hat was a journey in its self over the past seven weeks. For me, it came full circle and the main concepts that stuck were the importance of instilling hope in the client, letting them drive the service and that they are a powerful tool in recovery. We use scenarios as examples all the time, and the media uses people, why not start letting the people going through the recovery choose their models and people to support them. 
I believe I can continue advocating for people rights as well as sharing my knowledge of this course and through my gained experiences to better the recovery journey for others. I hope that those of us that have enjoyed these materials and gleaned some sense of recovery from it can keep it, that we do not enter into a system that will challenge our boundaries or our treatment ideas with clients. I hope we all get to work for a program as forward-thinking as we are and that will only strengthen our access to the system and the helping professions. 
-Sean K

Libby Nilsson (Elizabeth) is UNKNOWN!!!

Final thoughts

This course created more questions for me than it was able to supply answers. However, that is not a bad thing, it just means it has sparked my curiosity for the future of mental health care system. What it has reminded me is that where the mental health care system started and the possibilities we get to create as professionals in this field. The final review has provided me the acknowledgment of the greenness of my journey in the recovery field but reminds me I get to continue to learn and grow. My biggest take away is that recovery is multidimensional almost an entity of itself. It infiltrates many aspects of our lives and everyone in someway is recovering. Each week provided an opportunity to link principles of recovery into my life through additional research and implementing daily interventions. This course has allowed me to be excited about the evolution of recovery and help contribute to a positive progression.

Final Thoughts

In my current work as a children's case manager I felt I had a solid foundation on many aspects of recovery. This course gave me so much inspiration how to continue to support individuals with mental health needs and challenge me to think deeper about how incredibly crucial it is to have the client's involvement every step of the way during treatment.

A few aspects of the course stuck out to me. The first aspect, in the beginning of the course, which I will carry with me is Particia Deegan speaking about how individuals are "experts in their journey of recovery." This statement really challenged me to take a good look at if my practice is client focused and I hope to carry this on as I continue in social work.

Another piece of insight I will carry with me is of Judi Chamberlain's narrative when she spoke about her time in a psychiatric hospital. Judi notes towards the article, "Recovery is for everyone." This part really spoke to me. I hope to continue to remember this piece not throughout my time as a social worker but as an advocate as well and to challenge any person who does not think recovery is for everyone.

This class definitely greatly elevated the foundation I had for client centered recovery.

(published by Jenn Luja)

Final Thoughts

My major take away from this course that there is hope. I don't mean this in a cheesy, fluffy kind of way. I mean it in a gritty, genuine sense. The mental health profession has come so far, and it seems to me that while we have so much farther to go, there is true progress being made. I ended my final review thinking about Daniel Fisher's thoughts about empowerment in regard to treatment for mental illness. What a concept it is that recovery is not merely stabilizing people so that they can learn to cope with their symptoms, but rather it is recovering in full from the disease itself. I must admit that this idea challenges me, because I have seen mental health symptoms seem pervasive and long lasting. But what a gift it is to begin a client's treatment with the belief that they can and will get better. This, to me, is hope.

I liked this class because it presented ideas that made me feel intrigued and excited to continue on in my career as a social worker. I want to bring this sort of radical hope presented by Addams, Pinel, Pussin, Deegan, Fisher, Karon, and so many more. It makes me feel lucky to know that I have chosen a profession in which I can help someone regain their power in their own life. It also makes me happy to think that I can have some part in dismantling the old, as well. The humans that I will work with in the future deserve more than the old way of doing things. Instead, I will continue to hope.

Final Review/Thoughts

             I am completing this course with a more well-rounded and in-depth understanding of the principles of recovery and my role in supporting recovery as a future mental health care professional. With a clearer and more understanding of the historical forces at work, I feel that I am better equipped to both comprehend and combat forces that work against the recovery movement.

            While completing the Final Review/Exam, I focused on connecting what I learned within each module to the principle of recovery. This allowed me to reflect on multiple principles and think through ways that I would be able to incorporate the principles into my future work. The principle of recovery that sticks out to me the most as a big “take away” from this course is “Recovery is person-driven.” This principle suggests that, “individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience” (SAMHSA). Shery Mead and Mary Ellen Copeland write in What Recovery Means to Us (2000) that, “all people grow through taking positive risks.” It is my job as a (future) practitioner to support clients to take positive risks that provide the opportunity for growth.

