Deinstitutionalization and Manteno State Hospital
In December of 1930 Manteno State Hospital officially opened. The number of patients grew quickly; from 100 when it first opened in 1930, to its peak of 8,195 in 1954. Due to the high number of patients, medical staffing at Manteno became such a concern, that eventually high school dropouts were allowed to be hired as nurses. This lack of qualification lead to the misuse and abuse of standard treatment for the times. In fact, there were allegations of sexual abuse; decades later it was revealed that in the 1950s, the hospital had been conducting experimental surgeries on patients without consent. It was also during this time that lobotomies were a popular experimentation technique for treating mental illness, and Manteno State Hospital was no exception. In addition, numerous other controversies had surfaced; there were allegations of the U.S. military conducting secret medical testing at Manteno during World War II. Patients would unknowingly be injected with malaria in an attempt by the military to find a remedy for the illness. In 1941 alone, 462 patients would die from the experimentation. Another 198 escaped from the facility. Then starting in the late 50s, Manteno patient population started to dwindle; most likely brought on by the wave of deinstitutionalization. By 1983, it was finally time to shut the hospital down. After 55 years of operation, Manteno Mental Health Center closed its doors in December of 1985.
Deinstitutionalization can be defined as “the social policy of encouraging mentally ill individuals to be treated in community-based programs rather than in large mental hospitals” (Levinthal, C.F.). The deinstitutionalization of mental patients was a movement that aimed to minimize the amount of care provided in institutional settings, particularly in the state mental hospital, and to increase the care provided by outpatient agencies in the community (Shadish, W. R., Lurigio, A. J., & Lewis, D. A.). It has had an enormous impact on the mentally ill, the community, family members and taxpayers. First off, he widespread use of new drugs beginning with Thorazine in 1955 served as a catalyst for the release of many patients from psychiatric hospitals. Patients that could not previously function well in society could, with the use of newer drugs, live independently in society. In addition, the process of deinstitutionalization was greatly accelerated by the enactment of federal Medicaid and Medicare programs, which enable many patients to sustain themselves financially in the community. This enactment was instituted with the best of intentions. However, there have been unintended consequences accruing to many in society, due to an absence of sufficient planning for alternative care with adequate resources. While most consumers of care benefit from the increased freedom associated with deinstitutionalization, many of the more severely ill have been neglected. This resulted in other members of society having been adversely affected by deinstitutionalization (Krieg, R. G.).
Prior to deinstitutionalization, one of Manteno State Hospitals most well-known patients was Gennie Pilarski. Gennie enrolled at the University of Illinois in 1941 with a major in chemistry. She would study for three years being sent to Manteno State Hospital in 1944, after an argument with her parents; she would never be the same. While at MSH, she was given an experimental version of hydrotherapy at Manteno State Hospital. The hydrotherapy used at the time involved plunging the patients into bathtubs filled with extremely hot and cold water back to back for extended periods of time. By August of 1945, Gennie had been given 40 insulin coma treatments and she was nearing her fifteenth session of electric shock therapy – all in addition to her hydrotherapy routine. By the middle of 1953 Gennie had already received 187 electric shock therapies, averaging treatment twice a week. She was transferred to the research ward at Manteno State Hospital, where medical experimentation took place on mostly involuntary patients. One procedure that was beginning to spread across the country at the time was a form of psychosurgery known as the lobotomy. For reasons unknown, Gennie was the subject for a lobotomy procedure in early 1955. According to records she had “extensive neurosurgery with bilateral extirpation of most of the frontal and temporal lobes.” Post-operation, the chart also noted Gennie was “now mute, totally dependent on demands for functioning of everything from toilet urges on up. To be given an experimental course of electric convulsive therapy to see if any affective change can be brought about.” Or in other words, the lobotomy was a complete failure. In September of 1998, Genevieve “Gennie” Pilarski quietly passed away in her nursing home room at the age of 79.
References
Krieg, R. G. (2001). An interdisciplinary look at the deinstitutionalization of the mentally ill. The Social Science Journal, 38(3), 367-380.
Levinthal, C. F. (2014). Drugs, Behavior, and Modern Society. Boston, MA: Pearson.
Manteno State Hospital. (2013, March 1). Retrieved from http://sometimes-interesting.com/2013/03/01/manteno-state-hospital/
Shadish, W. R., Lurigio, A. J., & Lewis, D. A. (1989). After deinstitutionalization: The present and future of mental health long-term care policy. Journal of Social Issues, 45(3), 1-15.
The Story of Gennie Pilarski. (2013, April 24). Retrieved from http://sometimes-interesting.com/2013/04/24/the-story-of-gennie-pilarski/
This article is interesting in that it is a prime example of early psychology in action before ethics became an immense part of research and treatment. It shows how our search for knowledge can sometimes hinder our morals or values. The story of Genie is one of a woman whose life gets turned upside instead of getting the help she needs. This sort of thing could happen to any of us which is why her story is somewhat relatable and somewhat haunting to hear. I do wish the article provided information about how family members were affected by deinstitutionalization and how they now had to support a mentally ill individual. Overall it feels like it stop abruptly.
The article was interesting, but the ending felt cut-off. The story about Gennie is horrifying, and it does help us realize that we have come a long way in treating mentally ill patients; however, one thing the author can include is information on how deinstitutionalization negatively affects members of the community, allowing the reader to be able to see both sides of the story.
This article did a good job at creating an introductory lesson on deinstitutionization and explaining what positive programs and resources came out of the breaking away from large mental hospitals. I feel that what it was missing was the continuation on the thoughts about those patients who would not directly benefit from the new resources being developed during the time. I felt that it was presented as something to be considered but never gone into detail. What happened to the patients who were not immediately helped through the introduction of new drugs or outpatient clinics? What of those who did not have supportive families to help with treatment and therefore more susceptible to being forced into these medical procedures without consent? I think this article scratched the surface of an important subject but lacked depth.