Dr. Bertram S. Brown, a psychiatrist who figured prominently in federal efforts to re-envision public programs to deal with mental health and intellectual disabilities in the 1960s and ’70s, died on May 14 in Bala Cynwyd, Pa. He was 89.
The cause was cardiovascular disease, his daughter Wendy Brown-Blau said.
A Brooklyn native who was trained as a classical pianist even as he envisioned a career in medicine, he joined the National Institute of Mental Health in 1960 and directed the agency from 1970 to 1977.
In a government career that spanned five presidential administrations, Dr. Brown helped expand drug abuse treatment programs and worked with the Federal Bureau of Prisons to provide psychiatric services to inmates.
Dr. Brown was a foe of radical psychosurgery on patients who were confined involuntarily. In the mid-1960s, as head of the Institute’s Community Mental Health Facilities Branch, he was hailed by mental health reformers for administering federal support for deinstitutionalization, the discharging of patients from mind-numbing custodial care in warehouselike state-run hospitals to treatment in more humane group homes in their own communities.
By 1984, though, he saw, as he acknowledged in an interview with The New York Times, that “the doctors were over-promising for the politicians,” and that once federal funds for community centers had been exhausted, many state and local governments had failed to assume the costs of caring for former mental patients, leaving large numbers of them homeless and without medication.
“We knew that there were not enough resources in the community to do the whole job, so that some people would be in the streets facing society head on and questions would be raised about the necessity to send them back to the state hospitals,” Dr. Brown said. “It happened much faster than we foresaw.”
Dr. Brown was also an early proponent of decriminalizing marijuana possession, a recommendation his agency made in 1972.
Bertram S. Brown was born on Jan. 28, 1931, in Brooklyn to David Brown, a furrier, and Jean (Gupkin) Brown, a homemaker. He later made up the middle name Steven because he got tired of telling people that the letter “S” on his birth certificate didn’t stand for anything.
He studied classical piano at the Juilliard School, but always aspired to a career in public health.
He attended Brooklyn Technical High School, earned a bachelor’s degree in psychology from Brooklyn College in 1952 and, after graduating from Cornell University Medical College (now Weill Cornell Medicine) in 1956, went to the Harvard School of Public Health, where he received a master’s degree in 1960. He then joined the U.S. Public Health Service, where he later attained the rank of rear admiral.
In 1952, he married Joy Gilman. She died in 2018. In addition to their daughter Wendy, he is survived by two other daughters, Dale Susan Brown and Dr. Laurie Browngoehl; a sister, Harriet Saperstein; five grandchildren; and two great-granddaughters. Another daughter, Tracie Sophia Brown, died in 2017.
Dr. Brown said he learned later that a study he conducted as a medical student in the mid-1950s about intellectual disabilities had helped persuade the Kennedy family’s Joseph P. Kennedy Jr. Foundation to shift its focus from supporting custodial care to also subsidizing research into the causes and mitigation of what was then called mental retardation.
The family’s interest in the issue had been prompted by the condition of Rosemary Kennedy, President John F. Kennedy’s younger sister, who had intellectual disabilities.
“You can imagine what a thrill it was to find out that a medical student paper had this kind of — even if it were minor — impact, deciding impact,” Dr. Brown recalled in an oral history interview.
He continued his research into intellectual disability among offenders as well as the general population, and he was enlisted by President Kennedy, who in 1961 named a panel of experts to address the problem.
In 1963, a month before he was assassinated, Kennedy signed an amendment to the Social Security Act, the first major legislation to address mental illness and intellectual disabilities.
Dr. Brown worked as a special assistant to the president for issues regarding intellectual disability and later as special assistant for drug abuse prevention, serving the secretary of Health, Education and Welfare. In 1972, while deploring the spreading use of marijuana among the very young and other vulnerable groups, he asserted that penalties for its use and possession were “much too severe and much out of keeping with knowledge about its harmfulness.”
In December 1977, Dr. Brown, who had lobbied against Republican attempts to downgrade his agency, was dismissed by the new secretary of Health, Education and Welfare, Joseph A. Califano Jr. Mr. Califano praised Dr. Brown’s performance but said it was time for “fresh blood.”
Dr. Brown later served as senior psychiatrist at the RAND Corporation, chairman of Horizon Health Group and, from 1983 through 1987, president of Hahnemann University Hospital in Philadelphia.
The White House, unlike any other executive suite, is a “character crucible,” Dr. Brown was quoted as saying in “In the President’s Secret Service: Behind the Scenes With Agents in the Line of Fire and the Presidents They Protect” (2009), by the journalist Ronald Kessler.
“Even if an individual is balanced,” Dr. Brown said, “once someone becomes president, how does one solve the conundrum of staying real and somewhat humble when one is surrounded by the most powerful office in the land, and from becoming overwhelmed by an at times pathological environment that treats you every day as an emperor?”
“Here,” he added, “is where the true strength of the character of the person, not his past accomplishments, will determine whether his presidency ends in accomplishment or failure.”
During his 17 years in Washington, Dr. Brown emerged as the capital’s most prominent mental health expert in matters of public policy. As the nation’s top mental health official, he was also called upon to offer informal counseling to cabinet members, military leaders, the Secret Service and others in the highest levels of government.
“I was the chief psychiatrist around and did ‘curbstone consultation,’” he once said.
In the process, he discovered a panacea. “Exercising power,” he told The Times, “is the most effective short-range antidepressant in the world.”
