A Return to the Community

 
1966 marked one of the biggest changes to state care for the mentally ill. That year a law was passed which directed that each county in the state of Pennsylvania shall establish a county mental health program. This law, which was passed in October also gave the Department of Public Welfare the right to review all non-criminal admissions to any state hospital. In 1969 Philip Laucks became the seventh superintendent of the hospital and with him came drastic new changes. Until now patients were house in separate building by their type of illness. Laucks adopted a "Unit" System in which all patients, regardless of their illness were places in one building according to the county from which they came. Male and female patients were still separated on different floors. By 1971 there were four such units functioning at the hospital. There were also geriatric, adolescent, and alcohol rehabilitation units.
Laundry workers loading a truck in 1970

The year 1972 delivered the next big blow to the state care system. Essentially a new patient "bill of rights" came into being after a lawsuit was filed against the state of Alabama over the quality of care that was being administered at the Bryce Hospital in Tuscaloosa. The courts ruled in favor of the patient and their family and the result was these new guidelines: "Patients have a right to privacy and dignity. Patients have a right to the least restrictive conditions necessary. Patients have an unrestricted right to send sealed mail. Patients have a right to be free from unnecessary or excessive medication. Patients have a right to be free from physical restraint and isolation. Patients have a right not to be subjected to treatment procedures such as lobotomy, electroconvulsive treatment, or other unusual or hazardous treatment procedures without their consent. Patients are not deemed incompetent to manage their affairs, to contract, to marry, to register and vote or to hold professional or occupational or vehicle operator's licenses by reason of their commitment to a mental hospital." However the greatest blow to the state hospital system to come out of this ruling was that "no patient shall be required to perform labor which involves the operation and maintenance of the hospital." Patients would still be allowed to work at the hospital voluntarily, however all such work had to be compensated in accordance of the minimum wage laws of the day. Almost over night this changed the way Harrisburg State Hospital, as well as all state hospitals in the United States operated. No longer would it be acceptable for patients to work in the fields, planting and harvesting crops, no longer would they be allowed to shovel snow or tend the lawns, no longer would they make furniture, clothing, or blankets. Farming was shut down almost instantly. At Warren State Hospital in up state Pennsylvania, large fields of vegetables which had been plants before the ruling were just left to rot in the hot sun. Eventually most state hospital farm lands were sold to developers. At Harrisburg the farm land and buildings are currently leased to a private tenant.

1972 also saw an end to the unit system that was introduced just a few years prior. By all accounts the system was a success and patients seemed to benefit from it, but the resources required to support the system were more than what was available at the time. Harrisburg, as well as all state hospitals in Pennsylvania were now completely under the control of the Department of Public Welfare. There were no longer any paying patients at the hospital, there was no private fundraising by the board of trustees, and there was no more selling of excess goods produced by the farm or from the various "manufacturing" activities at the hospital. Now the hospital was required to get by on only what the state provided in it's annual appropriations, and there never seemed to be enough money.
Male 1 in 1970

Through the late 70s, 80s, and into the 90s the population of the hospital fell rapidly. This was a result of a combination of new drugs and a push to return the care of the mentally ill to community centers and homes. It seems that the belief of what is best in the care of those with mental illnesses has come full circle in 200 years. From a push in the 1800s to get people off the streets and out of homes to state run institutions where they could be cared for by professionals and have 24/7 supervision. To today when we are returning them back to the homes and even the streets from which they came. In 1992 it was estimated that there were 250,000 people with serious metal illnesses in the United States, of them, only 68,000 were receiving hospital care. Most of those receiving care were of a middle and upper class status, the "indigent insane" that Dorothea Dix and other reformers of the nineteenth century tried to help are once again on their own. The patient population of the hospital in 1992 was a mere 450. Only those who have repeated admissions to a county mental health center were being referred to a state hospital. Of those that were still being admitted to the hospital, the average stay was down to six months. The hospital was finally closed on January 27, 2006. Three months prior to the closure the patient population was down to only 148.

Today (2010) the hospital buildings still sit atop the hill over looking the Pennsylvania Farm Show Complex. On a spring day the campus is a beautiful place to visit, with numerous types of trees lining the many walkways and roads. With exception of the North and South Branch Buildings and the Female Nurse Home, all the hospital buildings that were constructed after the Main Building still exist today. Some of them have been altered, but most still look as they did when they were built. Unfortunately, the few that have been altered have been done so to such an extent that they don't even resemble the buildings that they once were. Once example of that would be the Infirmary Building. It was added on to several times through the years, each time it lost more and more of it's unique features. But the most resent addition, a bland brick facade that sticks out from what was once the front entrance of the building is so out of place amongst the historic buildings that is sticks out like a sore thumb and spoils the scenery around it. Most of the buildings are in use once again, now occupied by various state and private agencies.
One of the many tree lined walkways that connect the buildings

 

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