Eastern Washington State Hospital
|Eastern Washington State Hospital|
|Building Style||Kirkbride Plan (Demolished)|
|Location||Medical Lake, WA|
The great distance in transporting patients to the Western Hospital for the Insane at Fort Steilacoom, which is situated in the extreme western part of the state, led to the erection of the Eastern State Hospital.
The first buildings were erected in 1890 and consisted of a central administration building, with a wing on each side and a rear wing for the kitchen, engine room and laundry. The entire plant was made of brick, with a granite foundation, lathed and plastered inside. Each wing was three stories high and accommodated 150 patients. The buildings were of the old Kirkbride plan. The building commissioners were D. M. Drumheller, B. B. Glasscock and Stanley Hallett. The first Board of Trustees, consisting of D. F. Percival, Dr. Wilson Lockhart and Charles McDouall, were appointed in 1890. In 1892 W. J. Dwyer was appointed in place of Dr. Wilson Lockhart, whose term had expired. This local board continued in office until 1897, when it was abolished and the State Board of Audit and Control assumed power.
In May, 1891, 20 patients were received from the Western Washington Hospital and in July, the same year, 102 more. These patients had been committed from counties east of the Cascade Mountains, the territory which thereafter was designated as the district especially belonging to this hospital. As the patient population quickly rose additional room became necessary. A second wing was erected for men in 1894. It was, like the two original wings, three stories high and accommodated 150 patients. While not fireproof, it was an improvement over the older wings, having all partitions made of brick and tile, with hard plaster finish. It had no rooms or dormitories in the front of the building, so the wards were exceedingly well lighted. The flooring was of maple and each ward had two fireplaces—one at each end.
Further growth of the hospital population made it necessary to erect additional wards for women. In 1903 a three-story wing, accommodating 105 patients, was built for women. It was somewhat similar in construction to Wing Two South, but the wards were not so well lighted, as there were four rooms in the front of the building on each ward. The floors were of fir instead of maple. Wing Three South was built in 1907 and accommodates 150 men patients. It is as nearly fireproof as can be made.
Wings Four South and Three North were completed about July, 1912. They are, like Wing Three South, practically fireproof, with many modern conveniences. Wing Four South was erected especially in view of caring for the convict insane. The number of convict insane is steadily increasing with the increase of the general population and they are too dangerous to keep in ordinary wards This wing is as light, airy and cheerful as any of the others, but specially prepared window guards and doors are installed.
Other additional improvements consisted of large dairy and stock barns, separate buildings for the carpenter and blacksmith shop, laundry, paint shop and bakery. A new farm house, with accommodations for the farmer, cook and 15 patients, has been erected on a detached farm. Improvements made and in course of construction consist of additions built to enlarge the congregate dining rooms, water closets, lavatories, bath rooms remodeled, floors and walls covered with white vitrified tiling, and modern sanitary plumbing installed in nine of the older wards.
Hydrotherapeutic apparatus was installed in 1912; and a modern equipped surgery centrally located, with dressing rooms on the wards. Six of the older wards were re-floored with white maple. A cold storage plant, with five large cooling boxes, each 8 feet by 20 feet by 8 feet, and granite and concrete root cellar, 120 feet by 36 feet, have been built, as well as a hay and straw barn. A modern dairy barn to accommodate 61 cows with milking machines; an aseptic milk-cooling room, and a cutting room, with electric-driven machinery. An entirely new poultry plant has been rebuilt to accommodate 1000 laying hens and the piggery remodeled on modern lines to accommodate 500 pigs There is also a fruit house 20 feet by 40 feet by 10 feet. A granite addition was made to the boiler room, doubling its capacity; also a new concrete coal bunker, with a capacity of 2000 tons.
At the end of 1914 The hospital owns 833 acres of land, about 400 of which are in cultivation. The population in 1914 consisted of 719 men and 337 women, a total of 1056.
The Custodial Care phase represents the first five decades of the hospital’s operations. The main emphasis of this phase was the isolation or “asylum” of patients, separating them physically from the world to simplify patient lives and to protect those in the community. It also protected them from the community, as mental illness was heavily ostracized and stigmatized in those days; though there is still a significant stigma today, it is much less than at the turn of the century. At this point in history there was little to no understanding of the nature of mental illness; considered causes of illness at the time were “age, tobacco, constipation, whiskey, and morphia[sic],” and any person seen as problematic (alcoholics, the mentally retarded, those suffering depression, criminals) were placed in the hospital.
This disrespect and lack of understanding of patients can even be seen in the original name of the hospital, which from its 1891 opening until 1918 was called “Eastern State Hospital for the Insane.” Treatments were targeted at symptoms, and many of those treatments were completely ineffective. Such treatments included religious actions (prayer, exorcisms, forced religious study, etc.), physical restraint, and other punishments. The hospital suffered severe overcrowding and was very understaffed in this period, with a single attendant being responsible for 40-50 patients, working in 12 hour shifts, with a total of 800 patients in the original building. Over time, 22 new buildings would be added to the hospital complex and the population peaked at 2,274 in 1954. Many of these new buildings were the result of Works Project Administration spending during the Depression, which sought to both create jobs and to ease the overcrowding.
A significant development in therapy came in the 1930s. Daisy Lewis, an attendant, gave an insulin shot to a woman who didn’t recognize her husband nor daughter and was “completely oblivious to reality.” The effects wore off shortly and treatment was repeated, but it gave hope that there was something that could be done for patients. Despite the positive results such treatments had for some, they had numerous negative effects on patient health. Different kinds of convulsive therapies, or “shock therapies” (insulin shock, metrazol shock, electroshock), were used for all manner of patients, as these were the only treatments with any consistent efficacy yet discovered (though they were only truly effective on a small number). The overuse is clear in the hospital’s statement: “During a two year period in the early 1950s, over 1,100 patients received one of the convulsive therapies; altogether, about 15,000 treatments were administered.”
