Visual- People Walking

1. According to the national institute of mental health, One in four adults—approximately 57.7 million Americans— • experience a mental health disorder in a given year. • One in 17 lives • with a serious mental illness such as schizophrenia, major • depression or bipolar disorder1 and • about one in 10 children live • with a serious mental or emotional disorder. • http://www.nami.org/Template.cfm?Section=About_Mental_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=53155 • Today, much has been discovered about mental illness. However, for a large part of history, little was known about mental disorders and people suffering from them were misunderstood, and often treated cruelly. Audio: http://www.youtube.com/watch?v=qeATjVHFpRQ http://www.youtube.com/watch?v=JKdXJYEHZEQ Visual- People Walking http://www.youtube.com/watch?v=1sJXG26P5Q8

2. The first mental hospital, Bethlem Asylum, was founded in 1337 in Bishopsgate, England. The conditions were terrible and patients were treated inhumanely. Patients were placed in cages and people could pay a penny to taunt them and poke them with sticks. In 1833, in Massachusetts, Worcester State Hospital was formed. It was barely an improvement from the almshouses of Europe. It was crowded and employed many, barely humane treatment methods. http://www.necn.com/pages/print_landing?site_define_args_1=print_landing&site_define_args_2=&blockID=155853&tagID=23965

3. In an 1877 report, the Board of Health reported that“…the excited insane were found by a committee of our legislature in 1848 to be at the Worcester Asylum…in small rooms, ‘having the least advantages for light, none for ventilation, unfavorably located, dark, dreary, damp and uncomfortable to the extent as to aggravate, rather than to assist the cure of the unfortunate beings placed there.” It was overcrowded, and prisonlike. Harsh restraints were often used to control patients.

4. There were many convoluted notions and desperate theories concerning mental illness. Treatments were often painful and did not help patients. Some included bloodletting, purging, being strapped into an armchair and spun rapidly or placed in a sweltering room to sweat collect sweat samples. These methods were meant to kill or identify the disease inside the mind, but actually harmed the patient’s body. http://www.kirkbridebuildings.com/blog/life-magazine-at-worcester-state-hospital

6. http://images.google.com/hosted/life/f?imgurl=07ea84b863eda13a&q=brain%20source:life&prev=/images%3Fq%3Dbrain%2Bsource:life%26hl%3Den%26biw%3D1026%26bih%3D542%26tbm%3Dischhttp://images.google.com/hosted/life/f?imgurl=07ea84b863eda13a&q=brain%20source:life&prev=/images%3Fq%3Dbrain%2Bsource:life%26hl%3Den%26biw%3D1026%26bih%3D542%26tbm%3Disch

7. The Asylum for the Insane in Charleston (later Somerville), Massachusetts accepted its first patient in 1818 and it operated on the principal of moral treatment, in contrast with the asylums that had come before. THESIS Rufus Wyman was chosen as McLean’s first director. He set a precedent by following the principles of moral treatment. He set up a pleasant, pastoral environment for patients who had recreational time and a wide choice of activities “the greatest reforms in the care and treatment of the insane… lay rather in the substitution of kind for cruel treatment than in scientific therapy. “Indoor activities such as backgammon, ninepins, reading, writing, and music coupled with outdoor activities such as swinging, sawing wood, walking and gardening .. . All of which “tranquilizing the mind, breaking up wrong associations of ideas, and inducing correct habits of thinking as well as acting” - Dr. Wyman’s first report to the Trustees in 1822 McLean helped change treatment of those with mental illness and public attitudes towards them through research and innovative methods - medical community

8. Under Wyman, McLean became a center for radical, new treatment. Older, out of date practices, such as bloodletting and purging, were not used at the new psychiatric hospital. “Chains or strait jackets have never been used or provided in this asylum, no attendant is allowed to put the smallest restraint on a patient without direction of the supervisor, who enters the fact in a book and reports it to the physician. No person is ever allowed to strike a patient, even in self defense.” - Dr. Wyman’s report to the Trustees in 1833 Recovery, rather than restraint was the highest priority at McLean. Info about mental illness being “treatable”

9. The second superintendent, Luther Bell, was also known as a humanitarian. He was a founding member of the American Psychiatric Association. After its first meeting in 1844, the progressive association declared, "It is the unanimoussense of this convention that the attempt to abandon entirelythe use of all means of personal restraint is not sanctionedby the true interests of the insane.“The association continues to “advance public understanding of mental illnesses… and promote awareness of mental illnesses and the effectiveness of treatment” to this day. Much of its progressive ideology was reflected in Bell’s leadership of McLean from 1836 to 1856. Luther Bell was also a close friend of Dorothea Dix, who was a well known advocate for the rights of the mentally ill. She did much of her work in MA and is buried at Mt. Auburn Cemetery.  necessary?? http://www.psychfoundation.org/Functional/AboutAPF.aspx http://www.psychservices.psychiatryonline.org/cgi/content/full/56/12/1621-a

