1 Dr. John Bel.l Well., in terms of' my career with the NIMH, I was twelve years with the Institute,.alI of it was in San Francisco ••• EAR With occasional visits to Washington •••• JB More than. occasional. In retrospect, it was probably the most exciting,,expanding, illllova.tive,ereative period o:f my career. I joined NIMHbecause I was so :fed up with university lif'e. I had had :fourteen years of' university and I was stuck in a rut where I was the on.1.y clinical person at Clark and so the basic responsi­ bility :for all. sorts of' courses that were rel.ated to the clinical. field were always on me and so it gave very littl.e scope for shift­ ing as my interests shifted, as I was growing, except within. the framework of' the department. I really get fed up with it and l0oked around at other options in the academic life. Well, this was a time when clinical psychology in the universities was con­ tracting, instead of' expanding, and it wasn't very easy to find something that coul.d meet all sorts of' my personal desires and f'it in wii&h the family's preferences, and so on, and NIMH became very attractive in that kind of' a climate. EAR How was the initial con.ta.Qt· ? JB The initial contact was through Harry McNeil!. We were together on the board for the Society of' Projective Techniques. I was the president, and Harry was on the Board and during the course of' that we worked on an ethics case very intensively together for the Society and this was a very sticky and difficult one. I won't mention any names, and we became close person.al friends. It was a time that was kind of' rocky in his own personal life and he and Jerry Carter were very close together and he suggested to Jerry that he approach me to see if' I might be interested •••• EAR This was what, 54, 55? JB It woul.d be 55. I was actually in Britain at the time and Jerry wrote to me over there. I was teaching at the University of Edinburgh for a year, and he wrote me there and I recorresponded and then when I came back Jerry came up to Worcester and inter­ viewed me up there am finally in the spring of 56 an offer was made and I decided to come to NIMH. I came down from Worcester, by Friday we'd had a crisis meeting at Clark. We'd run out of three cent stamps, it must have been more than that, well, any­ way it was the basic stamp, and the budget wouldn't have allowed 2 JB eont. any purchases until the end of the fiscal year and the crisis meeting was to decide what we were going to do about the corres­ pon~ence. There was no way of sending out letters without stamps. I left there on Friday afternoon, after this crisis meeting. We drove down to Washington, arrived before nine o'clock on Monday merning and went over to old building T6 and expected, you know, that I 1 d immediately be ushered in somewhere and the secretary met me, and she said, everybody's busy. So I sat and waited and waited and waited. The crisis ~here was that morning Congress had sent up word from the Hill that there could be nine million dollars more in the budget; and the contrast in those climates was so intense, it was just almost unbelievable. But finally, tou know, the crisis meeting was over and everybody came over and greeted me, and I was happily started on my career at the Insti­ tute. My wife and I had wanted to stay in the East. Charlottes­ ville was our number one choice. An.d then, well, we were:n 1 t too sure where else we would go, But we were sure that was ene first choice. We had friends there. We put Dallas down second, we had friends in Texas and San Francisco third, and guess where I got sent. And that was a terribly expensive thing to do in those days. You had te pay all y~ur own meving expenses. It cost us nearly five thousand dollars to carry our household goods and all our possessions out to the West, but that was the best thing that could possibly have happened and later Jerry told me why they sent me to San Francisco. They had had all sorts of applications for the psychologist opening in San Francisco and they had a sus­ picion that anybody who wanted to come to San Francisco was pri­ marily interested in the climate and the city, and only second­ arily in the job and at least, I wasn't one who was really yearning to go. But the other purpose in their minds became obvious pretty soon because Henry Schumacher was the chief, and within a couple of months he announced that he was going to retire and would be moving to Florida and within three or four months, and that I was to act as Chief, which surprised me just because I was such a neophyte, but sI took it on and at that time there was a real reluctance to have other than,an M.D. as the program chief of a regional office, so I was acting chief for I think, about six years. Then it became embarassing to the Institute when the Civil Service 3 JB cont. Commissioner began to explore why somebody would be left in an acting position for all that period of time, so I was made Chief. EAR There was no written requirement that the chief be an M.D.? JB No, it was just sort of a standing practice in the Public Health Service, not in the Institute. The Institute was more liberal then. EAR Did you have a feeling, or did you know, whether Bob Felix had any role, one way or the other, in that situation? JB No, I don't think it was so much initiated in Washington at the Institute level as it was actually at the Regional Office level. Once the CiYil Service had raised some objection, it was the Public Health Regional Director who got on the ball. The Regional Office was a very interesting organizatien to work in because there was no place where you were more conscious of having two masters than there, because your immediate boss was Public Health Service heading up to the Regional Director who was HEW, and our program direction came from the Institute. We were always in the middle between these two forces and it was a real juggling act to keep the local in keen awareness of what was going on at the Institute and to extricate yourself from the local for concentrating on the work for the Insti­ tute. EAR And is it true that no other Regional Office representative had qhite that same keen affiliation so markedly so?, that is with a program aetivity on the one hand and the Regional Office, in general, on the other? JB Well, I was just trying to think of other components of the Public Health Service where that might have been the case. I would have the impression that MCH had somewhat a similar tension. EAR But not the Hill~Burton people, for example. JB. No, no. EAR That's the opposite side of the coin. JB No, the Hill-Burton people were very much identified with the Public Health Service. They did have some problems with NIMH over the implementation of the Hill-Burton Act as it related to mental he>s.