            During this course I also had the opportunity to reflect on personal boundaries in the context of a healing relationship and what that will look like for me as a professional in the future. How can we support people with human connection while still maintaining ethical boundaries? I look forward to continuing the conversations that have been started in this class, and to learning more about how to incorporate the recovery principles into my work in the future.  

Final Thoughts

Like others that have already posted this week, I also feel it is difficult to pick just one topic that I was most impacted by. I think after looking back through the modules what stands out to me the most is the overall meaning of this class. It seems that in almost every other class I have taken related to the field of rehabilitation, I am always taught to see the positives in any situation or topic. We are always looking at the good of the field and the good of the services being provided. I enjoy that because I like to think that I am a glass half full type of person, however, I thought it was really unique and rewarding to be asked to challenge things for a change. We were asked many times over the past seven weeks to question the way we approach recovery, and I have learned a lot by doing this. Sometimes it is actually helpful to see examples of what not to do in order to better learn what to do right moving forward. Some of the articles like the Karon (2007) article about hallucinations I found fascinating and will for sure change the way I view certain types of mental illnesses like schizophrenia. The Bellevue film was moving as well, learning about the day to day life for patients at the hospital will stay will me as I move on from this class. Sometimes people are literally asking for better help like the man who kept saying "the medications don't work here, nothing works here, I hate this place" I will take away how important it is to simply listen to people rather than premake judgments about them and move on. Another general thing that I will take away from this course is learning that it is actually ok to question our field.. It seems taboo to question the field that we are all passionate about, however, this class has helped me learn that having these conversations is how we grow as better counselors, and how our field progresses towards a better future. Overall the class was quite an eye-opening journey for me.

Final Review/Thoughts

As this was my final class of my Masters degree program, I went into it with an open mind and a belief that this class would finish all the learning that I would need to have in order to continue with my career. However, after taking this class, I realized that learning cannot stop here simply because the program is done. Throughout this program, I have been asked to question many topics and challenge more ideas than I was prepared to. This class, however, took that to a new level. I found myself questioning assumptions that I have always held, truths I believed I had been told, and it left me with new suspicions that I want to explore on my own. My top "take away" from this course is that I can never pass judgement on any other person's situation, and that I must always fight for my clients' rights to be as they are and change as they see fit. I had never considered how so much of my education around human behavior was very rigid.

Walking away from this course, I feel empowered to assist my clients moving forward. I feel as though I can move forward as a better counselor because I have learned these lessons. I walk away with a renewed sense of urgency to help create a positive change. Our history has no place repeating itself when it comes to mental illness and mental health, and I am grateful to have a platform as a counselor to advocate for my clients to see that it doesn't. In the future, I look forward to learning more on my own so that I can continue to grow and support my clients in the ways they would benefit from.

(Kaitlynn Littlefield)

Final Takeaway

Throughout reviewing all of the modules we looked at through the class, I found many to be controversial, empowering, and eye opening. While many of the modules had profound impacts on the movement of the recovery model, one of my favorites is the concept of mind and body.

Throughout history, professionals and researchers have debated on whether the mind and body should be viewed as one, or as two separate entities. I think it can be both. I think we, as professionals, can view each mental health symptom and concern and each medical symptom and concern as independent components while viewing the person as a whole. Viewing a person as a whole allows professionals to holistically address all areas of their lives. This also allows for an outlook into a persons life and how each independent component could be contributing to another.

Lastly, if professionals chose not to view the mind and body as a whole, they could miss critical puzzle pieces into who a person truly is. In total, this movement has helped shape and further the recovery movement by providing a holistic view while working with a client who is seeking a state of recovery.

