Riverview Hospital for Children and Youth. Richard J. Wiseman
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guy, drunk or on drugs, gave me directions and I finally found the place. They were very happy to see each other.7
In an effort to get a better picture of the population and program, T. Wayne Downey, a consultant to High Meadows, published his study “A Comparative Study of Residential Treatment Populations: Children’s Unit of Connecticut Valley Hospital and High Meadows, Hamden, Connecticut.” The article paints a rather dismal picture, describing the patient population similarly reported in other studies (the chronicity of diagnoses such as chronic brain syndrome, childhood schizophrenia, severe behavior disorders, social pathology, mental retardation, and severe, aggressive behavior). In comparing the treatment milieus at High Meadows and the Children’s Unit, he writes about his bias as a consultant to High Meadows and describes his observations:
High Meadows appears to be functioning at near optimal efficiency in terms of its treatment plans and goals, staff morale, and maintenance of physical plant. At the time of [this] study, conditions in the Children’s Unit provided a stark and dismal contrast. The staff was laboring dedicatedly and valiantly under enormous handicaps, inadequate staffing, a deteriorated physical plant both improper and inadequate for the needs of disturbed children, and a lack of high-level professional and administrative support. The school program at Connecticut Valley Hospital seemed the strongest part of the treatment program on the Children’s Unit. In most cases (and in spite of the efforts of an earnest but overwhelmed staff), treatment at Connecticut Valley Hospital consisted of little more than holding the child securely and waiting for time to cool off the crisis situation, allowing for disposition home or to another institution.8
In an addendum to the article, Downey expresses his dismay over the mental health system and care for these children:
While some children at Connecticut Valley Hospital would have benefited by long-term intensive treatment in a closed setting, a significant number of children were there as testimony to the glaring lack of acute children’s psychiatric inpatient treatment facilities. Perhaps ten to fifteen percent of the children at Connecticut Valley Hospital and five percent of the children at High Meadows were being “over treated.” These children were not in need of long-term treatment or hospitalization, but were there by accident, default, or artifact. Some children carried the label of psychiatric disorder primarily because no child shelters or domiciles were available in their communities where they could be harbored for the forty-eight to seventy-two hours until the crisis had passed, so that psychiatric treatment and social work intervention could be continued with them and their families in a more meaningful home situation. Certainly the lack of acute psychiatric inpatient facilities serves to perpetuate symptoms in degree and chronicity until separation of a child from home and community under emergency conditions is the only option. The child’s separation from his family then becomes undesirable in terms of what we know about the psychiatric treatment of children and the need for maintenance of family and community ties with individual, milieu and family therapy as modalities to re-establish relationships on a more stable, mature level. This task is infinitely more difficult under the present centralization of child treatment facilities in the state. The twenty-five percent of children in this study from Fairfield County are one to two hours from home, mitigating against consistent close contacts with their families. Acute psychiatric treatment centers for children on a decentralized community basis are called for. Additionally, attention must be given to the special needs of the disturbed, mentally deficient children in the Connecticut Valley Hospital population. They require a special program oriented to the specific needs, capabilities, and tolerances of these children. They require a program, which bridges the gap between their retardation and their emotional disturbance, with special education and therapeutic approaches which a general children’s psychiatric service cannot provide.
A final impression is that many of these deficiencies could be resolved or avoided, were there a central agency or agent charged with and committed to the care and treatment of emotionally disturbed children in the State of Connecticut.9
Downey’s analysis clarified the need for massive amounts of help from the government, the community, and the hospital. Arafeh, superintendent of CVH, requested assistance from the Connecticut Council of Child Psychiatrists, asking them to review the Children’s Unit program and make recommendations not only on how to improve its functioning but on how they could help provide psychiatric leadership for the unit.
Partially in response to this request, in February 1969 the Council and the New Haven–Middlesex Chapter of the Connecticut Psychiatric Society submitted a report to the Ad Hoc Joint Committee on the Children’s Unit. In it they reiterate the conclusions of the previous studies and describe their own observations:
The wards have a markedly institutional character, they are cold and generally forbidding, and there is already a sense about them of considerable dilapidation. Clearly they were not designed to withstand use by a fairly active group of children. Some of the rooms are exceedingly overcrowded and there is about them a sense of starkness, which is distressing. There are few personal possessions in evidence and very little sense of any kind of privacy. With one exception, the recreation or public rooms are empty and bare. The one exception is a recently established combined recreation and snack shop which the patients established themselves, which they run, and which has a somewhat more festive, livable and desirable air about it.10
The report went on to conclude, “The Children’s Unit must have full autonomy. This includes full administrative and program control and in the management of all services with all staff reporting directly to the superintendent of the unit, rather than to the CVH chiefs.” They also recommended a salary level that would attract a qualified person, “optimally a child psychiatrist.”11
Some support came from the judicial side of government with the appointment of a new juvenile court judge, Margaret Brenneman. Judge Brenneman was a strong advocate for children and over the years supported the development of children’s mental health services.12 Unfortunately, the judicial system changed eventually, and juvenile court judges were replaced with superior court judges who rotated through the juvenile courts, making it difficult to get to know the judges and vice versa.
Early in 1969, Suzanne Peplow resigned, partly because of poor health but certainly out of frustration with not having moved up from the acting-director designation, as well as a sense of futility based on what she perceived as a failure to move more quickly in meeting the needs of the children.
One of Suzanne’s final acts was to recommend an increase in childcare staff from an average of two staff members per shift per ward to an average of just under three staff members per shift per ward. A ward consisted of an average of thirty children. This would raise the number of childcare staff members, including nurses and supervisors, from thirty-seven to fifty-nine, with an average daily census of eighty children on two wards and an “annex” for the autistic kids. This increase would also accommodate the change from a forty- to a thirty-five-hour workweek. Suzanne also recommended an increase in social service staff in order to decrease the caseload of each staff member to fifteen.
Upon Suzanne’s resignation, Margery Stahl, supervisor on the boys’ ward, moved up to acting director of the Children’s Unit, and Marcia Pease-Grant accepted a promotion to senior psychiatric social worker.
Marge Stahl took charge and brought immediate order to a rather dispirited situation. In an interview she describes what it was like at the time:
The hospital really didn’t like the children being there. [The children] broke things, were noisy. We had a child who could pull up a tile in a second. They didn’t like that very much. But basically, the wards in Merritt Hall were very sterile. They had a bed and a locker. And the thing that bothered me most as the nurse on the unit was that the kids had nothing to play with. They didn’t have games, and if they did you were constantly looking to find the pieces. One of the mothers of one of the autistic kids who used to come up to the unit to help with the autistic kids wrote a letter supporting us.13
Judy Raczkowski McCain began at the Children’s Unit in 1968 and was assigned to Wards 91 (girls) and 92 (boys) in Merritt Hall. She describes a similar situation:
There were minimal resources for kids. I remember one of the seven-year-olds