The Philadelphia State Hospital at Byberry: A History of Misery and Medicine (Landmarks) (PA)

by J. P. Webster

  Looking to recruit more forces in the battle for closure, Welfare Secretary John F. White Jr. chose to seek outside help. He brought Martha Knisely on board as his mental health secretary. Knisely learned of the closure of a state hospital in Columbus, Ohio, just months before and the success with which it occurred. A key figure in the success of its closing was Estelle Richman. Richman was a strong believer in community treatment teams. Her analogy of any successful mental healthcare facility was a “three-legged stool,” made up of the three essentials: funding, properly trained staff and functional facilities. Byberry apparently met this criteria, but not to the necessary levels. Knisely recruited Richman to the cause, to the dismay of some staff. But ultimately, Richman would prove a crucial element in the closing.

  By 1986, Byberry had become a dangerous environment for everyone, patients and staff. The hospital’s infrastructure had deteriorated almost to pieces. Staff had dwindled to less than one hundred, but the patient load was nearing six hundred. Most of the unused buildings’ utilities were shut off, and unsupervised patients had the run of the remaining campus. Truly a sinking ship, Byberry was shedding its doctors and psychiatrists much faster than its patients. The buildings were, in a way, war zones. The situation in the three buildings that remained in use became increasingly chaotic as the inmates, some still forensics, were under almost no control at all. Dangerous patients were shackled to their beds, but many were freed by other wandering patients. It was justly comparable to a horror film scenario.

  Robert Patrick Casey was elected governor of Pennsylvania on his fourth attempt in 1987. He had been a state senator and served as auditor general of Pennsylvania. As a Democrat, his pro-life attitude was a notable tag of his campaign, as was his pro-gun stance. But he may not have done anything more important or humanitarian than undertaking the cause of Byberry’s patients. He deserves serious praise for this act, for it was not the popular thing to do and he certainly made a number of political enemies as a result. Casey proved himself more than a worthy governor, thankfully, after having ran three other times. Casey had his work cut out for him, however. Upon assuming the office, the Byberry issue was one of the first he dealt with. On his second day as governor, Republican State Treasurer “Bud” Dwyer, whom Casey had lost to when running for that position, committed suicide on national television at a press conference preceding his allotted prison sentence for accepting bribes. Casey was impeccable in his multitasking of several startling issues facing the state upon his appointment. Perhaps he was still full of adrenaline from his campaign race. For whatever reason, Casey shined, and for the first time in fifty years, patients’ rights advocates had real hope.

  The Blue Ribbon committee released its report in September 1987, and the results were certainly damning. It showed an emotional portrait of what amounted, figuratively, to a torture chamber with a tiny but luxurious lounge section. Most of the patients who were conscious enough to give their opinion to investigators expressed negative feedback about their care. The ones who weren’t were either drugged or in seclusion. The results of the report, although negative, were said to have been achieved only due to another maneuver by the staff of temporarily releasing patients just prior to the committee’s arrival and then supposedly bringing them back when they were gone. The staff, in turn, charged the state with using the committee as a way to shut the hospital down. The committee’s report, they said, would say anything the state wanted it to say. It did seem, in a way, that Casey had his mind made up long before setting foot in the governor’s office. The hideous report that he received just days after taking office was not hard to respond to. He acted on it quickly, and his desire for the closure was voiced almost immediately.

  In September, State Secretary of Welfare John F. White Jr. announced that the end was finally near for Byberry. Speaking to the press from the hospital grounds, he said that the hospital would be completely shut down in twelve to eighteen months. Many of the employees interviewed were found to be sincere in caring about their patients and were clearly hoping against the closure. One could argue that they were fighting for their jobs, but it is the opinion of the author that the welfare of the patients, in most cases, was their true priority. Upon White’s announcement of the closure, many of the employees felt almost betrayed. They had spoken highly of Byberry and the dedication they had for its well being, and after positive conversations with committee members and assurances that their opinions would be considered, many employees were confused. But during the brewing of battle, neither the staff nor the state would prove capable of controlling the ever-mounting chaos that continued to erupt out of Byberry’s wards. Superintendent C. Charles Erb, having agreed to fill the position only until his retirement on January 1, 1987, was counting the days.

  Upon the release of the Blue Ribbon report, Secretary White took immediate action. Three assistant superintendents and the clinical director were suspended for sixty days. Twelve attendants were investigated for abuse by White and his staff. Of these, four were fired, three were moved into positions not involving patient contact, one was transferred to Norristown and two resigned. C. Charles Erb was allowed to continue with his planned retirement and was not held responsible for Byberry’s conditions.

  White was able to scramble together a team of professionals to hold the place together for two years until its scheduled closure. Filling the new superintendent position in September 1987 was Dr. Ford Thompson, of Harrisburg State Hospital. His assistant superintendent was Dr. Norman Flaherty, of Mayview State Hospital in Bridgeville. Thompson agreed only to hold (or bear) the position for one year, after which Flaherty would take over. Thompson was a respected psychologist and deserves proper credit for running both hospitals, Byberry and Harrisburg, simultaneously for over a year. When Thompson took over in the immediate aftermath of the explosive report, he said he’d been selected to clean up the “trash” at Byberry. He called attention to the horrific plague of abuse at his new hospital. “Early in September, and into October, we were averaging one new (abuse) allegation per day,” he reported. But by November, the rate had dropped significantly.