Thoughts after Final Exam

Now that I have completed the final exam for this class and have been reviewing the modules all week, I am finding it hard to pick just one concept that sticks out the most to me. In some ways, all of the concepts intertwine with each other. Deinstitutionalization was such a life altering change for people to go through and I believe it really started the beginning of the recovery movement. Society began to look at the way people were being treated in the mental institutions and started to realize that it wasn't right and that there were other options. Since everyone was transitioned to living in the community, I think the other key concept from these modules is the importance of community programs that enable people to live independently in their communities. Without these programs in place, people would not have the hope or courage to live independently or in some cases, learn the skills to be able to live independently. I also think peer support is another major concept in recovery and one that appears to be gaining more recognition in community mental health services over the past several years. I have gained a lot of useful knowledge from these modules and at times, it has been a humbling reminder of how recovery began but has also provided an optimistic view into the future as people continue to advocate for changes to be made in mental health care.

Final

When I first began HCE 619, I was not sure if the content would be to hard or not for me to comprehend. Going from bachelor level classes to master-level classes can be intimidating. I am also a social work major, so I was not sure if the content would be beneficial to my career. I am so happy I choose to take HCE 619 as an elective I have learned so much from the seven weeks of participating in a discussion board or reading through content. The biggest take away from these seven weeks is that people who have a mental illness can recover. Before taking HCE 619, I had never heard a mental health professional utter the words recovery. Recovery for a person who has a mental illness may not be in the same context as a person who has got into an accident. Recovery in the mental health profession means to be in control of your mental illness and being an active member of the community. Having a life is possible for someone who has a mental illness. It does not limit their ability to have the life they dreamed they would have. I plan to help my patients understand that recovery is possible, and they can have a life even with a mental illness. When working with children in the past, I have told them their mental illness is their superpower, and I plan to do the same with adults. People with mental illness have been hidden away and oppressed for so long it is their time to rise to the occasion and live. 

There but by the grace of God go I....

Though in some circles I am Dr. / Professor Barrett, with a Ph.D., there are other contexts where I hold highly stigmatized statuses. In a medical context, I am a person with psychiatric disability, and even more stigmatized, I am a person who has lyme disease...also known as a "lyme loonie."

Because of my life experience, I feel deeply about our history, the lives of people with MI, and the origins of recovery movement within psychiatric rehabilitation. I teach because I think it is important to expose providers to a different way of thinking, or a perspective they may not have considered. No approach or theoretical orientation will apply in every situation (e.g., therapeutic use of hallucinations), but as a person who has skin in this psychiatric game, I also feel strongly that some approaches are more consistent with recovery than others.

When I am symptomatic, I want someone to listen and validate my experience. I want to feel emotionally safe.  I want encouragement, and to be reminded of all the things I have made it through in the past. I want to be reminded that I have the ability to figure it out, whatever "it" is. I need to know that I have value.

What I don't want: judgement, use of a skeptical or scolding tone, being told what to do, being told the obvious (e.g., you would feel better if you lost weight), being mocked and/or humiliated, being physically controlled, and being asked if I've taken my medication (!). The surest way to escalate my agitation is to tell me to "calm down," which in my estimation, is the ultimate invalidating statement. Under certain circumstances, that response may cause me to behave aggressively, or lash out in anger. What happens then? My fate as a person with mental illness is sealed. I am now labelled a problem, "out of control," and potentially, a victim of the "goon squad" or worse. (Goon squad is a group of nurses who restrain someone and administer PRN tranquilizers to chemically control a person).

For example, think of the young man at the Judge Rotenberg center being shocked remotely while prone and in a 5-point restraint.VIDEO HERE Think of Natasha McKenna, naked, strapped to a restraint chair, in a jail cell. Ten men in hazmat suits and gas masks approach her to move her to another facility, and they end up killing her. We can pat ourselves on the back about how far we've come in psychiatry, yet there are too many stories of my brothers and sisters suffering at the hands of providers. The officials responsible for Natasha's death felt so confident in the way they treated Natasha that they posted a 48 minute video of the incidents that led to her death. The official video of the incident is no longer on youtube. However, someone else posted a version...VIDEO HERE

How does this happen? What is the story these "providers" tell themselves? Why didn't anyone object at the time? What might be a better way, according to Shery Mead? Other recovery advocates? Answer these questions, feel free to post your own, and then reply to at least 2 of your classmates.

OUTPATIENT COMMITMENT - ASYLUM RECREATED IN COMMUNITY?

Above is the case FOR Outpatient Commitment, also known as Assisted Outpatient Treatment. Some folks who have been subjected to / received AOT agree with this approach AFTER they have completed it...however...its this "retrospective endorsement" enough to warrant coerced medication and ECT administration?  Is AOT just recreating asylum in the community? Answer these questions, and respond to one of your classmates' replies.

