It was probably 1965 when I did my co-op job at Fairfield Hills State Hospital in Newtown, Conn. This was a huge state hospital campus housing thousands of inpatients from all over the state in need of (mostly) long-term custodial psychiatric care. Although this was decades ago, many of my memories of this time are fresh and crisp. It was one of a few experiences that shaped my interest in becoming a mental health professional.
The setting, a large institution in rural Newtown, Conn., was woefully isolated for two young women in their early 20s, dispatched by Antioch college to fulfill their co-op job requirement. We hung out with some other co-op students from Boston and two male psychologists doing their internship at the hospital. Gimlets at weeks end with the psychologists were all that was available for "partying."
There was basically no town in Newtown, as I remember it. We had to catch a ride into New York City if we expected much fun.
My memories of the facility where we worked -- me as an occupational therapy assistant, my friend J. as an art therapist -- are quite positive. The woman under whom I worked was a consummate professional. She was highly skilled at creating a program for people who were severely mentally ill, and compassionate in her attunement to each individual. I learned a lot from her. When I wasn't working directly with patients, she sent me down to read case records.
On one of those occasions I accidentally discovered that one of the inpatients with whom we worked had come to the hospital voluntarily, for a short period, had somehow gotten lost in the system and was now a long-term resident. Tommy was not psychotic, he had come to the hospital for the treatment of depression. Over time, he had come to look like he belonged there and did not have anyone to advocate for him. He was heavily medicated, and a physical impairment made him look much sicker than he was.
When I shared this with Madelyn, my boss, she got busy, had him reevaluated and, in short order, "sprung" from the hospital. Tommy was the poster boy, you might say, for "institutionalization." The system had swallowed him whole. It was only a lucky accident that freed him.
Madelyn was not alone among the staff of competent and compassionate employees. This was a good facility. Some people got stuck, but most were there because they needed the shelter and the supervision. Many had nowhere to go. Larry was an example. He was in the end stages of Huntington's disease, a neurodegenerative genetic disorder (the disease that Woody Guthrie succumbed to) with no cure. The end stage is sometimes characterized by psychosis.
Larry was a very sweet, bright guy. He had been a working jazz musician in his prime. Now he had a hard time walking, controlling the jerky movements characteristic of Huntington's disease. And he had psychotic episodes. He needed the care that the hospital offered and had few or no other options. Madelyn was very fond of him and took good care of him.
Patients like Tommy inspired the civil rights activists who felt that the mentally ill were unjustly stripped of their legal rights and were often incarcerated against their will. They became "institutionalized" and were unable to care for themselves out of the hospital only because they had been socialized to the hospital setting. In Tommy's case, all of this was true.
But they forgot about Larry, and so many other patients who derived protection from the system, not exploitation and abuse. Sadly, Larry needed the care and protection that the hospital provided.
How strange it is for me to meld my memories of Newtown with current events, in which how to care for the mentally ill is heartbreaking front-page news. My memory is also vivid for the sweeping policy changes and paradigm shifting of the late '60s and '70s that emptied the state hospitals, filled the streets with the homeless mentally ill, and made it next to impossible to care for the seriously mentally ill in any viable custodial arrangements.
In the name of freedom, we forsook the mentally ill decades and decades ago. Instead of re-thinking the system, we jettisoned it, de-funded it, and provided nothing to take its place.
I join my voice to all the others calling for a humane reconsideration of our responsibilities to the seriously mentally ill.
For more by May Benatar, Ph.D., LCSW, click here.
For more on mental health, click here.