~/~, pitals and particularly with the development of the Alaska hospital. There was a lot of contention between the Hill-Burton side and the Institute side. EAR Are you talking about early on, or later 0n? JB I'm talking about later on. EAR About Harold Granning, and people like that? 4 JB cont. It wasnit early. You see, on •~~the first jobs I did at the Regional Office was join the team that went up to survey Alaska in 56. That was the start really of the Alaska Mental Health, that is the Stste of Alaska Mental Health Program, statehnod really wasn't achieved until 59, perhaps, arrl the actual cons­ truction of the Mental Hospital d:idn't start until after state­ hood. EAR I don't want to divert you from what you're doing, but I think that's a very important event in the whole history of NIMH. Was that when Dan Blaine went up, when the Alaska Mental Health program began. He didn't come on till later on. JB No, the team included other people. Starkey was a member, Ruth Knee from the Institute, Terza MaRgin, a nurse, Dale Cameron and who was the man who was in mental retardation in Maasachusetts Furnough School, he was a member of the team, his name has slipped my mind, he was a psychiatrist but he was primarily in::~~,mental retardation. Cameren and this man from Furnough really carried the ~all and they were very reluctant t0 have a regional office representative. The team was all composed at Central Office level and did not include a representative of the Regional Office and Henry Schumacher before he left protested to this and since it was known that H~nry was leaving where was reluctance to put him in, so Henry nominated me to go, and that was in September 56. It was a difficult role for me, because I was new to the Public Health Service, new to the Institute, new to the state and the territory, new to all these people, and an unwelcome outsider whe, because the whole team had been briefed in advance of my joining it, and I had a specially difficult time with Terza who could be difficult under any circumstances. She sort of took on the role of preserving the integrity of the team and warding off my intrusion. We had a reugh time. Dan Blain I don't think had too much to do with it, in fact even when he was in California I don't get the impression that he had. Car,1 Bowman was really the key figure in the oonsultatton. EAR Yeah, I think i 1 m just remembering. He oame later on when the Training Program developed, some years later, I'm sorry. JB Carl got to be the Superintendent there on his retirement. Why he chose to do that, I ' l l nvver know, a man of 73, off he went and did a great job •••••••• But one of the delightful things about 5 JB cont. NIMH in those days was that T6 was poor quarters, but there was a marvelous camaraderie among the sta:f:f. It was small enough·': so that everyone of significance could be photographed in one pic­ ture. It was a really intimate kind of association and I felt very much included. There was little of the pulling of rank and inter­ professional tension. There was a very open kind of :friendly relationship. EAR That was a conscious perception on your part at that time? JB 011., yeah. I felt most enthusiastically welcomed. I immediately felt at home with the staff. Jerry was very protective of the psychelog±s.ts. He was especially cordial. And I I m speaking especially of the community services staff, because we came to identify the key figures in training and research, we were distant from them, a big chasm, which was soon accentuated by the fact that the Institute outgrew T6 and got scattered. Biometrics went off to its building, and community services went up to Silver Spring and that was really, I think, the beginning of a very destructive period for staff interrelationsmips. EAR Can I ask you a question about that? Do you think that just the sheer phenomenon of growing played a significant role,? JB. Oh, very much. There's no question. But I think it was more the inability to hold the Institute geographically together and I don't think the Institute ever really recovered from that dis persion in terms of the integrity, although Bob Felix did his darndest to hold everything together. I think, for example, Biometrics got off on an island from which it never really returned and the chasm that existed between Veety and the other components 0f the Institute was deepene.d1~, and it made for :far more tension and hostility between community services and training and research, too, I think. Was Phil there then? EAR Yes, John Eberhardt had been there earlier but then Phil came 0n. JB John Eberhardt was still around ••• EAR Well he was gone by 53, 54, I think it was, maybe 55, I'm not sure of the dates but Phil was in certainly for a couple of years before I came in and I came in 58, and John was at C0mmonwealth, as you know. JB Well, I remember meeting Eberhardt when I first earae to the Institute. EAR Well, then, you're probably right. JB Well, I'm not sure, I wouldn't bet on it. He may have been there 6 JB cont. for a meeting of some kind or other. Phil was more cordial in his relationships with community services people but the whole program was also very distant from us and I felt this particularly coming from a university environment where I had lived in a climate of research and training, and suddenly everything I knew from the university seemed no longer to be even a basis for our communica­ ting openly. E.A.R But what do you think, okey, size is one of the problems, obviously another problem was that as the Institute grew each of these program heads developed a kind of possessive attitude about their programs. Vesty :tml.d.,~me·;,,,when I first g0t there in. 58 tha~, in a sense, I wasn't supposed to have anything to do with the Regional Offices. He told me that and I think Phil's attitude was, well, they're nice people but what have they got to do with what we're doing. But do you think there are any other aspects to this, do you think that the training people and the research people had some kind of status ••• . JB Well, there's no question about that in my mind. I think, cer- tainly there was competition between research and training for number one position, budget-wise and in terms of positions, power and the ear ~.of the Director, and so on. Community services ll,asn•t even in the same ballpark, as far as those issues were concerned, but it was easier, in a sense, to exclude eommunit"¥" services than to fight some of the battles between research and training. I don't say battles in the sense of fighting, but in the sense of competition. EAR Sure, and in one sense, maybe part of that could have been healthy, and in an.ether sense, of course part of it was not. JB But, at the same time, not only was I feeling the isolation from a professional point of view, but I was feeling it in theRegional Office and in the State9 from the point of view of the lack of integration of the training program, the research programs and the service programs in the states. It was especially an issue here in California, and the potential for the development of mental health, training, research and program development, was greatly reduced by that lack of