LOCATING MENTAL ILLNESS TREATMENT EXPERIENCES IN INDIANAPOLIS, 1945-1975

My dissertation, “Locating Mental Illness Treatment Experiences in Indianapolis, 1945-1975” examines this therapeutic revolution in mental illness treatment at an important historical and geographic crossroads. As opposed to the current focus on de-institutionalization, I propose a new conceptual model of re-institutionalization to understand the multi-level experience in mental illness treatments during the transitional period. Re-institutionalization is a conceptual framework for locating the therapeutic revolution in mental illness treatment by layering the dramatic expansion of the places and modes of treatment within an embodied therapeutic landscape. The dynamic changes of the therapeutic landscape in Indianapolis stand as a metonym for systemic changes in which mental health care was integrated into medical health care not through the closing of institutions but through creation and redefinition. My findings demonstrate that re-institutionalization in Indianapolis was characterized by 1) the development of governmentally funded institutions to improve the treatment of the mentally ill, 2) the development of therapy in-patient, out-patient, and community mental hospitals and clinics, 3) the differentiation and professionalization of therapeutic modalities, 4) primacy of a clinician diagnosis of mental illness, 5) patient’s acceptance of therapeutic identity as mentally ill.

Indianapolis was both emblematic of the broader therapeutic revolution in mental illness treatment and specifically significant in the development of biopsychiatry. Indianapolis leaders embraced biopsychiatry as a pragmatic path between the psychodynamic focus on unconscious desires and neuropsychiatric focus on structural and electrical models of the nervous system. Indianapolis was the home of pathbreaking neurotransmitter research at Eli Lilly Pharmaceuticals, Indiana University Medical Center, and the National Institute for Mental Health-funded laboratories at the Institute of Psychiatric Research. Strong legislative, philanthropic, hospital, and university leadership shaped Indiana’s plans with surprisingly little connection to the federal government’s mental health initiatives.