Collection JHH, Series

The Alan Mason Chesney Medical Archives

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1910-2007 - inclusive

The Social Service Department (SSD) at Johns Hopkins Hospital (JHH) opened in 1907. (It was renamed the Department of Social Work (DSW) in 1961.) Trustee John M. Glenn and Dr. Charles P. Emerson, who had relationships with aid organizations across the city of Baltimore, played an important role in bringing the first social worker to JHH. The JHH was the first hospital in which a social service department was established by the administration itself, as an integral part of hospital service. Helen B. Pendleton, who previously worked as District Supervisor of the Charity Organization Society in Baltimore, acted as the first chief of Social Service from 1907 to 1908. From 1908 to 1909, Helen Skipworth Wilmer (Athey), a 1905 graduate of The Johns Hopkins Nurses’ Training School, served as department chief. Wilmer was succeeded by Margaret S. Brogden, who served in that capacity from 1908 to 1931. Brogden graduated from the Johns Hopkins Nurses’ Training School in 1899 and previously worked as a public health nurse with the Babies Milk Fund Association and Instructive Visiting Nurses Association (IVNA) of Baltimore. During her more than two decades as chief of the SSD, Brogden saw the department grow from one staff member to over thirty paid social workers and as many volunteers.

Historically, the SSD worked with clinics, departments, and facilities across the Hospital, including Department L (syphilis), Dermatology, Epilepsy clinic, Eye/Ophthalmological Clinic, General department, Gynecological/Obstetrical clinic, Harriet Lane Home (HLH) for Invalid Children, Laryngology, Library department, JHH Colored Orphan Asylum (COA), Medical Clinics/services, medical wards, Neurological Clinic, Orthopedic clinic, Pediatrics, Phipps Psychiatric Clinic, Phipps Tuberculosis Dispensary, Radium clinic, Rehabilitation, Surgical Clinic/Department, and Urology. Many of the early employees in the SSD were trained nurses. As the field of social work was further professionalized and more educational opportunities became available, staff often had undergraduate or graduate degrees from Schools of Social Work and were licensed by the state of Maryland. The University of Maryland, Baltimore School of Social Work opened in 1961.

Following Margaret Brogden’s retirement in 1931, the SSD went without a director or chief for several years. In 1938, the Women’s Auxiliary Board requested that Dr. G. Canby Robinson conduct a survey and evaluation of the SSD. Based on his findings that the department lacked an adequate staff and budget to meet professional standards, leadership hired a new chief in 1939. Amy Greene led the SSD from 1939 to 1947 and Helen Woods served as director from 1947 to 1960. When Woods resigned in 1960, JHH president Russell Nelson appointed a Committee on Social Work to explore the Hospital’s needs and desires for social services and to search for a new director. Addie Thomas was hired as chief of the renamed Department of Social Work in 1961 and served in that capacity until 1973. The Committee on Social Work continued to function in collaboration with the DSW director, with Victor McKusick serving as committee chair for more than a decade. Addie Thomas and subsequent directors were appointed as Assistant Professors of Social Work in the Johns Hopkins University (JHU) School of Medicine (SOM) to acknowledge their role in overseeing educational activities throughout the Department. Subsequent directors included Patricia Volland (1974-1982), Barbara Spence (1982-1985), Frances P. Lawrence (1985-1988), and Gerald Reardon (1988-1996).

The DSW was completely decentralized in 1996. By that point, the DSW was responsible for five units in the Hospital: Oncology; Psychiatry; HIV/AIDS; Medicine/Surgery; and Pediatrics/Ob-gyn. In 1996, the position of director of the overall DSW ended and a new system was put in place, with a director for each of the five units mentioned above; social work unit directors then reported to the medical director of each unit. Unit directors sat on the Social Work Council, which was “charged with the responsibility to uphold the social work and Hospital missions by establishing and maintaining standards and ensuring that professional activities such as quality improvement, risk management, recruitment, training and regulatory compliance are viable in the profession across the institution.” The chair of the Social Work Council was charged with reporting social work issues directly to the JHH executive leadership.

