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Founded in 1923, Central Clinic has been providing quality Behavioral Health and Forensic services for over 85 years to children, adults and families. Central Clinic's main location at 311 Albert Sabin Way is a converted nurse's dorm on the University of Cincinnati Medical Campus. This building, called Logan Hall, was designed by the Samuel Hannaford and Sons Architect firm and is on the National Historic Registry.


Notes on the Early History of Cincinnati’s Central Clinic.


When the Public Health Federation was organized in 1917, it had several Councils consisting of persons interested in particular phases of public health.  One of these was the Mental Hygiene Council, which is now the Mental Health Association of the Cincinnati Area.  At that time there was an upsurge of interest in mental health.  Drs. Lurie and Greenebaum refer to it in an article "The Perspective of the Mental Hygiene Movement in the Jewish Community" (1) in these words: "Dr. Adolph Meyer, at Johns Hopkins, had introduced the term 'mental hygiene,' the Binet-Simon psychometric tests had become very popular, and Dr. E.E. Southland at the Boston Psychopathic Hospital had begun to stress the importance of social and environmental factors in the determination of human behavior and the development of the personality.  In Europe, Freud and his disciples were advocating the psychodynamic approach to the study of emotional problems of man.  As a result, tremendous public interest was aroused in the study of the causes and prevention of mental illnesses, and especially in the study of the causes and prevention of juvenile delinquency and criminality."

                  They mention also the fact "that since psychometric testing had become the rage", feeblemindedness was believed, on the basis of these tests, to be far more extensive and a greater factor in delinquency and other social problems that subsequent and more careful studies proved to be the fact.

                 Mrs. Rebecca Boyle, then a social worker on the staff of the Associated Charities and later chief psychiatric social worker of the Central Clinic, makes some pertinent observations as to conditions that stimulated concern about mental hygiene in the era.  The Army draft in 1917 was causing general unrest, tensions and disruption of family life.  Delinquencies among young adolescents increased.  Illegitimacy became more prevalent.  Institutions, including Longview and the Columbus Institution for the Feebleminded, were overcrowded.  There was a shortage of trained social workers, due in part to their being drained off for service with the Red Cross.  This meant that the limited group of social workers was overtaxed and beset with frustrations.

                  In those days there was no full time Professor of Psychiatry at the College of Medicine of the University of Cincinnati.  The teaching was done by Dr. H.H. Hoppe in what was then called The Department of Neurology and Psychiatry.  Community mental hygiene facilities were very limited.  Among them were the Vocation Bureau of the city schools which did psychological testing, the Child Guidance Home and the Psychiatric Consultant who served in the Juvenile Court.  The Vocation Bureau was headed by Mrs. Helen Woolley and the Juvenile Court by Judge Charles W. Hoffman with Dr. William Ravine serving as consulting psychiatrist.  The Juvenile Court sent some pre-delinquent children to the Bureau of Juvenile Research at Columbus for study and recommendations.

                  Dr. Louis Lurie directed the professional program at the Child Guidance Home.  He and Mrs. William Rosenthal, the founders of this valuable organization, both gave voluntary service over a long period of years.  The Home's function was primarily diagnostic.  Children were studied for periods varying generally from two to four weeks and recommendations were made for such disposition and treatment as seemed feasible in the light of the then existing community facilities.  Some of the children were followed for considerable periods as out-patients.1

                  Longview Hospital cared for the mentally ill committed by court action.  At that time the hospital was owned by Hamilton County, although the operating costs were borne by the State.



Proposal for a Mental Hygiene Study

Members of the Mental Hygiene Council soon began to try to appraise the community facilities and the community's needs.  The records indicate that the possibility of a community mental hygiene survey had been discussed as early as 1920.  This matter was brought to the attention of the Coordinating Committee, the governing body of the Public Health Federation, at its meeting on November 5 of that year.  The Council learned that the National Committee for Mental Hygiene, as it was then called (now The National Association for Mental Health) was planning to form a professional team to study the mental health problem in communities that might request such a study.

                  This possibility promptly commended itself to the members of the Mental Hygiene Council headed by Dr. T.A. Ratliff.  On January 12, 1921 the proposal that the National Committee be asked to make a survey here was submitted to the Coordinating Committee of the Public Health Federation and approved.  The National Committee promptly agreed to make the survey and named Dr. V.V. Anderson to direct it.

                  On March 30, 1921, Dr. Anderson, after a series of conferences with the Mental Hygiene Council, presented his plans for the survey to the Coordinating Committee.

