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Monday, July 16, 2001
By Steve Twedt, Post-Gazette Staff Writer
By the time state officials closed Mayview State Hospital's adolescent unit in December 1996, the 70 or so youths there had already been transferred to places like Southwood Psychiatric Hospital, a private institution three minutes from Mayview, or group homes scattered in communities across the state. A few went home with relatives.
The program's end marked a change in philosophy, observed Donald Stidham, Mayview's longtime supervisor of therapeutic activities.
"There was a fear that young kids in an institution would become too dependent on the system, that it was better to treat them in the community. And, also, there is the negative connotation to having been in a state mental hospital."
But without Mayview and similar adolescent units in other state hospitals, Pennsylvania lost a secure, long-term treatment option for mentally disturbed teens.
Should they be brought back?
Licensed psychiatric hospitals such as Mayview have tangible advantages. They must meet high standards of care and staffing, such as having a physician on site.
State officials say other facilities, such as the secure treatment unit for boys in Allentown or the privately-run New Morgan Academy in Berks County, can serve many of the same purposes as Mayview did. But there's another important difference -- unless they are committed to a hospital, anyone 14 or older can refuse treatment, including medications that keep their moods stable.
"Kids will just avoid things, but here you had a captive therapy patient," said Mayview nurse specialist Maureen McHugh. "You just said, 'It's time for therapy.' You didn't wait for them to show up at the office. You also had the advantage of having a kid over time. If you have someone for six months, you get a better idea of what you need to treat. You also had the time to establish a relationship, for good therapy to occur."
Among many mental health professionals, though, there is not much sentiment for bringing back large institutional programs like Mayview's.
"I don't think we need a Mayview now. We know better. To reopen those programs would be to deny a lot of kids their right to live in the community," said John VanDenBerg, a nationally-recognized expert on individualized therapy for teens.
For some teens, though, living in a residential neighborhood in an unlocked home is not feasible.
Lynne Struble, CEO of Southwood Psychiatric Hospital in Upper St. Clair, says there are teens who simply have to be in a secure building where they cannot run away and cannot hurt themselves or others.
"There's definitely a need for something more than [a residential treatment facility] and less than an inpatient hospital, and anybody in this business will tell you that."
While its adolescent program was operating, Mayview had two to three units for teens, with up to three children in a room, and they were kept separate from adult patients. They had their own dining area. Daily activities might include a few games at the hospital's bowling alley, or a swim in the pool. "It was a summer camp sort of thing," recalled Stidham.
Confidentiality laws prevent Stidham and other staff from tracking former patients, but he's certain that Mayview kept some youths -- those with a history of aggression, or setting fires, or running away -- from getting into trouble with the law.
He's certain because, every now and then, he's seen former residents on the evening news -- handcuffed as they climb out of a police squad car.