The Road

The Road Less Traveled: Historial Foundations for Three Decades of Progressive Mental Health Leadership in Oregon

By Bob Nikkel

Progressive leadership in mental health reform has involved people at many levels.  This presentation will begin to outline the contributions of advocates, peers, largely unrecognized historical figures, public servants in the state’s Mental Health Division, and even courageous innovators in the state hospitals.  All of these individuals confronted problems that were undeniably present in the systems they confronted. Without question there are more than enough shortcomings for current and future leaders to address and reform in Oregon’s mental health world.

The beginning point of what we call “mental health” or worse, “mental illness” is obscured in the several thousand years before the white man showed up here.

It is important to consider that what has become known as “mental illness” by the white man had been unusual or even unknown by the Native Americans because the last name of a person who was the first white man with mental health problems who came to the attention of Native Americans became a part of Chinook jargon as designating a “mental affliction.” It appears that people in Native American tribes implicitly recognized the value of community supports for people with these challenges because they were accepted into their communities rather than ostracized and institutionalized as we have.

The story of Archibald Pelton, the man whose last name entered Chinook jargon for “mental afflictions” goes like this according to Olaf Larsell’s 1945 article in the Oregon Historical Quarterly:  Only a few years after the Lewis and Clark expedition in 1804, a massacre took place at an American Fur Company trading post in the Snake River River Territory with a lone survivor, Mr. Pelton, who had become “mentally ill” or “demented.” As the lone survivor of the massacre he was captured by the Native Americans but then cared for until he was recovered enough to join the John Jacob Astor party and traveled all the way to Astoria with this group in January 1812. So in addition to his name becoming part of Chinook language, Pelton’s recovery was the earliest recorded historical example in Oregon of a person in recovery.

The other possibly more familiar story is that of John Day who arrived in Astoria about a month after Mr. Pelton.  He too recovered enough that he was able to begin his journey back to the eastern part of the United States in the spring.

Here then are the first two white men with mental health problems who recovered.  We may sometimes mistakenly believe we invented recovery in recent decades.

Shortly after the establishment of the territorial government at Champoeg in 1843, several laws were passed that spoke to how Oregon settlers viewed people with mental health challenges.   An example of one such law was one which specified that a mentally ill person should be “let out publicly…to the lowest bidder, to be boarded and clothed for one year…”. By 1850, there were 5 such persons identified out of a total population of 13,294.

Within a few years, Oregon started down the path of institutional care when Dr. John Hawthorne opened a private institution in Portland to care for persons with mental illness. His first temporary quarters were established in Portland between 1st and 2nd Streets and Taylor in the fall of 1862.   By almost all accounts,  Dr. Hawthorne operated a very safe, sanitary, and efficient asylum, but in 1883 the Oregon Insane Asylum was opened and 370 persons were transferred from the Portland facility to Salem.   By 1958, the state hospital census peaked at over 5,000.

A pivotal figure in Oregon mental health history who came along around this time is Dr. Dean K. Brooks.  Dr. Brooks came to Oregon State Hospital in 1947 and became Superintendent in 1955.  I had the privilege of getting to know him personally in the years just before he passed away in 2013.   His family asked me to spend time with him so that I could record the many stories he hadn’t had time to record before.  In his 90s, Dean still exuded his passion for the love and care he always showed patients at OSH. 

He served as Superintendent from 1955 until he retired in 1982 — 27 years.

His guiding mission statement was simple:  “It’s all about the patients.”  This wasn’t just an empty slogan.

He told me his greatest accomplishment was that he started the Superintendent’s Committee in 1960.  He invited a patient from each ward plus others who were invited by the patients, not the staff, to attend.  The most who ever came to a meeting was 75. 

An example of the kind of issue raised by the Committee was the fact that hot coffee was being served on one ward in the mornings in wax paper cups.  Dean was incensed and had one of these cups filled with extremely hot water; he gripped it by the edges and headed straight for the food service manager who was responsible for the unit and handed it to her.  She yelled in pain and said there was very hot water in there.  Dean made his point.

I could tell many stories about other things that he did–quite far beyond what most people remember about him–allowing One Flew Over the Cuckoo’s Nest to be filmed and acting in it as Dr. Spivey. 

He started the first AA meetings at OSH because in his residency training in Akron, Ohio, he got to know the founders of AA, Bill Wilson and Dr. Bob Smith.

He stopped “gang showers.” 

He stopped staff from collecting all the shoes worn by patients during the day and putting them in a bushel and redistributing them the next day.

When someone asked him to make the state hospital a “Christian hospital.”  He told them, “Goddamn it, get the hell out of here!”  Just to note, Dr Brooks was a longstanding member of the Episcopal Church.

He invited patients to attend staff meetings, something that had never been done before. 

He started the mountaineering program in which patients and staff went off together for outdoor activities.

He said, “It takes people to help people.”

My favorite story was one he told when I asked him what he thought when Thorazine came along in the early 1950s.  He said everyone had high hopes that something better had come along.  They put one of the persons on it who was viewed as a hopeless case and one who would never be discharged.  6 months later, staff came to him and told him they were ready to talk discharge.  Dean pulled the person aside and told him what the staff was saying.  The patient looked at him and said, “I’ve been cheeking them the whole time.”  Dean said to me, “So who the hell is the medication for, the staff or the patients?”

