Riverview Hospital for Children and Youth. Richard J. Wiseman

was no clarification on any of these issues. During this period we were asked to work on a new budget for the ’71–’73 biennium, when we had no idea of our current budget or operating expenditures. We were asked to reorganize our unit (the new Table of Organization), to change the role and function of the co-directors, to develop our Philosophy of Treatment and Education, and the role of the program coordinators. Requests for new positions and the filling of old positions were repeatedly lost through the bureaucratic process.

      We were repeatedly asked to submit new priorities for staff vacancies after each new deadline was passed.⁸

      Early Sunday morning, 2 May 1971, I received a call from Commissioner Ernest Shepard, who had replaced Wilfred Bloomberg at the Department of Mental Health. He asked if I had read the front page of the Hartford Courant, which basically quoted a letter signed by many of the Children’s Unit staff deploring the governor’s action in holding up the funds to open the new facility. I had not read it but he said he would like to meet me at the hospital at 10 a.m. He was obviously very upset and angry. It took a lot to convince him that I had no idea (and I didn’t) who had called the paper with the story. That afternoon the governor was on television announcing that he fully intended to fund the necessary positions so that the children could move to their new facility. He told the reporter that he had ordered that the $150,000 be released for such purpose.

      In July 1971, my “Six Year Progress Report of the Children’s Program,” as a follow-up to the 1965 Task Force on Mental Health Services for Children, expressed my philosophy of treatment, including “giving more responsibility to group living, those with the most direct patient contact.” I added, “To accomplish this we are considering the concept of program coordinators within each cottage.” This would mean opening the position to childcare workers (psychiatric aides) instead of restricting the positions to RNs. Additionally, in order to curb overcrowding and decrease the age range of kids living together, we limited the age of admission to fourteen for boys and sixteen for girls. It was also at this time that I reiterated my suggestion that the department’s future goals be to create several mental health centers, one in each third of the state, with the Children’s Unit serving the middle third, and to provide a full range of mental health services, both inpatient and outpatient.

      In October 1971 we were able to hire our own child psychiatrist, Charles Rich, just after his discharge from the air force. It had taken us more than a year to convince the state personnel office that a child psychiatrist was needed and in fact, as mentioned earlier, there was no such job description. Rich describes what it was like for him at that time:

      I was the only psychiatrist for over fifty kids and there was little control over admissions. Some parents would just drive up late at night with their child and would just leave them at our doorstep, just saying they couldn’t take it another second and had lost complete control of their child. Because of this large demand and lack of space, a lot of kids ended up having to stay on the adult ward. Arafeh called this “the red zone on the thermometer,” so at least that started to serve as a buffer to the amount of admissions.

      I was trying to receive new kids, deal with meds and acute management. I had to keep up with all the problems kids presented and I could not do it all. It was totally overwhelming. When I returned [seventeen years later] I really felt Riverview had evolved a lot.⁹

      [ CHAPTER 5 ]

      CHILDREN DO NOT BELONG IN PSYCHIATRIC HOSPITALS!

      …

      A dedication ceremony for the RiverView School took place on 8 October 1971. The quarterly report covering October–December 1971 describes “an elaborate program in which a large number of community representatives interested in the mental health of children participated.” Governor Meskill and Edward Zeigler of the Office of Child Development Health, Education and Welfare headlined the bill. In his introductory remarks, Mr. Abraham Lippman, chairman of the board of trustees, emphasized the board’s strongly expressed position that the children’s program continue as part of Connecticut Valley Hospital.

      The actual move to our new facility happened on 11 November 1971. Finally. After the entire administrative and clinical staff moved, the children were moved to their new dwellings. First, the autistic kids, with the help of their parents, occupied the top floor of the Silvermine Building. Then, assuming the girls would be better able to handle the round configuration (wrong), we placed them in the round cottage, simply named Cottage A. Next came the boys: younger kids to Cottage B, older kids to Cottage C. By the end of November, new staff members joined Charles Rich on the Children’s Unit. Among them were a psychologist, Randy Burnham, who had volunteered on the Children’s Unit while interning at CVH, and, shortly thereafter, another psychologist, Clara Chapman.

      But wait! Let’s step back for a moment. This seems like a good place to articulate more fully my philosophy, or point of view, about children with emotional, behavioral, or psychiatric disorders: Children do not belong in psychiatric hospitals!

      Sound heretical? It is. Many believe unstable children should be hospitalized only as long as necessary, but most people believe hospitalization is a necessity some of the time. I disagree! The psychiatric hospital, formerly known as “insane asylum,” is a concept that applies to adults. Historically, the “insane” were eventually seen as diseased and therefore the purview of physicians and the medical profession. Children were more likely to be tolerated, kept at home, or, when necessary, placed in children’s homes or residential treatment centers. It wasn’t until much later that adult hospitals began accepting children as “patients.” This was a mistake!

      Instead of developing more comprehensive community services or increasing the capacity of residential treatment centers, adult psychiatric hospitals developed children’s wards, utilizing the same adult/medical model of treatment—primarily, I suppose, because it was the only way insurance companies would pay for the service. In fact, when we were rewriting the state statutes to transfer the Children’s Unit of CVH to the Department of Children, Youth, and Families, the question arose as to our name and description. My preference was to describe the new program as a children’s community mental health center, including the widest range of inpatient, outpatient, emergency, and outreach programs. This was consistent with my argument that two similar facilities should be built in the eastern and western parts of the state. It would also avoid the stigma associated with psychiatric hospitals. However, the state required that there be a “hospital” for children, and so Riverview Hospital came into being. A “hospital” qualifies for higher-level medical and nursing staff and is eligible for Medicaid reimbursement.

      Money aside, several key experiences inform my point of view. The earliest was my experience as a high school camp counselor, when I learned the value of working in a natural setting as a way to help a child through real-life struggles. Terry was a seven-year-old, beautiful, terrified boy who obviously found himself in strange, unfamiliar surroundings. Afraid to interact, he avoided any contact with other children and stayed next to me. He also didn’t want to go near the lake. Since we had enough good counselors, I took sole charge of Terry. We watched other kids eat together, play games, and swim. I finally got Terry to go near the water, then put his feet in; and very gradually, over days, he put his head in. With the encouragement of the other kids, he joined in games and actually learned to swim. Needless to say his parents were happy when they picked him up after camp. As for me? Terry helped me pick my career direction.

      At Children’s Village, first as a recreation director, then as a house parent, I saw the importance of daily interactions: modeling appropriate behavior, teaching social skills, dealing with problems as they arose. I knew my daily actions and interactions were at least as, if not more, important than the one or two hours per week the children spent in therapy. As mentioned earlier, this prompted me to seek further study.

      LESTER

      At Michigan State University (MSU), working one-on-one in a play therapy mode, I discovered the dynamics of play and its meaning for children as a way of expressing some inner turmoil. The MSU Psychology Department, as part of its community service and training program, operated its own child guidance clinic. While completing my practicum course in play therapy,