NO WAY! Therapeutic use of hallucinations?

(READ THE KARON ARTICLE ON Bb -- FOUND IN MODULE 9 -- THEN READ THIS AND POST)

Historically, people with schizophrenia have been told that their symptoms (i.e., hallucinations) need to be medicated away. "Once you are stable, then we can address your other needs..." This week, as we consider deinstitutionalization and people's rights in the community, often it is hallucinations that mark people as "other" or "crazy." Hallucinations can be very stigmatizing.

The recovery movement offers a different narrative. One does not have to be "stable" and "symptom-free" before recovery can begin, quite the opposite in fact. The community is a place one can recover and learn to advocate for rights. One can have symptoms and live well in the community.

What if hallucinations were recast as unconscious needs? What if people in the community, family, and support professionals viewed hallucinations not as an aberration, but as communication? We all have dreams, and some of us even dabble in dream interpretation....what if hallucinations are just waking dreams? What if a recurrent theme in a person's hallucinations means something? A need breaking through into wakeful consciousness?

If we viewed hallucinations as communication, would we still want to medicate them away? Would people be seen as "crazy" by providers and/or society at large?

Reply with your reaction to this premise (using hallucinations in therapy), and the questions above. Then reply to at least 2 of your classmates' posts.

Eastern State Hospital- Williamsburg, VA

The Eastern Lunatic Asylum was opened in Williamsburg, Virginia in 1924. The facility continues to currently operate today under the name, Eastern State Hospital. 

The construction on this facility began in 1771 and the facility was initially a public hospital but also doubled as a place for individuals suffering from other ailments. After a fire in the late 1800’s the facility was modified to what we now call a mental health treatment facility. This fire left two individuals dead and over 200 patients displaced. After being rebuilt, the facility had an outdoor yard for “patients to walk and take air in” but also had a fence put around it. The facility held about 20-30 patients, depending on which resources are used and it was difficult to find narratives of patients time spent at the facility.

One notable aspect of the hospital is patients were admitted to the hospital on a first-come, first-serve basis and admission to the hospital did not rely on qualifiers such as type of mental illness or treatment recommendations. Patients were treated for both physical and mental illness.

Another noteable aspect was the number of recreational activities offered to patients such as dances, steamboat rides, team parties and various games (such as checkers). However, during this time restraints were significantly utilized such as strait-jackets and Utica cribs.

In the 1920’s the Eastern State Hospital housed about 2000 patients and around this time treatment of the patients changed as well with the introduction of psychiatric drugs being used in the facility.

The Eastern State Hospital continues to exist today, with their website noting they have over 300 patients and 900 staff and over 500 acres of land. 

In terms of the question of “if I would like to choose treatment at this facility”, this is a difficult one for me to answer. In the early 1800s, no, I would not choose to seek treatment there. However, if I needed help and support this facility does appear to have the staff and facility to manage individuals with significant mental health needs however my hope would be to receiving treatment in my community, rather than in an a hospital or facility.

Resources:

http://www.esh.dbhds.virginia.gov/

https://research.history.org/DigitalLibrary/View/index.cfm?doc=ResearchReports%5CRR1078.xml

http://www.asylumprojects.org/index.php/Eastern_State_Hospital

Howard Dully, Walter Freeman, StepMom, Dad and Lessons Learned

I have so many intense feelings after listening to Howard Dully's account of what happened to him. At 12 years old, he received a transorbital lobotomy, because his step-mother convinced an eager doctor that the boy was unmanageable. Truth was, he had just lost his mom, and the adults had told him she had just "gone away." A loving Mom was replaced by this stepmother who was, at best, unkind to Howard.  Of course the cause of the problems was "Howard was a difficult child." That was the story the stepmother and Freeman told themselves.  It seems Howard's Dad was too disengaged to question his new wife's motives and/or judgment. The child, in this case, was labelled and treated yet was NOT the source of the problem, in my opinion. Grief. Loss. Emotional abuse. No one in his "corner." - these are the things that I believed were causing Howard's issues (if he even had any!).

