Editors’ Note: Bill Bush discusses the history and impressive impact of the Hogg Foundation for Mental Health.

The concept of “wellness” has become a widely accepted, if loosely defined, feature of the everyday cultural landscape of American society. Central to that wellness ideal is mental health, itself a concept readily found in news coverage of catastrophic events such as natural disasters and mass shootings, as well as long-term calamities such as the opioid epidemic. Philanthropic foundations play a central and widely accepted role in informing the public about mental health; supporting research on mental health policies and treatment protocols; and collaborating with public and private actors in providing services to groups such as military veterans, survivors of abuse, or recovering addicts.

But it was not always so. The idea of mental health emerged in the early twentieth century due in no small measure to support from professional philanthropies such as the Commonwealth Fund, which famously supported the opening of child guidance demonstration clinics in several American cities in the 1920s. But understanding and acceptance of mental health was hardly widespread and took hold only after decades of research, policymaking, and activism – much of it supported by foundations. In my book, Circuit Riders for Mental Health: The Hogg Foundation in Twentieth-Century Texas, I tell the story of how a small family foundation with relatively modest resources successfully transformed attitudes and policies regarding mental health in a socially and politically conservative state during the middle decades of the twentieth century.

The Hogg Foundation for Mental Health opened in 1941 as a unique enterprise: a private foundation housed within a public university, the University of Texas at Austin; and, a foundation devoted entirely to the cause of mental health. Both features stemmed from the family who provided the foundation’s endowment and name. Will C. Hogg, a prominent alumnus who had accumulated vast wealth during the oil boom of the early twentieth century, left a bequest to the university upon his death in 1930. The execution of that will was carried forth by Will’s sister Ima, or “Miss Ima” as she was known to her many admirers. Ima and Will had spent their childhoods alongside their father, James C. Hogg, who had served as Texas attorney general (1887-1890) and governor (1890-1895). A crusading populist reformer who curtailed the power of big business interests in Texas, Governor Hogg inculcated in his children a sense of civic duty typical among the generation of self-made, nouveau riche Americans who founded some of the nation’s first large, professionally run philanthropies.

After both her parents died prematurely, Ima began experiencing emotional breakdowns that drove her to seek treatment outside of Texas. In 1924, she met Austen Fox Riggs, a Massachusetts-based psychologist active with the recently formed National Committee for Mental Hygiene. Along with his colleagues, Riggs believed that most people with mental illness could and should be treated outside of the prison-like mental hospitals that typified psychological and psychiatric treatment across the United States. Herself a consumer of mental health services, Ima empathized with people experiencing mental illness, and returned to Texas determined to spread the gospel of “positive mental health.” Her relentless focus on mental health overcame numerous attempts to transform the Hogg Foundation into simply another department at a state flagship university striving to become an emerging research institution.

The Hogg Foundation began its work with an endowment of $2.5M and an annual budget of $32,000 (roughly $43M and $500,000 in 2017 dollars). Its offices were located on the University of Texas campus, and it supported fewer than five paid full-time positions during its first decade of existence. One of those was its inaugural executive director, Robert Lee Sutherland, a Chicago-trained sociologist who brought a vast national network of experts and a savvy strategic perspective. In the Foundation’s first decade of operation, Sutherland launched a massive public education campaign, recruiting well-regarded experts such as Margaret Mead to deliver thousands of talks about mental health to audiences in school gymnasiums, community centers, and church sanctuaries all over Texas. These “circuit riders” included Sutherland himself, who personally traveled state highways and farm-to-market roads hundreds of times, often speaking in three or four different towns in a single day.

Within a few years, these activities had built popular demand for mental health services. In the 1950s, the Foundation led a protracted and ultimately successful campaign to reform the state’s decrepit, scandal-ridden mental institutions. Some of this work was done behind the scenes. Sutherland astutely built personal relationships with prominent political brokers in Austin, while also awarding grants to journalists who published widely-read exposés of Texas’ horrendously underfunded mental health services. In 1956, a documentary film entitled In a Strange Land, which had been produced by Foundation staff and UT film students, dramatically portrayed the plight of patients in Texas’ state hospitals on television stations throughout the state. One year later, the Foundation brought William Menninger, one of the nation’s best-known psychiatrists and a prominent critic of mental hospitals, to deliver an address to a joint session of the Texas legislature. Menninger’s exhortations to build “brains before bricks” elicited a long standing ovation, followed by the enactment of the state’s first mental health code, drafted on the campus of the University of Texas and published by the Hogg Foundation.

By the early 1960s, a clamor for community-based mental health services – led in part by veterans of the Hogg Foundation’s mental health reform push in Texas – had created sufficient momentum for significant federal action. In 1963, President John F. Kennedy signed the Community Mental Health Centers Act, which authorized $150 million in grants to states, which responded by developing state-level agencies to administer federally funded mental health services. In Texas, the Hogg Foundation led a statewide task force that drafted what became the Texas Mental Health and Mental Retardation Act, adopted in 1965. In the late 1960s, the Foundation began supporting pilot programs to deliver services to historically neglected African American and Mexican American populations in various parts of Texas.

For a period of about thirty years, the Hogg Foundation was the driving force for education, policymaking, and the development of community-based services in one of the largest and most influential states in the nation. Some features of this story are unique: the timing of the foundation’s start with an emerging national concern during a period when Americans held credentialed experts in higher regard than they do in the twenty-first century. Nevertheless, it may offer some useful lessons for smaller foundations seeking to make a larger impact today. For scholars, this story highlights the potential value of regional and state-level histories of smaller philanthropies, which can uncover new perspectives into broader historical policy shifts.

-Bill Bush

Bill Bush is Associate Professor of History and Chair of the Department of Arts & Humanities at Texas A&M University-San Antonio. In addition to Circuit Riders for Mental Health, he is also the author of Who Gets a Childhood?: Race and Juvenile Justice in Twentieth-Century Texas (University of Georgia, 2010). He has co-edited a collected volume, Ages of Anxiety: Youth and Governance in Transnational Perspective, that will be published in 2018 by NYU Press.