  On December 7, 1987, Casey formally announced that the closure would take place over the course of two years. The remaining 530 patients would be transferred to an array of other locations, including nursing homes, community centers and other state hospitals. “Last spring we created a Blue Ribbon Task Force to find out just how bad the situation was,” Casey said via telephone press conference. “By September, we understood that it was every bit as bad—and perhaps even worse—than we had feared.”

  Figuratively speaking, the soul of whatever made Byberry so primordially sadistic was beginning to feel backed into a corner. It was hitting back hard with acts of morbid cruelty, straight from the heart of evil itself. As the administration fought with officials and advocates over the validity of the report, consecutively more horrific stories reached the surface. One such story was that of Anna Caroline Jennings, whose unfortunate experience in Byberry seemed to help exorcise part of the evil there. Anna was born in St. Louis in 1960. Her troubled childhood involved sexual and physical abuse, causing Anna to develop PTSD and other anxiety disorders. She was placed in a state hospital before the age of fifteen and would spend almost two decades being transferred from one state hospital to another. As a result, Anna’s mother moved from state to state. Anna possessed amazing artistic talent, however, and her artwork has since been acclaimed. In 1984, Anna was admitted to Eastern Pennsylvania Psychiatric Institute (EPPI), where she was evaluated and ultimately sent to Byberry.

  Anna was twenty-four years old when she arrived at Byberry just before Christmas 1984. In the two years she spent there, her experiences stretched between some of the best in her life to some of the worst. Soon after arriving, Anna was faced with abusive staff, dangerous patients and almost no helpful treatment. She began cutting herself and attempted suicide several times. She was drugged or restrained for days at a time as a result. Anna reported being se
xually abused by staff and other patients and spent a lot of time in seclusion. Once a treatment plan for Anna was laid out, her experiences began to improve. More time was spent with Anna, and a more aggressive form of treatment was engaged.

  Her artwork was encouraged and became popular at the hospital. Anna became romantically involved with another patient, who had a similar background. The psychologists at Byberry worked well with Anna and were able to diagnose her with PTSD. Anna reported that she was in full agreement with her diagnosis and was working her way out. She maintained a positive attitude and continued to work with staff. Further studies of Anna’s behavior suggested she may have had multiple personality disorder. Her treatment involved medications, hypnotherapy and insulin therapy. But Anna was making the most progress she had yet.

  By 1986, Byberry’s budget was dangerously low. Transfers continued to reduce the patient load but, with it, the staff load as well. Life at the little city of buildings was becoming increasingly perilous. Anna’s treatment was beginning to dissolve as more staff abandoned the sinking ship. Her treatment team transferred to other hospitals, and her psychiatrists’ workload increased threefold until they, too, finally fled. Anna, with the help of her mother, reported what she witnessed at Byberry to state authorities. The staff resorted back to restraining and secluding Anna. She attempted suicide again and was drugged heavily by staff as a result. Anna, too, finally plunged away from the chaotic shipwreck. In November 1986, Anna and her boyfriend eloped from the hospital and began looking for a place to live in the nearby area.

  Anna wound up back in the system, and after spending time in Norristown State Hospital, she escaped and moved to California. While living there with her mother, the death of her grandmother caused Anna to resort to her old behaviors, and she wound up in Napa State Hospital. While there, she reported experiencing further abuse by staff. In November 1992, Anna finally committed suicide on her ward, ending her traumatic existence and finally achieving piece. For more information about Anna and the charity that exists in her name, please visit www.theannainstitute.org.

  Another is the story of Billy Kirsch, which made headlines. William “Billy” Kirsch was a young boy when his father, a single parent, noticed something different about him. His adolescent years seemed to be worse. Peers would tell Billy to get naked and run down the street, and Billy would. And when Billy was diagnosed as mildly retarded in the 1970s, it put his treatment in a precarious position. Billy had a real problem with violent outbursts. He would destroy furniture and walls at home and lash out at his father. The kind of aggressive treatment Billy needed was very expensive, and his father, knowing of Byberry’s bad reputation, did his best to avoid putting Billy there. Coming from a working-class family, it became harder and harder to afford treatment for Billy, and in 1980, Billy was committed to Byberry by his father. “When the insurance money ran out,” explained Billy’s father, William Kirsch Sr., “I had the choice of bringing him home or putting him in Byberry. I brought him home, but after three weeks, I just couldn’t keep working.”

  Billy’s time at Byberry was like a whirlwind. It was probably the worst place for someone like him to be. The first few years seemed to improve Kirsch’s condition. He received ground parole and was allowed to visit home frequently. But by 1985, his violent outbursts earned him a transfer to Norristown State Hospital. In only one year there, he had proven unmanageable to staff, who refused to keep him any longer. He was transferred back to Byberry, where they took the precaution of using restraints on him a regular basis. When his father visited him in 1986, he was unsettled to see his son in five-point restraints. According to an Inquirer article, “He was in bed. Both ankles had leather cuffs on them that were tied to the bedposts. Both wrists had leather cuffs on them that attached to a belt around his waist. Across his chest was another strap.”