Do you think that this happens today? If so, give an example -- but do not share any confidential information. If children are serving as scapegoats so to speak, what can we do as practitioners to limit the risk to kids?

Answer these questions, and then respond to at least 2 of your classmates.

Cherry Hospital - North Carolina. Meg Curtis

Encouraged by the influence of Dorothea Dix, the North Carolina General Assembly appointed a committee to spearhead the construction of a new mental health facility for African American patients in 1877.  (Dorothea Dix argued that mental illness was an educated, White affliction only).   

In August of the following year, 171 acres of land was purchased in a town called Goldsboro, which would eventually come the cite for the official “Asylum for the Colored Insane”, as it was called then.  The institution has undergone several name changes, including the Eastern North Carolina Insane Asylum, Eastern Hospital the State Hospital at Goldsboro, and finally Cherry Hospital in 1959, after of Governer R. Gregg Cherry, who was widely known for his work expanding mental health services in the state. 

None of Cherry Hospital’s iterations adhered to the Kirkbride Design or focused on Moral Treatment as a practice model.  The goal was to provide a place for African Americans dealing with mental illness (although the definition of mental illness in this instance is incredibly broad – one official document lists possible diagnoses such as masturbation and ‘deranged menses’) to stay separate from the rest of the community.  The original hospital included 76 beds but housed over 100 patients by Christmas of the hospital’s opening year.  In 1881, Eastern North Carolina Insane Asylum was incorporated, and a board of nine directors were appointed to oversee its operation.  They approved the construction of a second building for patients suffering from tuberculosis, and in 1924, another building was erected for patients diagnosed as criminally insane. 

Eastern North Carolina Insane Asylum, 1896.

State Hospital for Colored Insane, 1950.

It was the state’s sole mental institution for African Americans until 1965, when the hospital was desegregated in order to comply with the newly-passed Civil Rights Act of 1964.  The most widely documented therapy used at Cherry Hospital was called “work therapy”.  Until 1974, the fields surrounding the primary building were tended by its patients, which generated considerable income for the hospital.  An 1884 Superintendent Report boasts, “80 barrels corn, 6,000 pounds of fodder, 50 bushels of peas, and 3,000 pounds of oats.  We now have 37 hogs for butchering and estimate their weight at 4,000 pounds.  An accurate account of the vegetables has not been kept, and the value of our kitchen garden can hardly be estimated.  The orchard gave us apples in abundance.”  Occasionally, patients were loaned out to local farmers as additional laborers.  As the farm grew, so did the number of patients required to harvest the crops, so the hospital numbers swelled to well over 3,000.   During Cherry Hill’s first century of existence, it supported over 91,000 patients. 

Other treatments included sitting in a rocking chair (the most frequently-used treatment, per the hospital’s small museum), electroshock therapy and caging patients (a practice that continued until 1956).  Although overcrowding was a known issue, the Superintendent Report from 1884 includes the line, “It is not…recommend here that steps should be taken for enlarging.  The State, at present, has a large burden in providing for the white insane.”  An occupational therapist was hired in 1932, but most therapeutic interventions occurred on the farm, and used other in-hospital tasks, such as laundry and kitchen work, etc.  Chapel services were eventually made available to patients in the 1950’s, as well as tranquilizing and psychotropic medications. 

The band of the "Asylum for Colored Insane" in Goldsboro, North Carolina.  Date Unknown. 

The hospital remained open until a newer facility took its place in 2016, three years after it was originally slated to open.  There have been several controversies surrounding the care provided at Cherry Hospital, especially in 2001 and in 2008.  In 2001, a deaf man named Junius Wilson died at age 93 after spending most of his life in Cherry Hospital.  Wilson was accused of rape in 1925, and was assumed insane as he communicated solely with a sign language taught in the South.  His charges were dropped in the 1970’s, but he remained at the hospital until 1991, when a social worker realized he was deaf.  In 2008, the hospital nearly lost its national accreditation due to a highly-publicized case of malpractice.  A patient named Steven Sabock died while strapped to a chair, ignored by staff by over 24 hours. 

For all of these reasons, I would not want to be treated at Cherry Hospital.  The original institution was nothing but a means of continuing to profit financially from slavery despite the end of the Civil War, and the new institution seemed to perpetuate dangerous, problematic practices like electroshock therapy and an over-reliance on psychotropic medication.   

