Mary Starke Harper (September 6, 1919 – July 27, 2006) was an African American nurse who worked in bedside nursing, nurse research and health policy. ^[1] She spent several years working for the Department of Veterans Affairs. ^[2] She performed clinical research on the geriatric psychiatric population and minority health. ^[3] In 1972, Harper created the NIMH Minority Fellowship Program. ^[3] She served on four presidential administration advisory panels with regards to mental health and health care reform. ^[3] She died in 2006 as the recipient of several honors and author of over 180 publications. ^{[4] [5]}

Mary Starke Harper was born in Fort Mitchell, Alabama on September 6, 1919 and later moved to Phenix City. ^[1] She was the oldest of seven other siblings in her family. ^[1] As a child, she enjoyed reading, studying ^[1] and raising mice to sell to nearby laboratories and hospitals. ^[2] Though her parents wanted her to settle down as a housewife, she decided to attend pursue a business administration degree at Tuskegee Institute. ^[2] Her father died when she was in college and after his passing she switched her major to nursing. ^[3] She later became George Washington Carver's private nurse before he died in 1943. ^[3]

Mary Starke Harper attended Tuskegee Institute and earned a diploma in nursing in 1941. ^[1] She later applied to several bachelor's programs in the late 1940s. The University of Alabama rejected Harper's application on the basis of her race ^[6] and she decided to attend the University of Minnesota instead, a school which at the time had never had a black woman graduate from their program. ^{[6] [5]} In 1950, she graduated from the University of Minnesota with a bachelor's degree in education. ^{[1] [5]} In 1952, she earned her master's degree with honors in nursing education and educational psychology. ^{[1] [5] [7]} In 1963, Harper graduated from St. Louis University with a doctorate in medical sociology and clinical psychology. ^{[1] [7]}

When Harper 19-years-old and enrolled at Tuskegee Institute earning her diploma in nursing, she volunteered at the " Tuskegee Study of Untreated Syphilis in the Negro Male." ^{[1] [8]} As a young nurse, she did not know the extent of the study or that several of her patients were denied treatment. ^{[3] [5]} In 2003, approximately 60 years later, Harper recounted, "I was very angry that they had me, a black person, doing something bad to black men." ^{[3] [1]} She claimed her involvement in the study sparked her interest in the treatment of minority populations. ^{[1] [2]} This experience prompted her to become an advocate for minority health care for both geriatric and psychiatric populations. ^[2] Later, she assumed a teaching role and trained minority patients about informed consent and the importance of asking questions about research before agreeing to participate. ^[1]

After earning her nursing license, Harper began working as a registered nurse at the Tuskegee Veterans Administration Hospital. ^[2] She spent over thirty years working with the Department of Veterans Affairs over her career. ^{[9] [1]} She moved every few years to a new hospital under the Veterans Affairs headquarters. ^[6] In total, Harper moved nine times. ^[6] In 1952, Harper became the nursing director at the VA in Tuskegee. ^[1] Through these years as a bedside nurse, she cared for patients with chronic, debilitating mental illnesses. ^[2] She developed hospital wide initiatives to engage family members in patient care and normalize patient admission stays by allowing street clothing, diet adjustments and altered medication regimens. ^[2] Harper later worked at VA hospitals in Michigan, New York, Ohio, and Missouri conducting clinical research and educating staff about treatment program improvements. ^{[1] [2]}

In 1943, Mary Starke Harper married Willie F. Harper at the age of 24. They had one daughter, Billye Louise Harper, in 1944. ^[3] As Harper moved to different cities as a result of her research, she prioritized her family. ^[6] She had two requirements for the moves: that her husband be offered a job comparable to the one he would be leaving and that the time frame coincided with the end of her daughter's school year. ^[6] Her husband, Willie, died in 1963 and her daughter, Billye, also died in 1969 at the age of 25. ^{[3] [10]} Later, Harper's sister died and from 1972 to 1998, Harper moved to Washington, DC to raise her sister's three sons and care for her elderly mother. ^{[3] [8] [10]}

Harper began her clinical research career learning about the elderly population. ^[3] She was a member of several professional organizations including the American Psychological Association and the Society of Clinical Geropsychology. ^[10] In 1982, she attended the World Assembly on Aging in Vienna and presented her research on long-term care for the elderly. ^{[7] [5]} She found that often, elderly patients had mental illnesses that went undiagnosed. ^[3] These patients were at risk for being improperly treated in institutional homes. ^[3] Harper noted that overmedication and drug interactions posed significant problems for this population. ^[3] In 2003, she shifted the focus of her research to caregiver burden. ^[3] Even though family members provided 90% of long-term care for elderly patients, Harper realized there was no organized system in place to support those families. ^[3]

