Riverview Hospital for Children and Youth. Richard J. Wiseman

Program—Staff Manual 219

      3. Excerpts from Sunburst Program Manual 235

      Notes 245

      Bibliography 253

      Index 259

       Illustrations follow pages 58 and 134

      FOREWORD

      …

      Historically, state-operated mental health systems are not noted for innovation. Funding limitations, staffing issues, political realities, and the slow speed at which public systems often operate mitigate against cutting-edge treatment approaches no matter the good intentions of those in charge. Images of public mental hospitals pervade the movies and literature, promoting visions of large brick and stone buildings with barred windows and locked doors. Patients are imagined to shuffle about wearing faded, institutional pajamas. Rooms look bleak, beds uncomfortable, and personal items absent. Sadly, this portrayal isn’t far from the mark. And our children were once a part of this system. Even after mental health reform began, children were treated like adults. Eventually, however, came the recognition that children are not small grown-ups. Children need to be treated differently.

      For numerous reasons, Connecticut lagged behind much of the nation in this movement. This book tells the story of Connecticut’s initiative to develop a state-operated children’s hospital that treats children as children, adjusting to developmental, learning, and experiential differences. It’s a story told from the perspective of those who were intimately involved by the individual who was at the center of our work. It’s a story of how this vision drew in others of like mind and put together a work family that revolutionized children’s mental health care in the public sector.

      Richard “Doc” Wiseman imbued his work with the notion that the children who needed mental health services should be treated most basically as children. Along with individual, group, and family therapy, the program at Riverview Hospital encouraged play and recreation. Children wore their own clothes, and it was not uncommon for staff members to purchase clothes that were a little more trendy so that a child could better “fit in.” Kids were encouraged to decorate their rooms and participate in community activities. This is not such a big deal now, but it was quite remarkable in 1974.

      Certainly Doc was supported by the academic environment at Yale, the state legislature, and numerous mental health and children advocates. Even with this support, however, children’s mental health reform in Connecticut occurred only because people with courage and determination pushed hard. Doc Wiseman had the ability to identify people with commitment and to nurture that quality. He always fostered new ideas and gave people the latitude to work on areas of interest or concern. In times of fiscal deficiency, political strife, and organizational inertia, he held their dream together with charisma, determination, force of personality, and hard work. He and others named in this book have improved the lives of thousands of children. I’m privileged to have known and worked with many of them.

      At the time of this writing, a spotlight has been turned on the issue of mental health. With the horrific events of December 2012 that claimed twenty-eight lives at Sandy Hook Elementary School in Newtown, Connecticut (including those of the disturbed perpetrator and his mother), attention has turned to mental health services and needs. A task force was established, co-chaired by a psychiatrist and a physician, to examine and make recommendations regarding access to mental health services for youth. In addition, legislation has been passed requiring that the Department of Children and Families develop a plan to create an integrated mental health service delivery system involving six state agencies.

      As a start, these efforts are laudable. However, caution is necessary. To not repeat the mistakes of the past, it is important to be reminded that children are not small adults. As this book documents, children’s services must be developed and provided in a different way than adult services. Since adult mental health issues tend to be discussed more frequently in the media, any crisis and/or threat to public safety could result in children’s services losing resources.

      Finally, there is a natural tendency for policy makers to move on to the next problem of the day. It is up to us to hold the focus. By writing this book, Doc Wiseman helps us keep one eye on the successes and failures of children’s services in Connecticut’s mental health system as we move forward. It is incumbent on those of us in the mental health field now and those who choose to serve in the future to keep the needs and concerns of children always in the forefront.

       Louis Ando

       Middletown, Connecticut, 2014

      AUTHOR’S NOTE AND ACKNOWLEDGMENTS

      …

      Children’s mental health is an intrinsic part of their overall health and well-being. At least one in ten children—as many as 6 million youth—experiences a mental illness that severely disrupts his or her daily functioning at home, in school, or in the community. Numerous barriers prevent children and their families from obtaining needed services, including stigma, shortages of mental health professionals, insufficient coverage of mental health services in public and private health insurance programs, inadequately trained clinicians, and complex and fragmented service delivery systems.

      This book is an institutional history of a progressive psychiatric hospital for children and youth, one of the first of its kind. My own experiences as superintendent and clinician at the hospital form the spine of the story, and the voices and experiences of many staff members and administrators round out the picture. You will note that very few former patients appear in the book. This is because the stigma of hospitalization is still very real.

      I hope you will find within these pages a story of hope and courage. The institutional history of Riverview is a personal history. It is about the people who made it happen. Over the years, hundreds of individuals—psychiatrists, psychologists, social workers, nurses, childcare workers, groundskeepers, administrators, teachers, recreation/rehabilitation workers, housekeepers, nutritionists, business managers, personnel workers, clerical staff, medical records technicians—played special roles in making Riverview what it was and is today. Throughout this book, I mention many names as a way to preserve some of this history. In addition, I enjoyed spending time with and learning so much from each of the many people I interviewed and who contributed to the writing of this book. Weaving our stories together, I hope to present an account that is not only interesting, but also a useful record of what was and, for good or for bad, what could be. I have also included samples of key documents and tools, so that those interested in helping children with mental health issues can easily access and adapt these materials. Throughout the text, you’ll see many endnotes. Some document interview data, but many expand and add anecdotes to the narrative.

      My most heartfelt thank you goes to the staff and volunteers who worked so selflessly to make Riverview the model of effective mental health services for children that it was for so many years. While the cover of this book designates me as the author, the fact is that I have relied extensively on the words and experiences of many others. This is particularly true of Louis Ando, my friend and colleague who assisted me in many ways throughout the writing of this history. During the past year, as I began to lose steam, it was Lou’s enthusiasm and encouragement that motivated me to finish the task. He started out simply by editing some of the earlier chapters, but as he became more and more involved in the project he contributed his segment of Riverview’s history, significantly broadening the story. He restructured the format,