Riverview Hospital for Children and Youth. Richard J. Wiseman

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СКАЧАТЬ physical area. This was contrary to the hospital’s position as stated in the Quarterly Report Ending in December 31, 1960:

      We are unable by any statutory authority, to limit the number of children referred to our hospital for admission from any part of the state. Admissions flow in from general practitioners via 30-day emergency detention certificates, from child guidance clinics, from other institutions, including hospitals and correctional institutions that cannot handle these children, from the Juvenile Court and from frantic parents requesting voluntary admission. We are asked to not only treat them but to evaluate them prior to admission. This does not point to a deficiency on our part but clearly to a deficiency of the various communities of Connecticut, individually and jointly, who are neither prepared nor willing many times to accept the responsibility for the children in their midst who deserve a highly specialized kind of care. We suffer from a lack of sufficient numbers of specially trained professional staff at various levels, including senior staff, nurses and ancillary personnel.⁸

      There were sixty boys and thirty girls in residence, an overwhelming number in view of the anticipated admission rate. In our 1995 interview, Herbert Gewirtz recalls the situation as he remembers it:

      The hospital was not interested in having children. They were totally against it. It was imposed upon [the facility] by the governor’s office—they were getting a lot of pressure to provide mental health services for children. The whole thing was just dreaded by the hospital administration. Kids were trouble. They just caused a lot of grief to the administration and so they weren’t interested in them at all. So Max Doverman was operating in a vacuum because he had no power and they weren’t about to give him any. At that time it was basically lip service and window dressing and just hoping it would go away. But Max got some things started. He hired a principal and some teachers and a recreation person. Then he gave up. He had enough and left.⁹

      When Gewirtz was appointed, he set as a priority the task of bringing the children’s programs into a unified service. This was not a popular idea. Nevertheless, he pushed forward, and eventually succeeded. He talks about the process in our interview:

      The resistance to unification was tremendous. Nobody wanted to give up their domains, nor did anyone want to exert the effort to do so. The only thing that didn’t frustrate the staff was what was happening outside the hospital. People were now interested in this children’s service. Marjorie Farmer, state representative, was very vocal. Others behind it were people in the Mental Health Association; mental health professionals in various administrative positions; child guidance people who needed a place to send a kid; the Institute of Living [at Hartford Hospital]; Dr. Zeller. People started coming down to the hospital to visit, and I always presented the seamy side—never told them what was good—and that was my policy. I told them what we haven’t got and what we need. At this time I had no authority; however, when I found a vacuum I just went ahead and tried to fill it.

      The first real step in unification was the assignment of the assistant superintendent of CVH as responsible for the services for children—Charles Meridith, M.D. That was really a result of all the pressure being put on Whiting (superintendent of CVH). He didn’t want to have anything to do with it so he gave it to Charlie. I developed a good relationship with him, and it was a result of the influence that I could exert on him that we thought about unification—because all we were doing was putting out fires—functioning like an occupational therapy department. So we began to move toward towards unification.¹⁰

      CHILDREN’S SERVICES

      In November 1962 I had my first experience with the newly formed children’s services. I started work in the Psychology Department of CVH. My training and previous experiences had been with children, and I felt I needed to get some practical experience working with adults. I decided, however, to at least take a look at this new children’s services, vowing only to look and not get involved. When I walked onto the ward in Beers Hall, I was stunned. Having just come from Michigan, where I interned in a state-of-the-art psychiatric program for children, I couldn’t believe my senses. While forty years have passed since that day and recollections fade, the dismal images that come to me are of a large room with some thirty or more beds, high ceilings, dim lighting, and creaky floors, and all I could think of was the movie The Snake Pit.¹¹ For the moment, I kept my vow to stick with the adult unit, but I knew someday I would get involved with the children.

      By this time all children under sixteen had been transferred from the other hospitals, and with a steady stream of new admissions the population of children’s services had reached fifty-five boys and twenty-eight girls. The first floor of Beers Hall was opened up to thirty-eight boys, with seventeen boys still residing on the adult wards. Soon thereafter, the girls were moved into adjacent housing in Dix Hall.

      In a River Views interview, children’s services worker Andrea Spaulding recounts, “Things were very chaotic, every patient seemed to exhibit a different problem behavior or psychosis. All you tried to do was keep them in order.”¹²

      The Hartford Courant, in a series of articles about the plight of children in Connecticut hospitals, aroused public outcry when it revealed the use of straitjackets on children.¹³ This naturally caused a political furor, and the commissioner of the Department of Mental Health ordered an internal investigation. Charles Leonard, who had vast experience in conducting surveys of children’s facilities, volunteered to do a survey if he could do it his way, which was to live on the grounds and be granted free run of the place, both day and night, for a period of one week. The commissioner agreed to ask CVH superintendent Harry Whiting. Harry graciously agreed to Charles’s stipulations and made arrangements for him to stay in a guesthouse. Leonard spent the days and several nights on and off the wards and described meeting “some real good, down-to-earth, competent psychiatric aides at two and three in the morning,” but the Beers Hall facility was an “awful, awful, terrible place—even the toilets were awful, stinky.”¹⁴

      Another major step in the unification of the children’s programs was the assignment of psychiatric residents. According to Gewirtz, “Previously … kids on different wards … were assigned to whoever worked on that ward. Each ward had its own personnel. Now residents were responsible to me—not for clinical supervision but more administrative, general strategies around kids. This was historically a first for psychiatrists to come under a non-physician.”¹⁵

      Fragmentation had been true in all other disciplines—significantly nursing, which, of course, included all nurses and psychiatric aides. Nursing the hospital’s largest department. The hospital structure included a nurse supervisor for males and one for females, each reporting to a director of nursing. In order to add a nurse supervisor for children’s services, Gewirtz established a new position, director of group living, reporting directly to him as director of the Children’s Unit. With this new title, Louise Nelson had more direct responsibility to children’s services and its administration. She therefore became a pivotal person in the program. Also, John Thomas, the medical director of High Meadows, in Hamden, became a consultant. This added to the political pressure for unification of child services. Gewirtz explains:

      It had political implications because everyone was looking to see what was going on. It was very shaky yet. At that point, Lou Perlman completed his residency and came on to help run the children’s services. He started as co-director. There were a lot of problems, however. I thought it could work out because we were good friends. I was looking forward to his coming. We handled it by splitting our domains. Lou had the clinical side and the ward, and I took the outside work (administrative, politicking, etc.). It didn’t work out. Lou became appointed director, and I became assistant director. There were a couple of reasons for that. One had to do with a letter I sent to a doctor in New York…. The guy was a big name in the field who talked to Bloomberg [then commissioner of mental health], who called Dr. Whiting, and people were very upset with me. Bloomberg went on to say, “I think we need a medical person there,” so I left, primarily because of that. СКАЧАТЬ