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[ CHAPTER 5 ]

CHILDREN DO NOT BELONG IN PSYCHIATRIC HOSPITALS!

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A dedication ceremony for the RiverView School took place on 8 October 1971. The quarterly report covering October–December 1971 describes “an elaborate program in which a large number of community representatives interested in the mental health of children participated.” Governor Meskill and Edward Zeigler of the Office of Child Development Health, Education and Welfare headlined the bill. In his introductory remarks, Mr. Abraham Lippman, chairman of the board of trustees, emphasized the board’s strongly expressed position that the children’s program continue as part of Connecticut Valley Hospital.

The actual move to our new facility happened on 11 November 1971. Finally. After the entire administrative and clinical staff moved, the children were moved to their new dwellings. First, the autistic kids, with the help of their parents, occupied the top floor of the Silvermine Building. Then, assuming the girls would be better able to handle the round configuration (wrong), we placed them in the round cottage, simply named Cottage A. Next came the boys: younger kids to Cottage B, older kids to Cottage C. By the end of November, new staff members joined Charles Rich on the Children’s Unit. Among them were a psychologist, Randy Burnham, who had volunteered on the Children’s Unit while interning at CVH, and, shortly thereafter, another psychologist, Clara Chapman.

But wait! Let’s step back for a moment. This seems like a good place to articulate more fully my philosophy, or point of view, about children with emotional, behavioral, or psychiatric disorders: Children do not belong in psychiatric hospitals!

Sound heretical? It is. Many believe unstable children should be hospitalized only as long as necessary, but most people believe hospitalization is a necessity some of the time. I disagree! The psychiatric hospital, formerly known as “insane asylum,” is a concept that applies to adults. Historically, the “insane” were eventually seen as diseased and therefore the purview of physicians and the medical profession. Children were more likely to be tolerated, kept at home, or, when necessary, placed in children’s homes or residential treatment centers. It wasn’t until much later that adult hospitals began accepting children as “patients.” This was a mistake!

Instead of developing more comprehensive community services or increasing the capacity of residential treatment centers, adult psychiatric hospitals developed children’s wards, utilizing the same adult/medical model of treatment—primarily, I suppose, because it was the only way insurance companies would pay for the service. In fact, when we were rewriting the state statutes to transfer the Children’s Unit of CVH to the Department of Children, Youth, and Families, the question arose as to our name and description. My preference was to describe the new program as a children’s community mental health center, including the widest range of inpatient, outpatient, emergency, and outreach programs. This was consistent with my argument that two similar facilities should be built in the eastern and western parts of the state. It would also avoid the stigma associated with psychiatric hospitals. However, the state required that there be a “hospital” for children, and so Riverview Hospital came into being. A “hospital” qualifies for higher-level medical and nursing staff and is eligible for Medicaid reimbursement.

Money aside, several key experiences inform my point of view. The earliest was my experience as a high school camp counselor, when I learned the value of working in a natural setting as a way to help a child through real-life struggles. Terry was a seven-year-old, beautiful, terrified boy who obviously found himself in strange, unfamiliar surroundings. Afraid to interact, he avoided any contact with other children and stayed next to me. He also didn’t want to go near the lake. Since we had enough good counselors, I took sole charge of Terry. We watched other kids eat together, play games, and swim. I finally got Terry to go near the water, then put his feet in; and very gradually, over days, he put his head in. With the encouragement of the other kids, he joined in games and actually learned to swim. Needless to say his parents were happy when they picked him up after camp. As for me? Terry helped me pick my career direction.

At Children’s Village, first as a recreation director, then as a house parent, I saw the importance of daily interactions: modeling appropriate behavior, teaching social skills, dealing with problems as they arose. I knew my daily actions and interactions were at least as, if not more, important than the one or two hours per week the children spent in therapy. As mentioned earlier, this prompted me to seek further study.

LESTER

At Michigan State University (MSU), working one-on-one in a play therapy mode, I discovered the dynamics of play and its meaning for children as a way of expressing some inner turmoil. The MSU Psychology Department, as part of its community service and training program, operated its own child guidance clinic. While completing my practicum course in play therapy, I volunteered to work with Lester, a six-year-old autistic child whose parents had requested a psychological evaluation. Working with that little boy turned out to be one of my most valuable clinical experiences at MSU.

