My Time in a State Mental Institution…
There’s been a lot of discussion lately about the state of our mental health system. I agree that it needs some drastic improvement. However, it is also good to remember the past…so we don’t repeat it.
I’m not shy about my depression diagnosis. It’s really not a reason for shame and it doesn’t usually upset people when I tell them.
What does upset them is when I say in my late teens, I was in Philadelphia State Hospital for three months. I watch their faces and then grin.
I was in “Byberry” as a nursing student and it was not the best experience of my nursing school years.
First a short history of the facility:
Byberry, set in northern Philadelphia, in the late 1960s was a formidable scattering of brick buildings connected by underground tunnels. It was originally created in 1906 as a working farm for the mentally challenged. It grew into the asylum remembered by many as large brick buildings sitting on green lawns behind a brick wall. The increase in the numbers of patients, including the criminally insane, forced the facility to grow in size, especially when it became part of the state system in 1953. Unfortunately the care did not improve much from the early beginnings when naked inmates were found walking around in their own excrement.
During WWII, Conscientious Objectors were assigned to asylums and one, Charlie Lord, found the Byberry conditions so bad that he took secret pictures that ended up in a Life magazine expose. There were some improvements but by the 1980s, the state hospital had failed at least two state inspections and administrators were fired. By 1990 with the change in mental health policies (from institutionalization to community — which some believe increased homelessness) the facility had closed and the buildings virtually abandoned. During the coming years, the buildings were stripped for anything that could be sold, ghost hunters trespassed, and there was evidence that Satanists had used the area for rites. Of course the community surrounding the abandoned buildings forced the city to raze what was left of the asylum. The tunnels, however, still exist.
My tenure in Byberry began in 1966. I was a newly “capped” (exactly what it sounds like) nursing student who was to be at the facility for my three month psych rotation. Students lived on campus in the nurses’ residence in single rooms. We did have a kitchen on the unit but most of our meals were to be taken in the cafeteria. We were not excited about that — the patients prepared the meals. It turned out to be an informative time for me; I learned to smoke and play pinochle (a patient favorite — at least for alert patients).
We were given a chain to wear around our waists; from the chain dangled a set of keys. There were locks (of course) all around us. There were also double doors into the dayrooms and units. You would unlock one door to find yourself in a small anteroom; turn around and relock that door; then unlock a second door, turn around and lock that one.
We were assigned to a male unit and then to a female. We were usually given one patient to follow and were told to write a care plan for that patient. My patient on the male unit was diagnosed as catatonic but he was able to walk. I had to lead him to the toilet and assist him with eating. He could not/would not talk. He was not much older than I was at the time. My care plan was supposed to include goals for the patient and how we (I) would achieve them. Seriously all I wanted was for him to get to the toilet in time and to eat enough to sustain him but the PTB needed more. I tried by writing that I would get him to say one word. Yes, yes, I did. And no, no he didn’t. He’d been mute for years.
What I remember about the female unit was trying to get hygiene completed and maybe a bit of make-up (from a community make-up kit). We also had dance parties.
Needless to say I was very happy when my three months at Byberry came to an end.
The change in our mental health system began in the 1980s and, for what I’ve seen as a citizen and a professional, has not been all that successful. Rehab facilities for addicts do not seem to address many issues. Mental health care should start before an addiction begins. Group homes can hide systemic abuses. And the number of mentally ill people homeless on the streets has increased. The use of community mental health clinics was a good starting point but that idea never seemed to have been given the amount of funding needed.
We need to realize mental health, financial health, and physical health are connected.
But hopefully the Byberry of the early 1900s and the 1960s is gone for good.