As an African American nurse, Harper was a pioneer researcher investigating health disparities within racial and ethnic minorities and exposing the failures of the health system. ^[2] Tuskegee University developed an endowed chair in geropsychiatric nursing in Harper's name. ^[11] Additionally, in 2001, hospital administration in Tuscaloosa, Alabama named the Mary Starke Harper Geriatric Psychiatric Center in her honor. ^{[11] [10]} This hospital contained 126 beds to care for the mentally ill elderly population. ^[10]

After working as a clinical nurse, Harper joined the National Institute of Mental Health (NIMH) in 1972. ^[3] Over the following years, she earned a senior position. ^[7] With the NIMH, Harper established research and development centers throughout the country dedicated to mental health research and improvement. ^[11] She organized the NIH Minority Fellowship Program in 1972. ^[3] Harper claimed her primary reason for implementing the fellowship program was her involvement in the Tuskegee project. ^[3] Since its development in the 1970s, the program has educated over 12,000 doctors, scientists, nurses, psychologists, social workers and other health professionals. ^{[3] [11] [1] [10]}

Harper worked 28 years for the US Department of Health and Human Services. ^[9] With her knowledge of mental health and aging, she served as a consultant in all 50 states of the US, most US territories, and 21 countries. ^[7] She served on White House advisory panels during four presidential administrations: Clinton, Reagan, Bush and Carter. ^[3] In these roles, she consulted with the National Institute of Health (NIH), the National Mental Health Association, Johnson & Johnson drug manufacturers, and the Rosalynn Carter Institute for Caregiving, among others. ^[3] From 1979 to 1981, during President Carter's administration, Harper was the director of the Office of Policy Development and Research for White House Conference on Aging. ^{[2] [6]} At this time, she was the first woman to hold this title. ^[6] She continued to serve as director through Reagan and Bush's presidencies. ^[6] When President Clinton came into office, Harper was instrumental in the development of the Clinton Mental Health and Public Sector Task Force for Health Care Reform. ^{[6] [10]} In 1995, she served as a consultant for the White House Conference on Aging. ^[10]

Mary Starke Harper's research focused on geriatric and psychiatric nursing. ^[5] She studied depression, delirium, Alzheimer's, suicide, and overmedication in the elderly. ^[5] Harper noticed that elderly patients were often over-prescribed medications and this impacted their health both clinically and socially. ^[5] She also studied the elderly population living alone and how chronic diseases impact lifestyles. ^[5] Within the psychiatric research scope, Harper focused on mental health, substance abuse, schizophrenia, and healthcare in prisons. ^[5] Additionally she studied recidivism within these populations. ^[7] Harper recognized that patients returning to the hospital for multiple admissions were a failure on behalf of the health system and treatment plan. ^[7] A hallmark of her research was incorporating family members into the treatment plan. ^[6] She also studied minorities in healthcare and ethical issues surrounding disparities in minority populations. ^[5]

Harper wrote more than 180 journal articles and five books with regards to her research. ^{[3] [11] [5]} The bulk of her publications occurred between 1972 and 1988. ^[5] Her papers are stored at the University of Pennsylvania ^[12]

Mary Starke Harper earned numerous awards in her time as nurse and researcher. ^{[13] [11] [4]} The Tuskegee Institute recognized Harper as Best All Around Nurse, Scholastically and Clinically. ^[13] In 1963, she earned the Federal Nursing Service Award from the Association of Military Surgeons of the US. ^[13] The Veterans Affairs awarded Harper the Surgeon General's Medal of Honor twice for her patient advocacy. ^[11] In 1966, Harper was inducted into Chi Eta Phi Sorority and recognized for her outstanding achievements. ^[13] In 1970, the Tuskegee Institute selected Harper to receive the Alumni Merit Award. ^[13] In 2001, Harper won the Living Legacy Award in Aging from the American Academy of Nursing. ^{[4] [1]} At the ANA convention, she received the Mary Mahoney Award which commended a nurse who advanced equal opportunities for minority groups. ^[13]

Mary Starke Harper lived in Washington, D.C. until 1998 before moving back to Columbus, Georgia. ^[3] She died of cancer on July 27, 2006. ^[4] She was 86 years old. ^[4] Her papers can be found at the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania. ^[5]

• Mary Starke Harper papers from University of Pennsylvania: Barbara Bates Center for the Study of The History of Nursing