The Asylum Life: House on the Hill.

The Asylum Life: House on the Hill.

What goes around comes around.

It’s still nurses week and I’m giving my brain a rest from the usual suspects.

Danver’s State Hospital was the second state hospital in Mass that I worked in. My third job in psych. I had worked at the “Cambridge Hotline” as a volunteer and Metropolitan State Hospital as  a Mental Health Tech. As a nurses I’ve worked CCSU with kids (South County Mental Health) from 5-18, Home Health, In patient chemical dependency, general psych population, nursing supervisor, and then back to Medicare Home Health.

This is the haunting place.

I drove past this place  my whole life driving from Mass to Maine and always wondered what went on up there on the hill.

Danvers-State-Insane-Asylum23

One woman’s life at Danver’s State

Images of Danver’s State Hospital

So as we learned from the story of Dorothea Dix she wanted the mentally ill separated from the people who were in jail.

The hospital was opened May 13th, 1878.

image from: Wikimedia Commons

image from: Wikimedia Commons

Danver’s was originally established to provide residential treatment to the mentally ill, it expanded its repertoire in 1895 with the opening of a pathological research laboratory.

By the 1920s the hospital was also operating “school clinics” to identify “mentally deficient children”.

It was also during this time period that reports were made of various inhumane shock therapies, forced lobotomies, and the use of experimental drugs and straitjackets.

This is where the frontal lobotomy was born.

During the 1960’s as a result of increased emphasis on alternative methods of treatment and deinstitutionalization and community based mental health care, the inpatient population started to decrease. Danvers State Hospital closed on June 24, 1992 due to budget cuts within the mental health system.
After it closed it was bought by a group that was going to convert it into apartments.

“4-11-08 After fire, Danver’s State complex almost finished By Ethan Forman Salem News

Almost one year after a fire swept through the former Danvers State property, the 433-unit Avalon Danvers apartment complex atop Hathorne Hill is nearly complete.The fire, which burned down three buildings and whose cause was never determined, set construction back six to eight months. All the buildings in the apartment complex are now scheduled to open June 1, with some ready for occupancy May 1. By the time an open house is held in June, the developer expects it to be 80 percent to 90 percent occupied, said Scott Dale, vice president of AvalonBay Communities.

Today, the complex, which cost $80 million to build, sports apartments with lofty ceilings, large windows and sweeping views of the North Shore. Another 64 senior condominiums should take shape over the next 18 months.In a way, this is the second time Danver’s State Hospital has risen from the ground. The push to redevelop 77 acres of the former Danvers State Hospital has meant the demolition of most of the buildings of the former insane asylum, with just one-third of the 1878 Kirkbride building remaining.”

Rents in the Kirkbride building range from $1,300 to $1,700 for a one-bedroom apartment to $1,575 to $2,400 for a two-bedroom apartment.

So the need was there. The state hospital’s were built to separate the mental ill from criminals. Once we started having medications to treat these people instead of frontal lobotomies, electro shock treatment, insulin shock treatment ended and they used neuroleptic drugs.

The Hospitals were emptied out and we supposedly had Community Mental Health Centers.

  1. Is an entity that meets applicable licensing or certification requirements for CMHCs in the State in which it is located; and
  2. Must provide all of the following core services to meet the statutory definition of a CMHC.  However, effective March 1, 2001, in the case of an entity operating in a State that by law precludes the entity from providing the screening services, the entity may provide for such service by contract with an approved organization or entity (as determined by the Secretary) that, among other things, meets applicable licensure or certification requirements for CMHCs in the State in which it is located.  A CMHC may receive Medicare reimbursement for partial hospitalization services only if it demonstrates that it provides such services.  The core services include:
    • Outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically mentally ill, and residents of the CMHC’s mental health service area who have been discharged from inpatient treatment at a mental health facility;
    • 24 hour-a-day emergency care services;
    • Day treatment, or other partial hospitalization services, or psychosocial rehabilitation services; and
    • Screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission.

The 90’s was the decade of the brain.

http://en.wikipedia.org/wiki/Decade_of_the_Brain

There was hope.

Here is a fact sheet from NAMI

http://www2.nami.org/factsheets/mentalillness_factsheet.pdf

Here are some recent statistics.

http://www.cdc.gov/nchs/fastats/mental-health.htm

Now the mentally ill are back in jail.

http://kaiserhealthnews.org/news/by-the-numbers-mental-illness-jail/

  • In state prisons, 73 percent of women and 55 of men have at least one mental health problem
  • In federal prisons, 61 percent of women and 44 percent of men
  • In local jails, 75 percent of women and 63 percent of men

The Affordable Care Act—and its expansion of Medicaid—is expected to connect previously uninsured ex-offenders with medical care and mental health treatment. But in the short term, jails and prisons remain the places where those with severe psychosis are housed: There are now three times more people with serious mental illness incarcerated in the United States than in hospitals, and the types of behavioral and mental health problems among inmates are becoming more severe.

This is the kicker.

“In trying to explain the rise in mental illness in prisons and jails, public health officials and researchers point to the closure of state psychiatric hospitals in the late 1960s.”

http://www.newsmax.com/US/prison-mental-health-inmantes/2013/09/26/id/527895/

The nation’s jails and prisons are turning into warehouses for the mentally ill, with the three largest jail systems housing more than 11,000 prisoners under treatment on any given day.

Now let’s bring it on home.
______________________________________________________________________________________________
State Statistics:
Florida
Mental Illness Is Common
Of Florida’s approximately 18.3 million residents, close

to 660,000 adults live with serious mental
illness.
 About 181,000 children live with serious mental health conditions.
Untreated Mental Illness has Deadly and Costly Consequences
In 2006, 2,440 Floridians died by suicide
Suicide is almost always the result of untreated or under-
treated mental illness.
Nationally, we lose
one life to suicide every 15.8 minutes.
Suicide is the eleventh-leading cause of
death overall and is the third-leading cause of death among youth and young adults aged 15-24.
Public Mental Health Services are Inadequate to Meet Needs.

Florida’s public mental health system provides services to only 26 percent of adults who live with
serious mental illnesses in the state.
Florida spent just $38 per capita on mental health
agency services in 2006, or $686.6 million.
This was just 1.1 percent of total state spending that year.
In 2006, 56 percent of Florida state mental health
agency spending was on community mental health
services; 42 percent was spent on state hospital care.
Nationally, an average of 70 percent is spent
on community mental health services and 28 percent on state hospital care.
Criminal Justice Systems Bear a Heavy Burden

The average rent for a studio apartment in Florida is
119 percent of the average Supplemental Security
Income (SSI) payment, making housing unaffordable
for adults living with serious mental illness who
rely on SSI.
How is this better than the Asylums?
How does this fit into the rights of the mental ill?
Then we have sick things like this.

According to the Herald, three former employees of the psychiatric unit at Dade Correctional Institution have alleged that staff at the facility were tormenting and abusing mentally-ill inmates for years. One of the former employees took their complaints to the U.S. Department of Justice last month.

The Herald reports:

In his complaint, George Mallinckrodt, a psychotherapist assigned to the unit from 2008 to 2011, related a series of episodes, including the death of inmate Darren Rainey. The 50-year-old was placed in a small, enclosed, scalding-hot shower by guards and left unattended for more than an hour. He collapsed and died amid the searing heat, suffering severe burns when he fell, face up, atop the drain.

reference sites
How can we continue to go in this direction and not care for the people who need the care? How can we close our hearts and minds?
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