Sickness at HEW

One of the unhealthiest places in Washington these days is the Health section of the sprawling Department of Health, Education and Welfare. And perhaps the most emotionally disturbed place within Health is the National Institute of Mental Health. Last week, just before the departure of HEW Secretary Robert Finch (see THE NATION), the institute underwent the bureaucratic equivalent of a psychotic breakdown. Its director, Dr. Stanley Yolles, 51, was summarily fired, and announced that he was seeking early retirement from Government service.

The trouble in HEW began at the top. Secretary Finch had tried to steer between the necessities of the Administration's hard-line budget trimming and the demands of his progressive subordinates, many of them Democrats. In the process, he satisfied no one--least of all himself. "He keeps everything inside himself," says a high-placed HEW physician. "That's why he's sick--it's destroying him."

Below the Secretary as the nation's chief health officer is burly, outspoken Dr. Roger Egeberg, who was installed as second choice after an unseemly brawl in which the American Medical Association persuaded the President to veto Finch's favorite for the job, Boston's Dr. John H. Knowles (TIME, July 4). After eleven months on the job, Egeberg succeeded only last week in filling three of the five top spots (carrying the rank of deputy assistant secretary) with nominees who are politically acceptable to the Administration. Among the special agencies under Egeberg's authority, the Food and Drug Administration has been racked by top-level firings and the installation of untried new men. Last month, largely on White House orders, Dr. Joseph T. English was sacked (while Egeberg was out of the country) from his post as administrator of health services and mental health. He will become head of New York City's new Health and Hospitals Corporation and at the same time double his salary.

Drug Penalties. As in many of HEW's other plague spots, the emotional disturbance at Mental Health involved both personality conflicts and political interference in scientific and medical matters. As director of the institute since 1964, Yolles was accused of arbitrarily imposing his views, rather than winning acceptance for them. The byword at NIMH became: "What Yolles wants, Yolles gets." He might have got more--and still be in office today--if he had been willing occasionally to settle for less.

What first brought Yolles to public attention was his forthright opposition in 1968 to congressional bills that would have increased the already stiff penalties for possession or occasional use of marijuana. His intervention in what he regarded as strictly a medical question was surprisingly effective, and Congress eased the penalties. But his victory won him few friends and set the law-and-order forces against him.

Yolles himself dates the beginning of his downfall from that courageous testimony, which he reiterated with equal force last September. Many insiders at NIMH disagree. They contend that his troubles stem from his insensitive techniques in dealing with both equals and political superiors at HEW. For whatever reason, Finch's office concluded early this year that Yolles must go. The word spread quickly through HEW.

No Ripples. Last week Egeberg asked Yolles if he had heard the rumors. Then he added: "Well, they're true." Yolles spoke of submitting a "little letter of resignation that won't cause any ripples." Next day Egeberg sputtered as he read a vituperative letter of resignation from Yolles, who also had given it to the press. Yolles delivered an indictment accusing the Administration, among other things, of abandonment of the mentally ill, substitution of rhetoric for monetary support in federal drug-abuse and alcohol-control programs, allowing the Justice Department to meddle in medical determinations, and "introduction of partisan, political considerations in the appointment of individuals to scientific positions."

From Arizona, where he was making a commencement address shortly before he left HEW, Finch hit back, saying that the charges "grossly distort the position of this Administration in the mental-health area." Furthermore, he declared, "Dr. Yolles has consistently shown a complete unwillingness to cooperate in this department's planning for more effective mental-health programs. Rarely, if ever, did he deign to participate or communicate with others in the department in efforts to bring better help to the mentally ill."

At week's end it was evident that help was needed not only for the mentally ill but also for HEW and one of its most ailing members, the National Institute of Mental Health.

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