Madison State Hospital

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By the 20th century, four mental institutions operated in Indiana. All were overcrowded, causing state officials in February 1905 to establish a fifth one in the southeastern region, based in Madison. The attraction to Madison included its beautiful and remote hilltop location overlooking the Ohio River.

The concept of “moral treatment” was a popular one at the time, based on the premise that environment and productive activity could be therapeutic to the disturbed mind. This opposed the 18th and 19th centuries’ treatment of the insane, which often included caging patients and physically beating them in order to keep them in line.
The $1.172 million new hospital was initially called the Southeastern Hospital for the Insane. It admitted its first patients on Aug. 23, 1910. By the end of the first fiscal year, the facility housed 544 patients with a staff of 74.

Even though the land had a natural beauty to it, it lacked paving, trees and shrubs, and other luxuries made possible by artificial landscaping. Hence, its first two superintendents, Dr. Edward P. Busse (1910-1915) and Dr. James W. Milligan (1915-1944), turned to using hospital resources, such as patient labor, to beautify the land. This proved particularly helpful in a day when money was scarce.

“The asylum became a communal opportunity, where the occupants grew their own food and even made their own furniture,” said Jerry Thaden, who served as the hospital’s superintendent from 1979 to 1996.

Other services that made the hospital self-sufficient included a patient-run canteen, a dairy and chicken and turkey farms. Due to the efficiency and impact of the patients’ work and the growing recognition of mental illness as a disease, the state Legislature on May 16, 1927, changed the facility’s name to the Madison State Hospital.
Shortages of money became a problem in the 1930s during the Great Depression. The staff-to-patient ratio suffered a tremendous imbalance, with 110 attendants caring for 1,585 patients. As a result, some treatments, such as shock and hydro therapy, could not be given because of high costs. Many patients were staying at the hospital longer than necessary as a way of keeping it operating to meet state funding requirements. Administrative changes also had an impact on the facility. During the 1940s, the hospital saw five different superintendents.

Advancements in medical care
The 1950s marked a decade of significant change for the hospital. Medical advancements of the time helped provide more medical care. Dr. M.W. Kemp started the hospital’s nursing department in 1949, bringing trained registered nurses to the staff.
“Many patients had not had physical examinations for years,” said Dr. Robert Snodgrass, who served as an medical extern in 1952 and returned in 1990 to work as a psychiatrist. “Some of them hadn’t had physicals for 20 or 30 years. There were no medicines, and the place was full of patients.”

When Dr. Ott McAtee became superintendent in 1952, even more nurses were brought to the facility. Snodgrass said he has McAtee to thank for this because he eventually married one.
“When Dr. McAtee came, it became a totally different place,” said Nancy Fisher, who worked in the hospital’s administration department from 1950 to 1997. “No strait jackets, no restraints. He went to Indianapolis to recruit more people and get more money.”
“He was a humanitarian from the word ‘go’,” said her husband, Bernie, who worked at the hospital from 1955 to 1997, first in the physical and sewage plants, then later as director of fire safety and security. McAtee’s first act at the hospital was requesting money for an on-site fire engine and department.
Assistant superintendent Vernay Reindollar also joined the staff about that time. Reindollar came to the hospital in 1956, initially to obtain two years of administrative experience. But he stayed after meeting and marrying Dotti Inglis of Madison.

“Just about that time, anti-psychotic medicines were coming into use,” said Reindollar. “That was a breakthrough in treating mental illness. That is when the behavior in patients could be modified enough so that they could exist in residential programs.”
Complementing the rise of these medications was the increase in outpatient psychiatric care, particularly among those involved with military mental health practices during World War II. The positions of psychiatrist and social worker expanded as independent public professions. This decreased the patient population, according to Thaden.
“As the population began to decline, we found ourselves including more human-related services,” Thaden said. “Buildings became empty, so we brought in programs like Head Start, Point in Time and special education programs.”

Thaden, who had been appointed to the hospital by Indiana Gov. Matthew Welsh, had also been responsible for initiating many of the changes that took place in the 1960s.
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