  Albert B. Resnik, a PSH psychiatrist, stated, “To be utterly frank, I have never seen anyone like Billy before—never. We wrack our brain trying to come up with a new idea on how to deal with the symptoms that Billy presents.” This proved an understatement. Byberry staff stated that the more Billy acted out, the more they restrained him. But the more they restrained him, the more he acted out and the more violent he became. The staff resorted to restraining him as part of a daily routine. He was let out much less frequently, and the few times he was, he became enraged. In September 1986, Billy was restrained in his bed and not let out for an astonishing fourteen months.

  Day room, N-8, circa 1984. Pennsylvania State Archives, RG-23.

  When William heard about his son’s treatment, he filed a lawsuit against the hospital. With the landmark suit Haldeman v. Pennhurst coming to a close and the spotlight on patient treatment in Pennsylvania, the Kirsch suit did much for Byberry’s closure. As Philadelphia civil rights attorney Edmond Tiryak put it, “The story of Billy Kirsch raises questions about what’s going to happen to the people of Byberry. The Welfare Department, when it announced it was going to close the place, assured everyone that they would use that money to provide community services. But here we have a situation where they have a guy they admit they’ve wronged and their solution is to ship him across the state to another institution. They’re saying one thing, then, a couple of months later, they’re turning their back on this kid.” Patients like Billy Kirsch and Anna Jennings became Byberry martyrs. Their stories, tragic as they were yet fatefully timed and immortalized in the flow of the struggle for closure, would help send Byberry back to hell.

  In January 1988, as agreed, former assistant superintendent Norman Flaherty moved up into Ford Thompson’s vacancy, and Thompson returned to Harrisburg State Hospital. Shortly after his appointment, Flaherty reported that the situation at Byberry was repairable. But apparently after reading the Blue Ribbon report, White had been too deeply sickened and believed Byberry was far beyond repair. “Unfortunately, the legacy of Philadelphia State Hospital, which has been allowed to go on fifteen or twenty years,” White said, “is one that I cannot change.”

  By 1988, Byberry consisted of a skeleton crew. Only a handful of janitorial staff remained, and the maintenance department was down to a few men. Aides and low-wage positions were almost completely gone. Naturally, filling these positions was impossible in light of the looming closure. The staff who remained at this point did so solely out of care for the remaining patients, but a dangerous situation was brewing. On January 2, fifty-eight-year-old patient Lonnie McRiley, missing since December 31, was found frozen to death on the hospital grounds. As a result, staff started a “locked-door” policy for all wards, which amounted to a three-by-five card taped to the door of each ward reading “door must be locked at all times” in black magic marker. Ten days later, on January 12, a second patient was found frozen to death just outside a locked door. The patient, seventy-one-year-old Carmella Rocco, walked off of the geriatric ward, presumably locked, after dinner the previous day.

  It was not hard to blame the hospital after the death of the second patient during a new locked door policy. The policy itself, some argued, actually caused the death of Rocco, as it did little to secure her on her ward. Ironically, the locked doors could not be opened from the outside, and the scarce population of attendants assured that no one knew of Rocco’s dilemma. She was found curled up in the snow as if sleeping, wearing only a hospital gown, by a local resident while walking his dog the next day. Although two police officers searched the grounds until their shifts ended, they found nothing. A police investigator commented, “You tell me how someone who supposedly is mentally deficient and seventy-one years old sneaks out of a locked building. That place is huge, and if you don’t want to be found, you won’t be found. It’s so big, and there are so many hiding places you can’t cover it all.”

  Rocco’s son settled with the State in December 1988 for $100,000 after he began a lawsuit. But Philadelphians, especially Somerton residents, had had enough of Byberry. They had enough of its stories of horror and the quick rushes to reform that would follow,
only to break down, over and over again. Nothing at this point was too shocking. The good residents of the neighboring houses on Carter Road had seen patients on their lawns, in their homes and in their cars. They had found dead patients far too often in their community and were not sympathetic to the state’s money problems. They wanted Byberry closed for good. In a January 1988 Philadelphia Inquirer article, however, local residents spoke of their experiences while living next to Byberry. They gave mostly positive testimonies, and they all mentioned that they thought the patients were the top priority.

  Frank Novak, whose home was only feet from the hospital property, recalled friendly encounters he’d had with patients and the terrible stories they told him about the hospital. One patient told of being extorted monthly by aides for his disability check. Another neighbor, Irene Jones, recalled moving to her Somerton home in 1965: “Back then, the buildings surrounding Byberry were in good shape,” she told the Inquirer. “Azalea bushes lined the fences, and it was well taken care of.” Jones remembered cows grazing in the field on the southeast corner of Southampton Road and Route 1, where the National Guard Armory currently stands. She also remembered seeing patients from her window, cheerfully doing gardening and farm work. But by the 1970s, neighbors began to notice obvious signs of trouble.