Today’s Dank, Odorous Yet Truly Morbid Fact!
By 1947 to say that conditions in the state mental hospitals was deplorable would be an understatement. Overcrowded conditions, rapidly deteriorating buildings, underpaid staff with very low morale, horrible working conditions, high staff turnover; the list goes on. In Shame of the States (1948), Albert Deutsch writes that, “Many persons have asked me… how did you ever get departmental and institutional officials to let you in with a camera man to expose their own institutions? … the plain fact is that most of them welcomed the opportunity to get the true story before the public.” Deutsch goes on to say that when he arrived at Byberry (Philadelphia State Hospital), he was told “… I give you carte blanche… go wherever you like… all I ask of you is that you be truthful.” Deutsch was impeccably truthful. His reputation for fairness was well known. When he began his work on Shame of the States, he did so with the express purpose of helping patients, with improving the hospitals. He never imagined that things were as bad as they turned out to be.
Deutsch found patients chained to beds, chairs, and radiators. He found naked, incontinent people standing, sitting, or sprawled in dank, odorous, bare rooms. Walls and ceilings were falling down, roofs and ceilings were leaking, windows were broken, floors were rotting, lighting was poor. Patients ate their food with their hands. Food was cold, dumped on trays with no plates, and totally unappetizing. All forms of therapy were limited because of grossly inadequate staff. There was no occupational therapy or recreation. Many hospitals were fire traps. The superintendent at Milledgeville stated that he was surprised that a fire had not already occurred. Many hospital scenes were described as similar to Dante’s Inferno or reminiscent of the Nazi death camps. The cause of this decay was laid directly on the heads of penny-pinching state legislatures who were too willing to amass surpluses in state treasuries at the expense of social services such as the state mental hospitals. At the conclusion of his book Deutsch outlined an ideal mental hospital where everyone would work for the good of the patient.
While the public reaction to Dutsch’s book forced some action, hospitals soon became “cogs” in the legal system whereby patients were moved along as quickly as possible and given little or not treatment. Patients who did require more treatment were shunted off to other institutions. Under the is system, the patients continued to suffer terribly.