Resources:

https://www.commongroundprogram.com/blog/love-and-outrage-asylum-for-the-colored-insane

http://www.jazzloftproject.org/blog/general/the-most-haunting-band-picture-ive-seen

https://docsouth.unc.edu/nc/eastern84/eastern84.html

https://s3.amazonaws.com/kajabi-storefronts-production/sites/41305/themes/924270/downloads/tmvFCiJhToGbABIu72q9_In_Our_Own_Voice.pdf

https://www.northcarolinahealthnews.org/2016/08/31/new-cherry-hospital-makes-its-debut-three-years-late/

https://modernfarmer.com/2017/12/strange-horrifying-history-cherry-research-farm-north-carolina/

One Thing That Can Help : Advocacy

One thing that I saw both in the movie and in the life of Jane Addams was the mobilizing of people with lived experience. In the documentary, it was folks with mental illness, in the case of Jane Addams, it was the people living in poverty in the Chicago neighborhood in which she lived.  So often being diagnosed with a mental illness or living in poverty can take away the power of a person or even a whole subset of people. Because of this, Addams believed that the best way for a person to get better from a situation that they were suffering in was for they themselves to take action.

The story in which Addams and her community organized around the issue of  trash in her neighborhood is a prime example of this. It was first an issue of just the trash that was not getting cleaned up, but soon the focus was their living conditions in the neighborhood in general. Soon there were dozens of tenants from Hull House and the surrounding community that had begun to organize around the issue, led by Jane and her partner in such issues, John Dewey. As a result of the investigations and activism done by this group of individuals, 11 of the 24 people employed by the Chicago Sanitary Bureau were fired.

The example from the documentary that illustrates this is the Foundation House's tenant's work with getting a bill passed around free bus passes for folks on SSI, just as their counterparts with SSDI did. He was able to go to talk to law makers themselves, and prepared information and charts to back up the claims that he was making. The bill ended up passing with flying colors, making his advocacy efforts successful. This was not only good practice for this gentleman in advocating for himself and his community, but it also was a valuable experience for the lawmakers that heard him speak, as it proved that people living with mental illness are able to do things just as successfully as others who do not ave MI.

There is one major thing in the way of assisting people become advocates for themselves: the societal belief that others know better than them. As it says in the text: "The idea that people with mental illnesses can still identify their own needs and know what is best for them remains a radical notion in much of the current mental health system in the United States." (p. 95) People who are oppressed, such as those living in poverty, those experiencing homelessness, racial minorities, or those living with severe or persistent mental illness, have been silenced. They have been told that their voices don't count or that in no way could they know what they are talking about. Even though they are the ones who are living or have lived the oppressed experiences, others - even social workers - tell them that what they can and can't think about their own lives. Even in efforts to serve folks, we are at risk at further taking away any agency that they might hold in their own lives, something that Jane Addams felt firmly against. Even when those with MI or those in poverty have a chance to have their voices heard, they can easily be discredited or dismissed. For people to have full agency over their lives, society needs to give them space to do so.

Pilgram State Hospital, Brentwood, Long Island, New York- Lindsay Hill

In 1927, Governor Alfred Smith of New York pressed the legislature for money to build a hospital with a minimum of 10,000 beds to relieve the overcrowding in other state hospitals, Kings Park State Hospital and Central Islip State Hospital. By 1929, construction began for Pilgrim State Hospital and it was named after Dr. Charles W. Pilgrim, who was the Commissioner of Mental Health in the early 1900s. It officially opened on October 1, 1931 on 825 acres on Long Island and 100 patients transferred from Central Islip State Hospital. It was the largest facility of its kind when it was built, according to New York State Office of Mental Health (2019). In nine months, there were 2,018 patients who were hospitalized at Pilgrim State Hospital. In 1954, it’s number of patients reached its peak at 13,875 patients as well as 4,000 employees. Pilgrim State Hospital opened as a small community that included its own police and fire department, post office, train station, power plant, swine farm, church, cemetery and water tower. Houses were also available for staff and administrators to live in. Underground tunnels were used to route utilities. There were multiple sets of buildings that did follow the Kirkbride design with the “wing-like” additions on a main building in the middle. The additions did not stretch out as long as other Kirkbride hospital designs. There were also sets of buildings known as quads, which were four buildings placed around a center building.