communication. For instance, our situation:c, was complicated by the fact that we would get challenged on issues of training or research, as for instance, when a research project would be funded which was based on a philosophy that was diametrically 7 JB cont.' opposed to that of the state program and which was given a large sum of money and the state program was trying to wheedle out of us some pittance of money to do something which the state director thought was very much more practical, mom appropriate for the population, for the environment, etc. And in these kinds of tensions, we were middle men because of bearing the name of NIMH but we were as isolated in point of communication from research and training as the state people were. In fact, some of the state people had more access to Phil Sapir and Vesty than the Regional Office did. And that was another side of the tension and we never got away from that, really, and it was accentuated by the physical separation. We felt that we were kind of sent out to the ice floes to perish when we got sent to Silver Spring. EAR Let me probe that a little further. What do you think might have been done, what could have been done that would have more facili­ tated this kind of integration at the operatio:}1evel in the region itself. I mean, this is now the result of this demarcation among the programs emanating from Washington, each individually making its contact separate. But what might have been done? JB Well, it was my impression that the primary need was for open com­ munication. We did gradually get access to increasing amounts of information about the research and training programs but we had the feeling, for example, that when certain training or research applications were being considered there was an.other point of view that the regional office people had which would have been, we felt, constructive to the Institute in making decisions about these, particularly if they had a service component to them. But even in the absence of this, some of the more abstruse research pro­ jects had a program impact in the local setting because of the hiring of people, and the funds that were granted, which were interpreted often as misdirected. We were not in any position to defend the Institute, we didn't have any of the facts, didn't even know the existence of the applications. There could have been an awful lot of formal communication which would have faci­ litated our interpretation of the Institute and the relationship of the Institute to the mental health programs. EAR Well, let's put this on the record, because I think you're touching on a very important point, and in fact, I guess in some not insig­ nificant way, when I was involved in the training program, I added 8 EAR cont. to the problem by the manner in which I operated. I think it was a continuation of the format that I had learned, but let me just ask you to respond to a couple of things because I think we're on a very important point. I'm talking more about training now than research but it's illustrative. I guess there was a kind of internal reinforcement which occurred from the training institu­ tion itself, which wanted to keep things as clearly communicating to the training program as possible and didn't want to involve it. The consultants on our review committees who felt they were res­ ponsible to the training program and who therefore had only to examine it from the perspective that was the criterion that we used, namely, is this a good program or are these good people for the training center and in general, should one not accept the thesis that a good program is a good program, therefore to be supported even though it may or may not interact with programatic needs at the regional level. I think they were, if not intolerant of it, somewhat unconscious or insensitive. JB Not unconscious. EAR Okey. So you had this kind of reinforcement going around and then, I think, to be very blunt about it, some of the people felt that the regional office staff while they certainly knew the regional office, probably didn't know that program, that is, the training program well enough to make a contribution. JB I'm sure they didn't. EAR You w~re, if I could say so, perhaps not representative of all the regional offices, having come precisely from the kind of back­ ground that you did (JB- right, right_) so maybe your situation vis-a-vis the regional office was somewhat anamolous for the totality. Would that be correct? JB Yes •••• EAR Not that the basic issue is not correct, that you're making. JB I think it's fair to say, that from a personal point of view, I was in a distinctive position, not unique but distinctive. I think actually, though, that that had very profound implications for later NIMH status and programs. EAR Yealf, b:e;cause I was going to say, is it ironic that we eventually had a community mental health centers program in which what you're talking about should have been the mode. JB Yeah, but even then it wasn 1 te The whole groundwork had been la~d 9 JB cont. so solidly within different traditions within Washington that it was very difficult to pick up at a later period and try to achieve any kind of integration. In fact, it never did happen. It was a failure, and I think what's happening today in the community mental health centers is a product of that failure to ' really achieve a unified kind of mental health program for the country. I think that actually what happened in the Nixon adminis­ tration was possible because there wasn't the groundwork laid for a real solid NIMH front to the whole country. EAR Let me ask you one more question about this because I want to voice.__a point that was made most vociferously by people like Stan and others too, and that is that when it came to the point general where some kind of political and where some kind of/community or involvement in defense of/the development of the program was concerned, that when that need occurred the academic community especially revealed itself to be incredibly naive and often unwilling to participate in this. JB Well that's another side of it. And there had been no expectation laid on them through all those years that they would participate in the development of community programs, or even be~ in communi­ cation with people who were concerned with that aspect, and so they didn't know the people, they didn't have any kind of basis for communication. I really think that that was a major error of programming with the Institute that kept compounding itself as the years went on. I think it's not possible to undo the impact of that and I don't think we really have an integrated national mental health program at the present time because we didn't have an integrated program in the Institute. EAR Well, in that connection, then, how would you place, and how would you describe and interpret the role of such programs as the hospi­ tal improvement program and the in-service training program, where for the first time in the