Pioneering a profession: A history of innovation at the MGH, 1905 - 2005 Pioneering a profession: A history of social work innovation at the MGH, 1905 - 2005

1905 1905 1906 DECISION: FIRST SOCIAL WORKER: PRACTICE: Initiate Social Services Garnet Pelton, a nurse, is hired Main Divisions of Work Richard Cabot, MD, decides by Dr. Cabot, using 1. “Tuberculosis” to bring social services to his own money, to 2. “Hygiene teaching” his clinic patients. Purpose: see patients in the “to make medical care Clinics. Due to her 3. “Infant feeding and the care of effective” by addressing illness (tuberculosis), delicate children” basic needs of poor patients. she leaves six months later. 4. “ Vacation, outings and convalescent homes 1905 OFFICE SPACE: 5. “The care of unmarried girls, pregnant, “The Corner” morally exposed or feeble minded”

“A few small 6. “ Help for patients needing work or a tables, chairs, change of work” a bench and two white screens 7. “P rovision and provisions for patients to give some dumped at the hospital” privacy were the 8. “ Assistance to patients needing furnishings.” treatment after discharge”

1906 EPIDEMIC: Tuberculosis Tuberculosis is “everywhere.” Volunteers are recruited to supervise educational classes and to refer patients to agencies, The West End, circa 1906

1821 1846 1869 1892 1898 1904 1904

MGH Ether, the first anesthetic The Ladies The Vincent Dr. Richard Cabot National Average The Boston admits used in surgery Visiting Club, strong named Physician Wage in the U.S. is School of its first Committee, supporter of to Outpatients 22 cents an hour Social Work patient strong Social Work opens, supporter of Simmons Social Work College 1907 1907 1907 DECISION: ADVOCACY: PRACTICE: Cabot Hires Cannon Patient Hunger Referring Patients Ida Cannon, RN, completes 8-month At request of social workers, The process is known as course at Boston School for Social hospital opens clinic lunch “steering, shoving and Work, during which time she volunteers counter to ease patients’ following-up.” with G. Pelton and Dr. Cabot in the hunger during long waits to Clinics. Cabot hires Cannon. Shortly, see physician. Milk, crackers she is named Head Worker with and cheese cost 5 cents . five staff and 30 volunteers. 1907 PRACTICE: “Methods of Psychiatric Work” • “Establish a friendly relation with patient” • “Encouragement” • “Suggestion and persuasion” • “Home visits and letters” 1910 PRACTICE: • “Re-education and explanation” 1907 Medical and Social Diagnosis and activities like the FIRST SOCIAL WORKER: Clay Modeling Class and Physicians increasingly use “Sex Problems of Girls” “country vacations” Medical Diagnosis as their Mrs. Jessie Hodder is hired to work practice incorporates more with unmarried pregnant girls. Her scientific thinking. Cannon premise: “We must meet them where proposes the use of Social they are.” In 1911, she leaves to Diagnosis to link social work become the Superintendent of the Massachusetts Reformatory for 1909 Women in Framingham. ORGANIZATION: Supervisory Committee 1908 Supervisory Committee formed OFFICE SPACE: to oversee and finance the “The New Corner” work of this new “non-medical” Sign above desk reads: department. Committee 1908 “DO NOT LOSE YOUR BLUE CARD” members are: Drs. Richard PRACTICE: Cabot, Daniel Jones, Robert Referrals to Social Service Osgood, James Putnam; Ladies Visiting Committee: Mrs. Nathaniel Thayer; Boston School for Social Work Director: Jeffrey Bracket; MGH Superintendent, Dr. Frederick Washburn.

1908 1909 1912 1912 1913 1916

Henry Ford MGH neurologist, Dr. James Dr. Cabot writes Children’s Ida Cannon World War I introduces the Putnam, brings Freud to Clark Social Service Bureau writes Social begins Model T Ford University, Worcester and the Art of established Work in Hospitals Healing 1910 1911 1911 ANNUAL REPORT: FIRST SOCIAL WORKER: FIRST SOCIAL WORKER: Patients seen = 1709 Children’s Clinic Handicapped General work: 50% Diseases of the children referred: Kings Chapel, in Boston, pays for social Tuberculosis: 35% “tuberculosis; rickets; gonorrhea; worker to provide services to the handicapped. Nervous Disorders: 9% feeding problems; chorea; She works at both the Clinics and at Kings Unmarried Girls: 6% heart disease; whooping cough.” Chapel.