When I opened the door and entered the waiting room to greet Lester and his mom on that first day, I found Lester cowering in the corner. Instead of approaching him too closely, I told him who I was and invited him to a playroom down the hall. I then moved aside so he could pass me at a distance. He ran through the waiting room and into the play area. He quickly surveyed all the room’s features, making sure to keep distance between us. After opening and closing every cabinet and drawer, he pointed at each animal picture hanging on the wall as he said, “coowwwmooooooo,” “sheepbaaaa,” identifying with, or “becoming,” that animal.

I asked him if he wanted to sit down at the table and draw a picture of a person—a standard testing method. He ignored me and continued to investigate the room and its belongings. Finally satisfied, he sat down at the table, picked up a pencil, and began drawing. At first I saw no connection between his illustrations and my request. It wasn’t until I 1ooked closely that I could see that, in fact, he was telling me exactly what I wanted to know. Lester drew Humpty Dumpty having fallen off the wall and broken; a cracked Easter egg; and several balloons, some with faces and others that had popped. The image of a fragile little boy was obvious, but I had no idea yet of the profoundness of this feeling.

During our sessions over the next several months, once a week for one hour, Lester became more and more preoccupied with the balloon imagery. He wanted to play with balloons, but would not let me blow them up, although he would pretend to do so. I learned from his mother that he had a closet full of balloons at home that nobody could go near without setting off a panic in him. One day, someone who had previously used the playroom left a filled balloon in the room. Lester was terrified. He kept one eye on it all through the hour from the opposite side of the room; and he would not allow me to go anywhere near it, even when I offered to retrieve and remove it.

As time went on, the balloon imagery began to include a person contained inside something. Eventually Lester started playing with an airplane, which he placed in one hand while the other hand pressed a small doll against the bottom of the plane.

During the first ten months, Lester pretty much did as I asked, while I did a running commentary, trying to be supportive and interpreting what I perceived to be the feelings, worries, and fears behind his activities. If he needed help with something, he would simply take my hand or push me toward the task. However, he did not respond verbally to any direct question.

One day, after a long Christmas recess, Lester returned to the playroom and I greeted him with a casual, “Well, what did you do over the Christmas vacation?” Without uttering a word, he went to the blackboard, which covered one whole side of the room, and began drawing. There was the YMCA swimming pool, a bowling alley, a Christmas tree, Santa coming down the chimney, presents, Lester opening one. He drew until he got to the end of the board. Since he hadn’t finished his story, he turned around and walked back to the beginning of the blackboard and simply continued to draw over what he had first drawn. Occasionally, he would realize something was not clear and fix it. This form of storytelling took Lester the entire hour. When he was finished, I thanked him for telling me about his vacation. He was very pleased—and so was I! It was the first time he had communicated directly with me in response to a question.

As the weeks went by, the airplane with a boy clinging to the bottom began taking more and more precedence in his activities. He’d fly the plane and doll back and forth “to California,” making sure there was no separation between the two. I began commenting about the imagery: telling Lester how it was like a boy being in a balloon or like a baby being born. I suggested that it was all right for the boy to come out of the plane. The boy would be safe because I was there to help him.

Then one day it happened! After flying around the room several times, holding the boy tightly against the belly of the plane, Lester took hesitating steps to separate the two, and with further encouragement on my part, he finally pulled his hands apart, separating the boy from the plane. He was ecstatic, jumping up and down and brimming with self-satisfaction.

He then walked up to me said, “You say to me ‘What’s your name?’ and I will tell you ‘Lester!’”

I said to him, “What’s your name?” And he very proudly replied, “Lester!” After repeating the entire scenario several times, he said, “I will say to you, ‘What’s your name?’ and you will say, ‘I am Mr. Wiseman.’” And so I did. After repeating this several times, he went around the room, pointing to each animal picture on the wall, saying, “This is a picture of a cow” and “Here’s a picture of a lamb,” until he identified each of the animals. I said to him, “It’s like you are seeing them for the first time.” He looked at me and smiled.

Lester was born.

During the next several months, Lester used personal pronouns and began to lead me through his developmental stages—right out of Freud’s books. Lester took complete control of our sessions, taking me by the hand and instructing me on my role in the various scenarios that he wanted acted out. For example, first I was to be a “mommy bird” as he would chirp around the room, come back to the nest, sit on my lap, and open his mouth for me to feed him. This scenario became part of every session for several weeks. Gradually the emphasis changed, and I became the “big bad wolf” and would have to chase him (and not catch him). Scenes were enacted with big “daddy bears,” nighttime monsters, airplane trips to California, all having a theme of horrible things happening from which I was to protect him.

