What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Wednesday, December 06, 2006

Weyburn Mental Hospital Project, The Precursor to Universal Public Healthcare

I’m not sure what the T.V. program “Weyburn Mental Hospital Project” was intended to do, but it brought back some good memories for me.. I watched the entire program, and as someone that worked there in the summer of 1958, I felt the presentation dwelt on the negatives and gave short shift to the positives; most of which, in the program, were attached to the architectural aspect of the physical facility. They mentioned the grounds to some degree, but not truly in the context of the patients. They did show some tomato plants growing, mentioned vegetable gardens, and mentioned the dairy farm, but for the most part dwelt on the supposed “atrocities” that occurred within the walls of the building. Granted, there are many things about institutional living that most of us would find offensive, but I think the Weyburn Mental Hospital was, in fact, a step in the progress of our society (almost like a huge societal experiment), to address the issue of “What do we do, as a humane society, to look after those who are unable, for whatever reason, to look after themselves?” From my perspective, the major problem with the endeavor was that the scope of what they were attempting to do, with the facility and staff they had, was simply “over-reaching”. Apparently at one point, the facility housed and cared for over 2000 patients, when it was originally designed to look after approximately one thousand.
Much of the T.V. program showed the dark underbelly of the facility, the bed on bed overcrowding, and the fact that the facility was greatly understaffed. Some of the primitive treatments were shown (Insulin and electroshock therapy) that, to the average person, would appear to be inhumane. Mention was made of the use of leg and wrist restraints for violent patients, and the use of the drug epecac to induce severe vomiting. (Unfortunately, the person that mentioned it suggested it was a form of punishment when in fact it was used to cause exhaustion through repeated vomiting in an effort to prevent self-mutilation). Mention was made several times of the fact that our modern anti-psychotics and anti-depressants were not available in those days, but not enough was said as to what would happen to the patients if there was no intervention. Suicides were mentioned, but there was almost the inference that these occurred because of the terrible living conditions rather than their mental health condition. In those days, the Weyburn Mental Hospital “housed” all the people that had no where else to go.
I look back to my summer of work at the Weyburn Mental hospital quite fondly. I had visited the grounds many years before, and being a farm kid, thought it was great. The dairy farm was incredible, clean and well kept. The grounds were immaculate. Many of the patients had gardens of their own, in which they grew a variety of fresh vegetables. As a summer student employee in the summer of 1958, (of which there were many), I had only on rare occasions, been on the wards. My job was to be in charge of the grounds crew of some 11 to 13 patients. This included looking after the green house (beautiful), some weeding, picking up papers, watering flower beds, occasionally digging and planting, etc. My patients had “grounds privileges” (as many other patients did), and would be at the garden shed as the sun was rising. I can still see the old timers sitting around the shed, smoking their pipes, savoring the warmth of the morning sun.
I enjoyed my work there; and in particular I enjoyed the patients. Since my job was one of supervision, and their jobs were more for the purpose of giving them purpose, I had plenty of time to visit with them and get to know them. Most of the patients in my crew suffered from some sort of organic brain disease, although there was “King George”, who was quite psychotic and delusional, and “Two Step” (who was mentioned in the program), who had had a severe psychotic breakdown after his family had been destroyed in a house fire. Poor Two Step; He would take three steps forward and two steps back where ever he went. Naturally he was very late for his meals, for getting his gardening tools, for getting to the work site, etc, but it really didn’t matter because he could be relied upon to get there eventually. Whatever had happened to his family (I was not privileged to his record because I was a student), his pacing was continuous and in cadence with “Burn their heads, burn their bones, burn their goddamn heads, burn their goddamn bones, burn their heads, and so on. As the summer progressed, because I continually engaged them in conversation, I became familiar and friends with almost all of them. One day “The Millionaire” approached me and told me he had decided to leave all his money to me in his will. I, of course, thanked him and enquired as to whether I could use the money however I wished, even on wine, women, and song. He drew himself up to his full height and exclaimed “Then you aren’t god anymore”. Later I reassured him that I wouldn’t waste his money on wine, women and song, much to his relief.
One of the female patients that had ground privileges was about forty and her name was Sadie (not sure if that was her real name). I had been forewarned about a few of the other patients (with ground privileges) and Sadie was on that list. In addition she had signs put up in her own print (stuck to trees, etc) that stated plainly “Tail, Ten Cents”. Now Sadie was quite a smoker so on occasion I would chat with her and see if she was “firm” on her price. She would giggle and tell me secretly’ on occasion, a cigarette was sufficient. I would tease her and admonish her about being too “easy” and she would get a big laugh out of it.
One very large lady (about thee hundred pounds) was quite fond of men and would occasionally try to catch one. One day I heard screaming from around the side of the hospital. I rushed around the building to find the screaming coming from a window cleaner twenty feet in the air on a ladder. Our hefty lady was giggling and about half way up the ladder to “capture” him. She was reluctantly “talked down” the ladder; much to the window cleaner’s relief.
The only patient that really caused me and my crew a problem was a twelve year old girl who had been admitted for psychiatric evaluation because she was actively soliciting sex. I really didn’t know much about her situation, but during her “ground privilege” times she would hang around my crew and “display herself”; sort of like the recent “Brittany Spears thing (I guess if you’re older that’s allowed). The agitation level of some of the patients rose considerably and I had to report her to her nurse. I never saw her after that.
The program mentioned that between 1964 and 1966 they threw the doors open to many of the previous “closed” wards of the hospital, and from time to time patients would be scattered all over the city and country side. My parents reported two naked ladies walking down highway thirty nine on a hot July day. The hospital was quickly, over this time, downsized to approximately 300 people from 2000 people. Many were discharged to relatives, foster homes, etc, but many ended up on the street or in other institutions (nursing homes). One has to wonder if these people are better off on the street or in an institution, no matter what the institution is called. Are we more humane leaving them sleep out in minus 20 degree weather and foraging for their food in dumpsters? Or for that matter bussing them to a warm “sleep-over” and then back to the minus 20 temperatures through the day? How will the generations 50 years from now judge us on our treatment of this group of people who seem unable to live with dignity? And I wonder what ever happened to Two Step, the Millionaire, and Sadie.
Isn’t it always just about money. Is it not possible that if the Weyburn Mental Hospital had continued with the 1000 occupants it was designed for, kept the staffing and programs up, and with the advent of mental health treatments we have today, would have been a facility that would be a mental health gem? Someone made the decision that these mentally afflicted people could make decisions for themselves and make out on their own, at about the same time the government was deciding to put in place a monopolistic health care system that basically declared that the people with all their faculties were not able to responsibly arrange their own healthcare coverage. In our present Universal Public monopolistic health care system, have we not abandoned those very people that need societies help while depriving capable people the right to insure and provide for themselves? As time goes on, the present system has become increasingly burdened with those people who could fend for themselves, with too few caregivers and crowding in our facilities. Meanwhile, the people that really should be cared for and protected wait on long “risk lists”, and are not specifically targeted with intervention and preventative programs. Have we really not just expanded the Weyburn Mental Hospital situation into a National Monopolistic Universal “Healthcare” project? Has our Universal Public Healthcare system become the Weyburn Mental Hospital without walls? Think about it; the Weyburn hospital simply and inappropriately tried to do too much for too many people with too few resources and at some point, rather than being more discriminative in their “coverage “ of their dependant patients, simply threw the doors open (more to the point, pulled the rug out from beneath them), and left most of them fend for themselves. As costs rise in our public healthcare system and the needs outstrip the capacity, will the government at some point, suddenly throw their hands up and declare that we can all look after ourselves? Wouldn’t it to be appropriate (and sensible) to encourage those that are able and wish to provide for themselves through insurance programs and a private system, the opportunity to do so?

