Manteno State Hospital

Personal Account – “Notes on a Sociologist’s Observations”
May 27, 2009, 12:19 pm
Filed under: Personal Accounts | Tags: , , , , ,

The following are notes taken from an  interview with a sociology professor who had once worked at MSH as a mental health care professional:
One of the most disturbing, yet not shocking, discoveries made about Manteno State Hospital was the sexual activity of patients and staff during the 1960s and 1970s.  It seems that personal accounts state that not only were the patients inadvertently allowed to have sexual relations, but that the staff was also fooling around with other staff members as well as some patients.

Another point of interest is that in 1955, when MSH was at its peak population of over 8,000 patients, 2 things brought on the rapid decline of the population. #1, it seems was the invention of thorazine and the other, the prevalence of television.  When these two things were combined it made for a zombie-like captive audience.  Medicated to the gills and set in front of a television on the day-room ward for hours on end made life much easier on staff.

A portion of the patient population was deemed criminally insane or pathological patients.  Manteno was not built for isolation and patients could only be isolated from each other by ward buildings.  One or two had to be designated to dangerous patients.  But this only made for the complex problem of having pathological patients grouped into one building.

One story recalls of a particularly violent patient who had been sent home on home leave from the hospital and murdered his wife, chopped her into pieces and packed her into the back of his car.  He was eventually caught and returned to MSH where he was supposed to have been locked up for good.

When nursing homes became a popular way to care for the elderly, many elder mentally ill were tossed out of the state hospital system and shoved into nursing homes.  Here, care was not as good.


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As a “social work trainee” at Manteno from 64-66, I was there as the “deinstitutionalization” movement began in earnest. While the ideal was commendable, it was in many ways driven by political and budget concerns, and was rife with mismanagement. In those days it was difficult enough to get anyone in Chicago on the phone to discuss aftercare, and all but impossible to arrange placement or treatment. I can’t confirm from personal experience that patients were bussed to Chicago and dumped (although I heard that story enough times to consider it plausible), but I do know that many patients sent out in those days came back in short order. It’s also important to remember that instead of asking for more money to improve patient care, the then Hospital Director actually took pride in not spending his budgeted alotment and returning funds to the state at the end of the fiscal year.
As for the sexual behavior of staff and patients, I really don’t think that the mood of the 60s had as much to do with this as the fact that 1)when you lock people up segregated by sex, the fact that sex is proscribed makes it all the more desirable, and 2)as in any place where staff has almost total power with very little oversight, there will sexual predation. In my experience, in terms of nursing staff attitudes, most patients fell somewhere between nursing home patients and criminals, depending on their behavior. Patients who were cooperative and docile were treated with benign neglect while patients who were “uncooperative” (questioning treatment, demanding civil rights, complaining about staff behavior)were seen as dangerous. Indeed, if a patient became too “dangerous” he/she was often transferred to “Hydro.” These were two wards located in Singer where those who could not be managed on the wards were sent until they would become more cooperative. I worked on these wards for more than a year and can confirm from first hand experience the methods used to induce “cooperation.” Patients were overmedicated to the point of dyskenesia and other side effects (drooling, pill rolling tremors). When that didn’t work (or sometimes even when it did), patients would be “hot-tubbed” or “cold-packed.” Because I wanted to see if patient complaints about these procedures were legitimate,I convinced the male nursing staff to tub and pack me. I found both treatments soothing, the packs more than the tubs. I’ve never cared for hot tubs and, believe me, these tubs were hot. There was also no way to get out as a plastic/rubber cover was placed over the tub to hold in the steam and heat and prevent egress, with only a hole for your head. With the cold packs you were wrapped naked in iced sheets so cold they were frozen and had to melt a bit so the staff could pry them apart. Mummified in such wrapping with only your head out, your body soon warmed up the pack, ideally inducing (it did in me) a relaxed, drowsy state.But remember, I was a staff member experimenting. The problem was not with the treatments themselves but with how they were often administered.In a tub or pack you are helpless and vulnerable. In order to relax, you must trust your caregivers. Some were trustworthy. Unfortunately, many were not, and would use the tubs and packs as punishment rather than treatment. They would terrorize patients with threats of packs or tubs. They would leave patients in tubs or packs far longer than prescribed, sometimes so long that patients would be humiliated by having to urinate or defecate. While patients were helplessly confined some staff would taunt and threaten them.
Even worse, however, was electric shock. When I was at Manteno the practice of pre-frontal lobotomy had stopped (although you could still see some McMurphy’s out on the wards). Electric shock, however, was still practiced daily. Once again, it was less the treatment itself that was the problem than how it was administered, and by whom. Staff on the women’s Hydro ward were cautious about letting an outsider see what went on, but having read Goffman’s ASYLUMS and being a quick study, I was able to ingratiate myself enough that they shared some of their secrets and rituals. I should say here that several of the staff on that ward were wonderful human beings doing their best with limited resources in a bad situation.Others, however, were vindictive and cruel. And the doctor was someone from another world – literally. Dr. Kajar was a Persian from a well-to-do family who had fled to the US after the CIA coup that installed in Shah in the early 50s. Her manner toward staff was best described as noblesse oblige. Her attitude about patients could best be described as that of an English noble toward a serf. Although she signed the orders, staff decided which patients needed shock, and it usually wasn’t those who were depressed. Most often, the patients on Hydro who got shock were those who acted out in any way, and those who had to be cleared from the ward (there was limited space) to make room for others. Again, it was less the treatment, brutal enough, than how it was administered, that I can never forget. Before hand some staff members would have terrified patients with stories about shock, and this terror would run through the ward. Every time one or more patients would fight going to the shock room, screaming in fear as they were literally dragged away. In the shock room (also sometimes used for packs)the women were wrapped as if packed, but in dry sheets. The purpose was to immobilize them as much as possible to reduce broken bones caused by seizures. There would be a row of between ten and twenty women prepared this way for shock without anesthesia or muscle relaxants. All were scared. When all was in readiness Dr. Kajar would enter. She was a hawk faced woman in her 60s who must once have been quite beautiful. She was always impeccably dressed and groomed and wore large diamond rings on bony fingers with red nails. She wore her white hair up. Her manner was imperial; if obeyed, she was pleasant, but if not she grew cold and haughty. Her English was serviceable but far from fluent and it was obvious that she resented the need to work in such a place as Manteno (as did many of the Cuban doctors who’d left Cuba after Castro). Once Kajar entered the room the shocking began. A rubber tooth guard was placed in the first patient’s mouth and a staff member held electrodes on either side of the patient’s skull. Kajar would specify the voltage, this would be set and then, at her nod, the patient would be shocked, convulse, gag and usually pass out. Then on to the the next, and the next. But remember, all this was done without any medication to mediate the physical effects so that by the time Kajar got to the third patient the first patient was coming around, confused and in pain. Usually, she’d begin moaning or screaming, and soon so did the second patient. This would, of course, further terrify all the women waiting for their shock treatment, and soon they, too, would be screaming with fear, begging Kajar to spare them, that they’d be good, not cause trouble, weren’t depressed. When that happened staff would often have to pry apart a woman’s jaws to insert the tooth guard, and then hold them shut to keep it in place. And all the time Kajar moved from patient to patient with never a word beyond the voltage, and when it was over she washed her hands (though she had never touched, much less comforted, a patient, and walked out, leaving staff to do the best they could with moaning, screaming women. It is an experience I have never forgotten because it was (I hope) the closest I will ever come to the utterly callous brutality of the Auchwitz doctors. Yes, I know that sounds extreme, but you had to be there.


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