training program the effort to involve the regional office people really took place? Do you think that that demonstrated itself as a step in the right direction, or if not, what was the problem there? JB Oh, that was a kind of sop program. You know, there never was the investment 0£ the Institute emetionally in this as a major enter­ prise. EAR Oh, yes, I'm sorry. I didn't mean it in that sense at all. 1() EAR cont. You're absolutely right. That was an interim program, pend­ ing the dissolution of the hospitals and the development of all of the community mental health centers. No, I think that's perfectly true. I was referring more to the issue of, given the prior opera­ tion of the training program, the region office people were never involved whatsoever, what never could occur from the regional intelligence on a training program operation here in these two programs, we literally had regional office people participate ••••• JB That's right. And from that point of view it worked out. There was amutual respect and while, from the training branch side of it, this was a sort of little pocket of people who were relating to us. Nevertheless, a mutuality developed quite easily. There was really goo~,, collaboration. EAR And of course it's interesting that Jerry and Warren were involved in this a:av±ng come from their previous background. Let me go back, though, I think you touched on a couple of important philoso­ phical issues. I want to ask you, perhaps, a little bit more, about those early years and what were some of the other aspects of your development as a senior person at the NIMH and the regional res­ ponsibility that might be worthwhile for us to put on the record here. Some other sorts of things that took place. JB Well, I think an important factor in our having a rather special status in San Francisco, we had a much larger staff than any other regional office and we had a pretty distinguished staff. I think one o:f the reasons for that was the distance between San Francisco and Washington. I don't think that in national programming the Institute sufficiently took into account the implications of distance in terms of programming. We were so far from Washington that when somebody in the universities, or somebody in the state programs or local community wanted information, they might turn to us, especially in the clinical and community programs. We became a middle person in terms of securing input from Washington. EAR What was the role o:f Wichie in this situation? JB Let me just finish that one part. Whereas somebody in New York or somebody in Bosten, · .if~ they had the resources, went directly to you in Washington and welcomed in the cordial way that the Insti­ tute extended itself for pe0ple from the community and cut cross the regional office staffs. And I can understand when there were far more mental health people in the East than in the West, it was more 11 JB cont. difficult for the regional office people anyway to be in touch with all these different programs and activities as in a state like New Yerk or Massachusetts. So they weren't so much help to the Institute people. That was just another burden as far as the state people were concerned in trying to get their business done. I think our expertise expanded by virtu.e of the expectations of the state people and the need for us to grow to meet their expec­ tations. And I think if some way had been possible to expand the regional offices and use them as the primary contact point for people in the East as well as in the West, it would have been a far better naltional development of the programim.gs. I think the impact of Barton's getting on a plane and going down to Washington and folks from Atlanta coming up, and all that Eastern seaboard being in intimate touch with the people in Washington led to a far greater expansion of services and training grants and research and so on in the East and an impoverishment in the West. EAR But at the same time, and the reason I mention Wichie, I think at the same time there was a regional integration of greater strength and stability out of the San Francisco office precisely because, not only the distance from Washington, on the one hand, there was all this interaction going on among the components in the Western states in one fashion or the other. JB I still had very little comprehensive relationship with Wichie. We were used in specialized ways. One person would attend the annual meeting of the Wichie representatives, especially if it were held in California and normally I was the person who went. Others would come in, especially to meet a counterpart, the nurses would get together and so on, I was always invited to speak and tell what was going on at the Institute and I had more exposure and knew more people and was called on mere by Wichie people in the various states for various things which they wanted from the Institute. The nurses became pretty actively involved in the nurse program, but when it came to actual program development in aJsense Wichie was like another Institute in relationships with the regienal office. The Wichie representat:i:we, Bob Huett, came out directly to Sacramento. We didn't know that he was there and actually that led to his being recruited. And Phil, not Phil but oh, I've repressed his name. Dan Blaine of course came from Wichie. EAR You don't mean Kretsoh (JB, no, no) in mental health. 12 JB Dan brought him out •••• Phil Sirotkin. EAR He's in charge~of Wichie. He's been there not quite a year. JB Oh, I didn't know that. I've lost touch with Wichie. Well, you know they developed this close relationship with state eo"tJ.D.ter­ parts and by-passed the regional office. EAR Well, let me ask then, it sounds like a silly question, but what did you find then as the major source of professional satisfac­ tion, given the difficulties you were having, really getting the thing going•••• ,. JB Oh, there were lots of satisfactions and the satisfactions were in facilitating the development of the state programs for one thing and trying to get around Washington and play the system better on behalf of the states. That was a great satisfaction and in that respect we were very closely allied with the state people. I guess our advocacy of the state people put us into some rea11y belligerent attitudes towards the Instiate as a whole and speci­ fic components of the Institute. EAR Okey, now I want to kind of ask you a philosophical question that is a variant of something I've been thinking of up till now. And 1et me just give you background. This morning, in talking to Gardner Lind~ey, he was making a point, since he had spent some time as a member of the psychopharmacology study section from its inception in 58 for some five or six years, and it was clear at the beginning that many of the prejeets that came in for support were not of the highest calibre. By the same token, it was a brand new program and there was a great need to get things moving and so I said t0 him, "Don't