WAYMART, Pa. – The official reason that the Commonwealth supports the new state hospital is to provide a place for criminals who are mentally ill.
But that does not explain why the support continues in spite of the alleged murder, brutality, sodomy, neglect, extortion and theft which have been detailed in recent days by The Inquirer and which have long been known to state authorities.
The reason that Farview has remained a sacred cow to politicians decade after decade has nothing to do with providing care for the patients.
The real reason is that Farview State Hospital provides 500 jobs and pumps $7.6 million a year in the local economy that has been moribund ever since anthracite ceased to be black gold.
The lobby that speaks for Pennsylvania's mentally ill criminals is so small as to be nearly nonexistent; but, for state workers, the opposite is true. Through their unions and the politicians they support, they can and do generate fierce pressure in Harrisburg.
Nobody knows this better than Mrs. Helen Wohlgemuth, a former secretary of welfare in the Shapp administration who once tried to close Farview.
"People kick and scream when an institution for criminals or the insane is proposed for their area, and they fight all the way," she said recently. "But once the institution is built, just try and take it away. The residents are the first and loudest protesters."
Two years ago, Mrs. Wohlgemuth came up with a plan to transfer Farview's patients to other state hospitals. Wayne County, where Farview is the largest single employer, was ready.
"The plan collided with 40,000 signatures on petitions protesting the closing of Farview," she recalls, "and the plan lost."
The figure represents 10,000 more persons than lived in Wayne County as of the 1970s census.
The number of patients at Farview has been declining since 1962, when there were 1,410. Today, largely because of court decisions on the rights of mental patients, the number is down to 354.
Corresponding cuts in the staff have been resisted by the American Federation of State, County and Municipal Employees (AFSCME), to which most Farview employes belong. As a consequence, Farview today has almost one guard for every patient, although it has only five physicians, about 30 registered nurses, eight social workers and no certified psychiatrist at all.
The staff, recruited mainly from the rural area around the hospital, has also been shielded by local Republican leaders, who have long used the institution as a patronage base. Consequently, Farview now has more employes (509) than patients (354).
Thus, to some extent, those who are committed to Farview are not only prisoners of the state; they are also prisoners of the Wayne County economy.
While there has been heavy pressure on the state to leave Farview as it is, shifts in population in recent decades have made its location less and less desirable. Most inmates come from the Philadelphia and Pittsburgh areas, and the distances involved make patients' contact with families and attorneys often difficult and sometimes impossible.
Perhaps in response to the challenges to its existence, Farview has generated institutional pressures against releasing its inmates.
Lawyers, psychiatrists, and other who have dealt with individual patients at Farview say that the institution operates so as to keep patients there as long as possible – including patients who are neither mentally ill, nor dangerous nor even under criminal sentence. Patients are returned to society, when it all, grudgingly
"Once a man went there, he had limited chance of leaving," says Barry Schnittman, a New York attorney who had extensive dealings with Farview while working with the Prison Research Council of the University of Pennsylvania law school. "If you don't have patients, you don't need guards."
He cites examples.
Another example of a patient kept at Farview for no reason is described by David Ferleger, director of the Mental Patient Civil Liberties Project.
In recent negotiations to gain the release of Donald Watkins, 64, who had been in Farview for 23 years, Ferleger says, an officer in the State Department of Public Welfare openly agreed that Watkins had no legal or psychiatric problem that would require his being detained in the hospital.
The officer's admission came almost a year after Dr. Thomas S. Szasz, a nationally recognized professor of psychiatry at State University Hospital, Syracuse, N. Y., had examined Watkins' attorney's request. Dr. Szasz called Watkins "a model inmate and a valuable worker in the hospital," and went on:
"Mr. Watkins presents the tragic story of a man imprisoned (for murder), in effect, for 22 years, without trial or conviction of any crime. Ostensibly, then, he was and is incarcerated because of his mental illness and or dangerousness.
"If he is incarcerated for his mental illness, then it is important to note that mental illness is not a sufficient justification for commitment. Moreover, Mr. Watkins is not receiving any kind of treatment.
"Finally, if his 'illness ' were treatable, the hospital surely has had enough time - 22 years - to treat it. If it could not cure till now, more lime will not enable it to effect this miracle."
Dr Szasz' recommendation was to "restore a legally innocent and mentally competent human being (Watkins) to the freedom that is his constitutional right."
Even with Szasz' and another psychiatrist's independent evaluations, it still took almost a year for Watkins to gain his freedom. And that came only alter Ferleger continued to press the authorities for his release. Finally, Ferleger says, one official of the State Department of Public Welfare said:
"If anybody is going to push his case, we will let him go. Do you want him out? OK, we'll let him out."
Watkins was released in May.
Families of patients, too, tell of Farview's reluctance to part with its inmates.
One woman, who asked that her name be withheld because her former husband, a former Farview patient, is now leading a normal life in suburban community near Philadelphia, says that doctors at Farview "told me my husband would never ever come home, that he would be there the rest of his life."
"In fact," she said, at the time her husband entered Farview, "the doctors advised me to get an annulment of our marriage even though our baby "was only 2 months old."
She said the hospital asked her to sign a statement giving it permission to administer electroshock therapy to her husband, "and then the doctors wanted me to sign another statement releasing them from any responsibility if my husband should die while undergoing electroshock treatments."
She refused to sign either statement and immediately went to a public defender to get help. She was able to have her husband transferred to Norristown State Hospital after three months at Farview.