1913 1912 FIRST SOCIAL WORKER: EDUCATION: Research Boston (Simmons) School of Social Work Social worker joins Dr. Edsal studying “lead poisoning Cannon and Cabot advise on curriculum and cases.” Resultant criteria used in new Occupational teach . Students do field Disease Clinic. education at MGH during their second year.

1914 1912 CHIEF OF SERVICE: PRACTICE: Ida Cannon appointed Chief of Social Service. Assumes What Works? responsibility for social worker on inpatient services. As social work Hospital pays for in-patient social worker; Supervisory is practiced, Committee pays for out-patient social workers. Ruth the staff and Emerson, first trained social worker, appointed Head leadership are Worker in the wards. simultaneously developing methods and theory.

1913 FIRST SOCIAL WORKER: Occupational Disease 1. Screens all outpatient charts daily watching for occupations such as painter, rubber worker, tinsmith, or stone cutter.

2. Educates these patients re: dangerous processes and what precautions to take.

1913 - 1918 3. Submits information to physicians. FIRST SOCIAL WORKERS: Specialty Clinics 4. Studies what needs to be reinforced by Social workers are assigned to Syphilis Clinic, legislation. Genito-Urinary Clinic, Diabetic Clinic, Orthopedic Clinic, 5. Follows-up on all 147 cases of Infantile Paralysis Clinic and Neurology Clinic. lead poisoning seen.

1917 1918 1920 1927 1929 1934

Mary Richmond Ida Cannon is 19th Amendment Group work The Great Federal writes Social instrumental in passed, women first used Depression Crippled Diagnosis organizing the get the right to vote as treat - Children’s conferring with American Association ment modal - Program Ida Cannon of Hospital Social ity organized Workers Ida Cannon’s 1915 Motto 10th ANNIVERSARY: Ida keeps this Major challenge: meeting the individual needs of so drawing on many patients. “Should we be focusing on mass work her desk. It (populations) or individual work?” Over 200 social workers exemplifies her from across the country gather to talk about progress, approach to mutual difficulties and look into the future. developing a Staff includes: new service in 13 social workers a conservative, 4 stenographers tradition-bound institution. 19 student social workers 8 student nurses 1917 64 volunteers DISASTER: Nova Scotia Budget: $11,626.07 Explosion of ammunition ships in Halifax Harbor causes 1,600 deaths and numerous injuries. Ruth Emerson and Edith Baker go to 1918 Halifax to: PRACTICE: Feeding Clinic for Infants 1. Aid victims with clothing and shelter 2. Arrange after care and follow-up “Purposes: to make sick babies well; to teach mothers appointments for injured how to keep them well; to reduce the death rate among 3. Establish special care for injured children babies; to teach mothers motherhood. 4. Conduct a census of those handicapped Methods: improved milk supply; supervision of well babies; 5. Provide intensive case-work for those with encouragement of breast feeding; milk fund for needy social problems families; instructions in proper feeding; home visits by Miss Emerson stays on helping to establish nurse; cooperation with public health authorities and medical social service permanently in Halifax. social agencies on matters affecting infant welfare.”

1918 1919 EDUCATION: ORGANIZATION: Summer Institute Officially Accepted Students come for By vote of the Trustees, practical work from Social Service becomes both Smith College, administratively and financially an Boston School integral department of MGH. of Social Work Supervisory Committee becomes and the Red Cross the Advisory Committee. Institute. Ida Cannon: “... for 14 years we were free to try experiments and make mistakes.” We are now “officially accepted.”

1935 1938 1938 1939 1940 1941 1942

Maternal and Child Minimum Wage March of World War II Penicillin MGH establishes its Cocoanut Health Services established, Dimes begins available to 1st Emergency Plan Grove established 25 cents per hour established non-military nightclub to fight patients fire polio 1929 1931 FIRST SOCIAL WORKER: EDUCATION: Tumor Clinic Director Named Social workers supported by a 2-year DPH grant. At surgeons ’ Salaried from the Cabot Fund, Harriett Bartlett (below center) joins as educator. She studies the functions of medical 1930 social work and the role of social 25th ANNIVERSARY: workers in the teaching of medical Two hundred fifty gather and Dr. Cabot speaks on “The Future students. of Hospital Social Work.” Donors give over $20,000 in honor of Dr. Cabot establishing an educational fund for social workers.