Pilgrim State Hospital, as well as Kings Park and Central Islip, were considered “farm colonies” because of their live-and-work treatment programs, agricultural focus and patient facilities. The idea of the farm colonies was that mentally ill patients could receive treatment while also working on the farm doing a variety of different jobs that would help them to recover from their mental illness. As the number of patients continued to grow, the state of New York decided to expand its service by building Edgewood State Hospital as a subsidiary of Pilgrim State Hospital. During World War II, the government took control of Edgewood State Hospital along with three buildings of Pilgrim State Hospital and renamed it Mason General Hospital. This psychiatric hospital was used to treat soldiers returning from war who had been traumatized.

As psychiatric medications and community care became options for patients instead of living in an institute, the number of patients began to decline in all psychiatric hospitals. Edgewood State Hospital closed in 1971 and parts of the Pilgram campus began closing in the 1970s and 1980s. Several buildings were used as a correctional facility in the 1980s but then were reverted for psychiatric care. In 1996, Central Islip and Kings Park transferred their remaining patients to Pilgram, and the two facilities closed due to declining patient populations.

            Long Island Psychiatric Museum is currently located in three rooms of Building 45 on the Pilgrim Psychiatric Center campus. The museum displays photographs of patients playing softball, acting in a play and weaving rugs in an occupational therapy session (NY Times, 2002). There is also a piece of a wall mural one of the patients had created. The museum also has on display an old console used in electro-convulsive therapy; commonly known as shock therapy. Pilgrim continues to use the controversial shock therapy as a form of treatment today. The evidence of lobotomies performed at Pilgram State Hospital is absent from the museum, which is also debated about the truth being hidden from the public about what truly happened at the hospital.

Pilgrim Psychiatric Center, formerly known as Pilgrim State Hospital, is still open today but has downsized considerably since it was initially built. Today, Pilgram provides inpatient and outpatient psychiatric, residential and related services to patients with approximately 275 inpatient beds, four outpatient treatment centers and one assertive community treatment (ACT) team. There are 12 inpatient wards, 2 geriatric wards and seven psychiatric rehabilitation wards at Pilgram Psychiatric Center (New York State Office of Mental Health, 2019).

I was unable to find specific patient experiences or narratives about their time at Pilgram Psychiatric Center, but I was able to find this collection of photographs from Time Magazine. It shows 24 pictures of patients in 1938 at Pilgram and I think the pictures speak for themselves about how patients were treated. Many of them in straightjackets, have a lack of expression on their face and were forced into treatments they probably did not want to do and that were still experimental at that time. This is the link to see the photos; if you click on the picture on the top, it will bring you to the other ones to scroll through- https://time.com/3506058/strangers-to-reason-life-inside-a-psychiatric-hospital-1938/

I do not think I would have wanted to be a patient at Pilgrim Psychiatric Center. Especially at the time it opened for patients in the 1930s, treatment was so poor for anyone who was believed to be mentally ill. Medications were still experimental, and doctors were still determining the side effects and dosages of anti-psychotic medications as they were being introduced in the 1950s. I think many people were used as guinea pigs and their lives were forever changed because of the treatment they received. I think the pictures in the link above show how patients were treated and the effects of the treatment so after seeing those and reading all the information I did about this state hospital, no, I would not want treatment there.

https://www.nytimes.com/2002/12/29/nyregion/a-selective-memorial-for-an-unsettling-past.html

https://time.com/3506058/strangers-to-reason-life-inside-a-psychiatric-hospital-1938/

https://www.omh.ny.gov/omhweb/facilities/pgpc/

http://www.asylumprojects.org/index.php/Pilgrim_State_Hospital

Byberry Insane Asylum - Philadelphia. Erin Kelly

The Philadelphia State Hospital at Byberry was constructed beginning in 1907. The facility grew until it  included over fifty buildings such as male and female dormitories, an infirmary, kitchens, laundry, administration, a chapel, and a morgue. Because of this, the hospital's population also grew rapidly, quickly exceeding its capacity. In fact, the peak patient population was over 7,000 in 1960. The design was not a Kirkbride one; any form of moral treatment did not seem to be in mind when this building was being constructed (Kirkbride actually did in fact design an institution in Philadelphia in the 1850s, but did not contribute to Byberry). 