In World War II, treatments turned into “work therapy” for all those not residing in locked wards, or roughly 80% of the total patient population. Patients worked between two and eight hours a day on a variety of tasks, including baking, farming, sewing, gardening, cobbling, landscaping, housekeeping, cooking, and many others. After a day’s work, patients received either group or individual counseling; this counseling focused on correcting perceived moral or religious deficiencies, which were seen as the cause of a “demented” condition.
This period of hospital history (as in many other mental health facilities) is regarded as a low point, and even hospital officials have stated that it “must have been a frightening place through [those] decades.” Through the first five decades of the hospital’s history, the number of patients rose steadily, and most of them never left the hospital. Concerns were raised when so many patients were being admitted, and so few were being reintegrated into the community; the effectiveness of any treatment was cast into severe doubt.
Such concerns over the hospital’s retention rates of patients led to the next phase of treatment styles at the hospital, the “patient-is-problem” phase, from 1941 to 1954. Treatment began to incorporate Freudian theory of the causes of mental illness, and focused on an individual patient’s thought processes, formative experiences, and genetic factors. A significant factor in this approach came from returning WWII soldiers and medics, who had front line experience of mental trauma caused by war. On the front lines, these groups developed methods for first-response, short-term crisis therapy for those in distress to allow them to return to the battlefield. This interest in understanding mental illnesses increased as group therapies were found to be effective, and research by military medical personnel and social workers increased through both WWII and the Korean War (1951–1954).
The third reworking of hospital treatment policies began in the mid-1950s, ushered in by the new availability of psychotropic drugs. While some saw the new use of pills to treat mental illness as little more than “chemical strait jackets,” they allowed a large number of patients to be released and being their reintegration into the community. As the hospital’s 12th superintendent Dr. G. Lee Sandritter stated, “as long as we hang on to a patient, he won’t get well.” Thus, the new policy was for patients to be kept in the hospital only as long as medically necessary before being released and reintegrated. Sandritter was fired in his 2nd year amidst much controversy. The Spokesman Review had run a number of articles alleging misconduct at the hospital under his supervision, including runaways and sexual misconduct between staff and patients. It is unclear how much of these allegations were based in fact, and how many were generated by the hysteria over Sandritter’s loosening of hospital policies confining patients; the primary sources of the accusations were “disgruntled employees,” according to official hospital literature.
These liberalizing policies were continued by Sandritter’s successor, Dr. Harris Bunnell. A volunteer program was started to help integrate the hospital with the public, and in 1965 over 2400 visitors came to the hospital, helping to lessen the “asylum” stigma that had plagued it for so long. The patient population was also falling dramatically; by 1970, the hospital was at a quarter of its peak 1950s numbers at around 500 patients, a number not seen by the hospital since 1907. Treatment responsibilities for released patients were delegated to Community Mental Health centers, which were established locally under guidelines established by federal legislation.
The Community Mental Health Movement
This phase, which continues today, was catalyzed by new legislation in Congress. The Mental Health Study Act, passed by Congress in 1955, established the Joint Commission on Mental Illness and Mental Health to evaluate mental health treatment in the United States. The commission’s recommendations for reforms were incorporated, in large part into the 1963 Community Mental Health Act. This act provided federal grants to state and municipal governments to establish community mental health centers to deal with outpatient treatment of the mentally ill.
Many were not accepting of the newly released mentally ill in their communities, and discrimination was fairly common and institutional: released patients could not vote nor hold driver’s licenses, despite having been declared “sane.” This changed in 1974, when the Washington State Legislature passed laws guaranteeing equal constitutional rights for patients. Treatment of the mentally ill today is increasingly done on an outpatient basis, and ESH focuses predominantly on more severe cases, as well as providing a space for group therapy and workshops. The hospital today has room for 312 patients, and has roughly 700 staff; nearly 100 patients are admitted on a monthly basis.
- Adult Psychiatric Unit (APU) - APU is a 91 bed unit that provides inpatient hospitalization for adults 18 to 50 years old who are severely mentally ill and are committed for evaluation and treatment by a civil court proceeding.
- Geropsychiatric Unit (GPU) - GPU is a 101 bed unit that provides inpatient psychiatric evaluation and treatment for individuals 50 years of age and older, or persons under 50 years of age with medical concerns. Included in GPU is the Habilitation Mental Health (HMH) Unit. The HMH consists of patients who are dually diagnosed with a mental illness and a developmental disability.
- Forensic Services Unit (FSU) - FSU is a 95 bed inpatient unit for patients who enter the forensic (legal) unit in the hospital through the criminal justice system. Evaluation and treatment services are provided for adults prior to their trial, after they are convicted, or after they are acquitted by reason of insanity.
- Treatment Malls - Eastern State Hospital provides a treatment program that recognizes the worth, dignity and rights of all patients. Treatment focuses on the psychiatric illness and behavioral issues which make hospitalization necessary. The treatment programs are conducted in an area termed the "Treatment Mall." ESH maintains two treatment malls, one is located in the activity building and the second is on the first floor in GPU.
Images of Eastern Washington State Hospital
Main Image Gallery: Eastern Washington State Hospital
Medical Lake, WA
Phone: (509) 565-4000
Individual or group tours to the hospital and museum can be arranged by calling the volunteer coordinator (509) 565-4280
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