                  The survey was underway by June 1921.  It was financed by funds appropriated to the National Committee by the Rockefeller Foundation.



Scope of the Survey

The survey staff, in the words of the final report, set itself "to determine what sort of problems feeblemindedness and insanity were to Cincinnati and Hamilton County; what part these and other mental conditions had to play in various social problems, particularly chronic dependency, unemployment, outdoor relief, illegitimacy, family desertions, vagrancy, adult crime, and juvenile delinquency; and finally to determine the frequency of these abnormal mental conditions among public school children."

                  The survey included, aside from the study of facilities of certain agencies and institutions, a careful examination of the "run-of-the-mine" of the cases coming in contact with the Ohio Humane Society (now the Children's Protective Service), the Associated Charities (now Family Service), the Bureau of Catholic Charities, 50 dependant families in connection with United Jewish Social Agencies, the "run-of-the-mine" of the Juvenile Court, the Opportunity Farms for Boys and Girls (now Glenview and Hillcrest Schools), Hamilton County Jail, city and county infirmaries2, the Home for the Friendless, the Catherine Booth Home, the Children's Home, the General Protestant Orphanage, the boarding homes children and finally over 4,000 public school children.

                  In May of 1922 the survey had been terminated.  A complete report and a brief, more popular type of summary were printed.3  Eight recommendations were presented.  The principal on was for the organization of a Central Psychiatric Clinic which, the report stated: "will serve the social agencies, courts, and institutions of Cincinnati".  The second was that "the director of the psychiatric clinic should be professor of psychiatry and mental hygiene in the Medical College".

                  Other recommendations included supervision of mentally defective children, and of psychopathic and epileptic children; more special classes in the public schools; placing the Opportunity Farms under the Board of Education; and ample number of probation officers for the Municipal Court and public education in mental hygiene.

                  These recommendations continued under study by the Mental Hygiene Council and the Coordinating Committee of the Public Health Federation for some months.  The President of the Federation appointed a committee to examine especially into ways and means of establishing the proposed clinic. 

The members of this committee were as follows:

  •        Dr. Frederick Hicks,  President of the University of Cincinnati;
  •        Dr. Henry Page,  Dean of the College of Medicine;
  •        Dr. T.A. Ratliff;
  •        Dr. Randall J. Condon, Superintendant of Public Schools of Cincinnati;
  •        Dr. Julian E. Benjamin, President of the Public Health Federation;
  •        Honorable Charles W. Hoffman, Judge of the Juvenile Court;
  •        Dr. H.H. Hoppe;
  •        Mr. Robert Kuhn, Sr.;
  •        Mr. A.E. Anderson;
  •        Mr. Emil Pollak;
  •        Bleecker Marquette;

This committee recommended to the Budget Committee of the Community Chest that an appropriation of $20,000 be included in the 1922 Community Chest campaign for the establishment of such clinic.  This was approved by the Budget Committee and recommended by this Committee to the Executive Committee of the Community Chest, which then voted to include such an appropriation conditional upon the raising of the total amount set for the drive.

                  Mr. C.M. Bookman, then Director of the Community Chest, continued to give vigorous support to the proposal and, in a recommendation to the Board of Directors of the Chest, stated that "the time had come to pass beyond those things in social work that are obvious and appealing to do more in a constructive and preventive way, unless we want to keep on pouring money into social patchworks with little hope of really reducing the size of our problem".

                  The Board of Directors of the Community Chest finally approved the establishment of the clinic on a five-year demonstration basis, with a budget in the amount of $30,000 annually and on October 22, 1922 named a committee, Dr. Julien E. Benjamin as chairman, to proceed with the establishment of the clinic under the direct supervision of the Public Health Federation.

                  The three men to whom major credit goes for bringing this about are: C.M. Bookman, Dr. T.A. Ratliff and Dr. Julien E. Benjamin.

                  This action received nationwide attention.  An editorial in the New York Sun in October 1922 commended Cincinnati's proposed Mental Hygiene Clinic, stating that this city was taking the lead on one of the most important problems facing our communities.  Laudatory articles appeared in almost every leading health journal in the country.

                  Dr. Emerson A. North, then Superintendant of Longview Hospital, was made Director of the Clinic in January, 1923.  The Clinic opened its doors for service in May of that year in the old Community Chest building at 25 E. Ninth Street.  Dr. North's staff consisted, in addition to himself, of Dr. A.W. Foertmeyer, psychiatrist; Dr. Ada Hart Arlitt, psychologist;  Mrs. Rebecca Boyle, Chief Psychiatric Social Worker; Miss Bertha Allen (Mrs. William Bahlman), social worker, in addition to the office secretary, Miss Mina Sessions.