On one very dramatic occasion, Lester told me he had to go to the bathroom and asked me to go with him. When he flushed the toilet, he showed obvious distress and we quickly returned to the playroom. He then said, “Pretend I’m falling into a big hole.” He began sinking slowly to the floor. I went to him and said, “I will help you,” and extended my hand. He grasped firmly and pulled himself out.

Eventually, we managed to get Lester into mainstream school classes, where he prospered. One day he proudly announced to me that he was president of his class, which meant he led his classmates in the pledge to the flag, lunch count, and so on.

During my appointments with Lester, my faculty adviser treated Lester’s mother using hypnotherapy, with apparently equally dramatic results. Interestingly, Lester’s father was a professor of communication skills at the university.

ON TO CONNECTICUT VALLEY HOSPITAL AND THE CONNECTICUT SERVICE CORPS

Upon graduating from Michigan State University I landed a job at CVH. After two years of doing psychological testing on adults, I grew tired of the emphasis on testing and the deemphasis on the patients themselves. It was during this period that I decided one day to accompany a fellow psychologist who did some volunteer work on the new Children’s Unit, as discussed earlier. The horrifying images are still vivid. The fact was, I was told, this setup was a big improvement over previous conditions! The children there had come from the three adult psychiatric hospitals, always living on adult wards.

Having just come from the Hawthorne Center in Michigan, a new, state-of-the-art children’s program, where I worked with Lester, I was appalled.

Two years after accepting the position as a CVH psychologist, I accepted a new position: director of the Connecticut Service Corps, which included running a summer program for adult patients from the hospital’s back wards (occupied by long-term patients whose condition was considered chronic). That first year we rented a Girl Scout facility, Camp Laurel, and the next year we began building our own on an abandoned reservoir site in Danielson, what would become Camp Quinebaug. During my four summers living in a tent, I witnessed the devastating effects of long-term hospitalization. Being a “patient” was self-defined, a way of life where one must act accordingly.

I soon learned that the Connecticut Service Corps was an offshoot of the newly formed Peace Corps. Dave Boynick, the public relations contact from the Department of Mental Health had gone to Washington, DC, and talked with Bobby Kennedy, proposing that the Peace Corps be expanded to include projects at home. He offered Connecticut as a possible host for a pilot project. Boynick outlined a plan whereby college students would volunteer to spend summers at the state psychiatric hospitals, providing companionship and social activities for chronic patients from the back wards. Kennedy liked the idea and sought funds through the Peace Corps. As the bureaucracy would have it, funding was slow in coming and so Connecticut decided to go it alone. The Service Corps was founded when the first group of thirty volunteer college students accepted their assignments to spend the summer at Norwich Hospital. The students lived in the nurses’ quarters and, in the final two weeks, accompanied the patients to Camp Laurel.

The students brought new life to the hospital, and their experiences spawned their own professional careers. The success of the program allowed three more hospitals to join Service Corps programs, and an expanded summer program was ordered. That’s where I came in.

Camp Laurel, located in Andover, Connecticut, became home for my wife, Eunice, and me; our two children; fifty elderly, chronic, schizophrenic patients; thirty college students from the Connecticut Service Corps; and a few select staff members from the hospital. The students and staff knew the patients, which was a big help.

One of my fondest memories of that period, however, had nothing to do with experience or expertise. It had to do with a very lonely-looking, extremely withdrawn white-haired man called Sam and my young son, Ken. The two would sit on the bank of the lake and talk for hours. Well, at least Ken would talk. Sam just listened. One day, Sam brought along a piece of paper and a pencil and proceeded to draw a portrait of Ken as he talked. The drawing was beautiful. It turned out our elderly camper was an artist and writer, yet hadn’t revealed this to anyone in years. Eventually, Sam started a camp newsletter.

CAMP QUINEBAUG

Our Camp Laurel experiences paved the way for the challenges and deep rewards ahead of us. For the next three summers we would build Camp Quinebaug. Shortly after we closed down Camp Laurel, I immersed myself in recruiting college students for the next summer. I had the authority to hire thirty students for each of the large hospitals (housing approximately 2,500 patients)—Norwich Hospital in Norwich; Fairfield Hills Hospital in Newtown; Connecticut Valley Hospital in Middletown, plus ten for the Children’s Unit—and twenty for the smaller hospital in Meriden, Undercliff, and thirty who were to be groomed for the intricacies of camping with patients. The camp group included fifteen American Friends, a Quaker organization led by Mr. and Mrs. Paris. I also needed a supervisor for each group. I hired Alex Sotir, assistant football coach at Wesleyan University, as program director. Alex, his wife, Norma, and their three children were family friends, and having them with us that first summer was invaluable.

