Robert Hanna Felix – 1997 Inductee

The son of one eminent Osborne County physician did his father proud in becoming instrumental in changing the direction of national mental health treatment in the United States for much of the twentieth century.  Robert Hanna Felix, known affectionately as “The Kansas Windstorm,” was born in Downs, Kansas, May 29, 1904, to Doctor Tasso O. and Neva (Trusdle) Felix.  He grew up in Downs and graduated from the high school there in 1921.  Bob then attended the University of Colorado at Boulder, where he graduated from the medical school in 1930.  After his residency he joined the U.S. Public Health Service in 1933 as a licensed psychiatrist.  On June 18, 1933, Robert married Esther Wagner in Denver, Colorado, and they later became the parents of a daughter, Mary Katherine. During World War II Bob earned his master’s degree from the John Hopkins University School of Public Health.  He then served as senior medical officer at the U.S. Coast Guard Academy and became the overall chief of the Medical Hygiene Division for the U.S. Public Health Service.  His greatest achievement came when he helped develop the National Mental Health Act of 1946, the first-ever federal legislation focusing on the mental health field.  It established the National Institute of Mental Health to serve as a focal point in directing major reforms and all research in the field.  In 1949 he became the first director of this facility.

“As its first director, Dr. Felix had a total commitment to the Institute, which grew under his leadership to nearly a quarter-billion dollar annual budget.  It was the foremost Institute of the National Institutes of Health constellation in its application of new knowledge and the fruits of research to patient care at the local community level.  Its activities in research, training, and service were so inextricably interwoven that it weathered several vigorous administration-inspired study group and task force efforts to disassemble it in the early sixties. With Dr. Felix’s combination of personal charm, administrative capacity, and political adroitness, together with an irascible refusal to back down on a matter in which he believed, he emerged as the master strategist in those confrontations, and the Institute survived, stronger than ever.  Congress in one decade manifested its confidence in the administration of “The Kansas Windstorm” by increasing Institute budgets by $120 million over requests.  His activities in national and international organizations and his awards and honors were myriad.” — From the June 1974 handout for Dr. Felix’s official retirement dinner as Dean of the St. Louis University School of Medicine.

Robert Felix (far right) and fellow recipients of the 1961 Rockefeller Service Award meeting in the White House with President John F. Kennedy.

During his life Bob was a member of numerous professional organizations and served on the editorial board of a number of trade periodicals, among them The Psychiatric Bulletin, The Quarterly Journal of Studies of Alcohol, and The American Journal of Psychiatry.  He was president of the Southern Psychiatric Association in 1946-47 and also a past president of the American Psychiatric Association. He was the recipient of many honorary degrees from various universities and he was honored with several distinguished awards from the academic world.  In 1963 he was awarded the Salmon Medal by the New York Academy of Medicine for his contributions to the field of psychiatry.  Bob also received the Nolan Medal, the D. C. Lewis Award, the Edward A. Strucker Medal, the Rubin Award, and the Norlin Award from theUniversityofColoradoas an outstanding alumnus.  The 1961 Rockefeller Service Award was given to Bob for his extraordinary service to the nation in the field of science, and in 1964 he received both the National Conference of Social Welfare Award and the Bronfman Prize, given to him by the American Public Health Association.  His award citation named him “a prime architect in creating national programs which revolutionized mental health research, training and care of the mentally ill.” Bob was a longtime mental health advisor to the World Health Organization (1952-78).  In 1957 he was commissioned an Assistant U.S. Surgeon General by the U.S. Public Health Service.  In October 1964 he retired after fifteen years as the National Institute’s director to become a professor of psychiatry and Dean of the School of Medicine at St. Louis University in St. Louis, Missouri. “The entire program of the Institute reflects his [Dr. Felix’s] foresight, administrative skills, professional knowledge and his ability to articulate its technical, scientific, and humanitarian needs and achievements.  Dr. Felix has been an extraordinary effective leader in the development of a new national mental health program based on knowledge, common sense, and concern for human dignity.  His qualities of leadership persuasion have helped to rally thousands of professional persons and interested citizens to his belief that the mentally ill can best be served by a community-based program of treatment providing a continuity of care, available to everyone at the time of need.” – Then-U.S. Surgeon General Luther Terry in his announcement of the retirement of Dr. Robert Felix. After ten years as head of the St. Louis University School of Medicine, Bob relinquished the post and became Dean Emeritus. “Bob was realistically aware that God had given him an abundance of unusual talents–personal charm, leadership skills, political adroitness, unflinching courage–and day after day he applied those talents to the challenges and opportunities that came his way.  In the farewell testimony to Bob when he retired as dean here in 1974, a very telling comparison was made between his career and that of his contemporary –Pope John XXIII.  Both were in their senior years when selected.  Most people expected a settled caretaker government of each of them.  But each began to open doors and windows never before tried, wrought profound changes, and left an institution which could never be quite the same as it was before his leadership left its mark.” — From the eulogy given by Paul Reinert, S. J., at the memorial services for Dr. Robert H. Felix at St. Louis University on April 29, 1990. In 1975 Bob also became involved in research at the Scottish Rite Psychophrenic Research Program in Lexington, Massachusetts, a position he owed in part to his being a 33rd-degree Mason, and one that he held until 1985.  He remained a national force in the world of psychiatry until his death inSun City,Arizona, in 1990.  One of Osborne County’s most famous native sons was buried with honors in the Sunland Memorial Park at Sun City.

