Ghosts of healthcare in the valley

By Nick Losso

A few years ago I heard about an abandoned school near Amherst. It was a massive campus that once served intellectually handicapped children in the town of Belchertown. The girl I was dating at the time told me about it. She had a dial she had taken from one of the buildings on the bookshelf in her bedroom; an old piece of machinery that seemed like it would fit in perfectly in the underwater metropolis Rapture. I was excited about the idea of exploring the decaying and abandoned buildings.

I have since learned that this place was the Belchertown State School, which lies only a few miles from Amherst center. This massive institution once covered almost 900 acres and housed about 1,100 residents. The grounds included a farm, a power plant and, at one point in time, a large carousel.

Not far to the west of Amherst stood the Northampton State Hospital, a facility for the mentally ill and another institution run by the Massachusetts Department of Mental Health. I never knew much about these places until last year, which is amazing to me, given their size and proximity to Amherst. As I found out more about them, I became fascinated with the history of these institutions and how we, as a society, have chosen to respond to those experiencing mental illness or intellectual handicaps.

Belchertown State School was founded in 1922. But by the 1960s conditions had become abysmal; it was chronically overcrowded and understaffed with inadequate facilities. Benjamin Ricci, a professor of kinesiology at UMass, brought a 1972 class action lawsuit on behalf of his son, who attended the school. This came at a time when, on a national level, the country was becoming aware of the conditions in public mental healthcare institutions, marked by Geraldo Rivera’s career-making exposé of the Willowbrook State School on Staten Island.

The conditions leading to these scandals and lawsuits persisted for almost 20 years after ‘deinstitutionalization’ had begun, an unofficial process aiming to shift the patient population in state mental hospitals into community-based treatment programs. The patient population in institutions actually started to decrease after 1955. This corresponded with the advent of the neuroleptic (antipsychotic) drug Thorazine, which first appeared on the market in 1954.

Importantly, however, this period also coincided with the nation-wide realization that healthcare for the chronically mentally ill (i.e. hospitalization in state hospitals) was progressively more expensive for state governments to maintain. On average, between 1939 and 1950 there was about a 300 percent increase in the cost of mental healthcare institutions, which was a burden that states had to bear individually. There was little to no federal aid given in support of mental healthcare programs.

With state coffers running dry and patients made more manageable by Thorazine treatments, the shift away from state mental hospitals had begun. The goal of this shift was supposedly to allow patients to be given treatment in a community environment, rather than an institutional one, as institutions had begun to be seen as a hindrance to the therapeutic process.

By isolating patients from the greater community, state hospitals succeeded in creating a separate social context within the patient community, one that reinforced institution-specific behaviors. The idea was that it was impossible for patients to learn how to be well and function outside of the institution if the institution governed the entirety of their experience. Despite these noble ideals, it is important to note that they, in fact, seemed to be motivated by financial reasons. The first legislature surrounding community-based programs was adopted as a cost-cutting measure.

The history of modern mental health care is an ever-rotating cycle of different models of care. Each model emerges at a point when the previous model is realized to be therapeutically ineffective (and usually morally bankrupt). Then there is a period of successful treatment, followed by a long period of decay. That decay is realized and the whole system is swept aside by the next model. This is, approximately, how transitions have occurred between different treatment paradigms since the early 1800s, and the deinstitutionalization movement fits right in.

One of the reasons that it seems Americans so often change the way they care for the mentally ill is that every time a new treatment model is constructed, they want to believe that it represents the final cure. When asylums were first built they intended to put an end to all mental illness. As long as a new treatment method can claim success, it will continue to receive support and funding.

But once it becomes clear that people do not have an absolute cure, they become disillusioned with the system and start to withdraw funding. Unfortunately, the way they seem to have dealt with this, as a society, is to do their best to make the mentally ill disappear. If they cannot cure them, then they may as well make them invisible, either through physically removing them from our daily life or by medicating them into complacency. Americans must come to terms with the idea that it is unrealistic to expect a 100 percent efficacy in any treatment program. More importantly, they have to stop responding to imperfect treatment by ignoring the problem.

While much of the Northampton State Hospital was knocked down in 2006, the Belchertown State School is still standing, though abandoned. This is not abstract, immaterial history. This is something that happened here in the Pioneer Valley. This is something that happened within the last 50 years and it’s still something that’s unfolding in this state today. The Department of Mental Health is opening a new in-patient facility, the Worcester Recovery Center and Hospital, in July.

This history is invisible, like the greater issue of care for the mentally ill, yet it surrounds us. The Belchertown State School seems to be known primarily as an exciting place to explore abandoned buildings. Instead, we should look at it for the greater lessons that these institutions have to teach us, because it will soon be our responsibility.

Nick Losso is a Collegian columnist. He can be reached at [email protected]