Another Look at Mental Institutions

 

In 2014 there was a lawsuit settlement in New York City that has led to the removal of hundreds of patients from mental institutions into scattered site supported housing. A recent New York Times investigation found this approach largely wanting. https://www.nytimes.com/2018/12/06/nyregion/nyc-housing-mentally-ill.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

Before I researched and wrote Examined Lives, I had the common conception of a mental institution as a living hell from which few escaped. But my mother’s experience gave me a different perspective. Care of severely mentally ill patients is not a matter of cost-effective cookie cutter solutions. It is in my view a matter of the motivation and attitude of the staff caring for such patients in whatever setting is established.

In my mother’s case, there were no such things as group homes at the time. After being given a lobotomy by Walter Freeman, she began to have psychotic episodes (which she had not experienced previously).  She was legally “adjuged insane” and institutionalized.

The main administrative building of the mental institution where my mother spent two years of her life.

My mother ended up in a state mental hospital in the midst of the cornfields of Iowa that was operated on the Kirkbride system, developed by Thomas Kirkbride in the 1870s. He believed that the mentally ill should be treated humanely, according to the Golden Rule, and that the vast majority could be cured in the proper institutional setting. Part of the cure involved surrounding them with beautiful things and stimulating activities, such as putting on nightly entertainments, engaging in crafts and, when able, helping to work at the institute, all to promote a sense of pride and achievement . If you have ever seen the movie “Splendor in the Grass” you will have some idea of his approach. My mother took painting classes, helped make costumes for a minstrel show and worked in the employees’ kitchen, an obvious job given her background in the restaurant business. The 1950 employee handbook was very clear about its expectations of how patients were to be treated:

“1. Every patient is a person and is to be treated as such; . . .2. Address all patients by their proper names, using Mr. Mrs. or Miss unless the patient requests you to address him otherwise. . . 15.  Never ask a patient to perform any task you would not do yourself. Always work with your patients—never order—ask.”

I wonder if any of these strictures were followed in the mental institutions in New York which were at the center of the lawsuit settlement in 2014.

In October 1952, almost two years after being admitted to the mental institution, my mother was released, never to return. The lobotomy had taken away her “sparkle,” as my aunt put it, but her treatment at the institution eventually allowed her to live a normal life, working and enjoying life.

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