1930 FIRST SOCIAL WORKER: Baker Building Josephine Barbour assigned to “patients of moderate means.” Cannon insists patients need social services without regard for income or social status. Quickly physicians began requesting assistance for their private patients in the Phillips House.

9--bed room – $24 per week 4-bed room – $4 a day 2-bed room – $5 a day

Single room – $6 and $6.50 1936 a day PRACTICE: Operating room fee – $15 Home Care for Children with Delivery room fee – $15 Heart Disease Maximum professional fee – Social worker institutes “In-Bed $150 Club” and “In-Bed Magazine” for children with rheumatic fever. A “Mothers Club” and summer craft and 1939 educational programs are initiated. OFFICE SPACE: Enlarged Corner

1946 1949 1950 1954 1955 1955 1956

J. Barbour Boston Ida Cannon Brown v. Board of All social Peak of polio Salk polio vaccine made receives U.S. Housing receives honorary Education mandates work epidemic available to the public government’s Authority doctorate from school desegregation specialty Medal of administers Boston University groups join Freedom funds for to become urban NASW renewal 1942 1942 DISASTER: WAR: Cocoanut Grove Fire Granted a leave of absence, Social workers assist relatives J. Barbour, Cannon’s assistant, seeking to identify victims, joins the MGH Hospital Unit. serve as liaison to the Red Later she is promoted to Cross and counsel victims Field Director for Red Cross and families. Ida Cannon supervising all medical social and Dorothy Kellogg publish workers in Mediterranean. their work in the “Annals of Surgery” and “The Family” in 1943.

1942 1945 ORGANIZATION: NEW CHIEF: Staff Shortages Josephine Barbour, on staff since 1926, The pressing demand and upon return from her duties in North for medical social Africa, becomes the second Director. workers in Army and civilian hospitals makes it difficult to secure well-prepared workers to fill vacancies. Staff is in constant contact with the Red Cross providing family health reports for servicemen.

1945 1947 ANNUAL REPORT: FIRST SOCIAL WORKER: The six most frequent Staff Clinic for Employees problems presented by patients: 1947 1950 Chronic Disease: 1072 RESEARCH: FIRST SOCIAL WORKER: Convalescent Care: 587 Expands via Grants Cardiac Service Family Relationships: 544 Grants enable staff to collaborate with MD’s studying adults with hypertension 1950 Financial problems: 476 and children with heart disease, asthma, FIRST SOCIAL WORKER: Patients Attitudes: 468 arthritis, mental health problems and Emergency Ward Physical Handicap: 368 undergoing tonsillectomies. Ruth Abrams is hired to collaborate with physicians 1951 conducting research with cancer FIRST SOCIAL WORKER: patients. Alcohol Clinic

1960 1961 1964 1964 1964 1964 1965

Boston’s West Harriett U.S. escalates Civil Rights Act War on Food Stamp Medicare End begins Bartlett writes Vietnam War increases services Act and Medicaid redevelopment Social Work to the poor enacted Practice in the Health Field 1955 1949 EPIDEMIC: EDUCATION: Polio Foreign Visitors “The unforgettable, haunting picture of over 400 polio Visitors come from India, China, Greece, patients.” Social Service sets up a special polio office to Japan, Sweden, Argentina, South Africa, extend support to victims and their families. Virgin Islands and England to train in Social Services.

1955 1957 1964 50th ANNIVERSARY PRACTICE: NEW DIRECTOR Over six hundred and thirty attend. Social Work in Eleanor Clark, MSW, Supervisor in Special guests include Miss Cherry Adult Psychiatry, is promoted, Morris (England) and Mlle. Marie Social workers becoming the third Director. Terese Viellot (France). Staff includes: specialize: Adult (ward 35 professional social workers, and clinics), Child, 4 case aides and 12 secretaries. Community Mental Health, Alcoholism or the West End Research Project.

1963 PRACTICE: Twenty-four hour coverage in the Acute

1958 1967 PRACTICE: PRACTICE: Fees Patient Activity Center After careful study, fees are (PAC) instituted for patients seen A unique social and by social workers in Psychiatry. day health program is Average cost per interview: developed for clinic $4.72. Average hourly pay patients with chronic for social workers: $2.50. illnesses. Many serve as Fee is prorated based on MGH volunteers; some length of interview. become employed.