11 Comments:

Blogger Lanny said...

Surprisingly, you are more of an idealist than I am. I also watched the program but I assumed it would all be negative due to "political correctness" in society. I was actually pleasantly surprised that there were positives mentioned at all so I was probably more aware of the positives than the negatives when they were raised.

I totally agree, however, that institutions like Weyburn etc are sadly needed in today's society. In the guise of "freedom" and "political correctness", much like our health system, people who require help have been left out in the cold. Much like the cuts to the Weyburn mental hospital in the past to save money, our society's most vulnerable people have been thrown out into the streets to fend for themselves in the name of supposed "humanity". It does remind me of the healthcare system "cost efficiencies" and "innovations" where our most vulnerable people are dying and supported by the "politically correct" in the name of "humanity" as well. Governments and the media have learned very well that social engineering and sugar coating emotionally charged issues will cover their "cost saving" measures.

Dying people in our hospitals to avoid "rich people getting better care" and mentally ill people dying in the cold on our streets to avoid "institutionalization" are the result. It sure sounds good, doesn't it?

8/12/06 9:25 AM  
Blogger Mark said...

"mentally ill people dying in the cold " is this a housing crisis or a mentally ill crisis? What is the proper way to behave when you don't have a home? or can't afford one?

Freedom means you can think and believe in what you want.
If you are double your proper weight, you can continue to keep eating until you die of heart problems. If you drink alcohol in excess to feel better you can die doing that as well. Smoke yourself to a cancer death.
These people are given freedom, why not the mental patient?

Criminal actions should be judged and the criminals jailed for the protection of societies citizens.

Innocent people should not be jailed ( you call hospitalized) for behaving differently.

Coercive forced psychiatry is not help and will never be.

18/8/07 5:13 PM  
Blogger Al said...

