When I heard of the tragedy in Newtown, Connecticut I couldn’t help but be struck by the irony. At one time Newtown was synonymous with a 4000 bed state mental hospital.
Today, Internet searches of Fairfield Hills lead to low-quality videos or slideshows with menacing music narrated by young ghost-hunters who trespass and chatter about paranormal activity, torture, the criminally insane, lunatics and the terrifying tunnels connecting the buildings where all manner of mayhem were thought to have taken place.
Without the audio, the images of stately colonial-style buildings and rolling grounds better resemble a university campus. As a nineteen year old, I don’t recall feeling any fear as I entered the locked ward where the other student nurses and I were assigned for our three-month psychiatric rotation.
It had been decades since anyone but the attendants and a lone psychiatrist had shared time with these men. Each day I was more struck with a sense of disbelief that our charges were destined to spend the rest of their lives in boredom – rolling cigarettes and playing checkers and cards, than I was with any sense of terror or fear for my own safety.
The building housed 500 men. Among the ones I knew was a former architect with a traumatic brain injury he’d sustained from falling off a scaffold. He rocked restlessly in a chair by the exit. “What’s it like on the outside?” he’s ask each day. “Someday, I’m going to escape from here.”
“Does he ever try,” I’d asked. “No,” the attendant told me. “We’ve left the door open, but he just sits there, saying the same thing over and over.”
Another, slight fellow with bilateral indentations in his head and a decidedly flat affect, was said to have been violent before his lobotomy. He seldom spoke, not even to his mother, a white-haired woman who visited regularly.
Saint Anthony’s problem in society was that he liked to expose himself. Another man with schizophrenia had been a concert pianist. He played discordant music on an out-of-tune piano, two different pieces – one with the left hand and one with the right.
My favorite, Mr. M, was one of many alcoholics with Chronic Brain Syndrome, encephalopathy that is characterized, among other things, by memory problems. Each morning as I walked toward the building, he would call to me from the second story barred windows, “Murphy, old girl.” Mr. M had a twinkle in his eye. He couldn’t quite remember how he came to be there. He recalled vaguely being picked up when he was wandering the streets. Mr. M, imparted the same wisdom to me each morning before we would sit down to a game of gin rummy. “It’s a great life, Murphy old girl, if you don’t weaken.”
He had, and so had other whom we students accompanied through the tunnels on their way to the dining hall or to an occasional movie. I didn’t find the place menacing, only sad and depressing. From a distance, which was most people’s vantage point, the setting was idyllic and during my three months, the autumn foliage magnificent.
None of my charges suffered outwardly. They ate regularly. They had clean clothing and a roof. They were protected from outside harm, and the world was protected from them. Still, my teenage mind couldn’t reconcile how normal some of them seemed. It was disconcerting to think that a drunken episode on a public street or a change in mood or luck could land you in this asylum for a lifetime. The psychiatrist came only to write prescriptions, not to reevaluate anyone. These men and many of the others who lived here lacked hope of ever returning to society. They were going to spend the rest of their lives confined, and from my perspective, their fate seemed so unfair.
But even as I was horrified by the idea of forced institutionalization, reforms were already underway to integrate the mentally ill into the general public with the aid of The Community Mental Health Act. It was thought that with the advent of new psychotropic medications many individuals with severe mental illness could flourish in a community setting, provided the right supports were in place.
The Joint Commission on Mental Illness’s Action for Mental Health called for the integration of the mentally ill into the general public with the aid of Community Mental Health Centers. In 1963, the Mental Retardation Facilities and Community Mental Health Centers implemented the centers, but because of the financial drain of the Vietnam War and the financial crisis of the 1970s, the proposed program was not fully funded. The result was the release of patients into an environment lacking the facilities to adequately treat them. As hospital beds for the acutely mentally ill disappeared, fewer people got the care they needed. Many ended up in more expensive settings such as jails and prisons. Others relied regularly on hospital emergency rooms. The human cost was and still is exorbitant.
A few years after I graduated, I had long since rethought my youthful idealism. I watched people like those I’d cared for during my time in Newtown sleeping on park benches or hallucinating on city streets. Each time I’d see policemen handcuffing an inebriated wanderer, I’d think of Mr. M. The promise of deinstitutionalization and outpatient care that I so strongly believed in had failed.
Fairfield Hills in Newtown, Connecticut closed in the mid-1990s. Mr. M, Saint Anthony, the architect and the pianist likely lived their lives out there. I feel reassured knowing that.
Just as we should not define the lives lost at Sandy Hook School in Newtown by how they were lost, we should not easily define the solution to future tragedies. The issues are complex. Solutions should encompass all aspects of the problem.
For me, one aspect to be considered is the price we as a society pay for inadequate mental health care. At one time our net was too easily filled. Those gathered were put away, perhaps too easily, too permanently.
I don’t want to go back to the days when we effortlessly locked away people, because their behavior was inconvenient, but perhaps we can broaden our definition of who needs acute care. Maybe we can make it easier for the safety net of mental care to open for the families those who are in need. Perhaps we as a society can fulfill the promise of the 1960s, catching those who have weakened keeping them and us safe