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7. “Out of Sight, Out of Mind”
- Syracuse University Press
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139 7 “Out of Sight, Out of Mind” In her popular “My Day” column published in newspapers across the country on July 22, 1947, Eleanor Roosevelt, wife of deceased president Franklin Delano Roosevelt, gave a glowing endorsement of a recent book: “A book that everyone should read is ‘Out of Sight, Out of Mind,’ by Frank L. Wright, Jr.” The book, which described conditions at state mental hospitals, had just been published by the newly formed National Mental Health Foundation. The foreword of Out of Sight, Out of Mind was written by former U.S. Supreme Court justice Owen J. Roberts, chairman of the National Mental Health Foundation: “Mr. Wright’s forceful book cannot fail to shock us, to awaken us, to impel us to action. It is not pleasant reading, for it deals realistically with exceptionally unpleasant facts. Nevertheless, Americans should read it, for unless these facts are faced frankly, and the problem solved satisfactorily, many thousands of mentally handicapped persons will continue to be ‘out of sight, out of mind.’”1 Out of Sight, Out of Mind was reportedly based on more than two thousand eyewitness reports of conditions and treatment at forty-six mental hospitals in the United States. The institutions themselves were not named. The states in which they were located were Connecticut, Delaware, Illinois, Indiana, Iowa, Maryland, Michigan, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia , Washington, and Wisconsin. The implication was clear. The conditions and treatment reported in the book had been found in institutions among the most progressive and wealthy states—not poor states in the South, as Mrs. Roosevelt herself had assumed when first shown photographs of one of the institutions.2 The majority of the book consisted of edited narrative accounts, typically starting with a quote from a mental health authority on how patients should be treated or an observer commenting on the state of affairs. Photos comparing some of the worst institutional scenes with some of the best were interspersed with the narratives . The juxtaposition of what should be with what was led the reader to draw the inescapable conclusion that things were terribly wrong in the nation’s mental hospitals. The book contained sixty-three separate reports detailing horrendous conditions, brutality, and medical indifference. The first account was told from the perspective of the “first day on the job”: 140 | “A Lasting Contribution in the Field” “To attendants: You perhaps more than anyone else, can help patients get well. You are with them constantly—days to the doctors’ hours. The little things you do week by week, day by day, hour by hour, minute by minute, can make or break them. Of all the members of the hospital staff, you are closest to the patients. You can support the work of doctors and nurses, or cancel it. Yours is the important, cornerstone job in the hospital.” edith m. Stern In The Attendants’ Guide Published by The Commonwealth Fund. Picture, if you can, a ward where two hundred and forty mental patients are locked in one room from morning until night. No patient is ever permitted to leave the ward unless accompanied by an attendant. Most of these patients are forty-five years old or more. They’re vegetative. They eat, they sleep, they void. Then they eat, sleep, and void all over again. The only variation in this program is twice a week when someone shaves them and bathes them. Many of them can’t dress themselves or help keep themselves decently covered. They never stand up when they can sit down. They never sit down when they can lie down. Most of them look as if they wouldn’t even lie down if they could find a less demanding way of existing. Now, into this atmosphere, inject a young boy in his early twenties. He gets no greeting, no introduction, no explanation. The door is opened and he is pushed into the ward. He finds a seat or stands in the corner. He looks around him and sees hopeless despondency. His ears are assaulted by the vocal discord of two hundred disordered minds. His nose—well, you can’t picture that. You’re the attendant on the ward.3 The second report captured the labor problems experienced by mental hospitals: “During the period of July 1, 1944, through June 30, 1945, the employment situation has remained critical, and has shown little or no improvement over the previous year. With 660 established positions, we have had an...