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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.
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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.
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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.
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Male 1 in 1970 |
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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.
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One of the many tree lined
walkways that connect the
buildings |
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