                  From the beginning it was the conviction of the Mental Hygiene Council and of the persons appointed to the Board of Directors4 of Central Clinic and by the Community Chest that it should not continue as an independent organization but should come under the professional direction of the College of Medicine and should be located in the General Hospital.

                  At this point, it is interesting to note that Judge Joseph Woeste, then a Municipal Court Judge, asked the Clinic to provide a psychiatrist to sit with him while he was hearing cases in the Court.5

                  In 1923, Dr. North was made Professor of Psychiatry in the College of Medicine.  The Board of Directors of Central Clinic had acted to authorize Dr. North to serve in this capacity in addition to his duties as Director of the Clinic.

                  A report on the first four years of the Clinic's activities was published in August 1929.  At that time, Dr. Benjamin was still chairman of the Board.  The professional staff consisted of, in addition to Dr. North, Dr. R.A. Phillips, psychiatrist; Miss Elizabeth Seeberg and Miss Helen Whitshire, psychologists; Mrs. Boyle, chief social worker and Secretary of the Board, and the following three social workers: Bertha M. Allen (Mrs. William Bahlman), Ethel N. Coplan, and Dorothy Swisshelm.

                 The report indicated that 2,141 persons had been seen during the four-year period, an average of 535 per year.  Of the total, 70% were children and 30% adults.  486 had been referred for psychological study only.  Excluding the number, the average number of patients seen was 414 per year.  The report indicated that in a considerable number of these cases the service was diagnostic with referrals to various community agencies.  Approximately 400 cases were treated by the Clinic staff itself.  Of the children's cases, about 92% came from fourteen of the large social agencies and institutions, the schools, the Juvenile Court, and on direct application.

These conclusions which the 1929 report listed are significant:

  1. The Clinic cannot be expected to "develop beyond the social resources of the community";
  2. There is a pressing need for research;
  3. Coordination of all mental health activities in the community is essential;
  4. It is important that children showing emotional disorders be gotten under treatment early;
  5. The community should have a psychiatric hospital for children, large enough in size "to permit of careful classification and also of prolonged treatment, and offering opportunities for medical research as well as serving patients".

The Clinic was moved to Cincinnati General Hospital and placed under the direction of the Department of Psychiatry, College of Medicine in 1932. Only following this move was there provision for clinical experience in psychiatry for interns.

                  Dr. Emerson A. North was succeeded as Professor of Psychiatry and Director of the Clinic by Dr. John Romano in 1942.  This marked the beginning of a period of rapid expansion.  Dr. Romano served until 1947 when he was succeeded by Dr. Maurice Levine, under whose leadership the Clinic, the residential training program, and the community affiliations with the Department have developed to the point where both the Clinic and the training program are not only among the largest in the country but rated by such organizations as the American Psychiatric Association as outstanding in quality.

The Central Clinic has been unique in several respects, including the following:

  1. It was one of the first agencies actually organized by the Chest itself to meet a pressing community need,
  2. One of the first mental hygiene clinics serving both children and adults, and
  3. The first community mental hygiene clinic in the State of Ohio.
 

Bibliography

1. The Perspective of the Mental Hygiene Movement in the Jewish Community. Lurie, Louis A and Greenebaum, J. Victor. 1958, Cincinnati Journal of Medicine.

Prepared by Bleecker Marquette, former Executive Secretary of The Public Health Federation of Greater Cincinnati, Consultant to the Department of Psychiatry, College of Medicine, University of Cincinnati, Ohio June 1961


Notes
1 Following a survey in 1948, the Home was reorganized into a treatment center for children between the ages of 6 and 12, suffering from severe emotional disturbances.  The functions of the Home as now operated in its new building on the east side of Harvey Avenue are set forth in a paper by its Director, Othilda Krug, M.D., published in a later issue of the Journal in the same year.
2 These infirmaries no longer exist, having been replaced by the Hamilton County Home and Drake Memorial Hospital.
3 Copy of the complete report "A Mental Hygiene Survey of Cincinnati" is on file at the offices of the Public Health Federation.
4 Unfortunately, the early minutes and other records of the Clinic have been destroyed so that it is impossible to list the members of the first board.  However, the members in 1929 of whom most, if not all, were on the original board.
5 A Municipal Court Psychiatric Clinic was established on April 1, 1957.