Mental Illness in the Family, Part 3

Unfortunately, the Library of Virginia reports that no records among the Southwest Virginia Mental Health Institute files can be found for my grandfather’s brother, Dan C. Troutman.[1] At least, SVMHI still has his admission and release records. He was first admitted 12 January 1929 and released 30 June 1930, reportedly “improved.” He was second admitted 6 July 1934 and died there almost fourteen years later on 2 July 1948, cause of death “Chronic Myocardial Degeneration.”[2] He was 65.

His illness never went into remission, his foster daughter Lois said. She lamented that the only treatment available for mental health patients at the time of Dan’s illness was phenobarbital, a sedative.[3] However, other treatments were being administered. One was hydrotherapy:

“Hydrotherapy was a popular method of treatment for mental illness at the beginning of the twentieth century, and was used at many institutions. . . . Water was thought to be an effective treatment because it could be heated or cooled to different temperatures, which, when applied to the skin, could produce various reactions throughout the rest of the body. One of the main benefits of hydrotherapy treatment was its ability to take effect quickly. Hydrotherapy could be accomplished with baths, packs, or sprays. . . . A patient could expect a continuous bath treatment to last from several hours to several days, or sometimes even over night. Continuous baths were the most effective when held in a quiet room with little light and audio stimulation, thus allowing the patient to relax and possibly even fall asleep. Bath temperatures typically ranged from 92°F to 97°F, so as not to cause injury to the patients. Packs consisted of sheets dipped in varying temperatures of water, which were then wrapped around the patient for several hours depending on the case. Sprays functioned like showers, and used either warm or cold water. Cold water was used to treat patients diagnosed with manic-depressive psychoses, [italics mine] and those showing signs of ‘[e]xcitement and increased motor activity.’ Application of cold water slowed down blood flow to the brain, decreasing mental and physical activity. The temperature for a cold pack ranged between 48°F and 70°F.”[4]

Was Dan treated with cold water packs? It seems likely since they were used at SVHMI, at the time he was there.

“In 1939, wet sheet packs were thought to be a more effective and humane treatment for the acutely disturbed than the previous practice of administering large quantities of narcotic drugs. Several attendants were trained in the application of the wet sheet pack and this treatment was used daily.”[5]

Unfortunately, SVMHI was understaffed in the late 1930s, and nurses lacked training in psychology and mental health treatments. Attendants were required to have two years of high school, to pass a physical exam, to be under age 40, and to undergo a probationary period of three months. Some were taught how to apply the wet pack treatments and a few were taught a Red Cross course in first aid. “They were encouraged to read certain text books on psychiatric nursing and some were given several weeks’ training on the insulin treatment ward. The attendant to patient ratio at the time [1939] was 1 to 15, which barely permitted more than custodial care.”[6] This gives me concern for Uncle Dan. Fortunately, the staff numbers increased over the years he lived there.

Another treatment commonly used at this time was metrazol convulsive therapy.[7] Patients were injected with metrazol, a powerful stimulant that caused convulsions and coma.[8] This treatment fell into disuse because severe convulsions too often resulted in fractured bones, and patients greatly feared the treatment[9]; it was discontinued at SVMHI in 1940.[10] Another treatment was insulin shock therapy.[11] This type of therapy involved large doses of insulin to keep patients in a coma. Electric shock was combined with both therapies, thus they were known as shock therapies.[12]

These controversial electroshock therapies reached a peak of popular use during WWII.[13]

These treatments seem the most likely candidates to have been applied to Dan Troutman. Fortunately, patients who were able were still being employed on the farm. I would like to think of Uncle Dan  outside and working in the fresh air more so than comatose from shock treatment. Perhaps, he even had opportunities to sing and play his guitar.

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[1] Karen Arnold, Health Information Technician, Southwestern Virginia Mental Health Institute, Marion, Virginia, to Zola Noble, 22 October 2015, letter, informs that records for Dan C. Troutman cannot be located among SVMHI records at the Library of Virginia; Dan Troutman foler, hanging files; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana.

[2] Arnold, Karen, Health Info. Tech., SVMHI, Marion, Va., to Zola Noble, letter, 23 Sept. 2015, includes info. from the Admission Register of SWVMHI; Dan Troutman folder, hanging files; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana.

[3] Lois Faris, Glade Spring, Virginia, to Zola Noble, 15 August 2008, letter, information on life as a foster daughter in the Dan C. Troutman home; Lois Faris file, Troutman family; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana. Also, Treatment of the Mentally Ill > 20th Century > Treatment Therapies, 7th bullet point (http://mentalillness.umwblogs.org/20th-century/treatment-therapies/ : accessed 30 October 2015).

[4] Restoring Perspective: Life and Treatment at the London Asylum > Medical Treatments > Hydrotherapy (http://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/

hydrotherapy.html : accessed 29 October 2015).

[5] A Brief History of Southwestern Virginia Mental Health Institute, compiled by Phyllis Miller, (Virginia Department of Behavioral Health and Developmental Services, Richmond, Virginia, 2012.), p. 15; (http://www.swvmhi.dbhds.virginia.gov/swvmhi/about-us/brief-history-of-swvmhi.pdf : accessed 29 October 2015).

[6] Ibid.

[7] Ibid.

[8]  “What is Metrazol Shock Treatment?” Psychology Dictionary (http://psychologydictionary.org/metrazol-shock-treatment/ : accessed 29 October 2015). 
[9] Leopold N. Judah and Oddist D. Murphree, “Metrazol Convulsive Therapy Modified by Succinylcholine,” The Journal of Mental and Nervous Disease, Aug. 1959, Vol. 129, Issue 2, p. 198 (http://journals.lww.com/jonmd/Citation/1959/08000/Metrazol_Convulsive_Therapy_Modified_By.11.aspx : accessed 29 October 2015).

[10] A Brief History of Southwestern Virginia Mental Health Institute, compiled by Phyllis Miller, (Virginia Department of Behavioral Health and Developmental Services, Richmond, Virginia, 2012.), p. 16.

[11] Ibid., p. 15.

[12] “Insulin Shock Therapy,” Wikipedia (https://en.wikipedia.org/wiki/

Insulin_shock_therapy : accessed 29 October 2015).
[13] Treatment of the Mentally Ill > 20th Century > Treatment Therapies, 7th bullet point (http://mentalillness.umwblogs.org/20th-century/treatment-therapies/ : accessed 30 October 2015).