Good old times never existed

State hospitals, schools did more harm than good

AS A YOUNG BOY with cerebral palsy, I lived in a state institution.

As a young Boston College graduate, I worked in a state institution.

As a member of the Massachusetts Senate, I successfully sponsored legislation to close state institutions.

My actions as a Senator were inspired by, and directly resulted from my experiences, as a “patient” and as an employee in state “schools.”

During those years I experienced first-hand the substandard and sometimes subhuman “care” provided to “residents” of state institutions.  I was witness to the de-humanizing approach used to “treat” individuals confined to state “hospitals” and “schools.”   I saw rules and regulations implemented to benefit employees as opposed to meeting the needs of those being “served.”

That’s why from my first day in the Senate to my last day 30 years later, I worked with smart committed colleagues of both parties to close a system of state institutions that was doing more harm than good to those supposedly being served.  I worked with former governor Michael Dukakis and his administration to close Belchertown State School.  I worked with former governor Bill Weld and his administration to close Danvers State Hospital in my own district.

Criticisms in the recent Boston Globe Spotlight series that state government has not done enough to fund community-based services in the post-deinstitutionalization era are entirely fair.  In many ways, Massachusetts has not achieved the promise of a robust community-based system of mental health services despite the best efforts of many of my colleagues, past and present.

Anyone making the case today, however, that individuals living with a mental illness were better served in the era of institutionalization, doesn’t know what really happened inside the walls of those institutions.   I am fearful that the Globe Spotlight series may inadvertently fuel nostalgia for an idealized time long-ago where our family members and neighbors living with a mental illness were “treated in a safe environment where their greatest needs were met with expertise and compassion.”

I am here to bear witness that such a system never existed in Massachusetts, at least in my lifetime.  State institutions were not always safe and very rarely employed expertise and compassion to meet the needs of confined individuals.

Those implicitly or explicitly harkening back to a “kinder, gentler” era of large, state-run institutions ignore the fact that the state institution system was always underfunded.   Anyone who ever saw the insides of any of the now-closed state hospitals will attest that the state-funded facilities were sad and often times scary and dangerous places to live for the “residents” who were confined there for years and, sometimes, decades at a time.

More often than not, the “treatments” for patients were focused simply on managing the larger group with the least effort possible and not on treating the individual needs of those confined to the institution.  This was true in my case as a child with a physical disability as it was true for tens of thousands of other Massachusetts residents confined to state “hospitals” and “schools,” whether they had a physical disability, developmental disability, or psychiatric disability.

Community-based care, despite its imperfections, is exactly what the Commonwealth should be providing for its residents who need such services.  Every day thousands of individuals living with a mental illness reside safely and independently in neighborhoods across Massachusetts.  Hundreds of organizations from Boston to Pittsfield and everywhere in between do remarkable work with limited funding to help their clients live lives of freedom that was unimaginable less than 50 years ago.

Gov. Charlie Baker and my former colleagues in the Massachusetts Legislature must remember that in many ways, and for many individuals and families, deinstitutionalization has been a success.  It is a mistake for any of us to ignore this reality as we collectively address the issues highlighted in the Globe Spotlight series.  We don’t need to look to other states for solutions.  We have plenty of successful models here in Massachusetts that we can replicate.

If we want a truly first-class system of care and supports, however, we must find the means to pay for it.  Spotlight reports and concurring letters to the editor are not enough.  We must invest in community-based services in a meaningful way – and that means money.  It should not require sensationalized reporting or lawsuits against the state to grow a community-based system grounded in best practices.

Meet the Author

Frederick E. Berry

Former state senator, Massachusetts Senate
The governor and Legislature need to determine just how important quality community services and treatment are to them.   They need to move forward because we most certainly can’t go backwards guided by fantasy of a better time that never really existed.

Frederick E. Berry served is a former majority Leader of the Massachusetts Senate, where he served for 30 years.  He currently lives in Peabody.