1965 1967 1972 1972 1973

Older Americans St. Christopher’s SSI consolidates Aid to Chelsea Roe v. Wade Act Hospice opens in Blind, Aid to Disabled HealthCare Center legalizes London, England and Old Age Assistance opens abortion 1968 1968 1968 FIRST SOCIAL WORKER: PRACTICE: FIRST SOCIAL WORKER: Renal Dialysis and Continuing Care Planning Unit Bunker Hill HealthCare Transplant For the first time nurses are hired in a Center Social Service Department. They are Social worker joins new 1968 responsible for tailoring patients’ individual Family Health Service. Major PRACTICE: discharge plans and for evaluating nursing focus of early work is care Transfer Office homes. of the chronically mentally A team of nurse, social ill. Social Service Unit expands worker and administrative staff and community-based assistant develop services programs. to assure that all patients receive appropriate care 1970 after discharge whether to ANNUAL REPORT home or to community “Poverty, isolation and facilities. Agreements are depression are predominant established between MGH problems in our caseload. Social Service and nursing Alcoholism, drug usage, homes. Consultations to requests for assistance with ambulance companies unwanted pregnancies and improve patient transport. problems of family breakdown Contracts are made with leading to neglect and abuse the Boston VNA for an of children are increasingly in-house liaison. Day care 1978 reasons for referral. It is is established at the Don PRACTICE: reported that traditional social Orione Nursing Home. MGH Family Care Program agencies fail to encounter or house staff with social The first hospital-based, state funded, assist many of this population. workers make visits to foster home service offers an alternative to Perhaps it is our medical institutional living for adults who need care setting which encourages the and supervision. Nurse/social worker teams most needful to our door.” 1973 match patients to families and provide FIRST SOCIAL WORKER: ongoing oversight to both patient and 1978 Chelsea Health Center family. PRACTICE: Social worker joins the Child Protection newly opened Chelsea The Mental Health and Health Center. Is soon Social Service Unit of the named Unit Chief of Chelsea Health Center Mental Health and Social receives state grant to Services, which rapidly provide comprehensive expands to serve the entire services to all at-risk Chelsea community – children in the city of including immigrants from Chelsea. First time that many countries. Many child protection services innovative outreach programs are under the auspices characterize practice. of a health center.

1973 1974 1977 1968 1979

Medicare extended Child Abuse Prevention Massachusetts Charlestown NASW adopts Code of Ethics to the disabled and Treatment Act requires licensure HealthCare funds programs of social workers Center opens

MGH INSTITUTE OF HEALTH PROFESSIONS 1980 1980 PRACTICE: 75th Anniversary Screening of all Admissions Staff social worker receives prestigious award from Social Service initiates the screening Harvard University’s Ella Lyman Cabot Trust. of all admissions using criteria based on diagnosis, age, demographic characteristics and living arrangements. Allows early identification of patients at risk for discharge planning problems.

1980 EDUCATION: Institute of Health Professions Opens Barbara Berkman, DSW directs new certificate program in social work. Begins as pre-MSW program and transitions to a post-MSW program. 1985 1987 NEW DIRECTOR FIRST SOCIAL WORKER: Evelyn Bonander, MSW, comes from Revere HealthCare Center 1987 Barnes Hospital and Washington RESEARCH: Social worker is hired. University Medical Center in St. Louis, New Position Early work includes special Missouri to be the fourth Director. services to immigrant Research and Quality Assurance Cambodians enabling Program initiated. Grants from them to fully utilize and American Cancer Society fund benefit from medical post-graduate Social Work Oncology services. Program grows Traineeships. and new staff is added.

1987 PRACTICE: 1993 Coordinated Care Program FIRST SOCIAL WORKER: AIDS and HIV Following a successful demonstration funded by a Robert Wood Johnson 1994 Grant, a nurse/social worker team PRACTICE: evaluates and coordinates the care Obstetrics of frail elders in their own homes. After 50 years, Obstetrics returns to the MGH. 1990 Simultaneously social FIRST SOCIAL WORKER: workers are hired to develop Fox Hill Village broad in- and outpatient Health team (social worker, nurse, services. Social worker physician) opens Wellness Center for previously added in the residents of MGH affiliated retirement Fertility Center (IVF). village in Westwood.

