The three-volume set, “The Four Sisters: A History of Iowa’s State Psychiatric Hospitals” by David Rosheim, costs $150 plus shipping. Copies may be purchased through the author at
The three-volume set, “The Four Sisters: A History of Iowa’s State Psychiatric Hospitals” by David Rosheim, costs $150 plus shipping. Copies may be purchased through the author at

David Rosheim, a former Decorah resident and Luther graduate (1966), has published a history of Iowa’s psychiatric hospitals at Cherokee, Independence, Mount Pleasant and Clarinda – two of which, Clarinda and Mt. Pleasant, were closed last year.

“I was searching for some books on the topic since I had become curious,” Rosheim said. “I found none so I wrote one.”

“I thought I would find some books in depth on these institutions but none existed, save some interesting pictorial histories,” he said. “A history of them was certainly needed.”

Rosheim has done other books this way, too.

“I wanted, for instance, a history of the old Minneapolis Skid Row. No book on that, so I wrote one.”

Rosheim, owner of Timber City Books, Used and Rare, and the Andromeda Press in Maquoketa, began his writing career at Luther as literary editor for Chips and as a coeditor and contributor to the Oneota Review. He published his first booklet of poetry as a Luther student in 1964 at Anundsen Publishing in Decorah.

Since then, Rosheim has written a number of freelance stories, commentary pieces for the Des Moines Register, and published books of poems and fiction, as well as historical works including: The Other Minneapolis (1978), A Literary History of Jackson County (1994) and A Pictorial Bibliography of the Histories of the Cities and Towns of the State of Iowa (2011), which included 503 photos of Iowa towns.

Rosheim said his latest effort, The Four Sisters: A History of Iowa’s State Psychiatric Hospitals, was a three-year project.

“There was so much source material I ended up with a three-volume set,” he said.

Interesting timing
“I did not intend to make this a timely history but the times suddenly caught up to me as I was busily transcribing the historical record,” Rosheim wrote in a Feb. 17, 2016 article for the Independence Bulletin-Journal.

“Suddenly the controversy, not yet settled, about whether to keep these institutions open came into public awareness and I became involved in the discussion myself. I was well aware through my research that some of these big hospitals had abused the confidence the public had in them. I knew of their more sinister days; but, really, in their long history, they did what they originally intended to do: provide a safe haven for those whose illness caused them to be in peril from themselves and from a cruel world, which would injure them or jail them,” he added.

The controversy
When Governor Terry Branstad closed two of Iowa’s four mental health hospitals last year in a budget-cutting move, the action was met with widespread criticism – including the filing of a lawsuit against the governor by the state’s largest public employees union and 20 Democratic legislators.

A July, 2015 Des Moines Register article reported “the governor contends that most of the two state hospitals’ services could be provided more effectively and efficiently by private agencies … But critics say that replacement services are not yet in place, and that the hospital closures ripped away services from a mental health system that already was woefully deficient.”

An effort to move away from large mental health institutions dates as far back as The Community Mental Health Act of 1963.

Signed into law by President John F. Kennedy Oct. 31, 1963, the Act was the first of several federal policy changes signaling a major transformation of the public mental health system by shifting resources away from large institutions toward community-based mental health treatment programs.

In The Four Sisters: A History of Iowa’s State Psychiatric Hospitals, Rosheim said he considers the Act to have been “misguided.”

“The planners of this did not understand what the big state hospitals were for,” he wrote. “They did not take into account that large numbers of the state hospital patients had no place to go when released, that large numbers of the patients were too impaired to understand their illness and the need for medication and that some patients were really too dangerous to release.”

About the books
In the self-penned Independence Bulletin-Journal article, Rosheim characterized his three-volume study as a narrative and documentary history in which he stands aside and lets the people do the talking.

“I let them have the mike most of the time and what a variety of people they are: state and national officials, hospital administrators, staff members, patients, family members, journalists, conscientious objectors, firemen, county sheriffs, reformers and more,” he said.

Structurally, he added, “two of [the books] are histories of the kind I thought was appropriate to the subject. The third book is a compilation of some of the magazines and newsletters of the employees and patients, various staff members in fact, and an article by a former superintendent. I used newspaper files, magazine, microfilms, interviews, the Internet and whatever else I could think of to locate the information I was seeking.”

With this project, Rosheim described the context within which large mental health institutions were built, noting the four state mental hospitals in Iowa, for example, represented a change in how both medical science and society dealt with mental illness: Before them, he said, the mentally ill were either put in jail or were left to wander the streets.

Rosheim’s work also addressed the four hospitals’ emergence and their approaches to treatment, in historic terms.

Mount Pleasant was the first state hospital to be built, in 1861. Following, in order, were Independence, 1873; Clarinda, 1881; and Cherokee, 1902.
Mount Pleasant, which like Clarinda, is now closed, was set on more than 1,000 acres. Able-bodied patients maintained large floral and vegetable gardens, as well as farms, Rosheim notes.

Other practices, part of treatment protocol of the time, were not so positive – and ranged from dousing “manic” patients in alternating hot and cold water in an effort to calm them; the use of heavy, addictive sedatives; lobotomies; and sterilization.

By the 1960s and ‘70s, Rosheim wrote, psychiatric care at the hospitals began to change. Drugs that controlled mood disorders started being used; and voluntary stays became more common than before, when commitments were almost exclusively involuntary.

According to Rosheim’s study, the mental health hospitals have been falsely characterized as being obsolete – and that, contrary to the suggestion closing them would save money, the burden, an expensive one, has only been shifted to county officials, jails and state prisons.

Sources and conclusions
Rosheim said he sometimes felt overwhelmed by the sheer amount of available material, when he was starting work on this project. Source for his research included official reports, journalistic coverage and even books patients had written about their experiences.

But, he added, he received invaluable assistance from staff members of the State Historical Society of Iowa (SHSI) libraries.

“Mike Cook at Independence and Diane Knaack at Cherokee were especially helpful,” he said.

He and his wife were given some guided tours of the state hospital buildings, which contributed to his perceptions, as well.

“Mt. Pleasant, the oldest one of them, is a ghost now since the old institution burned down; what was left was demolished over time,” he said. The replacement buildings were a mental health institution but now are used for a prison and have been for some time.

“Mt. Pleasant is a fine community and I wish to go back there sometime,” he added.

Rosheim described Independence, the second one to be built, as having “charming architecture with mansard roofs,” and a friendly staff.

“Its superintendent has been there since 1984, which is rather startling,” he said.

Clarinda is striking, Rosheim noted, because though located in a fairly small community “it is still a huge and imposing structure.” Now closed as a mental health institution, its buildings have been put to other uses.

Cherokee, still in use, was the last one built.

“It also is a huge place. Several programs are ongoing there,” Rosheim said. The staff there was also quite helpful in assisting me with my project. Like Independence, it has some vast grounds and is situated well away from the town.”

Rosheim also traveled to Iowa City and Des Moines to look at the microfilm records stored by the State Historical Society.

“It would be much harder to research this book now, since the Branstad administration has cut the days the historical libraries are open,” Rosheim said. “Had he done that earlier I would be working on this project a few more years.”

With the project completed and available to the public, Rosheim said he hopes his work “helps illuminate the history and functions of these state hospitals.”

In particular, he wants to help people understand that such institutions still have a place.

“I think it will give a historical perspective on the absolute necessity in the past and present of providing these safe havens for the mentally ill and how foolish and cruel it is to dismiss and discard them,” he said.

The three-volume set, “The Four Sisters: A History of Iowa’s State Psychiatric Hospitals” by David Rosheim, costs $150 plus shipping. Copies may be purchased through the author at