you feet that it was a kind of pump priming operation initially which ultimately paid of:f very we11?" He acknowledge that that was so, But there was a clear an.d overt tension, at one level, tension between staff an.d committee people with the staff having done a 10~ o:f work to get a project there and have these people say it ain't good enough and turn it down. And now I think, and I 1 11 reveal my biases, I think that kind of constructive pressure is healthy. People play their responsi­ bilities. Would you say that, at one 1evel, it was healthy for you to try to by-pass Washington in one sense. It might have been better. I think: the basic philosophy that you're espousing is, look, this should have been a total program, a totally integrated program, greater commW1ication among all the parts 13 EAR to make a really cohesive whole. That did not take place, But is there anything that can be said for this demarcation in res­ ponsibilities which produces some of this tension or do you think it was largely overwhelmed by the negative attribut~ ..: of this lack of organization. JB No, I don't think it was overwhelmned but I think we were very proud of what our staff in San Francisco accomplished. And I think we accomplished a tremendous amount. I think the energy we had to expend, in a sense, battling the Institute instead of representing it was nonconstructive. But in spite of that I felt our program really moved ahead in;dramatic ways and We' were in lots of respects in collaboration, of course, with the state people, in the forefront of innovations in the mental health area and that was true, not only in California, which had such a large program but in lots of the other states with smaller programs who never­ theless were able to be very innovative. In fact, Hawaii has al­ ways been one of the most innovative places in the country but they never have had any confidence in what they've done and~ their innovations have become just matters @f history rather than matters of recognition and prestige. I always felt about Hawaii that they were running so hard te catch up with what they thought was going on in the rest of the country that they ran away in front of it. They really did a lot of pace-making things over there. EAR Could you give us an illustrati0n of what you're referring t.o. I get the general feeling, but I'm trying to pin it down to a par­ ticular. JB Well, I think for instance, their decentralization of the programs to the local community was well in advance of the rest of the country and was already instituted in 1956 when I started to become acquainted ••••• Well, the geography facilitated that, the separate islands, but they were moving to hospitalize people on their own islands and get away from the central system. EAR Another aspect of this general issue that we're discussing relates to, if the regional offiae and central office didnt interact as well as they might, how would you characterize the interaction among the various regions, in what sense was that mutually reinforcing and how was it done. JB We always had an annual meeting and that was sort of alove feast. That was usually a week long and people from all over the Institute 14 JB cont. came in and gave their little speeches, we had a great party and a great time with one another. In fact, later on, some of the meetings were held away from Washington and that even pro­ moted more camaraderie. It was more difficult logistically for us to have contact with the Institute people, with the central office people. Bob Felix, when he was Director, had such a marvelous way of relating to total staff and making each indivi­ dual feel singled out, absolutely unbeleivable, we never were made to feel less than first class people in Felix's company. Of couFee he was a very cordial person and did lots of things to boost the morale of his staff', but it never came across as phony. It was a style and it was very effective in interpersonal relations, but it wasn't just for the sake of effect. You felt there some real integrity behing these things that were being done, that it was an honest kind of expression of his affection and appreciation, and in that respect he was profoundly a factor in the building up of the morale of the regional office people. It was a terribly dif­ ficult act to follow. Alan Miller probably would have done a better job of that than Stan did, by nature of personalities and by nature of Alan's more intimate relationship with the regional office people, so we watched the competition between Alan and Stan from a distance and did not know what was going on, but, for the most-· part, I think were on Alan's side. I would say for Stan, that Stan never held it against us. He was always very supporting of us, he made us feel supported, but it was a very different kind of relationship than with Bob Felix. It didn't have that warm emotional quality to it. EAR Would you be willing to comment on what you think was the basis of that? Was it just differences in personality? As simple as that, or as complicated as that? JB Well, I can only speak: from my own perspective and personal ex­ periences. This relates a lot to the community mental health center program. You see, the Act was passed when Bob was still the Director and regulations were being written and during this period when there was, when Bob had announced that he was resigning and the competition was going on. Alan had the responsibility for the writing of the regulations. He called on me to assist him and I spent several days in Washington working 15 JB cont. with him on the preparation of these regulations and followed up by some work in the regional office in communication. L,,.thin.k that in what had been accomplished in that particular period it was fully obvious that there was to be a greater flex­ ibility in the regulations than eventually emerged. The intention was to give much more power to the local community in determining the shape and size and so on of the program, and not to impose such strict standards on the centers. I feel actually that Stan had a very valid point in his insistance on the size limitations as far as the centers were concerned. EAR five essential services ••• JB And by the nature of the services. I think those were very valid points and related in fact to the fundamental legislation, but they did violation to so much of what existed out in the communi­ ties and was possible in the communities, that it really held back the implementation of that program. Los Angeles was the best il­ lustration of all. Harry Brickman and Stan were at swords points all the time about this. Because of the crazy patchwork of com­ munity organization down in the Los Angeles area, with all these little communities, and then the districting the county, and then the total county as an organism, and the districting was •••• here for health programs, here for education, you know, every which way. It was a hopeless organizational mess and only local people