In 1868, two initial parts of the Connecticut General Hospital
for the Insane (now called Connecticut Valley Hospital) were opened in
Middletown, CT on the Connecticut river.
The physical layout was inspired by the work of Dr. Thomas Kirkbride and
was built in Second Empire Style. Large
stone buildings, four stories high, made up the initial construction of the
hospital. There were eight wards on
either side of the central building.
Over time, more land was acquired to total around 650 acres and 80
buildings. The hospital was constructed
to specialize in the humane treatment of the insane. The goal was to construct buildings that
positively impacted mental health and created an environment conducive to
treatment. Some spaces were decorated
with books, photographs, and art and the goal was to reduce stigma around
mental illness and create a sense of normalcy.
Those who complied with the regimens lived closest to the central
building and those who were more violent were furthest away from the center of
the building.
Activities and amenities were included to help instill a
sense of civility for the patients and increase responsibility. To promote wellness, there was a carpenter
shop, a baker shop, lecture hall, chapel, billiards room, and bowling. Patients also had the option of working on
the hospital farm. A strict regimen was
established, which included bells that would ring to dictate movements of
patients and staff.
Unfortunately, the intended results were not achieved due to
overcrowding. Immediately after the
initial opening, there was more and more demand. Once the hospital was deemed complete in
1871, the 450 beds were not nearly enough.
Extensions were not approved until 1881 and this still did not meet the
demand. Basic custodial care was the
emphasis as the hospital became a dumping ground for anyone needing this care
which included epileptics, alcoholics, and intellectually disabled. The patient to staff ratio was 230:1 by 1890.
There were some improvements when new superintendents assumed control in the
late 1800’s. Hydrotherapy was
introduced, a reorganization of the hospital layout, and development of a
pathology department to look at microbiological causes of mental illness were
part of these improvements.
In 1908, Clifford Beers, who was committed to the hospital
for a year and a half, published a book entitled A Mind that Found Itself. This book shed light on his experience and
what he witnessed at the hospital including lack of therapy, abusive staff, and
poor conditions. This work helped advance the movement of institutional care as
a last resort. In the 1950’s the peak population was around 3000. There is a cemetery on the grounds that has
1652 graves. Connecticut Valley Hospital, as it is now called, still is in
operation as a psychiatric hospital that provides inpatient care for forensic,
severe addiction, and geriatric treatment.
Hi Sandy - It is interesting to me how so many of these institutions were initiated to provide proper care and allow wellness for patients to recovery. In the beginning, like the Connecticut Hospital, they were nicely constructed, floor plans that made sense, areas to relax, etc however were not able to meet the demands. Overcrowding defeated the purpose as neglect and abuse set in. Sadly, so many died as a result. I liked reading about Clifford Beers in our reading and your blog. His work helped to initiate awareness and deter admission for the sake of admitting someone.
ReplyDeleteWow, thank you for your research and post, Sandy. It boggles my mind to consider a 230:1 patient to staff ratio but I can see how this easily happened. It makes me wonder about the training programs that existed at the time for mental health workers, and the culture around mental health issues and the ways in which families viewed and handled the mental health issues of their families. It makes me wonder if families were simply so overwhelmed that they immediately dumped their mentally ill families off as soon as the hospital opened. Perhaps so, and this would explain the rapid increase in population and overcrowding of facilities. As we read about the abuse and lower quality of care and support that resulted from such situations, it is an important reminder for us to remain focused on clients and their needs above all else.
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