201 Comments Posted by dme

I'm not disputing anyone's claims of abuse and mistreatment at Kings Park or anywhere else. But I do wish people would give more facts and specifics to back up their claims. "Shrieks and screams" alone do not mean a patient is being abused. The person might be screaming in response to internal stimuli, such as auditory hallucinations, particularly voices commanding him/her to do things he/she knows to be wrong. The person might be having a panic attack. The person might have autism and have no other means of communication, or have sensory integration problems. Any hospital is a scary place for children, unfortunately, and I hope steps were taken to make it as comfortable as it could be, especially for the children. I could tell you about several years of my life where I was forced to live in a very small room with people I didn't know, could only eat at certain times, had no choice of menu, had to use a bathroom down the hall that was shared with the whole hall, and was known only by a number, not a name. If I wanted to eat at all, I had to work in the kitchen. The elevators were often filthy, and frequently broken, forcing me to walk up four flights of stairs. Crazy people ran around yelling and pulling fire alarms at all hours of the day and night, even when there was no fire. I had to meet with visitors in a public room downstairs. Abuse? No...college.

While medication errors are never good, there is a big difference between a medication error and deliberate abuse. Medication errors are going to happen anywhere (I was in the hospital for medical issues for four days and caught four medication errors myself, some involving not getting prescribed medication or getting it hours later than ordered and one where a nurse tried to give me double the dose prescribed). They are even more likely when there is a high number of patients, low number of staff, patients on multiple medications at multiple times, and probably people giving medications who had little training and supervision in doing so. That doesn't make them ok, it just means that we are humans and not perfect. Complete elimination of mistakes is impossible. The goal is to set up systems that will minimize mistakes, catch the ones that do occur, and result in improvement. Again, in nearly all cases, the problem is with the system and not with the person. My understanding of moral obligation and legal requirement was always that if I witnessed abuse and did not report it, I was equally guilty of abuse.

I really liked this painting, and could even use it as the setting of a poem or story. But then, I guess I shouldn't really like it, because after all, I don't have any formal art training. How could I possibly know what is beautiful? In the past 25 years, I've heard many complaints from many people about their time in state care. The one complaint I have NEVER heard is that the art in the state facilities wasn't "good" enough. I also can second everything that Lynne said. Not only do the facilities watch everything very closely, so do the advocates and the state. Agencies are required to maintain files of all the "adverse incidents" that occur, and to properly investigate them, and correct anything that need correcting. Reports are also made to the state protective service division for any unexplained injuries (such as a person having a bruise on her knee, but no one remembers seeing her fall or bump into anything), and for any suspected abuse or neglect, so that outsiders are also observing, reviewing records, and interviewing staff. It is far more likely today that a person is placed in a group home or institutional setting because they are in an abusive situation in their community home than that they are abused in the group setting.

regarding getting a life and hanging out in psych centers...like I used to tell my kids when they didn't want to go to a discount store to shop because their friends might see them there: "Well, if they see you there, that means they were there too..."

In most cases a patient in a state mental hospital would NOT be sent out to a general hospital for care of physical illnesses or injuries. If a person's mental illness is so severe that s/he needs to be in a psychiatric hospital, then that person would be unable to manage in a general hospital without a staff person with them. The state hospitals were already short-staffed; they certainly couldn't spare a person to go be with a patient in the hospital 24 hours a day. So they had complete hospital facilities as part of their physical plant, and would only send a patient out for very specialized care that could not be provided on-site. Thus, most of the deaths at a psychiatric hospital were due to the same causes as death in any other hospital--heart disease, strokes, cancer, etc. Mental illness does make death more likely because a patient with a severe mental illness is less likely to seek routine medical care, less likely to have good insurance, less likely to be taken seriously, less likely to maintain a healthful lifestyle, etc.

I read Renee's comment yesterday about being told "this place is top secret," and wrote a joke about Saddam's weapons of mass destruction being hidden here, but decided it was in poor taste and deleted it. Today, on another site, I saw a picture of a buried Sherman tank being unearthed in 1981 from the grounds of either Pilgrim State or Central Islip...sorry, I don't know how to do hyperlinks, but the site is edgewoodhospital.com. Click on "pictures' and then on "other." The tank pictures are near the end of the set.

Any ideas on what it says on the last partition on the left (behind "clerical")? It looks the front partition says "Patient Life." (or some kind of life, anyway)

Dumbwaiters come from the days when kitchens were in the basement and the finished dishes were sent upstairs to the dining room via the dumbwaiter, rather than having to carry the food upstairs. Large private homes with servants had them as well as hospitals, nursing homes, etc.

Part of the reason these hospitals became so overcrowded and never had enough funding for quality treatment is because too many "normal" people think of people with mental illness as "weird" or "a freak show."

