The Mental Hygiene Movement and Forced Sterilization

Mental Hygiene.pdf

A 1935 Dallas newspaper article in favor of compulsory sterilization programs for the mentally-ill.

The “Mental Hygiene” movement was born from the recognition that mental institutions were woefully inadequate at improving the mental health of its inmates. The father of the movement, Clifford Beers, was a former patient of psychiatric hospitals and witnessed firsthand the atrocities present within them. Upon release, he wrote a book about his experiences, A Mind That Found Itself (1908), which launched the mental health reform movement in the United States. Beers’s intentions with the movement were to improve institutional care, to dispel stigma surrounding mental illness, and to advocate for the importance of mental illness prevention. However, these noble intentions took a turn when the mental hygiene movement's goal of prevention began to run parallel with the eugenics movement. Several U.S. states passed laws allowing for compulsory sterilization of the institutionalized “feeble-minded,” in order to “check the spread of mental disease.” 

Doctors Study Developing of Orderly Minds

A 1935 news article about the importance of prevention in the mental hygiene movement.

Although its constitutionality was doubtful from the beginning, this practice was largely deemed an acceptable way to "preserve" the intellectual and moral standards of society. Segregating and sterilizing an individual with mental illness from society was seen as a way to protect “normal” people and promote an “ideal” gene pool. Attitudes towards eugenics and “mental hygiene” were favorable even into the 1960s, at which point 60,000 individuals had been sterilized in pursuit of this goal. Forced sterilization as a form of mental hygiene even got the full approval of the United States Supreme Court in the 1927 Buck vs. Bell case, which ruled that state law requiring the sterilization of mentally ill individuals was constitutional. Although the practice of involuntary sterilization was widely ended by the 1970s with the introduction of consent forms for publicly funded sterilizations, this ruling has still not been overturned.

Mental Hygiene and the Texas Society for Mental Hygiene, 1935

A 1935 pamphlet on the Mental Hygiene movement in Texas and in the U.S., authored by the Texas Society for Mental Hygiene.

The mental hygiene movement did come with some positive developments, such as the establishment of mental health associations focused on research, education, and the promotion of mental health. Many of these organizations became strong advocates for reform. For example, the Texas Society for Mental Hygiene (later the Texas Society for Mental Health, the Mental Health Association in Texas, and finally Mental Health America of Texas) was established in 1934 and had a major role in improving the plight of the institutionalized in Texas. Additionally, the Hogg Foundation for Mental Health, a prominent Texas mental health organization today, was founded in 1940 as the Hogg Foundation for Mental Hygiene and became a leader in funding studies and disseminating educational reports to better the state of mental health care in Texas.

Although the mental hygiene movement was originally created out of concern for the dignity of institutionalized people and did serve this mission in many ways, its goals to educate people on preventing heritable mental illness also served to perpetuate stigma surrounding mental conditions, and to normalize the human rights violation of involuntary sterilization. It is important to recognize both the gains achieved and the setbacks incurred during the efforts of this movement in order to inform modern initiatives for mental health care improvement, so as to not repeat the mistakes of the past.