Saturday, June 04, 2005


Central State Hospital

History at CSH

Why is it important to look at history when discussing a new and innovative program such as the PAIR Program? For the same reasons the historians tell us that are important. History provides lessons. History often repeats. History is about honoring the endeavors and work of your predecessors. Mistakes can be avoided by studying history. Ideas can come from history. And history can often give us a moral compass and the strength to continue the good fight which often extends past the life of a mere mortal.

Here are just a few of my recollections and opinions from by 40 odd years of being around mental hospitals. I hope to be able recall and plug in to some of the memories and stories of my former colleagues who have a collective memory extending back into the 1930's. Personally, I have even worked with patients who had been in CSH since the mid-1930's.

My mother began working at Central State Hospital in the early to mid sixties. I was between 8 yo and 10 yo.

Central State Hospital use to be like a small town of sorts. It had a power plant, a police force, a store, a cafe, chapels, parks, grill, and space.

There were sports teams, volunteers, and outside involvement of the community.

The main building of CSH was a large gothic building with ornate steeples. It was known far and wide by the nickname "Seven Steeples."

And of course, there were mental patients since this was afterall a mental hospital.

Since most of the employees and patients at CSH were treated like family, I grew up in the midst of this---surrounded by the mentally ill and those who cared for them.

Central State Hospital [CSH] had a long history. It was formed in the mid 1800's as part of the reform and humane movement sweeping the country. It was believed that it was more humane to treat mentally ill people in a secure, safe, and clean sanctuary than it was to leave them to fend for themselves in the countryside and on the streets.

CSH use to be a large sprawling complex of buildings and grounds. It was
located near the official "potter's field" of the county were the homeless, indigent, and nameless was buried. For about a century, CSH even had its own farm colony were it grew much of the needed food for the residents.

After much political infighting, the State of Indiana, decided to continue the new nation-wide trend of closing state hospitals. The trend was and is to "deinstitutionalize" these many patients and to treat them in the community. What most people did realize was that this was a way for the state government to shift the expense of caring for the mentally ill from the state tax burden and to push it off on the federal government.

This tidal wave of pushing mental patients about continues. Many are washed to the community and get on the federal rolls of Medicare, SSI, and Social Security Disability. Many of these mental patients re-surface in the prison system. Some estimates are that about twenty percent of the prison population is made up of persons who are chronically and gravely mentally ill.

Some have speculated that as a percentage, we now have more seriously mentally ill in prison than in anytime in our nation's history. It would seem we need some of the humanitarians from the 1800's to re-surface today and provide a moral compass for the care of the unfortunate and diseased.

I began working with the mentally ill in 1975, at Central State Hospital, as a psychiatric attendant. I still work with the mentally ill some thirty years later.

There is by reports a catacomb of tunnels and dungeons transversing the complex of CSH. These were made for heating, utilities, and coal transport. One of my many regrets is that I did not get to explore these caverns for myself.

There was one patient, Danny, who use to be obessed with keys. Every chance he got, he would steal some keys and explore. One of the places he would run to was the tunnels. It was always difficult to find someone to go get him because the dark passages were rumored to be haunted. Besides, what normal person would want to go looking for a mental patient in the dark and moldy underground halls with a flashlight? It sounds like a scene from a horror film.

At its peak, CSH had thousands of patients....and not much help. I have heard of wards with a population of 75 being supervised by one attendant who was expected to provide for and protect the whole group. Mind you, this was in the early days of the new medications and the patients were often psychotic, catatonic, rageful, vegetative, or self injurious. It was a lot of work and responsibility for the workers who were almost always at the lowest end of the socio-economic payscale.

If there were ever an example of heroes in American labor, these men and women are it. Most did the right thing, the honorable thing, in spite of the hell like environment and the low pay. They cared and made a difference for the forgotten ones with quiet misery and the violent who attacked in their pain. Some of the workers endured life long injuries and a few were even killed.

Sadly, even as one you cares, I can not honor their names or tell you their stories. This information is hidden away. No you won't hear or read of their story, but visit any of the remaining state facilities and you will see buildings and monuments named for the ruling class who ran the historical hospitals. In life and career, these individuals were often treated like the the old royal ruling class and viceroys. They never risked life or limb. They didn't even have to risk a smell of a foul odor, but they are saluted as the heroes in the treatment of the mentally ill in institutions. They are remembered as the saints.

Maybe one day, we can re-pay this debt to history. Perhaps a monument to the forgotten workers who essentially spent their life in a mental hospital, the snake pit, eight hours at a time. Maybe the challenge can go out to at least collect and share their stories.

*****[a work in progress]*****

Some Links:

History of Central State Hospital

Link 2

Link 3

Link 4

Link 5

Link 6

IU Study

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