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.