half suffered from mental illnesses with stays of sometimes 20 years. The statistics are startling. But it is the stories Foote shares that make the most impact. Read this book and you will find yourself in tears.

As Foote related in her Tuesday evening talk, Schey quickly recognized that she needed help—of liberal churches, unions and writers—if she was to effect change within the system. She cared deeply. And personally. Her father voluntarily committed himself to the state hospital in Fergus Falls.

Eventually, the Minnesota Unitarian Church got involved, taking the approach of responsible study and analysis rather than jumping in and demanding immediate reform. The Rev. Arthur Foote (Susan Foote’s former father-in-law) led those efforts along with activist Genevieve Steefel and others.

Soon those initial reformers recognized the need to engage the press and political leadership and to build popular support, Foote said. Investigative news stories published. And some politicians, like then Minnesota Governor Luther Youngdahl, set aside partisan politics to make mental health care reform a top issue. Foote praised Youngdahl, referencing his stand that all mentally ill Minnesotans were entitled to fundamental human guarantees (dignity) and his goal to build a patient-centered mental health care system. A photo of Youngdahl burning a pile of straightjackets (and published in the book) signaled that change was going to happen, Foote said. And it did. Conditions improved both for patients and staff.

Like anything, though, change did not come easily nor is it always permanent. I experienced a deep sense of disappointment and frustration as I read in detail about all the politicking, untruths and denials. I can only imagine how those deeply involved in reform efforts felt. Youngdahls’s biggest disappointment, Foote shared with us in Owatonna on Tuesday, was that Minnesota churches (other than the Unitarians) wanted nothing to do with the issue of mental health. Has that changed much?

Youngdahl, in the ever-evolving political environment, suffered another disappointment in his failure to open a state hospital in Brainerd. One eventually opened there and my brother-in-law Brian became a resident after suffering incapacitating permanent brain damage. I knew him only briefly before his passing in 1984 at the age of 23.

At Tuesday’s talk in Owatonna, an audience member shared afterwards that a family member died of tuberculosis while hospitalized in a state hospital. Another attendee told me privately of staff intentionally breaking the legs of a man who lived at a state hospital in Faribault. For every story spoken, I expect many more remain unspoken. The hurt runs deep even all these decades later.

Although politicians and the public moved on and times changed and cuts began in the state hospital system by the early 1950s with Minnesota falling back to “average” in mental health care, Foote said, “I maintain this story is an inspiration, not a failure.”

She closed with a quote from Governor Luther Youngdahl: “Protection of the patient depends on our eternal vigilance.”

I agree. And I contend that we can all be Engla Scheys. We have within us—within our families, our circles of friends, our churches, our schools, our communities—the ability to make a difference in the lives of those dealing with mental illnesses and those who love them. Through our compassion, care, understanding, love and support. On multiple levels.

© Copyright 2019 Audrey Kletscher Helbling