In Our Own Voice
   

Nurse Ella Tam

Ella describes the sleep room of the old State Hospital South:

This room was supposed to have had twenty beds in it and because we had a census of 800 at that time, sometimes more, it was made to accommodate fifty to sixty people. Sometimes more. We didn't have a lot of medications to help them sleep. Many of them talked to themselves all night that they stayed in bed unless they become disturbed and for some reason had to be taken out and put into a side room where they slept alone. And that way they would settle down. Sleep Room

But if after they got in the room they continued to like beat on the walls or tried to tear their clothes off or something they were put on that permanently anchored frame with a mattress on and then strapped with restraints so that they could not harm themselves.

When I first came here there was no interaction at all between the men and women. We eventually began to have dances on some of the wards and music and they could dance together but they were kept away from each other. It was supposed to keep them from having inappropriate ideas about interaction.

Ella describes the Day Room:

Day RoomThe Day Room would have large wooden chairs around the perimeter and many times the patients were seated in those chairs all day except for the time that they would have a restraint around their waist that kept them in the chair. Those restraints would be removed and they would be taken to the bathroom at set intervals and then taken back and set there. And at mealtime the same thing would happen. They would be released so they could get up and go get a bowl of gruel. They were not allowed any utensils. They had metal bowls and only things that they could drink or eat out of the bowl were served to them and then they were taken right back and restrained back to the chair again. Patient

If they went unexpectedly, if they could not wait until the interval, they were taken in and given a cold shower and then taken back and set in the same place. It was a punishment. They were considered to be doing it on purpose and so they were punished for it.

There were mainly what we called bug-housers working at the hospital at that time.
These were people who made their living just going from one state hospital to another. And most of them were abusive to the patients. They would stay at say, Utah State until they got out of hand there then they were dismissed so they'd go to Nevada and then they'd go to Idaho. They just kept on the move. They didn't last any place very long.

During my earliest experiences it was always, "why are we punishing people who are sick? Why must they be punished"? And to me it seemed like punishment to have them there. But at the time there were no medications to control their behavior. There were not enough people to take care of anything other than just to maintain safety.

Ella describes methods of therapy before psychotropic drugs:

Hydrotherapy:

A hydrotherapy tub would have a canvas sling that was suspended inside the tub where the patient would lay in water that was body temperature so it was soothing. Over the top there was a canvas cover with just an opening for the head and they would have a pillow there for their head. The water was climatically controlled so that the temperature stayed the same all the time and it was very soothing for a manic or a very agitated person to spend time in the tub. They were taken out for very short intervals and then put back in but at times they were in and out of the tub for four to five days and longer sometimes.

Electroshock:

Electroshock at the time that I was working here was far above any other way to treat postpartum depression. And it still is used in that respect in many areas. But electroshock now is not like it used to be. It was very crudely done. Patients were not given an anesthetic before. They were just put on a table and supported around by maybe six people because electroshock produces convulsion and they had a mouthpiece put in their mouth. Then the doctor gave the electroshock to produce a convulsion.

Now, when they go into have ECT, they have an anesthesiologist there. He has an airway in, they've given a sedative before they ever go into the treatment room and then they are recovered in a recovery room just as if they'd had a general anesthetic. And it still is very effective for some types of depression that do not respond to anything else.

Lobotomies:

Craig's FamilyWe would scrub up early in the morning and maybe do four in a day. They were pre-frontal lobotomies and we chose the people as ones who had not benefited from anything else and were very assaultive and aggressive and had hurt other people.

There were several who became better hospital citizens after their lobotomies. Their lives were improved because they didn't have to be in restraint all the time, they didn't have to be in Seclusion Room all the time, they were able to go to the dances, to be involved in the picnics and things that they'd never been in before because they were too combative.

On the farm:

The FarmIn the early 1950s it was estimated that it cost $3.00 a day for board and room and care of every kind to take care of someone at State Hospital South. That was because we were self-sufficient. We had a farm. The patients worked on the farm. We had a dairy. They worked in the dairy. We had vegetable gardens, we had orchards, we had cattle and the people who got to work were the ones who did the best and you could see that the idleness was not good for people. The ones who had jobs improved faster and were more apt to be able to have a parole, to go home

On changes in the hospital:

In the early 50's we got a new administrator, Dr. Cromwell. His philosophy was it didn't matter how many people had improved on any given treatment; if any one had, we should try it here. And he believed that the patients should be treated as humans who had rights and that they should be treated so that they could get out and get back into their own living situations as soon as possible.

We began taking patients out of restraints. We tore down old 'E' Building it was called where the criminally insane were kept and slept on straw and had chains on their ankles. We had a teaching facility, we had interns. He was working for accreditation of the hospital and in 1951 we did receive recognition and an award from the American Psychiatric Association for the most progressive state hospital in the United States

(Before), all of the women and men had their heads shaved. It was supposed to protect from head lice and so we gradually started letting the women's hair grow and then the other nurse and I came in the evening when we were not working and gave them the old Toni permanents. And it was so good for their self-esteem. Then they'd start using better table manners and they'd be more concerned whether they were clean or not.

We started recruiting local people and training them before they ever went on to the wards so that they would learn the proper way before they were exposed to the cruelty and the mishandling of people.

On new drugs:

Thorazine LabelWhen the psychotropics came on the scene in 1951, Thorazine was the first one. And at first we thought, "Oh great. This is what we chose, our most assaultive, our most disturbed people to put into the study." But we found that they began to think more clearly. Their delusions, their hallucinations became less frequent.

It's been a miracle. We still don't have a cure because if they do not maintain medication compliance and take the medications their symptoms do return. But we at least know that they can be relieved of their symptoms if they take their medication. There is hope for them to live in the community with their families and stay on a stable if not completely full-functioning. But in the 40's and 50's there was nothing available that did anything but keep them and make them a better hospital citizen.

On violence and the mentally ill:

I have worked men's disturbed ward, I have worked criminally disturbed wards, I have worked with adolescents and I have never been slapped, kicked, assaulted in any way.

If you knew how many people that you're working with on an every day basis who are taking medication and who have had treatment for a mental illness it would be very surprising to you and they are not assaulting you, they are not harming you.

I treat them like I would treat my mother and father and like I would like to be treated myself. And if you give them your confidence you can help them but if they find that you are less than what you appear to be it's very difficult to work with them.

I think they are people who have a mental illness. They are not THE mentally ill. It should not be a classification. It sets them apart from anyone else who has an illness.