As a youngster, I never imagined that I would pursue the career I did as a mental health professional.
In the 1950s, the only exposure many of us had to the field of mental health was when we acted out. Sadly, people would say, “Behave yourself,” or “Stop acting crazy” because “you’ll end up in Northampton!” This was a fairly common threat made by parents, teachers or even other kids.
The city of Northampton had the closest state-operated psychiatric hospital to the Berkshires. Most of us never knew anyone who actually went there. Society was not very sensitive to mental health problems or illness back then, or to such treating hospitals. Patients receiving psychiatric treatment or any counseling were generally stigmatized.
In the mid-1960s I did, however, visit a patient at Northampton. A friend had been admitted for depression that was precipitated by the breakup of a long-term relationship. I really expected the hospital to be old and tired, but it was not as terrible as I was led to believe as a youngster. In fact, my friend got the respite needed, helpful treatment and a timely discharge.
Through the 1960s, the Berkshires did not have much to offer in terms of mental health and substance abuse treatment programs. A few community-based agencies were in their infancy or on the horizon. The local hospitals could only provide emergency or short-term services.
For those who could afford it, the Austen Riggs Clinic in Stockbridge was well-known for private residential services. But, there were not a lot of other affordable options back then for area residents in need of treatment. There were only a few private practitioners in the Berkshires, and the limitations in insurance benefits discouraged some people in need from seeking any treatment at all.
Thus, county residents in need of intensive psychiatric treatment were often sent to the Northampton State Hospital. The facility itself was a huge building and complex, not unlike other hospitals in the country built around the same period of time (1856). Once called the Northampton Insane Hospital, it was designed to hold 200 patients. Over the years, several expansions allowed for over 2,000 patients, though the hospital became and remained overcrowded for decades.
In the 1960s and 1970s, throughout the country, more mental health problems surfaced. Sociologists attributed the events and stresses of the times for the increased needs for behavioral health treatment. Baby boomers experienced an unpopular war, civil rights issues, student protests, illicit drug use, alternative lifestyles and excesses. For many, these factors led to more and more unmanageable stress and resultant emotional problems.
During the late 1800s and through the 1950s, the country’s prevalent philosophy of treatment was to send psychiatric patients away from their homes and make them feel comfortable in an institution. Too often, medication and the protective environment of the hospital made many a patient “institutionalized” and unable to return to society.
However, in the mid 1970s, a number of lawsuits throughout the U.S., coupled with allocations of state and federal funding for community mental health programs, led to a new treatment philosophy, i.e., deinstitutionalization. The goal was to close down those behemoth state hospitals and treat patients in the “least restrictive environment,” i.e., in the community.
Throughout the country, state psychiatric hospitals were shuttered as community agencies and smaller private hospitals proliferated to meet the service demand. Most of the huge state hospitals were razed. A few still stand vacant today, and others have been recycled into apartments or office buildings. Very few remain open, and those that are have much fewer patients than 50 or 60 years ago.
Northampton was no exception to this change in philosophy to community-based treatment. A 1978 suit in Massachusetts led to a consent decree to reduce the hospital’s patient population to 50 patients in three years. It actually took 14 years to do this, and by 1993 the state fully closed down the facility.
For the next 13 years, there were lots of plans discussed to repurpose the huge psychiatric hospital, but nothing ever materialized. It was razed in 2006. Today, on the hill where the hospital once sat, there is a mix of apartments and condominiums called Village Hill. No longer do kids have to fear being sent to Northampton.
As a society, we have a much greater public understanding of mental health problems than 50 years ago. We have more effective therapies, more skilled providers and better medicines. However, during these even more stressful pandemic times, there are still not enough services to meet growing mental health and addiction needs. We all need to continue to be advocates and support mental health services.