IN MEMORIAM

Robert Hanna Felix, M.D.

1904-1990

 “Psychiatry recently lost one of its most outstanding leaders, but he left us with a marvelous legacy.  That legacy has directly or indirectly influenced favorably the lives of thousands of professionals in the mental health and mental health-related fields, the millions of patients they served, and the patients’ relatives, friends, and neighbors.  His contributions to all these and our country have been, and will continue to be, enormous.  Robert Hanna Felix, the eighty-ninth president (1960-61) of the American Psychiatric Association, the architect and first director of the National Institute of Mental Health, and Dean Emeritus of the School of Medicine of St. Louis University, died at his home in Sun City, Arizona, on March 31, 1990, at the age of eighty-five.  He is mourned by his wife, Esther (Peg), their daughter, Mary Katherine (Kathy) Hoenigman, and two grandchildren (Robert and Rebecca).  To these must be added his legion of friends and colleagues. Dr. Felix (Bob) was ever mindful of the fact that psychiatrists, as medical specialists, must not only possess certain essential human qualities but also remember that they are, first of all, physicians.  This view he urged upon his fellow specialists. ‘The good physician must have honor and integrity and a genuine respect and regard for his patient. . . . In addition, there is certain technical knowledge he must also possess without regard to his type or degree of specialization. (1, p. 4).  ‘Just as the son is the child of his father, so is psychiatry the child of medicine’ (1, p. 8). Just so, he was the child of his father.  The latter was a country doctor inDowns,Kansas, who possessed special training in languages, history, and religion.  His mother was a pioneer physician’s daughter and a concert pianist.  As a boy, Bob, who was known as ‘Little Doc,’ accompanied his father on house calls, experiencing from earliest childhood the important interplay of professional skills, respect, and concern for others.  As his biographer, Dr. Francis Braceland, put it, he developed an ‘image of himself as a physician–he had it then, he has it now, and will always have it, no matter how far from the bedside he strays’ (2, p. 10). To these strong basic ingredients were added the influences of the Downs public schools and the University of Colorado’s premedical and medical curricula (he received his M.D. in 1930), internship, and psychiatric residency program.  He was a Commonwealth Fund Fellow during his residency years (1931-33) at Colorado Psychopathic Hospital, where Dr. Franklin Ebaugh, his chief, not only exposed him to intense clinical teaching but also stimulated a great interest in community psychiatry and public service.  These interests were further nurtured at The Johns Hopkins School of Hygiene and Public Health (he received the degree of M.P.H. [Master of Public Health] in 1942), where he came to appreciate the importance of clarifying the epidemiology of the many different forms of mental disorder.  There, according to a fellow student, he ‘began to think of communities (as well as individuals) as patients.  He also presented, as a class exercise in Public Health Administration, a ‘national program for mental health’ that foreshadowed the future National Mental Health Act’ (Harold J. Magnuson, personal communication, 1990).  A final formal learning experience, in the late 1940s, consisted of a training psychoanalysis with Dr. Frieda Fromm-Reichmann. It was during his residency that he met and married Esther Wagner, a nurse on the staff of Children’s Hospital and the love of his life.  In 1945 they became the more-than-proud and devoted parents of Mary Katherine, a much-wanted child.  She, in turn, became the mother of their adored grandchildren.  Bob’s family played a central role throughout his life. Upon the completion of his residency, Dr. Felix was commissioned as an assistant surgeon in the commissioned corps of the U.S. Public Health Service.  His first duty assignment was at the medical center for federal prisoners at Springfield, Missouri, and this was followed by five years at the U.S. Public Health Service hospital at Lexington, Kentucky.  The latter was the first federal hospital devoted to the treatment of drug addicts and to the pursuit of rigorous research into the causes of addiction and the treatment of drug-dependent persons.  During those years, he benefited from exposure to unusual types of clinical material seen in quantity by very few psychiatrists.  And his participation in rigorously controlled research, in association with professional colleagues from a variety of professional disciplines, was an experience shared by only a minuscule number of young psychiatrists at that time.  Dr. Felix’s research interests and skills were further honed while he was assigned to the U.S. Coast Guard Academy at New London, Connecticut (1942-44), where he was responsible for implementing ‘an integrated medico-psychological program’ (3).  That program involved a major, interdisciplinary research undertaking on the selection of officer candidates.  In 1944 he was transferred from the academy toWashington,D.C., where, standing on the shoulders of other big men, he stood tall in making his own major contributions to American psychiatry and mental health. Among those on whose shoulders he stood was Dr. Lawrence Kolb, his mentor in the Public Health Service, the man who chose him to go to The Johns Hopkins University for training in public health and who was his immediate predecessor as chief of the Mental Hygiene Division of the Public Health Service.  In the 1930s Dr. Kolb had envisioned the creation of a national neuropsychiatric institution within the Public Health Service to lead a concerted attack on the mysteries of mental illness, which then accounted for over half of the hospitalized patients in theUnited States.  