The Louisville Mental Hygiene Clinic

Established in 1914, the Louisville Mental Hygiene Clinic began as a program of Louisville’s Board of Education as an attempt to aid with “unusual” children both “defective” and those of “superior” intelligence. Approximately six years later the program developed into a Psychological Clinic that was located on East Walnut Street. Aside from moving once again to South Floyd Street, the Clinic stayed relatively static until in 1932 when Dr. Spafford Ackerly relocated to Kentucky from Yale University. Dr. Ackerly had been a professor on the staff of the Yale Institute of Human Relations. When Dr. Ackerly took over operations of the Psychological Clinic the name changed to the Louisville Mental Hygiene Clinic and its mission changed slightly to focus on children. By the late 1940s, the Louisville Mental Hygiene Clinic had outgrown its home on South Floyd Street and they decided to move into the DeFuniak House on Chestnut Street. The house had been used as apartments; there were six apartments in the main building with two more in the carriage house at the rear of the main building. In its new home, the first floor contained administrative offices and reception rooms. The second and third floors contained executive and staff offices along with interview rooms.

A staff psychologist assessing a child’s intelligence in 1934. *Image from the Courier-Journal.*

When Dr. Ackerly took over the Clinic its mission changed. They began focusing on addressing and treating mental or emotional upsets in childhood. The Clinic and its staff believed that it was easiest to address mental and emotional upsets in childhood in a curative approach or to improve quality of life as the child transitioned between developmental stages into adulthood. So what, exactly, was mental hygiene? Simply put, mental hygiene was the term referred to as the science of mental health around the middle of the 20th-century. In 1934, social statistics showed that one out of every twenty persons of high school age would be admitted to a mental hospital at some period in life. The belief that mental illness was a form of illness began taking traction around this time. As such, many physicians, scientists, and clinicians believed that illnesses could be approached from preventatively and curatively.

The Louisville Mental Hygiene Clinic, when located on South Floyd Street, approached mental disturbances in both children and adults in terms of four technical approaches; psychiatry (the cure of mental diseases), psychology (the science of mental phenomena), medical treatment, and psychiatric social work. Essentially, the staff at the Clinic sought to prevent nervous and mental disorders while assisting patients in adjusting to everyday life. Dr. Ackerly reported in 1934 that,

“industrial experts know that more persons are inefficient in their work because of nervous conditions than because of physical ones. The best road to mental health is to work efficiently, but efficient work depends upon how well one understands and handles his personal emotional problems.”

Social Worker, Miss Margaret V. Kirk, observing a child’s behavior at the Chestnut Street location in 1949. *Image from the Courier-Journal.*

Patients admitted to the psychiatric ward of City Hospital were turned over to the clinic for follow-up care (many years later, known as outpatient care). Before any diagnostic assessments or treatment interventions were utilized, the staff at the Clinic looked to find the root of the disorders. In order to do that we go back to their four technical approaches; the first, in this case, being physiological assessments. Physical assessments looking for organic medical causes of mental disturbances is an approach still used in the 20th-century. According to Dr. Ackerly, patients were put through minute physical exams since many undiagnosed physical disorders/conditions can often mimic nervous and mental disorders. Additionally, Dr. Ackerly noted that it was not uncommon for some patients to have “organic brain trouble” and that organic brain diseases could often be treated successfully. He also noted that sometimes-bad behavior problems could be traced back to sleeping sickness or improper glandular functioning. Afterward, psychological examinations could begin to help assess the patient’s level of intelligence along with completing social examinations to assess the patient’s environment and background history.

As time progressed and deinstitutionalization came around, the Mental Hygiene Clinic in Louisville would continue seeing new directors and name changes. Focus on patient care switched from inpatient to outpatient, a service the Louisville Mental Hygiene Clinic had essentially offered from its inception. By 1950, the Clinic was one of 12 mental hygiene clinics in the United States approved for training specialists in the field of child psychiatry. Staff at the Clinic has included psychiatrists from various US states as well as fellows from the U.S. Public Health Service. Additionally, social workers from the University of Louisville worked and trained at the Clinic. Columbia University used the facilities to train public health nurses that were studying mental hygiene. From its beginning, the Louisville Mental Hygiene Clinic treated thousands of adults and children. At any given time, the Clinic was staffed with qualified psychiatrists, social workers, and psychologists along with collaborating with local and state community and social service programs.

Contributed by Shawn Logan | contact@kyhi.org

⁘ Works Cited ⁘

The Lexington Leader, 9 December 1949
The Lexington Leader, 12 December 1952

The Courier-Journal (Louisville, Kentucky), 12 January 1935, p. 5.
The Courier-Journal (Louisville, Kentucky), 16 January 1939, p. 13.
The Courier-Journal (Louisville, Kentucky), 12 March 1949, p. 11.
The Courier-Journal (Louisville, Kentucky), 17 April, 1949, p. 16.

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