Riverview Hospital for Children and Youth. Richard J. WisemanЧитать онлайн книгу.

      [ CHAPTER 2 ]

      A PLACE TO START

      …

      In 1962 children diagnosed with serious psychiatric or behavioral difficulties were admitted to Connecticut Valley Hospital in Middletown and eventually placed in the Children’s Unit. However, it was many years earlier, in the early 1940s, that legislators, parents, mental health professionals, and scholars from the Yale Child Study Center planted the seeds for reforming children’s mental health facilities in Connecticut.

      These innovators identified problems in the mental health system and began talking about the need for a residential setting for children and youth unable to be served in traditional child guidance clinics or residential child-caring facilities. A survey in 1943 by James M. Cunningham of the State Bureau of Mental Hygiene provided enough evidence to support the need for a psychiatric study home. In 1945 Governor Raymond Baldwin appointed a child home study committee that repeated the survey, focusing on the number of new cases referred to the juvenile court, State Child Welfare Division, or Council of Social Agencies in the calendar year 1945. These agencies were asked to identify children under the age of sixteen who met one of the following criteria:

      (A) Required more careful observation and diagnosis than could be provided in an existing outpatient clinic if one were available. Or

      (B) Required a more extended period of psychiatric treatment, excluding children diagnosed as psychotic and needing long-term care.

      There were 636 children so identified, 355 in category A and 281 in Category B.

      In their preliminary report to the governor dated 23 December 1946, the Subcommittee on Operations unanimously recommended that “a cottage type of institution [be] required for satisfactory work with the children,” and “the individual cottages should be small, housing no more than twelve children each.” It was agreed that the central treatment building would be planned with facilities for carrying out treatment with one hundred children in residence. The committee recommended the “immediate establishment of a seventy two bed cottage type of institution with an embracive children’s program under psychiatric direction.”¹

      In 1947 the first positive step in the implementation of this recommendation came in the form of House Bill 441, submitted to the Connecticut General Assembly. It was favorably received by the Committee on Welfare and Humane Institutions, but not by the Appropriations Committee, which had the responsibility of approving the $643,000 needed.

      In 1948 the new governor, James McConaughy, former president of Wesleyan University, Middletown, Connecticut, reactivated the Child Study Committee. The committee submitted its report in December 1948 to Governor Chester Bowles after McConaughy’s untimely death. Amending the original study—“inasmuch as the records of the State Hospitals indicate that approximately fifty psychotic children are admitted each year to the state hospitals, it is therefore recommended that two more twelve-bed cottages should be added to the Study Home”—seemed to be a fallback decision. The report further states, “It was hoped that the three mental hospitals might establish in one of their institutions a children’s ward with proper personnel and a program to service the approximately twenty-five psychotic children now scattered among the three institutions. Since this proposal has not proved capable of accomplishment, and since the need to provide adequately for these children remains as pressing as ever, the committee has concluded and accordingly recommends … the inclusion of these children in the Study Home.”

      The subcommittee also recommended that “a psychiatric study home should not be established on the grounds of any existing institution in the state” and voted unanimously in favor of the recommendation.

      The final recommendation was that “the home be planned in terms of eight twelve-bed cottages, or a total bed capacity of ninety-six,” and an additional twenty-four beds for psychotic children. The subcommittee estimated that the cost of funding this venture would be $308,198, of which $198,198 represented expenditures for personnel and the remaining $110,000 for costs of operation.²

      THE CHILDREN OF CONNECTICUT VALLEY HOSPITAL

      On 1 October 1953, the Connecticut Department of Mental Health with John Blasko as commissioner replaced the Joint Committee of State Mental Hospitals. Elias J. Marsh, previously with the Department of Health, Division of Mental Hygiene, and an outspoken advocate for children, succeeded Blasko in July 1957. Marsh was instrumental in moving ahead with the development of appropriate services for children residing on adult wards. He therefore ordered a full assessment of all children sixteen and under in Connecticut psychiatric hospitals. This included Norwich Hospital, Norwich; Fairfield Hills Hospital, Newtown; and Connecticut Valley Hospital, Middletown (then known as Connecticut Hospital for the Insane). His assessment showed sixty children housed on the various adult wards—eating, sleeping, and mingling with adult psychiatric patients. This meant that, on any given day in 1957, you might run into a seven-year-old autistic girl sharing a room with a sixty-seven-year-old psychotic woman.

      Finally, after years of discussions, modifications, site searching, and various other delays, the State of Connecticut appropriated $250,000 to build Connecticut’s first Child Study and Treatment Home for emotionally disturbed youngsters. The result of these discussions was the building of High Meadows in Hamden, Connecticut. Unfortunately, funding was sufficient to house only a limited number of beds, many fewer than had been requested.

      After a lengthy search, the state appointed Charles Leonard as the first superintendent of the newly constructed High Meadows. In a personal interview conducted on 1 May 1990, Charles shares his account of what happened:

      The original plan was to have beds for sixty children, but even though the money had been approved on paper, the General Assembly only released enough for one building serving twenty children: fourteen boys and six girls. When it opened, everybody thought we would be able to take all the troublesome kids and of course that wasn’t true…. So the big questions came up about two years after High Meadows was built (about 1959 or ’60): one, how come High Meadows wasn’t taking these kids, and two, if High Meadows isn’t going to be the answer … then what about these kids in the adult wards?³

      Dorothy Inglis, newly appointed chief social worker at High Meadows, interviewed each child, read every record, and performed clinical evaluations. In an article published in the Journal of Orthopsychiatry and presented at the 1957 annual meeting of the unit’s board, she and coauthor Elias J. Marsh reported the results of their study. In their summation they conclude: “Mental hospital use for children points to the need for the community to review its resources and its problems, to bring programs inherited from the past in line with the present knowledge of human behavior. We may have many worthwhile individual programs. However, they must be coordinated in a community-wide effort to meet the full range of children’s needs. Until this is done those who are not provided for may continue to be found in places never meant to serve them, such as the state mental hospital.”⁴

      This remarkable study—as well as increased pressure from the professional community, hospital superintendents, the acting commissioner, and the legislators—led to the consideration of bringing all children under sixteen years of age to a single hospital as a demonstration project.

      Exactly why Connecticut Valley Hospital was chosen is not clear, but certainly its central location was a major factor. While superintendents from each of the three hospitals—Ronald Kettle of Norwich, William F. Green of Fairfield Hills, and Harry S. Whiting of CVH—were reluctant to admit children into their hospitals, Whiting apparently accepted the responsibility.

      Unfortunately, the children were not housed together; they were placed “wherever feasible throughout the hospital.”⁵

      In September 1958, Wilfred Bloomberg was appointed commissioner of the Department of Mental Health, and the intention was to establish nineteen new positions at the proposed children’s services at CVH. When hospital administrators were unable to find a psychiatrist interested in overseeing the CVH program, Max Doverman, the former