The large psychiatric facilities became much smaller or closed altogether, especially since 1970, for several reasons. New medications and more community mental health centers let patients be treated on an outpatient basis. States could no longer afford to maintain the huge facilities, many of which needed extensive repair and renovation to meet changing standards of care. There was increasing emphasis on providing treatment in the "least restrictive environment." A hospital usually is not the least restrictive environment. Many laws changed, but it is still definitely possible for a person with mental illness to be court-ordered to treatment in a state hospital. The standard that must be met is that the person is a danger to themselves or others.

There were/are patients committed to mental health facilities against their will, but probably not nearly as many as people think when they believe all the horror stories they've heard. In the past, some of the people committed to a hospital did not need to be there--they were sent by relatives, spouses, neighbors to "get rid" of them or because they were eccentric. Today, a person must be certified by a psychologist or psychiatrist (or both) as being an "imminent danger to self or others" and there must be no less restrictive option available. Thus today, even if someone does not believe he/she should be in the hospital, it is almost certain that the hospital IS the appropriate place. Often, not understanding that treatment is needed is one of the symptoms of the person's mental illness. Most of the unwilling patients come to realize this after treatment ameliorates their condition. Other people know that they are unable to manage in the community, and know that they need the hospital. A patient's condition is reviewed after no more than 30 days in the hospital to see if continued hospitalization is needed. If it is determined that it is needed, the commitment period is for a maximum of 2 years, at which time it must be reviewed again. A patient does not have to stay the full time if their doctor decides inpatient care is no longer required. There are also a few patients who like the attention and routine of the hospital, and will exaggerate their symptoms so the doctor will be persuaded to commit them. I had one patient, who when the psychiatrist thought she just needed a few days in our community-based crisis residential unit for evaluation, stood up and leaned over the doctor's desk and said ,"Well, if I said I'm going to kill myself, then can I go?" In another comment I mentioned people who preferred the hospital because it was a better place to live than their community home. Other reasons I've seen for patients who want to go to the hospital are being faced with criminal charges (usually a patient can't pull this off because in most cases, it wasn't the person's illness that led to the criminal act) and people who have co-existing substance abuse problems and owe money to their dealer. So, while there certainly were more abuses in the past, we can't extrapolate and assume none of the patients needed to be there, or that it was the hospital that made them "go crazy."

Does anyone know what the purpose was in having the two different colors on the walls? Was it just a decorating trend at the time? (I've seen walls painted like this in buildings and private homes in the Middle East even today, but I don't think it's as common in the US now as it was in the past.) Was a better quality (more expensive) paint used on the lower half of the wall that would get the most wear, and a cheaper paint on the upper half? Did they want to avoid a huge expanse of one color or create the illusion of a lower ceiling? Or maybe to be able to just repaint the lower half ? Sorry...I wonder about things like this...

I meant to add that beauty is also in those who go out of their way to take these pictures, preserving our past, and are generous enough to share their work with us.

"Beauty" does not mean "perfection." For me, the beauty is in the creativity of the people who invented elevators and safety devices, the pride and skill of the workmen who installed them with their own hands, the inspectors who made sure they worked correctly, the people who used them every day to get from one floor to another, the abilities of those who painted the walls and swept the floors to make others' lives easier, and how all of those souls can be remembered by looking at a picture. I would feel like less of a person if all I saw when I looked at this was some rust and peeling paint. Oh, and even "crackheads" are people too, and deserve compassion. "With God as our Father, brothers all are we." "Whatsoever you do to the least of my brothers, that you do unto Me."

This picture prompted many thoughts about how the world has changed, become much "smaller" in terms of ease of communication, and yet at the same time much less personal, summed up by the old telephone. Remember how heavy those phones were? And how you didn't own the phone, you rented it from the phone company? No direct dialing of long-distance calls (you had to use an operator). International calls were often an all-day process--you called the operator, were patched through to an international operator who hopefully spoke English, gave your information, and then hours later, when an international line was available, the operator called YOU back and connected you with an operator in the country you were calling to complete your call). It reminds me of the day my son came home to tell me about the fantastic thing he had seen at a friend's house--this machine with an arm that raised up and moved over, then went down to a thin round flat thing that was spinning, and music came out! I hadn't realized that digital age children had never seen a record player and didn't even know the word. I've tried to explain keypunch machines and card readers and getting up to change the tv channels (where I lived there were only three, and none of them broadcast between midnight and 6am), but it's like describing another universe. With all those changes in our lives, it should not surprise us that methods of caring for people with mental illness have also changed dramatically. It's more important to learn from the past than to judge and condemn the people who were doing the best they could with what they knew.