Friday, November 18, 2011

Ricky Wyatt of Wyatt v. Stickney Passes:Wyatt v. Stickney 1970 Case Discharged Thousands of Patients to Community Mental Health

I did part of my internship at the giant Tuscaloosa, AL state hospital, sitting right next to University of Alabama. It was a grind driving from Birmingham, past the mimosas in bloom, in my loaned VA vehicle (I had no car) in order to satisfy the criteria of my clinical internship. But I saw some things there that anyone who ever worked in mental health should see and I had excellent supervision.

In 1994, when I was there, they were lobbing off part of the large main building, second only to the Pentagon in size. For, you see, there had been over 30,000 patients warehoused there. When I was there, about 1000 patients remained. That is what an impact the Wyatt v Stickney case made and it all started at Bryce Hospital in Tuscaloosa, AL.

The patients who rode in sheriffs' cars down the tree-lined boulevard, just around the corner from the Crimson Tide campus---up to the administration/ admission building, lived there and died there; they kept the gardens that fed them and occasionally ran into the medical records department and grabbed documents revealing their sordid histories while the medical records person was busy somewhere else. And then they ran like the wind, holding tight their mental health records, never to be documented as mentally ill again (as did one friend I made in Birmingham, a street singer, indicated he had done. His history included singing alongside Pete Seeger and he didn't like it one bit that Bryce State Hospital had records indicating him to have a serious mental health issue. )

As I walked the wards at Bryce Hospital, I carried around a key ring of skeleton keys that had an entire soundtrack associated with them. I used them to let myself into locked wards and behind those doors were occasionally people who would rush them, trying to get out. There was madness in their eyes. There was Haldol in their systems; there were pink rooms where they could be straight-jacketed should they get too out of control; there were restless souls padding the halls at all hours.

And one of the more interesting assignments my supervisor gave me was to simply walk around and document what I 'saw' on the wards. And what I saw, in my fly-on-the-wall position, since I was after all a person of no importance, was nursing staff sitting at the ward desks, busy as bees, working away on their paperwork, while patients mostly patient stood waiting for long periods of time for someone to look up and acknowledge their existence. Or, if you stepped behind the desk, as I could, they would be in the nurse's small lounge in the very very old buildings, drinking coffee and talking.

And at the 'meetings' prior to the dismissal of a patient being permitted to 'get out' what I remember was the fear and trepidation of the poor schmuck who was essentially being interrogated to see if they had the common sense to state that they were free of suicidal ideation or wanting to kill someone. The patient would sit on one side of the table, sweating and squirming, and the psychiatrist, psychologist, psychology intern, nurse, social worker, and any other interested or mandated professional, would sit on the other side.

All people who have been involuntarily committed or convinced to stay for any period of time on a mental ward have learned what to say in order to escape. Anyone who has some modicum of mental health is ready to bolt within a week regardless of how helpful the psych unit has been. Being locked up is like being in jail. After all, it is frequently the sheriff that drags you onto the unit.

I have a client who has repeatedly run from the police or sheriff trying to drag her into a mental health ward because she could not wear her belly-ring or keep her wedding band. There are no cell phones there because you could use the wire to hang yourself. And indeed I have had clients who have needed to sleep in the hallways due to their own fears that they might strangle themselves with their sleep apnea equipment.

I have a client who stated that she was buggered by the orderlies, late at night, as she lie in her Thorazine haze. Her husband noticed the evidence when she returned home. And from that time on, she swore she would never return to that public mental health hospital in Morganton, NC and indeed she ran into the woods behind her home and dislocated her shoulder when a mental health worker sent out the sheriff again, years down the road.

And so, Ricky Wyatt, who has just passed, is today listed in the NYT on the Op-Ed pages as "appreciated" and this is what it says, in part:

".....The journey was Wyatt v. Stickney, the federal class-action lawsuit filed in 1970 against an Alabama state hospital and later expanded to other facilities. It was the first and most consequential of the legal challenges to the abuse and neglect that had doomed hundreds of thousands of patients to hellish lives in public psychiatric hospitals. It threw open the doors to treatment and to new homes in the community and, for the first time, established standards of adequate care and patients’ rights to receive it.

The ruling was made by an extraordinary federal judge, Frank Johnson Jr., a central figure in earlier desegregation rulings in the South. It was filed on behalf of thousands of Alabamans; Mr. Wyatt agreed to be its face. He had been placed as a teenager in the Bryce State Hospital in Tuscaloosa, where he was abused and drugged for no better reason than he was prone to troublemaking and in the care of an aunt who wanted to get rid of him. Back then, people could be locked up involuntarily, simply on a relative’s say-so.

The Wyatt standards led to civil rights and freedom for countless patients. But the follow-up was imperfect; many patients who were released with inadequate treatment and community support merely traded one form of warehousing for another — in prisons and on the streets. But no one who knew the pre-Wyatt world would want to return to it...."


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