1981 1981 1984 1987 1990 1990

U.S. reports its Revere HealthCare Friends of MGH McKinney Homeless Americans with MGH Employee 1st AIDS case Center opens Cancer Center, Assistance Act addresses Disabilities Act Assistance strong supporter of needs of the homeless is passed Program is Social Work organized 1994 1996 1997 PRACTICE: PRACTICE: PRACTICE: Community Resource Center Cancer Resource Room (CRR) HAVEN Program The center provides clinicians with The CRR offers a unique Social worker with staff of computerized access to information blend of clinical support and advocates begins program of about community services and public educational resources for services to victims of domestic benefits. Updates staff on legislative cancer patients and their violence. Program expands in activities enabling timely and effective families. Hosts support, collaboration with the EAP to advocacy. Resource specialists assist educational and wellness employees and grows to include cancer patients with transportation and groups. deployed advocates at Chelsea accommodations. and Revere Health Centers.

1995 PRACTICE: Major Role Changes Social work joins in restructuring of patient care. Continuing Care nurses transfer to Case Management which assumes responsibility for discharge planning. Social workers focus on 1997 clinical work collaborating with all PRACTICE: on health care team. HOPES Program This unique, multidisciplinary program offers educational 1996 and support workshops for FIRST SOCIAL WORKER: cancer patients and their families. Also sponsors wellness Palliative Care Service programs like yoga, music, expressive arts, massage.

1995 1996 1997 FIRST SOCIAL WORKER: PRACTICE: ORGANIZATION: MGH Senior Health Cancer Center Collaborative Leadership Teams Social worker joins new Geriatric MGH Cancer Center The Social Service Department reorganizes Practice. With additional staff, develops reorganizes into as Patient Care Services is restructured. MGH SeniorHealthWise to service Disease Centers. Social Structure becomes: Leadership Team, the local community of seniors workers are requested Specialty Programs, nine Self-Managed providing health and wellness as specialists for Staff Teams and Steering Committee. programs, screenings, education and Breast, Brain Tumor; linkage to social and health services. Bone Marrow; GI, GU, Gyn, Head and Neck, Hematology, Melanoma, Proton Beam, Sarcoma, Thoracic, Pediatrics and Radiation. Social work staff and program expand.

1995 1995 1995 1996 2000 2001

Partners Case Community Benefits Program Welfare Reform North End September HealthCare Management partners with social work in enacted: creates Health Center 11, 2001 forms: MGH joins assumes community outreach Temporary joins MGH with Brigham & responsibility Assistance for Partners Women’s Hospital for discharge Needy Families, HealthCare planning ending categorical programs 1998 2000 2003 PRACTICE: PRACTICE: AFFORDABLE LODGING: PACT Program Visiting Moms Major Changes In response to the Chelsea In collaboration with Community Beacon House community’s concern about Benefits, experienced, opens in 1984, violence, the Police Action paraprofessional, bicultural beautifully Counseling Team is formed to mothers are trained to visit and furnished by address the needs of children support new mothers (primarily the Ladies witnessing violence. Chelsea immigrants and refugees) through Visiting Committee. MGH at the HealthCenter the Chelsea Health Center and Inn opens in 1996. In 2003, social workers supervised by social worker. Beacon House is refurbished and join Chelsea MGH at the Inn moves to Somerville. Police reaching 2005 out to children. NEW DIRECTOR: 2000 Ann Daniels MSW, PhD, is promoted PRACTICE: 2003 from Clinical Director, becoming Child Protection Consultation Team DISASTER: fifth Director. Team of social worker and physicians Rhode Island Fire provide 24-hour consultation to all Social workers organize a center clinicians caring for at-risk children. providing services to families seeking identity of, and information 2003 on, victims of night club explosion ORGANIZATION: and fire. Families and the victims Clinical Recognition Program admitted receive ongoing Patient Care Services creates a program to formally recognize clinical staff for their expertise. 2001 Social workers participate in PRACTICE: every aspect from design to Backpacks implementation. Staff apply for Therapeutic backpacks help recognition as Clinicians, parents talk with their children Advanced Clinicians or Clinical about cancer, trauma, sudden Scholars. illness or grief. Each pack has developmentally appropriate 2005 educational, comfort and DISASTER: expressive items. Tsunami in Indonesia Three social workers, along with other MGH clinicians, provide disaster relief aboard the USNS Mercy.

2003 2003 2004 2005 2005 2005

War in Iraq begins Rhode Tsunami Hurricanes Katrina MGH Men MGH Cancer Center dedicates Island hits Asia and Rita devastate Against Abuse: First healing garden in the hospital’s nightclub the Gulf States hospital-based men’s new Yawkey Building fire group committed to heightening awareness of violence against women