https://www.americansuburbx.com/2015/05/byberry-mental-hospital-house-of-horrors.html

The hospital was constructed under the belief that while it might be possible for the mentally ill to receive treatment and decrease symptoms, they should be separated from the general public in order to do so. The separation of the mentally ill from the general public was also for the good of that general public.  Byberry was free for patients, so it was mostly the poor or others who could not afford better treatment that ended up there. Patients who were committed at Byberry suffered from a variety of things, spanning from physical disorders that made them "other," as well as the wide range of things that were deemed to be mental disorders at the time. 


https://www.americansuburbx.com/2015/05/byberry-mental-hospital-house-of-horrors.html

Byberry hospital became infamous for its mistreatment of patients. One of the biggest issues was that almost from the minute that the hospital opened, overcrowding became an issue. The depression years also offered its challenges due to lack of funding. Patients were often not fed or fed food with rats in it, and there are pictures of patients completely naked, as the hospital could not afford to clothe them. Aside from not being provided for in the proper way, there were also issues with severe mistreatment, with patients getting severely abused, and there were stories of patients getting raped and even murdered. There are also stories of patients committing suicide while in Byberry, due to the dire condition of the hospital. 

The conditions at the hospital were largely hidden until the 1940s, when two journalist separately took up the issue. In 1946, there was even an expose in Life magazine (https://mn.gov/mnddc/parallels2/prologue/6a-bedlam/bedlam-life1946.pdf), which was aided by photos of a man named Arnold Lord, who was employed at the hospital as an orderly, after he became a conscientious objector for the war. The article said this: 

Thousands spend their days – often for weeks at a stretch – locked in devices euphemistically called ‘restraints’: thick leather handcuffs, great canvas camisoles, ‘muffs,’ ‘mitts,’ wristlets, locks and straps and restraining sheets. Hundreds are confined in ‘lodges’ – bare, bed-less rooms reeking with filth and feces – by day lit only through half-inch holes in steel-plated windows, by night merely black tombs in which the cries of the insane echo unheard from the peeling plaster of the walls.”


Due to this article, there was an outrage at the condition of the hospital, which had previously unknown, except those who lived or worked there. Even Eleanor Roosevelt read the article and demanded change. New state funding funneled in, briefly making things better. However, in the 1950s, there was new tests on the patients, as new psychotropic medicines were beginning to be developed. As recently as the late 1980s, 27-year-old resident William Kirsch was in such restraints for more than 14 months — and possibly as long as three years. The U.S. District Court for Eastern Pennsylvania found that Byberry was infringing on Kirsch’s human rights, and demanded his release from the hospital. The hospital was not closed until 2006.


http://theduke81.tripod.com/id4.html






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Person As an Agent- response Jane Addams

I found Jane Addams to be such an amazing role model for human service workers. I was particularly impressed by he dedication to people with MI.    She had a down-to-earth way about her that I’m sure was appreciated.  As our reading explained, her father gently pointed out to her when she was young that her cloak was a little too fancy to wear to church.  This set the stage for a simple Hull-House environment.

In the quote from our reading assignment, Addams stated that she wondered how to make people more equal, “equal in things that mattered much more than clothes, the affairs of education and religion, for instance which we attended to when we went to school and church, that it was very stupid to wear the sort of clothes that made it harder to have equality even there. (Addams, 1910 p.13-14)
It was clear that she believe in a down to earth.
In the movie, the treatment home was similar. It was not like a hospital or formal intuition.  The actions of the staff reflected respect and humanistic approach. My favorite clip was when Frances had success in lobbying. He made the phone call to share is appreciation. The staff person said, “it goes both ways”. He thanked Frances.

I have been part of a movement that I think Addams would have approved of. It was a community action group that met monthly.  The worked together to develop programming for the community. It involved community members, services workers, and business workers.  They came up with community events to connect people such as a summer concert series in downtown Brattleboro Vermont.  The idea was to have live music and entertainment available for everyone. There was a free cookout as to have equal sharing of a meal.