Other key state hospital superintendents who should at least receive recognition for their efforts at improving services are George Bachik, Maxine Stone, Dr. Marvin Fickle and Greg Roberts.  One other person deserves credit along with Maxine Stone is Dr Satya Chandragiri.  During their leadership at Eastern Oregon State Hospital they created an atmosphere where 160 people there signing a petition to rename the place Blue Mountain Recovery Center.

3 years before I started working at the state’s Mental Health Division, I got to know Garrett Smith who had founded and was directing the Mind Empowered, Inc., MEI, a totally peer run non profit organization.  Garrett served as the research assistant for the NIMH Dual Diagnosis Demonstration Project in 1987-1990. 

Kevin Fitts, Michael Hlebechuk, Scott Snedecor and a few others were staff to a project that MEI started called the Community Survival Project.  It was one of the earliest of programs that were peer run.   They were trained as case managers and assigned the 25–30 most difficult to discharge people from Dammasch State Hospital.  It worked and received national recognition as one of the earliest examples of successful peer delivered programs by the US Surgeon General’s Report on Mental Health in 1996.

It is noteworthy that all 3 have continued in a variety of advocacy roles. Sadly, Scott passed away in 2019 and is missed by all who knew him.

Just to mention a few of the state leaders who laid the state’s administrative and fiscal foundation for establishing this and other creative projects were Dr. Rich Lippincott, Barry Kast, David Edwards, LuRee Kryger, Dan Barker, and Vicki Skryha.  These largely unknown “bureaucrats” focused attention, funding and administrative leadership for progressive supports and services such as MEI, housing, Supported Employment, Supported Housing, Supported Education, and innovative approaches to working with those who had both mental health challenges and substance use problems.

A key accomplishment in Oregon mental health history, among many others, was the carefully designed closure of the Dammasch State Hospital.  The decision was made after an 18 year old patient was strangled to death by staff who were using an approved hospital policy called “The Bum’s Rush.” 

We committed to discharging as many people as possible by creating community services tailored to their needs with a range of programs from intensive supported housing to at least 3 levels of residential care.   We made a hard and fast commitment that if we would not put a single person into the community without them.  Unfortunately, that led to the transfer of about 35% of the remaining patients.  We continued to develop about 200 new placements to keep discharging people from the state hospitals for the next years or so and they became known as the Extended Care services.

One of two other people who influenced me a lot was David Romprey who tragically passed away on one of his first days as staff in the Peer Bridgers Program at OSH.  He asked me one day, “Why do you call these programs you helped create “5 bed” and “16 bed” homes?”  I said, “Well, David, that’s how many beds they have, you know that.”  He looked at me and asked, “What do you think we’re doing, lying around prostrate all the time?”  Point well taken–the term “consumers” leaves the wrong impression.

And there was Gary Sjolander, who won awards from police agencies for his work in Crisis Intervention Training (CIT) on how to work with people who had mental health challenges.  He told me one day, “You know, Bob, you sure make a better administrator than you ever did as my case manager.”  The only time I ever left him without a smart crack back at me was when I told him, “You know, Gary, you make a hell of a lot better friend than you ever made a patient.”

We now have more heroic people working in the state hospital Peer Recovery Services Department, people like Rick Snook, Kris Anderson, Malcolm Aquinas, Delilah Kennedy, Cecillia Fiorillo, Nishimoto Fumiyo, and Lindsey Widmer.  One of the stellar achievements, among many others, is the 13 minute professional video that Rick Snook created, “You Are Not Alone,” which describes the history of the peer movement nationally as well as in Oregon and asks the key question of professional staff “who are you in relationship to power dynamics and respect for patients that lead to recovery rather than creating barriers?”

No attempt at listing other peer advocates who have contributed mightily to Oregon and beyond can really do justice to the many efforts to change the system.  But a few of them are David Oaks, the founder of MindFreedom International, Kevin Fitts of the Oregon Mental Health Consumers Association, Beckie Child, Ann Kasper, Rebecca Edens, Angel Prater, Laura Van Tosh, Janie Gullikson, Sharon Kuehn, and Drake Ewbank.  These peer advocates have been and continue to be involved in a variety of supports and services—the David Romprey Warmline, Folktime, the Mental Health & Addiction Association of  Oregon, coordinators for dual diagnosis support groups and many others. I readily acknowledge that there are many others and I apologize for leaving many important advocates and supports off this list.

Finally, the late Corbett Monica in founding Dual Diagnosis Anonymous should be recognized for the nationally and internationally esteemed work that DDA has been doing in Oregon for 15 years. 

DDA is now led by Doyal Smith.  Doyal converted almost all the in person meetings to on-line Zoom with the onset of COVID.  He initiated a chat box, and social events which will resume once COVID issues fade away.  He has recently started a specialized program for veterans that will include housing as well as other supports for people who have served in the armed forces and who have struggled with mental health and alcohol/drug problems.

Editor’s note: Bob was too modest to mention his own very impressive work as a leader in Oregon. Perhaps, we will edit this later to mention more of his work.