Eunice became my volunteer business manager, food service director, and waterfront director. In short, she was my organizer, right hand, lifesaver, partner, and compassionate saint working with students from around the world and, of course, “patients.”

That first summer we encountered a slight problem. Although during my own recruitment I was shown elaborate plans for a new summer camp in a reservoir and wooded area in Danielson, Connecticut, time went on and nothing materialized. When time ran out, I made an impulsive comment at one of the commissioner’s weekly meetings: “Well, I’m going out there even if we have to live in tents!”

Plans, funding, and promises fell through, and I had to eat my words. Next thing I knew we were calling the National Guard at Camp Dempsey asking to borrow tents. We asked Norwich Hospital to build us some platforms and picnic tables, rented some portable toilets, tapped into a freshwater pipe running along the road, and away we went. Only one major problem loomed: how to feed eighty people three meals a day with nothing but a fire pit. Fortunately, we were able to arrange a meal plan with Danielson’s technical school, otherwise closed for the summer. We transported two meals a day, one on weekends, to the campsite via the Blue Bomber, our antiquated school bus. We handled our own breakfasts and organized weekend cookouts. On Sundays, I cooked eggs for everyone!

With all the enthusiasm of those about to embark on an unknown venture, we sang as we put up the platforms and our tents—two 16-by-32-foot tents for the students, a smaller one each for the Friends’ supervisors, Mr. and Mrs. Paris, and one for Alex and me. By late afternoon we took a break and discovered the beautiful, clear lake. We picked a site overlooking the water for our dining room, a 100-foot-long army tent adjacent to a large, natural pit about 20 yards in diameter. This became our kitchen when we built a rock fireplace in the center. Eventually, we cleared brush, trimmed and cut down trees, and built an amphitheater. This gathering place hosted morning and noontime planning pow-wows and evening campfires. Two days later our families arrived and settled into our new summer tents—one for Alex, Norma, and their three children, Ted, Paula, and Michael, and one for our family of five, which now included our Dalmatian, Polkadot. This was our overall plan for the summer:

Week 1: We would focus on orientation and team building for the staff and Service Corps volunteers, pretesting for the research project, and camp preparations.

Week 2: Twenty “permanent” campers were to arrive, five from each hospital, presumably selected for the purpose of working with us to build the campsite, and stay for the entire summer.

Weeks 3–8: Every two weeks, forty new campers would arrive from the various hospitals, along with a few aides or nurses.

Weeks 9 and 10: The children from the new Children’s Unit at CVH were invited to attend the camp.

Week 11: We would spend a few days of breaking camp and falling from exhaustion.

Most of the patients/campers in the “permanent” group were fairly docile, friendly people, most more than fifty years of age, with diagnoses of chronic schizophrenia and having a variety of bazaar delusions and behaviorisms. Unfortunately, they arrived before we had a lot of our necessities, and I was still running around the state trying to get someone to respond to our requests. In fact, I put almost two thousand miles on my car in those first three weeks, while trying to run the camp and conduct some basic training for the students, who at first were overwhelmed by the variety of symptoms. Looking back, their inexperience actually helped. The student volunteers just ignored the strange behaviors and treated the patients as campers.

Nevertheless, because the days were so busy, our staff meetings usually started at 10 p.m. and lasted for an hour or so. By the end of the third week we were each averaging seventeen-hour workdays. Although I felt personally responsible for the fate of some sixty people, I was neglecting the needs of the students and staff who needed help. Finally, some of the students approached me and said, “We need more time to talk to you about the campers.” So we scheduled a meeting that evening. At midnight we sat at tables in the dining room tent and I began answering questions. At one point, while in the middle of answering a question, I noticed puzzled looks on the students’ faces. I suddenly realized that I was in the middle of a sentence and had no idea what the question was that I was trying to answer. I stopped, apologized, muttered something about being tired, and said I would talk to them in the morning. Shaking, I went back to my tent and woke Eunie. After we talked for a while, Eunie finally offered, “To hell with the department. Stop trying to depend on them. You can’t keep running around the state, beating your head against a stone wall. We’ll make do with what we have.”

The next morning I basically told that to everyone: “What you see is what you got. We all have to pitch in and not depend on the state to get things for us.” That was the turning point. We no longer held out hope of getting supplies and just went about our business building our camp while concentrating on the students, staff, and campers. I abruptly stopped going to Hartford or even making phone calls except to check in. I later learned that the department did not believe that the project was possible and wasn’t about to invest more money than it had to.