When the SSD opened in 1907, it was partly to address the needs of Baltimore’s poor, increasingly immigrant population who often had additional concerns beyond the physical care they received from physicians and nurses. Writing about the new department in 1908, JHH Director Henry Hurd noted that “when the care of the hospital is withdrawn and the patients return to their homes, they frequently lose the benefit which they receive, because of bad social conditions, lack of proper food and improper hygienic surroundings.” Medical social workers acted as a liaison between the patient/family, Hospital staff, and available services and support. Social workers saw patients at the Hospital’s outpatient clinics and dispensaries, but also made home visits. They received referrals from in and outside the Hospital for patients in a variety of circumstances – some patients had employment or financial concerns; some needed help understanding their condition and implementing the recommended treatment; some needed additional support and resources in order to leave their homes to enter the hospital or a sanitorium; some needed help getting equipment, such as orthopedic braces. In 2007, the DSW noted that some of the major needs they addressed were “Adolescent pregnancy, care of the terminally ill, child and adult abuse, rehabilitation of cancer patients, low income families, and the elderly.” Many of these needs were similar to those faced by social workers and their patients in the first half of the twentieth century.

Source:

Johns Hopkins Hospital. Department of Social Service

The records of Social Work/Social Service are organized into eight sub-series: Administration (1910-1993); Surveys and evaluations of the department (1939-1961); Margaret S. Brogden Memorial Fund and Symposium (1945-1974); Publications and presentations (1914-1982); History of the department (1938-1989); Patient statistics (1941-1943; 1994-1995); Case records (1985-1995); and Audiovisual material (1971-2007).

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While the records are dated from 1910 to 2007, the bulk of material preserved here is for the first several decades of the department’s history, from the 1910s to the 1950s. Material for later years is more scattered and consists primarily of case records. The collection provides insight into the organization and administration of the department; the kinds of services they provided to patients in different clinics and departments; and the history of the social work field in Baltimore and across the nation. It is also an important collection for understanding some of the work of individual clinics and departments within Johns Hopkins Hospital (JHH) during the first several decades of its operation, a period that was marked by significant growth and change and that unfolded in the context of racial segregation at the Hospital and throughout the city and state.

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Johns Hopkins Hospital was one of the first hospitals in the nation to establish a social service department. As such, the JHH Social Service Department (SSD) is important for understanding the development of the field of medical social work as a whole. In addition to other records, the collection includes several histories that were written about the JHH SSD, as well as additional articles and resources about social work in Baltimore and the nation. Researchers interested in this history should not only look at the History of the department sub-series, but also at the Instruction-related material within the Administration sub-series. The Publications and presentations sub-series also includes significant material written and/or presented by individual SSD staff members, providing some insight into their contributions to the profession and to larger conversations.

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The collection is a good resource for identifying and better understanding the duties of administrators, staff, and volunteers in the SSD over time. From its beginning, the SSD was a department led and dominated by women. Researchers will find relevant information in the Administration sub-series (including Reports and Policies and procedures). The names of individual staff and volunteers are most strongly represented in the Reports and many names are included in the folder-level descriptions. The Surveys and evaluations of the department sub-series also provides insight into chronic departmental problems with staffing and low salaries and includes multi-page surveys completed by staff in the late 1930s regarding their duties, patient needs, and obstacles in the work.

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The records of the Social Work/Social Service Department are particularly valuable because social workers had a different relationship with patients than most other departments and clinics, allowing us to see those women, men, and children in a fuller social and familial context. From its beginnings, Johns Hopkins Hospital treated a diverse body of patients that represented the breadth of diversity in Baltimore and Maryland, including a large population of immigrants and African Americans. Reading about patients’ interactions with the department gives us some insight into the health and social challenges which those men, women, and children faced in the first half of the twentieth century. The records speak to practices of racial segregation that existed at Johns Hopkins, as well as at other Baltimore and Maryland institutions. They further shed light on the impact of segregated health care which was separate but not necessarily equal; social workers often commented on the lack of hospital beds, sanitoriums, and other facilities and accommodations for people of color. To some degree, the records also tell us something about white staff’s beliefs about race, class, and gender, providing some insight into the social and cultural context in which patient interactions took place during that time period.