could have resolved the rational thing to do in the particular various areas of the total community. Instead, Stan came in with his firm fiat and got more than 203,000 as a sort of top maximum and they had to chop up Los Angeles into still another set of districts in order to cope with this. Absolutely irrational. That was an extreme, but the same thing happened all over the place. I don't think Alan's appreach would have been so rigid, and I say rigid, not in the sense of personal rigidity on Stan's part, but in terms of program rigidity. And if you sort of' wanted to balance the pic- ture, Alan was floppy in comparison to Stan and would perhaps have 1:een too easy in his relationships with the local communities. EAR Well, there's an inherent dilemma, and I wish~- you'd talk a little bit more about that, because I think I would like to be able to use that as ±llustrative of one very fundamental aspeej; of this whole issue, that is, ther_e are so many aspects of' this that yeu can com­ ment on. Let's go back "tea moment ago when you were talking about 16 EAR cont. Stan versus Bob Felix. They are two totally different people in terms of style and even, in some respects in terms of not just style but philosophies and areas of competence, so to speak, priorities, a whole host of them, but fundamental in one cur­ iously psychological way to the difference is, to overstate the case, I think Bob is a man, who when he was in that responsibility, operated on the philosophy and the basic belief that people are fundamentally good, and if you give them their head, they'll fun­ damentally do a good job. And I think Stan's belief is, that if something could go wrong, it will••••• JB If you think its' true, then they'll do it. EAR Yes, that's partly true. I think he's more paranoid than Bob is, but I think it's not so much personal ••••• and I think he has a cynical view of the world which he has to act out and protect against. Now, in moderation, both point of view are absolutely true and ought to be responded to. You have to know when to shift from one to the other. And I think Stan was too much in one direction, and perhaps Bob was too much in the other. JB You know, an organization is so much identified with the figure of the Director that it's bound to take on the coloration in the minds of the public, the minds of staff and ultimately in programming ••• EAR But to get back to Los Angeles, and I think here is a good case in point, could you talk a little bit more. Ultimately Brickman lost, right? JB Sure, it was inevitable where it would go. EAR Say a little bit more about that, how you saw it as it was growing, what it was that Brickman was doing that really rightfully should have been done, what sarts of responses do you think the Institute might have made, but that would have been more constructive? Can you describe the whole thing a little bit more because it 1 s another case. JB Okey. I have to reconstruct an awful lot that's so distant in my memory that it's hard for me to recapture. EAR Did anyone write it up? JB I doubt it. It was probably in some correspondence of that time. But of course, I think that another thing which is destructive to the Institute,, and this is just a passing recollection, is that the policy of destroying documents at the end of five years removes all that historical information frem your access and in many of 17 JB cont. programs you have to go way back, just as you have to do in the life of an individual to be able to comprehend what is going on. (EAR - to see the genesis). Well, one thing that happened in Los Angeles was that we got the program in sollB of the wealthy districts and even with this gerrymandering of boundaries and so on, cutting a health district in two to get half of it over here and the other half over there, and the Public Health Officer being distraught, and Public Health had a much more powerful hold on the politics of Los Angeles than mental health had, and so the three supervisors in the county, who were little dictators in their own way, there was terrific competition going, played favorites and destroyed the growth of the program by not being willing to go along with the games that had to be played. Then, the situation became so embarrassing that something had to be done with Watts. The history of Watts has been a pretty sorry story. You had t9_;_ impor.t leadership, you didn't have a good relationship politically with the local machinery, didn't have a base of acceptance in city gov­ ernment and city agency relationships. These people went off on their own and sort of belong to themselves, with the sanction of NIMH and got into more financial and other kinds of trouble, and the dream was great, but the reality could never live up to NIMH's expectations without the collaboration of the local authorities, whose good will was destroyed by the imposition of this arbitrary kind of program. We had more illustrations, I think, of this in the West than in the East, perhaps, I don't know about that. Of course, we were very conscious of that. The other extreme was trying to develop a mental health center in Alaska where the population of the whole state scarcely allowed for one center, one catchment area, there was no community base. I think, actually, that this led to an awful lot of political negativism towards the Institute, and destroyed the pub1ic goodwi11, the goodwi11 of the pe1iticians and reflected itself u1timately in sort of the dis­ memberment of NIMH. EAR Yell, again, to overstate. Do you see this as partially a1most an inevita'b1e Greek Tragedy. Sometimes eircumstan.ces are such that there is no way to make a successful resolution o:f things, or do you think really there was a •••••• JB I think the fwadamenta1 problem, and this may be a problem in many 18 JB oo:t;J.t. service programs in the federal government is that they didn't take into account sufficiently the local political reali­ ties. They didn't operate :from a political science base, they operated :from a program pro:fessional theory and practical base which was :fine, as :far as it went, but didn't go :far enough to transform the program ideas into political entities that had a chance to survive. And certainly we had some very good political science people in the Institute and some very wise politicians, particularly wise in terms o:f how to deal with federal government and with the Hill. I can't think o:f any politician that was more masterful than Bob, but Stan in his own way was also very success­ :ful politically. EAR Right, though I think he's not given su:f:ficient credit :for it. JB Oh, no. In many ways he exceeded by far Bob's skill as a politi­ cian but never was liked the way Bob was, or could be. EAR That's an interesting contrast. JB But I think that the seeds o:f destruction had already been sown a way, way back and part o:f them, I think, with the regulations o:f the mental health act. EAR Well, that's a terribly important part o:f the whole story. In