HISTORICAL BACKGROUND 3Mind, Brain, Body and Behavior
I. G. Farreras, C. Hannaway, and V. A. Harden (Eds.)
IOS Press, 2004
Establishment of the National
Institute of Mental Health
Historical Background to the National Mental
Health Program
The United States Marine Hospital Service (forerunner of the United
States Public Health Service [PHS]) was established on July 16, 1798,
when Congress passed an act that would allow for the creation and pay
ment of hospitals that would care for sick and injured or disabled Merchant
Marines in exchange for a 20-cent monthly deduction from each sailor’s
or marine’s pay.^1 The Service was reorganized in 1870 with a Surgeon
General based in Washington, D.C., overseeing its administration. Dur
ing the late 1800s, the PHS’s services were expanded to include the
medical inspection of immigrants to the United States.^2 This included
screening for mental illness, drug addiction, and alcoholism to avoid
admitting immigrants who might become a “public charge.”^3 In order
to be free from any political pressure, however, the Commissioned
Corps–consisting of physicians, dentists, engineers, and pharmacists–
was established in 1889 to administer the national health program.^4
On January 19, 1929, Congress enacted Public Law 70-672,^5 which
authorized establishing two federal “narcotic farms for the confine
ment and treatment of persons addicted to the use of habit-forming
narcotic drugs.”^6 The first narcotic farm was not opened until May 29,
1935, in Lexington, Kentucky,^7 and the second on November 8, 1939,
near Fort Worth, Texas. Both were intended exclusively for the treatment
of addicted patients–mostly inmates transferred from Federal prisons–
who had committed offenses, as well as a few who voluntarily sought
treatment. By 1942, however, the farms began admitting mentally ill
patients so as to alleviate the patient load of St. Elizabeths Hospital
in Washington, D.C.^8