Am J Psychiatry 156:5, May 1999 767 Images in Psychiatry The Hiawatha Asylum for Insane Indians: The First Federal Mental Hospital for an Ethnic Group T wo cycles of reforms aimed at improving the care of Native Americans occurred during the first half of this century. The first cy-cle involved the creation of a separate facility for native populations in 1903 at Canton, S.D.: the Hiawatha Asylum for Insane Indians. The promoters of this asylum were genuinely concerned with allevi-ating suffering among Native Americans by providing better care than jails, “hospitals,” or workhouses for the mentally ill, who were often homeless and poorly treated by the community. They argued that a separate institution for Native Americans was needed because they had unique mental health “afflictions.” In less than three de-cades after the hospital opened, the reformers were attacked for poor mental health care at the asylum. This led to the second cycle of reform. Changes in concepts of provision of mental health care
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