Thomas W. Salmon: Advocate of Mental Hygiene (original) (raw)

AS PART OF THE MENTAL hygiene movement that emerged in the early 20th century, Thomas W. Salmon proposed broadening the specialty of psychiatry to move beyond the traditional focus on institutional care. He argued that psychiatrists should spearhead new approaches to prevent mental illness and to rehabilitate criminals and “delinquents.” Salmon also played a key role in one of the earliest client advocate health reform movements in the United States, the National Committee for Mental Hygiene, which he directed toward the study of social problems across communities and the development of preventive programs.1

Thomas William Salmon was born to Thomas Henry Salmon, a country doctor, and Annie E. Frost in Lansingburgh (now Troy), NY, in 1876. His parents had emigrated in the 1860s from Britain, where his father had served as a surgeon in the British Merchant Marine. Thomas William also embarked upon a career in medicine, graduating from Albany Medical College in 1899. He married Helen Potter Ashley the same year and bought a country practice in Brewster, NY. The couple went on to have 6 children.2(p18–19)

Salmon struggled to make a living as a general practitioner while suffering from bouts of pneumonia and tuberculosis and unsuccessfully trying to settle his father’s debts. In 1901, after a brief visit to the Adirondacks for his health, he took up work as a bacteriologist at the Willard State Hospital, a psychiatric institution near Syracuse, NY. He investigated an epidemic of diphtheria at the hospital and in 1905 he coauthored, with staff physician and leading psychiatrist William L. Russell, a widely read report on the topic.3 As a result of this work, Salmon was appointed bacteriologist of all New York State mental hospitals.

In 1903 Salmon joined the US Public Health Service as commanding assistant surgeon in the US Marine Hospital Service. A year later, after a series of short assignments, he was posted to Ellis Island to perform psychiatric evaluations on the thousands of immigrants routed through the port of New York. He was shocked at the conditions of those awaiting deportation and made frequent appeals for improvements in their care. He also advocated moving psychiatric evaluations to the immigrants’ point of origin rather than waiting until they arrived in the United States. His criticisms created tension with his superiors, and Salmon was briefly suspended from duty for insubordination before being reassigned to the Marine Hospital in Chelsea, Mass, in 1907.2(p33)

In 1912, Salmon undertook research on the care of mentally ill patients in state and local institutions for the National Committee for Mental Hygiene. Although difficulties in securing funding prevented him from taking up a permanent position at that time, in 1915 he became the committee’s first medical director, a position funded by the Rockefeller Foundation. He worked for the National Committee for Mental Hygiene for the next 10 years.4 Founded in 1909 by client advocate Clifford Beers, who had written an exposé of the terrible treatment he had experienced while institutionalized, the committee had initially focused on improving psychiatric facilities. Salmon, acting on his firm belief that psychiatry should have a broader role in society, reoriented the organization toward the study of mental illness in the wider population and the prevention of mental illness.5

During World War I, Salmon served as chief consultant in psychiatry in the American Expeditionary Force. He devised a system to screen recruits for mental health problems, organized a military neuropsychiatric service, and instituted new procedures for treating “shell shocked” soldiers. Placing a high priority on the long-term health of veterans as well as the immediate needs of his injured patients, he also arranged for rehabilitation and treatment for soldiers sent home to the United States. In recognition of the success of his approach, Salmon was awarded the Distinguished Service Medal.

Salmon returned to his work at the National Committee, and from 1920 to 1921 he also served as an adviser to the Commonwealth Fund. He helped launch the fund’s mission to establish professional services for children with emotional and behavioral problems, persuading the fund’s directors to take on “juvenile delinquency” and laying out a plan for research. In 1921, Salmon left the staff of the Rockefeller Foundation to become a professor of psychiatry at Columbia University. He resigned from the National Committee in January 1922 to focus on private practice, and he completed his work for the Commonwealth Fund 5 months later. He went on to serve as consulting psychiatrist to the New York Presbyterian Hospital, and he helped integrate the New York Psychiatric Institute into Columbia Medical Center. In 1923, Salmon was elected president of the American Psychiatric Association. He died in a sailing accident on Long Island Sound in 1927.

References

1. Grob GN. Mental Illness and American Society, 1875–1940. Princeton, NJ: Princeton University Press; 1983:162–163.

2. Bond ED. Thomas W. Salmon, Psychiatrist. New York, NY: Arnos Press; 1980:18–19.

3. Russell WL, Salmon TW. Report of Epidemic of Diphtheria in the Willard State Hospital. Albany, NY: Brandow Printing Co; 1905.

4. Winkler KT. Thomas William Salmon. In: American National Biography. Vol 19. New York, NY: Oxford University Press; 1999:215–217.

5. Pols H. Managing the Mind: The Culture of American Mental Hygiene, 1910–1950 [dissertation]. Philadelphia: University of Pennsylvania; 1997.