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Information related to race and racism is most present in the department’s annual reports, which represent a significant portion of the collection. The Director of the SSD and social workers in individual departments often discussed examples of individual patients or groups of patients without disclosing personally identifiable information. Those examples included specific references to African American patients and families, as well as to the limited resources available to Black patients in need. Such references have been specifically noted in folder-level descriptions because they may be of particular interest to researchers. It is important to note that references to presumably white patients have not been specifically identified in the finding aid. A majority of patients discussed in the annual reports are not identified by race, which suggests not only that whiteness was the unspoken norm, but also that social workers included European immigrants in the category of “white.” Whereas one’s status as an immigrant was a marker of difference in some contexts, SSD staff apparently did not consider it noteworthy in these reports.

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While social workers in most clinics were working with both white and Black patients, it is important to note that the SSD was also responsible for the wards of the JHH Colored Orphan Asylum from 1913 to 1924. The Orphan Asylum was a segregated facility established in 1875 to provide care, education, and vocational training for African American children in Baltimore who had lost one or both of their parents. A social worker was assigned exclusively to the Orphan Asylum beginning in 1913 and submitted an annual report on the Asylum and its wards each year. When extant, these reports are included with the annual reports for the department. They provide important insight into that institution; the status, placement, education, and social lives of its wards; and the racist lens through which those young women were sometimes viewed by the white social workers assigned to them.

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The records of Social Work/Social Service also provide some context for understanding the larger field of social work and charity work in Baltimore and Maryland during the first half of the twentieth century. Individuals and families who required assistance often had to work and negotiate with multiple organizations in order to get their needs met. The SSD at JHH was part of the Social Service Exchange in Baltimore, a network of different organizations who assisted individuals and helped connect them with needed services across the city through a system of referrals. Annual reports for the SSD sometimes discuss work with particular institutions and organizations in more detail, but the reports also identify the source of all outside referrals for each year. A compiled list of those agencies, included here, sheds light on the kinds of entities that Baltimoreans in need had to negotiate with as they sought assistance. Some of these organizations were aimed at serving particular groups, such as members of African American or Jewish communities; so-called “Fallen Women” and unwed mothers; or those with particular health concerns, like tuberculosis. In other cases, referrals came from agencies of the state, such as the police department or health department. The Social Work/Social Service collection often includes additional information about the following entities which are identified as the sources of referrals: American Can Company; Ann Street Settlement; Babies Milk Fund Association; Bay View Hospital; Christ Church Dispensary; Church Home and Infirmary; City Medical Agency; Consolidated Gas Company; Ellicott Machine Company; Eudowood Sanitarium; Evening News; Exeter Street Home for Fallen Women; Eye & Ear Hospital; Federated Charities; Florence Crittenton Home; Fresh Air Society; Health Department; Hebrew Benevolent Society; Hebrew Hospital; Henry Sonneborn & Co. (SS); Henry Watson Children’s Aid Society; Hospital School for Children; Instructive Visiting Nurses’ Association (IVNA); Jewish Home for Consumptives; Juvenile Court; Legal Aid Bureau; Police Department; Prisoners’ Aid Society; Public Athletic League; Public schools; Reid Memorial Guild House; SPV; SS – Crown Cork & Seal Co.; SS – Massachusetts General; St. Agnes Hospital; St. Joseph’s Hospital; St. Vincent de Paul Society; State Board of Charities and Corrections; Supervisors of City Charities; TB Nurses; Thomas Wilson Sanatorium; Travelers Aid Society; United Women of Maryland; Volunteer Committee; Wilkesbarre Hospital; Workshop for the Blind; and Young Ladies’ Hebrew Benevolent Society.

Access to the records of Social Work/Social Service are governed by the HIPAA Privacy Rule. Refer to the Medical Archives policies for accessing archival holdings with restrictions.

2022-2023

The Johns Hopkins Hospital Social Work/Social Service Department records were organized and catalogued by Heather Cooper in 2022-2023, with assistance from student assistant Chizaram Ogbunamiri. This collection was processed as part of the Reexamining Hopkins History Initiative.