Coercive forced psychiatry?? That sounds a wee bit like you have some sensitivity regarding the issue.
What a just and compassionate society must always decide is whether a person has the cappacity to make decisions for themselves that are in their best interest. Granted, we all make bad decisions at times, but if we have the capacity to make those decisions, we will have to accept the the negative outcomes of those decisions. Obviously, we in Canada have taken the position that persons under a certain age cannot make decisions pertaining to such things as marriage, sex, etc. We also, in our courts, may consider someone not responsible for their action due to deminished capacity or mental illness. If a paranoid schizophrenic person assaulted someone because they feared wrongly for their life, would you simply throw them in jail rather than confine them, treat them,release them, and put in place out patient follow up?? We restrict the freedom of our pets so they do not come to harm because we care for them and recognize their vulnerability. Should we treat people with diminished capacity due to illness with indifference? The problems lie with determining who would benefit or need confinement and the time frames pertaining to that confinement. Unfortunately, those in power often get carried away with their "innovation" and the result is not what was envisioned.
We all believe in freedom until someone who has been identified as mentally unstable is not confined and treated and then guns down innocent school children. Then we all point our fingers at the psychiatrists involved and the system and shout "why was this fellow allowed to freely roam our streets"? Your approach and thinking, Mark, is simplistic and naive, but thanks for the comment.

19/8/07 4:50 PM  
Anonymous Anonymous said...

good and bad comes with everything. great psychiatric advances were made at the Weyburn Mental Hospital but they didn't come easy there were outstanding downsides to many of the experiments. It kept these so called "insane" people "out of the cold" and that's great, but you can't deny that some people didn't really need to be there. The environment could turn anyone "mental"...even the nurses. All the negative energy does something to a person. It happened it is history now. But I don't think that we, as a society, should be able to deem anywone insad]ne...maybe they just feel and see things on a different level and the "sane" ones don't allow themselves to go down that path of knowledge, but who is to judge. I think I can agree somewhat with mark when it comes to judging. and, al, I really don't think that it is your place to say someone's thoughts are simple or naive. there are alot of screwed up things in our world right now and negative judging isn't helping anything. What was, is..it can't be any other way once it has happened.

3/2/08 3:34 PM  
Blogger Al said...

I think in my comments that I explained why I thought Mark's "black and white" approach to crime and his "doors wide open" to freedom were simplistic. The resposibilities of a just society are extremely complex and as has been said "if we don't regard history, we are destined to repeat it". Certainly some of the people in the Weyburn Mental Hospital didn't need to be there, but they also didn't need to be "dumped" out on the street with little or no programs in place to monitor their "adaptation". The whole reason for my entry was to point out that the "Innovators" can go to far and when the task becomes too heavy they have a tendancy to walk away, down another road; so in essence I believe i agree with your positions that, at times, by attempting to do good as a society, we infringe on peoples right to live their lives as they see fit.

6/2/08 11:14 AM  
Anonymous Anonymous said...

My mother prior to my birth spent time in weyburn mental hospital.At the time they were experimenting with insulin.They gave her an overdose and put her in a coma.For thirty three days or so the would tell my father she may never come out the coma,and if she did she more than likely be a vegtable.You can imagine the horible time my older brothers and sisters,not to mention my father,went through.Well thank the lord my came out okay and i am here.No thanks to the horrible doctors who performed these so called experiments on human beings.I can only imagine what other familys went through watching there loved ones being put through.I am not saying these patients being put out in the cold was right,but for what they were put though,it sure beat what they suffered in the hands of a medical profession that admittedly can understand a very small part of what the human brain can do to this day and try to guess at the rest.

1/5/08 8:17 PM  
Anonymous Anonymous said...

I agree that facilities are needed for the mentally ill people but, after having seen what my mother went through for the better part of her adult life, in Weyburn, I am not convinced much good happened there. Yeah, you can all regale with your stories of the looney tunes, but, my mother was one of them and I find it disrespectful and insensitive to relay these stories.

19/9/08 11:29 PM  
Anonymous Anonymous said...

I was never there while it was open, but i do beleive that it is haunted, due to the fact of the times when i have been there and experianced parinormal experiances even outside of the building.

15/10/08 3:24 PM  
Anonymous Helen said...

Helen said...
My Mother worked there..she was a very soft spoken, kind hearted person who understood and reached out to the mentally ill. I listened to many sad stories of how some people were treated...very inhumane..it was a mad house. If only the walls could talk. I read about "Gordon" whose mother dropped him off there and never returned to pick him up. Why drop him off there in the first dam place. How sad is that ?
The Hospital is very much needed for people who do need help. Help that is administated properly !

12/4/09 10:34 PM  
Anonymous Raymond said...

We owe all the people who participated in wayburn a huge debt. Up until that time we treated the illnesses not much better then in medival times.We have chosen not to use many of the lessons we learned in wayburn.The science of orthemolecular medicine has been suppressed by big pharma lobby according to Dr. Abraham Hoffer and his associats that worked there.the cotinuation of that thinking can be seen in the legislation of natualpaths making simple vitamins put in narcotic classes The only scientifically proven method of CBT called dialectic behavoreal therapy is still struggling though now in use in Canadas womens penitenary system.Unfortunatly it still can be said that the care and treatment of the mentally ill is the last frontier in a truly just sociaty.

28/3/10 9:39 PM  
Anonymous kamagra said...

Is there anything as "universal [real] public healthcare"?

by the way, it's been almost four months that I visited your blog the last time! Now I found where I had it bookmarked and finally I'm back! Hahaha, let's just say that I'm an every day reader of your place here! Keep up the great job you're doing with your personal space of communication!

14/4/11 3:15 PM  

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