10. From 1879- 1903, Edward Cowles was the superintendent. He changed the name of McLean Asylum to McLean Hospital to help destigmatize mental illness and incorporate psychiatry into general medicine. The Worcester State Hospital had been called the State Lunatic Asylum. Previously, psychiatry had not been considered a legitimate branch of medicine and calling an asylum a hospital also showed that there was hope for a cure. Visual: McLean sign Additionally, he founded McLean’s scientific research program by creating laboratories- http://rkthomas.myweb.uga.edu/Franz.htm - "In 1904, I was practically ignorant of the problems and management of insane patients . . . [but three years at McLean gave me] a working knowledge of current psychiatry and a more intimate knowledge of the facts of abnormal psychology." (p. 106) -G. Stanley Hall First clinical chemist hired, first psychological laboratory- Otto Folin Additional Visuals: other equipment from site, current labs footage -( advanced the professional training of nurses and was among the first to hire male nurses)

11. Also under Cowell’s leadership, McLean moved from Somerville to Belmont due to increasing industrialization that disrupted the peaceful atmosphere essential to patient’s recovery. • It was known as the “little city on the Hill” since it was self sufficient, disconnecting it from Belmont. The hospital grounds were built on the cottage plan. Wards were spread out and patients were separated by age, gender, and disease. This principal remains the same despite its move from Somerville to Belmont. There are recreational areas and a communal eating area.The Belmont Bulletin described the campus: “All of the buildings are arranged for convenience and comfort, and vary from violent wards to the wards where people slightly demented are treated.” Many other hospitals such as the nearby Metropolitan State Hospital and Worcester State Hospital were modeled on theKirkbrideplan, where all patients were kept together in one main building. McLean was known as a comfortable, elegant hospital in its best days. In 1881, McLean removed bars from many windows and unlocked doors in lower security wards. This unprecedented freedom showed the trust McLean staff had in their patients. Previously, people with mental illness hadn’t been respected, much less treated as responsible humans. Now, with McLean’s progressive attitudes, the stigmas towards the insane were changing. http://www.wickedlocal.com/belmont/news/x868524757/Belmonts-McLean-Hospital-turns-200?photo=5#axzz1NzL7NwQS

12. As part of McLean’s moral treatment policy, it employed only therapies considered humane or progressive. Although lobotomies were performed, their numbers were relatively small during a time when they might be prescribed for relatively minor ailments such as headaches. However, (after WHEN/WHY?) the practice soon ended. McLean used group therapy and instituted a “no physical contact rule”. Doctors respected patients and tried to become people the patients could trust as confidants. In other hospitals, the distance between patients and doctors were breached with restraints and forms of sometimes violent physical contact. McLean’s new policy showed that it respected the privacy and integrity of the patients.

13. More recently, McLean has branched out other types of research and treatment. In 1972, the Alcoholism unit was established. In past eras, alcoholics along with other people suffering from mental diseases had been condemned as “feeble-minded.” Extreme eugenicists believed they should be taken out of American society. Opening a ward for recovering alcoholics proved that McLean believed there was a cure for alcoholism and that it was something that could be helped. This further treatment showed a trust in therapy and recovery for all patients. In 1974, the Alcohol and Drug Abuse Research Center was opened, further proving McLean’s belief that these were treatable mental illnesses. Then in 1980, the hospital opened a drug dependence treatment unit to try and provide addicts a place to rehabilitate in peace. This ward treated famous patients such as Ray Charles who continued to check in after his discharge to continue his progress. Another well-known patient was singer-songwriter James Taylor, who was admitted at age 17 with suicidal tendencies. He is open about his positive experience there and even attended the high school there. The Arlington School, established 1961 as a chance for teenage patients to get a high school diploma and prepare for college. Compared to other opportunities for mentally ill children, it was heaven.

14. Nearby Gaebler Children’s Center was a part of Massachusetts Mental Health Center that was centered around the needs of children. It operated on old-fashioned principals and has been referred to as a “poisonous” (madpride) environment. There were harsh punishments for misdemeanors and little opportunity for therapy and improvement. The environment of the school available was less accommodating that of the Arlington School at McLean. A patient at Gaebler and an attendee of its’ school was given doses of a strong depressant that would make him pass out in school daily. When he would refuse to go, the punishment was,” restricted to the ward for the next twenty-four hours.” Whereas the Arlington school Is famous for its flexible, stress free environment. James Taylor recounts, “You can't tell a whole bunch of potential suicides that they must have a high school diploma.” The school is an important part of McLean’s approach to treating the mentally ill. http://www.time.com/time/magazine/article/0,9171,878920-5,00.html pg 5 McLean Gaebler http://www.madpride.org/VFC10GaeblerHellandBack.htm

15. BPD (maybe)

16. ECT -Ann interview

17. Misc. Pix Worcester