a way it has some ironies because ostensibly it was the thing that ought to have hope:fully reconciled and strengthened the situation in pre­ cisely the ways you said was not true in the :first place, but didn't. And you know, another part of this that is so di:f:ficult to deal with I guess it's part of my own philosophy which I'm going to have to guard against in a sense, that is, that there are some things that happened over time that, when one looks at is retrospectively, he may be able to see ways that you might have avoided some of those pit:falls. But in the actual operation it is almost impossible to :foresee some o:f these things, the most simple o:f which would have been an impossibility, namely that i:f you allow the Institute to grow too much you, in :fact, are inevitably going to develop weak­ nesses. Now my understanding about Jerry Brown as governor here is this is part of his philosophy, small is beauti:ful. JB I'm sure that's the case. 0:f course, I think geographical environ­ ment, physical environment, has an awful lot to do with how things develop too. I think it was a shame that NIMH got booted o:ff' the campus and I think that was reaction to the growth and size. That's how I understood it. 19 EAR Well, a very complicated part of the whole picture is the relationship and rivalry between Bob Felix and Jim Shannon and the fact that NIMH was excluded, in a sense, because it wasn't part of the NIH model, so to speak, and yet their personal relationsMps were very good. They were pros, and they knew they were both pros for and had more respect for each other thanJany other directors of NIH. I think Shannon recognized Bob's worth, and vice versa. I'd like to be able to talk to Shannon some time, ••••••• Well, let me ask you if there is anything in terms of just going over this, the way we did, that you want to make mention of that we didn't touch on. JB Let me round off the story in reference to Stan by expressing my, tremendous appreciation of his own support of me as a person and as a professional and support of the regional office. In many ways Stan far exceeded his support for the San Francisco regional office and for me personally, far exceeded Bob Felix, becaus.e when deci­ sions had to be made, they got made and they took into account the regional office point of view, he responded, there was no question about it. EAR It's funny, because in a way he gets criticized for things some of which he deserves to be criticized for. I've been there and I know what his failings are, but by the same token, there are things that he has been criticized for, that are inappropriate because they don't really correctly assess the situation. One is that he did not do for the intramural program what Bob Felix did. Now the truth of the matter is that he did more for the intramural program than Bob did, not stylewise, no way did he even come close to what Bob could do stylewise, but in terms of nuts and bolts, that he did. And since he was born and bred and raised, so far as psy­ chiatric training was concerned in a community model, I think his personal beliefs aad commitment te the community model were much greater than Bob's. Bob had a Public Health model in the larger sense, but net a community mental health model. Stan grew up at the Prince Georges County Mental Health Center, he lived it, he believed it, he still does and whatever errors he made were not errers of intentiom. at all. I mean, granted that he's a very stubborn. man, that he's a very strong-willed man, that, you may or may not knew, basically a very shy person wh.o finds it difficult te 20 EAR eont. relate te people in the way that Beb did. But he can be vindictive, if he wan.ts te, hut Beb ceuld too. JB 0h, yes, he eeuld just completelysJa.u~ktera person. EAR But, tell me if i'm wrpng, if I'm trying tee hard to fit things inta seme kind ef meaningful place, but.in a sense, I believe that Bob was exactly the right person fer the Institute when he was there and in seme respects Stan was the right person for the Institute when he was there. JB Well, I think you're right. I think Bob was marvelous in getting the Institute founded, managink the gradual expansion of it with­ out ever creating too many waves but making sure always that it was growing and he couldn't have done mere. It was time fer him te retire. In fact, with the loss of some of the figures en the Hill his relatienships that he depended on were gone, it was time for a change. He was wise in that respect. I don't know how Alan would have dene •• EAR I think he would have done well. JB I've lost touch with Alan, muoh to my regret and I didn't have any chance really to touch base with him about how things went in New Yerk State. I had the impression from a distance •••• EAR They went well, I think at that level anybody can be criticized a.n.d it's an impossible job to be in, so that it's always easy to find areas in which weaknesses er deficits are present, but I think that's the name of the game, especially if one takes on that kind of respensibility. JB I think Stan actually made a choice ef personnel for community services which was very difficult fer us to live with in San. Franoisoo, when he obese so ma.my of the Californ.ia pr0gram people te come and take on the positions in Washington. EAR Well, Phil Sirotkin started that••••• JB Well, I'm sure Phil was the forwarder and he prometed that, natur­ ally but Stan went along with it, and did I think, enthusiastica11y and I think that led to a very inappropriate tension at the Central Office level between Phil, who had a very geod relationship with Stan, and other people whe didn't really work well with Phil. I had the impressions that most of the regienal office peeple found it difficult to work smoothly with him. EAR Yes, that's true. He had some of the same characteristics that Stan has, you know, forcing things int& a mold, being competent 21 EAR cont. in a way which tends to override the necessary attention to individuals and individual differences. You have to stroke people sometimes, not because they need stroking perse, but because they're human beings••••• JB Sure, well I always had the feeling with Phil that it was a kind of a contention every time there was any kind of a relationship. It started from a battle position •• EAR That's true. I find it fascinating, this whole thing, because of my own interest in human nature. It's fascinating, how inevitably when you look at what goes on, you've gone back to personalities, not in a small way, I mean to carp at people, per se, but that all of us have a certain style, all of us are bound by that style and it plays such a tremendous role, it just really is unbelievable. Intelligence, strive, ambition, luck of the draw, they all play a part, but behind it all, just continues to reveal itself in the way people operate. There's such a kind of consistency that con­ tinues over time. JB Even in mental health circles ••• EAR Even in mental health. The irony of