Prior to the Alaska Mental Health Enabling Act of 1956, a person accused of being mentally ill was to be brought before a jury of six people, who would rule him sane or insane. The patient was often sent to prison until his transfer to Portland. Medical or psychiatric exams were not required. This commitment process was established in 1905 by the 58th US Congress.
The full text for the part of the act relating to, “the care and support of insane persons in the district of Alaska…”, can be found here.