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Conditions In Mental Hospitals

Creator: Harmon Wilkinson (author)
Date: April 10, 1946
Publication: The Christian Century
Source: Available at selected libraries

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SIR: Mr. Hutchinson's letter describing institutions for mental defectives in his state was certainly very aptly entitled by you "It's Different in Connecticut," for my own experiences in another New England state, and those of other C. P. S. men elsewhere, make his description sound almost like a dream.


I am writing this letter during my rest period at an institution for defectives, a so-called "training school," and I speak from the point of view of one who is with the boys almost constantly from the time they rise until they go to bed. For the better part of this morning I was on duty in a large day-room with some 50 or more patients, and my main job was to keep them sitting in their seats about the room without making too much noise. Frankly I am required to have them do what I myself cannot for I find it impossible to sit in one place doing nothing for hour at a time; therefore I often read on duty, or just get up and walk about the corridors. There was a time when the C. P. S. men here tried to stimulate recreational activities, but the groups are so large and administrative resistance so high that over a period of two years we have lost our crusading zeal.


The building in which I work is not a low-grade building, for it holds the brightest boys on the grounds, some of whom have keys and take the places of attendants, while others work at various jobs around the institution. But recreational opportunities are almost non-existent. Those boys who have no jobs spend most of the day just sitting around, or lying down on the benches. They may go to the movies once a week and to a dance once in a long while, but what occupies their minds the rest of the time I leave it for the reader to imagine. "Custodial care" is almost flattery of the situation, since the boys are not always cared for in the most attentive fashion.


This institution, too, has a rule that any employee striking a patient is to be dismissed at once, but of course enforcement is a different matter. I do not mean to suggest that there is brutality here, for that is extremely rare, but the lack of organized or directed methods of treatment or training brings about situations that often make the application of corporal punishment seem necessary, and the punishment is often applied without much discrimination or intelligence.


What I find to object to in Mr. Hutchinson's letter, however, is the statement that increased wages and better working conditions would not improve the quality of attendants (implicitly admitting that the quality is often low). On the face of it the statement is preposterous, particularly to anyone who has worked in the situation. In our institution many folks have left because of salary or working conditions; moreover, it is apparent that an institution that offers very little will keep the men it has even if it must at the same time tolerate their faults. As a matter of fact the superintendent here has told me that he receives many letters of application for jobs, but that when the writers hear what the salary is they don't bother to follow up; on occasion he has also said that he was keeping certain men only because he could get no one else.


On the whole, then, my experience is more like that of Channing Richardson than like the description given by Mr. Hutchinson.


A New England State.
-Name withheld.-




SIR: We have noted with interest the two recent references in your columns to the problems of training schools for mental defectives. One was the article appearing January 23 by Channing Richardson and the other the reply to it made February 20 by Rev. Charles X. Hutchinson, Jr., a trustee of such an institution in Connecticut. As the repository for the reports of the experience gained by C. P. S. men working in training schools and mental hospitals during the war, we would like to add a further word for the record. Altogether there are more than 1,400 contributions in our files describing the 60 institutions where we have worked. A substantial number are from training schools.


In general, our state-operated institutions in this country do not present a very pretty picture. We know that the administrators in many of them are working diligently to give their patients the best possible care. But there are many things lacking in Connecticut as elsewhere. Some are of a nature not too easily discernible to the board member.


There is abundant corroboration in our files of the very charges Mr. Richardson makes against not only the school where he worked but others as well. It is too sadly true that he speaks correctly when he says patients receive little better than custodial care to the end of their days. Occupational therapy or training programs are greatly underdeveloped. Recreational facilities are in the large majority of cases inadequate.


Placement and parole systems are not developed as they should be to restore "patients to self-support and useful citizenship." In no instance do our reports show sufficient assistance given to patients in receiving release and placement outside the institution.

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We regret to say we are unable to view the disciplinary problem in training schools as simply the result of "more and more delinquents" committed to them. It seems rather to come largely from lack of activity for the children, from crowded buildings and little or no training for attendants in the responsibility which is theirs. In reports from nine training schools, it is explained that there is no program for training new employees -- no orientation in the elements of child psychology, or how to handle group situations, how to give directions to defective minds or to the development of a cottage recreation program.


There is far too much force and violence in daily use as a disciplinary measure. Though it may be true that hitting a patient results in dismissal, the catch is that this may result only "if upon interrogation the employee signs a written statement that he did strike a patient." We know two institutions where, admittedly, force dominates the day-to-day relations of attendants and patients. Corporal punishment is used in five of six training schools covered in returns from a recent questionnaire. And in the same ratio, disciplinary action is delegated by attendants to worker patients with supervision over them "only fair."


We do not believe the picture is a hopeless one with respect to obtaining a better class of attendant. Of course, higher wages are not enough. But they, along with shorter working hours, adequate living quarters for workers with families, sufficient recreational and off-duty facilities, the breaking down of feelings isolation from the community, will all help to bring better personnel.


We are convinced that appeal must be made to the religious community. A very great step forward will be taken in proper care and training of these "forgotten children" of God -- these who remain always in the happy and simple world of childhood -- when we can convince church people that here is an unopened area for full-time Christian service and when such people, fully trained, take up their lives with them.


National Mental Health Foundation,
Philadelphia, Pa.

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