However, World War II intervened. So it was that, in anticipation of Dr. Kolb’s retirement, Bob was called to Washington by Surgeon General Thomas Parran and shortly thereafter given responsibility for direction of the Mental Hygiene Division.  Dr. Parran was another of the giants on whose shoulders Bob stood.  Of Dr. Parran, a pioneer in the fields of venereal disease and tuberculosis control, Dr. Felix said, ‘His insight into the mental health needs of this country was phenomenal. . . . The program would never have gotten off the ground without his support with the Bureau of the Budget, the Department, and with Congress’ (2, p. 11). But what was the program that became Bob’s enormously valuable contribution to his country and his profession? He presented a ‘blueprint for mental public health’ which called for the erection of a structure with several wings, all of which are functionally interrelated.  Therefore, the  foundations for all the elements must be laid and construction begun at the same time.  It will not be possible to complete each part at the same time; but each part must be at some state of completion at  all times.  The efforts toward the specific objectives must be parallel…. The several parts of the plan are: 1. Training of personnel. 2. Psychiatric services for case-finding, and for diagnosis and treatment of persons who do not require institutional care. 3. Improved services in mental hospitals. 4. Education of the public. 5. An augmented and coordinated program of research (4). Under Bob’s guidance, and with the help and support of countless individuals and organizations, the National Mental Health Act was signed into law on July 3, 1946.  It provided for (1) support of research through the development of a system of grants-in-aid to institutions and individuals, the construction of a National Institute of Mental Health in the Washington area, and the appointment of research Fellows in various scientific fields that bear upon mental health problems; (2) support of training through a system of grants-in-aid to public and other nonprofit institutions; and (3) support of community mental health services through a system of matching grants-in-aid to the states (5). The act also provided for the appointment of a National Advisory Mental Health Council to guide the program.  Grants-in-aid for research and training projects could be made only with the approval of that council.  Thus was provision made for broad policy advice and peer review. As a comment on the usefulness of the program, I can do no better than to quote, once again, Bob’s 1961 biographer, Francis Braceland:  ‘The amount of good this Institute has done for the cause of mental health is incalculable.  To even hint at the scope of its research and teaching efforts would be far beyond our purview here.  Without its farsighted planning and help, the whole psychiatric picture in this nation would be one bordering on chaos’ (2, p. 12). Upon his retirement in 1964 from the Public Health Service . . . Bob accepted an invitation to become Dean of the School of Medicine at St. Louis University.  There he endeared himself to all.  Of him, the current Dean, Dr. William Stoneman III, said, ‘Dr. Felix served as Dean at St. Louis University School of Medicine from 1964 to 1974.  During this vigorous decade, the full-time faculty increased 300%; the total enrollment, 36%.  Student performance on National Board Examinations rose dramatically and consistently. . . . He opened doors and windows never before tried, he wrought profound change, and left an institution which would never be quite the same as it was before his leadership left its mark’ (personal communication, 1990).  The Reverend Paul C. Reinert, S. J., Chancellor of the University, upon learning of Bob’s death, said, ‘His ability to rally the enthusiasm and support of every person in the Medical Center–administrators, faculty, alumni, and students–was remarkable.  His openness and spirit of optimism gave us all a new perspective on how promising the future of theMedicalCentermight be’ (personal communication, 1990). In 1974 Dr. Felix not only became Dean Emeritus but also took on the task of serving as program director for the Bi-State Regional Medical Program inSt. Louis, a program dedicated to bringing all available resources and interests to bear on improving the health of the community. Bob and Peg moved from St. Louisto Sun City, Arizona, for their well-deserved retirement in December 1976.  But even then, he didn’t really retire.  He continued actively serving as research director of the Scottish Rite Schizophrenia Research Program of Lexington, Massachusetts (1975-85), played an active role in his church (as he had all his life), and served on the board of directors of Interfaith Services, an organization of over one hundred churches and social agencies.  He was the prime mover in developing its case management service, which currently responds to more than three hundred calls per month from persons needing some form of community help. During his lifetime, Dr. Felix was the recipient of . . . honors and awards too numerous to detail here.  He was also an active member of many professional and fraternal organizations, editorial boards, councils, and committees. Let me close this tribute to a great man, who was my close friend and colleague of fifty years, by quoting his comment to someone with whom he shared great affection and respect, Gloria O’Connor.  She was his principal secretary during his years as Dean.  As he bid her a fond farewell upon his departure from that office, he said, ‘Remember, when you hear that something has happened to me, that I have had a full life, that I have tasted its sweetness, that I have gotten back far more than I had any right to expect, so be happy’ (personal communication, 1990). We really are not happy about his leaving, but we are awfully glad he came!  His legacy will live on.”

