Riverview Hospital for Children and Youth. Richard J. Wiseman

autistic because their unit had some toys and he saw that as his way to be able to play with their toys. There would be two people on with forty kids. These children were extremely mad and aggressive. They hated being there. They would say things to me that I didn’t even understand—especially about my mother. But even though I didn’t know what they were saying, I could tell just how upset they always were. For a while there was no recreation for the kids. However, they finally hired recreation workers who organized activities and paid attention to the kids.¹⁴

      This frustration soon reached its boiling point. On 23 May 1969, a particularly frustrating day for staff, Marge Stahl remembers going home and sitting on her front stoop and writing a letter to Governor John Dempsey. She pleaded for recognition of the plight of the unit, recounting the various studies cited above without any recognizable results, the promise four years earlier of new facilities, and the immediate crisis of summer approaching, a camp program ready to go, and yet no approval for the necessary staff.

      The next day the entire staff of the Children’s Unit signed the letter. On Sunday morning the Hartford Courant headlined the story and Marge received an urgent call from the superintendent, Mehaden Arafeh. He asked Marge to meet him at the hospital. In any case, according to Marge, “for the staff, it formed quite a bond among us at the time and was a catalyst for moving the development of the construction for the new facility.”¹⁵

      A search committee—composed of Margery Stahl; Mehaden Arafeh; Charles Leonard, superintendent of High Meadows; Tom Frank, child psychiatrist and consultant for the Department of Mental Health; Albert Solnit, director of the Yale Child Study Center; and Ned Graffignino, director of the Institute of Living’s children’s program—began working to find a permanent director. Following much discussion and failure to find an appropriate or available psychiatrist, two men were approached: Peter Marshall, chief social worker at Highland Heights, a residential treatment center in North Haven, and myself. We were told that the committee was interested in both of us, that we had complementary skills, and that they would like us to get together and decide who would be the clinical director and who would be the administrator. After meetings at our homes, our offices, and atop a raft at Camp Quinebaug, where I was still working, Peter and I clearly felt our compatibility and decided to go for broke. We made several demands, among them to be appointed as co-directors, with equal pay and shared responsibilities, and to become independent of CVH, reporting directly to the commissioner of the Department of Mental Health. These proposals require some explanation:

      (1) The concept of co-directors was questionable. We reasoned as follows: There was a very big job ahead of us, and sharing that with someone would make the stress manageable and provide mutual support. We recognized that we could be vulnerable to staff members working one against the other. However, we also recognized that our shared position could work only if we had the utmost trust in each other. We felt we could develop such trust. We would have to define very clearly our separate areas of responsibility, those that we shared, and how we would resolve differences.

      (2) It had been the custom at the hospital to pay people according to their professional classification. Thus, the previous administrators had been paid as social worker, psychologist, or psychiatrist, with vastly different salary ranges, even though the expectations of the job were the same. Additionally, since we were going to be sharing the responsibility equally, we felt we should be paid equally. We also knew that a comparable salary level sent a message of equality to others in the state organization.

      (3) We decided that it was important to establish that the Children’s Unit was a major program of the hospital and that its leadership be accorded the rights and privileges of other major areas, which were led by psychiatrists. We felt strongly that the philosophy underlying the children’s program must be different and separate from that concerning the adults.

      (4) We wanted a voice in the state hierarchy comparable to that shared by the other facilities of the department. This included sitting in on the monthly meetings of the superintendents with the commissioner of the Department of Mental Health.

      (5) We needed complete control of all program decisions, with the authority to implement them subject only to the veto of the deputy commissioner for children who would be our direct supervisor.

      (6) We wanted to dissociate the children’s program from the stigma associated with adult psychiatric hospitals.

      (7) We wanted to make a statement that children’s mental health needs were very different from, but at least as important as, those of adults.

      To the credit of the committee and Commissioner Bloomberg, all of our proposals were accepted. While they had some difficulty with the concept of co-direction, they eventually agreed to it with the understanding that we would report directly to the newly appointed deputy commissioner for children’s services, Charles Launi. Charles would work closely with us and would act as arbitrator of any differences we could not resolve ourselves. The second issue caused some difficulty because it meant creating new job specifications rather than using the traditional ones. The creation of new job specifications in a state system is never an easy task, but the committee agreed to pursue it. In the meantime we were placed in “temporary” positions. It was three years later that a position called director of the Children’s Unit was created.

      The issue of autonomy from the adult hospital was a very ticklish one that had various emotional and political implications. The separation had been heatedly discussed in various circles between the child advocates and the greater number of mental health professionals who were not in favor, since it implied that children’s needs required special training or programming. We knew, however, that several members of the committee, as well as members of the Connecticut Association of Child Psychiatrists who had strong voices in the state, were outspoken in their endorsement of such separation.

      Commissioner Bloomberg, in a letter to Mehaden Arafeh, superintendent of Connecticut Valley Hospital, dated 25 September 1969, officially announced the appointment of the co-directors and clearly spelled out the condition: “Both individuals will have equal and comprehensive authority to operate the children’s services program.” And a separate budget was established. The letter also pointed out that the commissioner had asked the attorney general about the possibility of establishing children’s services as a separate unit of the department. He was informed that it required legislative action and an amendment to the statutes. The letter continues, however, “This amendment will be presented to the 1971 Legislature, and I believe there will be no difficulty in securing approval.”

      In the meantime, while legally still a part of CVH, Peter and I would have full responsibility for the program philosophy and implementation and, while reporting to the deputy commissioner for children, would also participate in the CVH administrative staff meetings. This arrangement worked out very well as an interim measure. Arafeh supported our goals and accepted us as members of his administrative staff.

      [ CHAPTER 4 ]

      A NEW DIRECTION

      …

      We assumed our new posts on 1 November 1969 and used that first month to get to know each other, to visit various children’s hospitals in Massachusetts, Rhode Island, and New York, and to begin to identify our various roles and responsibilities. While I had some experience both with CVH and with the Children’s Unit as a result of our working together on our camping program, Peter was relatively new to state service and the Children’s Unit.

      We found this first month, a period of looking at other programs, developing trust in each other, and sorting out problem-solving ideas and strategies, to be very productive. We decided that we would meet at the end of each day, discuss what issues arose, and how we had handled or would handle them. We agreed that whenever possible we would talk about solutions to problems before implementing them; but when decisions had to be made in the absence of the other, complete support would be given, with any differences discussed privately. Any unresolved differences would be brought to the attention of the deputy commissioner for children, Charles Launi. We also used this time to review the functioning of the Children’s Unit—how it came into existence and what had happened to it in the succeeding years. We identified the key players and generally figured