trying to do this book is that if you're really going to be talking about psychodynamics in a program, where is it more appropriate than in the field of mental health, to talk about psychodynamics. And when I first talked to people, including Jean Brandt, about doing this book, what I got back covertly, and in some respects, overtly, was, welll, you don't have the qualifications as a historian to write a book, you haven't been trained in the history of science or whatever, a:ral why are you trying to write a book like this. And when I try to say, well, I've been there and that's partially good and partially bad, but I think: that it's important to tell this story in terms of •••• What I have been telling people is that I don't want to write a history of NIMH, I want to write a biography of NIMH and I think you ebvious1y have te be accurate, and you have te have your facts in there, but it's net the ske1eton, it's the spirit that's import­ an.d here, and $hat's what you rea11y have to stress. Se that•s why it's so important te get these points of view frem peeple like yourse1f. This has been very helpful Jo-., and I don't wantiD cut yeu off, if there is something e1se that you wanted t0 comment on, but I'm p1eased. JB That's very geed. I don't kn.ow hew representative what I have to1d 22 JB cont. you has been of my tota1 experiences at NIMH. In retrospect it seems to me I got going on a theme and was sort of pushing ahead on that theme, there 1 e an awfu1 1ot that didn't get touched. Maybe it was even more important. Perh~ps one thing which I might mention, particularly in reference to Stan but also others, was the sense of functioning as a professional in real professional circles that surrounded me all the time I was in NIMH. It was manifest in a real consideration by the Institute in my own pro­ fessional interests, for instance, the extent to which they en­ couraged me to put on workshops in family therapy at a time when this was just starting and published that best seller little mono­ graph and then Stan made it possible for me to make that exciting study in Africa and Asia. You know that was really a part of my professional growth for which I've been tremendously grateful. It gave me an opportunity I couldn't possibly have had in the academic setting or in most federal agencies. EAR Well, I'd like to epitomize what you said in that regard, because I think that for many of us the attitude at NIMH allowed us to do in some respects, the best we could do. I think it gave us the freedom and the opportunity and that's very gratifying. JB It really was. Now that was diminishing, the freedom and the support and so on, was diminishing towards the end of my time, and one of the r.e.asons why I chose to leave NIMH was the fact that there were too many political intrusions that were becoming number one considerations in the regional office. EAR No, it's too bad. Maybe it's part of the advantage of getting older, but it's also kind of sad in a way, that things pass, so to speak, hive and we've been very lucky, I think, to participated in an incredible adventure, so to speak. And that term,has been used by some people. I think it was. I think it was a real adventure. And some peeple never have the opportunity. And part and parcel ef that was what you said, to work with good people, with similar interests, similar competencies and similar 0pporttlllities to grow themselves. JB And many ef my communications with the Institute was on the other side, when I worked with MRI, pointed out to me how much the Insti­ tute had really changed and how quickly tkat change took place. EAR It's sad. I can. tell you it 1 s lial:f' humorous, but muck more sad than h111Dorous, when we left, Stan and Sherman and I and Mort Miller, and came to New York, and somewhat facetiously, it was 23 ,,\ EAR cont- called NIMH East, but that had no realy meaning whatsoever, the thing that happened to me time and time again the first few years after 1972, people would say either, did you know this was going to happen, was that why you left? or the other thing which is satisfying, but much more sad, Look what happened to NIMH since you people have left. You can take some personal satisfaction out of that, but very little because my involvment with the Institute was much more being a part of it, than to hear that, it was very sad, and I think that's what happened. JB I had the same sorts of things said to me. My colleagues in San Francisco would say, Oh, how lucky you were to get out when you did ••••• I think it was very interesting to me, also, after I left how quickly I lost touch with what was going on. It was just simply astounding that within a few months ••• well, I had felt that I was really a kind of an authority on what was going on, for instance, in mental health in the West. Within a few months I had lost all that authority, I wasn't able to speak about what was happening in Oregon, or Arizona, with any<kind of authority and now I feel as alien as anybody in the university. EAR Which is a comment on how much input you were getting while you were there. JB Absolutely. That day-to-day intimate knowledge of a broad geographical expanse and programs of tremendous diversity. That's part of the growing experience of working, or was part of the growing experience of working at the regional office. I don't think that growing is taking place to the same extent now. EAR I know it isn't and I know at Central Office, of course I don't know about the regional office, but I know at central office it's just not the same situation. When I went back there, shortly after having talked to left, and people in the training program, in some respects it was almost like I was conducting a therapeutic sessien. They were depressed JB Oh, yes, and that Parklawn Bldg•••• Ell It was just terrible.• •• · JE It was a tragedy that the Institute had to take that place. And that's another aspect ef the influence of the physical envirownent. The Parklawn. Bldg. was isolated from the campus, hut it had a certain easy aceess~.....t't'"here was a lot of activity, and the staff were in 24 JB eont. close communication with one another. It was very lively and that was a good envirenment until it got too small and then te have to end up in that disastrous building. Oh, everybody in a cubbyhole and the depression that set in on the Institute was so severe that I don't think anything could have really rescued it. EAR You meant the Barlow Building before. You said tke Parklawn Bldg. e JB Tkat•s right. the Barlow Bldg. EAR The Parklawn is wkere they are now. Well, I should tell you, if' you don't already know, that the Barlow Bldg. owed much of' its character to Stan, who among his other talents is an interior decorator, and he's just treq';endously skillful at it. It wasn't just his ewn ef'f'ioe, but the whole place. JB Whereas when ~e got into the Parklawn Bldg. he didn't have that kind of' control. EAR Well, I guess he didn't care a.npmore. Well, there we are.