REFERENCES

1.  Felix H:  Presidential address:  psychiatrist, medicinal doctor American Journal of  Psychiatry 1961; 118:1-8 2.  Braceland FJ:  Robert Hanna Felix, eighty-ninth president, 1960-61:  a biographical sketch. American Journal of Psychiatry 1961; 118: 9-14 3.  Felix RH, Cameron DC, Bobbitt JM, et al:  An integrated medico-psychological program at the United StatesCoastGuardAcademy.  American Journal of Psychiatry 1945; 101: 635-642 4.  Felix RH:  Psychiatric plans of the United States Public Health Service.  Mental Hygiene 1946; 30:381-389 5.  Cameron DC:  The Mental Health Act and plans for its operation.  Southern Medical Journal 1947; 40:420-426 – Dale C. Cameron, M.D., M.P.H., in the January 1991 issue of The American Journal of Psychiatry.

Robert Hanna Felix, MD, MPH

“It is really quite hard for me to write any adequate summation of my father’s life. . . . Robert H. Felix was a highly talented and multi faceted man, but whatever he was, whatever he became, he attributed to the foundation he was given as the son of a ‘horse and buggy’ doctor on the Kansas prairie. It is really difficult to separate my father from my grandfather, because in all that he did my father used his father’s life and teachings as both an example and for guidance.  I think of both men as pioneers.  AlthoughKansaswas well settled when my grandfather was practicing there the medicine he practiced was pioneering.  My father, building on his father’s teaching, was often referred to as a pioneer in his chosen field of mental health.  As you can read from the enclosed, he was one of the architects of modern mental health practices. My father often told me of accompanying his father on his rural rounds.  He told me of assisting his father as he grew older.  He helped by handing his father instruments, helping to hold a patient during a procedure, sometimes performed on a kitchen table scrubbed with alcohol.  This could not happen today, but my father was really in early training for the family business, for Dad was not only the son of a physician, but the grandson and great-grandson of physicians as well.  Growing up in Downs Dad often was referred to by the nickname of ‘Little Doc.’  I’m sure it was no surprise to anyone then that my father chose medicine as a career, although he did seriously consider journalism in undergraduate school.  He always said that this early training made him the man he later became.  I found it interesting that often when he was testifying before Congress to justify the budget for NIMH (National Institute for Mental Health) he would refer to himself as ‘just an old country doctor.’  More than just a ploy, this also conveyed some very basic values, ones that were obviously well understood by the congressmen. When it came time for my father to retire as director of NIMH I was completing my senior year in high school.  Though sixty years old, Mother and I knew he was far from retirement.  As one can imagine, Dad really did not have to do a job search.  His talents were in great demand, and job offers came pouring in.  The decision was really quite easy when the offer came fromSt. LouisUniversityto become dean of the medical school.  Dad saw this as a return to his roots, for his father had graduated from Marion-Simms College of Medicine, the school that later became St. Louis University School of Medicine.  Whenever someone would visit him in his office, family included, he always took them down the hall where class pictures of all the graduates hung.  He would proudly point to his father’s picture in the class of 1898.  This was in a way the very essence of the man, a man who believed that it was one’s obligation to use his talents to their fullest, but also to always honor those who came before, those who enabled him to become the great man he was. So in a wonderful way my father’s life came full circle.  Like his father before him he was a man who was deeply devoted to his God, his family and his profession.  He never really fully retired.  He and my mother enjoyed life inSun City, but ever the activist, Dad helped form Interfaith Services, an organization of more than one hundred  churches and social agencies which provided case management services primary for the frail elderly.  Fittingly in his last years he became the recipient of many of their services, ‘as ye sow so shall ye reap.’  My father reaped many honors and the recognition of those in high places, but all who knew him knew him to be a humble, exceedingly kind man.  This comes from a firm foundation, one deeply rooted in the soil ofKansas, the foundation that made him the great man he was.” – Katherine Hoenigman, daughter, June 1997.

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