There are two other factors that encourage the staff at Farview to keep patients longer than necessary. One is that those who are nonviolent and good workers – and therefore excellent candidates for release – are also valuable assets in the day-to-day operation of the hospital. The other, according to attorneys who have dealt with Farview, is an attitude that the only mistake the hospital can make is to release a patient who might later get into trouble.
Dr. Michael McGuire, Superintendent or Farview for seven months until he resigned in November 1974 because his attempts at reform were constantly thwarted, says that when he arrived it was common to see patients who had been there 30 years fail to gain release "because they were good workers, either on the farm or in the kitchen or medical sections."
"Many patients' charts indicate that it is possible to remain at Farview State Hospital for 20 to 30 years, being termed too dangerous to be (confined) in less than maximum security but never or rarely tried on any medication likely to influence the course of the illness," Dr. McGuire wrote in a final report to then Secretary of the Department of Public Welfare Mrs. Helene Wohlgemuth.
"These same patients may have never been to (diagnostic) staff or may wait years between staffing. However, they may be regarded as safe to work for 10 to 20 years every day on the farm with minimal supervision."
In an interview with The Inquirer Dr. McGuire said the fact that "some men could be there for decades and never get therapy, yet be confined as crazy and just be used for labor, is almost more frightening than the misuse of drugs and the inhumane treatment.
Richard Bazelon, a Philadelphia lawyer who six years ago won a lawsuit that brought about the release of about 550 patients from Farview (only 30 were returned after outside evaluation), says that "all the pressures are felt at Farview to continue to hold somebody and never let them go. Doctors there just recommitted patients as an office procedure.
"There is a high degree of self-preservation there. The state entrusted those people (hospital staff) with safe-guarding society against potentially dangerous people. In essence, the state said, 'Make sure these people never bother us.'
"The only way the people in charge can make a mistake, then, is to release somebody who may go out and do something bad, So, the doctors there, and even most outside psychiatrists occasionally called in for independent examinations, continued to maintain that the patients were not significantly enough improved for release.
"Farview became a place for forgotten individuals. For them, it was like being put in a tomb."
Stephen Walker, a lawyer from Chicago who spent one summer at Farview as part of a Prison Research Council project, agrees with Bazelon's contentions, but adds:
"Even with outside, independent psychiatrists, recommendations on whether a patient stayed or was released depended more on who the doctor was than on the condition of the patient,
"Most of the so-called independent psychiatric evaluations would last between two and five minutes. The doctors were being paid by the state on a per-patient basis. The doctors tried to see a lot of patients in a day. Very rarely did the recommendation mention release."
One of the frequently noted problems with Farview is its location: as far away as possible from populated areas – and from relatives and attorneys.
This geographical positioning has had two significant results. One is that families can rarely see their incarcerated relatives – and, in some cases, the damage inflicted on them (most inmates are from the Philadelphia and Pittsburgh areas). The other is that face-to-face legal consultation between patient and attorney is difficult.
As Dr. McGuire pointed out to Secretary Wohlgemuth, "No matter how well motivated, it is very difficult and unlikely for counsel to travel 21/2 to 4 hours one-way to interview his client, and telephone consultation cannot he considered confidential at this institution."
One of the threats to Farview's continued existence is the continuing pressure of patients-rights suits.
Dr. McGuire, in his report to Mr. Wohlgemuth, said the state was vulnerable to "a number of highly winnable lawsuits, and if called to testify, l would have to support the basic contentions of the patients in most instances."
Among the subjects of legitimate lawsuits that he mentioned in his final report are "failure to treat, treatment inadequacy and maltreatment with ridiculous combinations and use of drugs, patient abuse, violation of peonage (work) regulations, illegal commitments"'
Sources closely connected to the hospital maintain that the last item on Dr. McGuire's list is something the state is and has been aware of for some time. In fact, actual lists of patients who are being held in violation of the law have been compiled more than once by staff at Farview. Such lists have been supplied to the hospital's superintendent, who notified the Department of Public Welfare of their existence.
The most recent such listing says that almost 200 of the 354 patients now confined at Farview are being held there possibly in violation of the Mental Health Act of 1966. About 65 of these patients were committed under a section recently declared unconstitutional because they were denied due process. However, the state is appealing the ruling and the patients are being retained at Farview pending the outcome of the appeal.
An additional 114 may already have been held longer than allowed by law, and14 or 15 more "should be converted to a different status because they have already been held longer than the 60 days allowed for the status under which they were committed," said one source familiar with the legal situation.
In light of the legal vulnerabilities and present staff and conditions, McGuire thinks the possibilities for reform and meaningful change at Farview are limited.
"I think the only correct course would be to close down the place," he says.
Ferleger thinks the same.
"It is my strong feeling that Farview State Hospital should be closed down completely, facilities taken down, and the property used for some non-incarcerating purposes," he wrote to Mrs. Wohlgemuth on Nov. 25, 1974.
"As you know," he wrote, "it is impossible to find qualified staff (especially nonwhite staff) for Farview, and the terrorism practiced on the inmates is so ingrained that it probably cannot be changed."
Can anything be done? Mrs. Wohlgemuth recalls that when she planned to transfer all Farview inmates to other state institutions, she got support from Lt. Governor Ernest Kline after a meeting in his office in November 1974.
"I know I wanted to close Farview," said Mrs. Wohlgemuth in a recent interview at her home in Sewickley, Pa., "and that Ernie Kline wanted to, too, and so did Governor Shapp.
"The reason they didn't close it is based on politics, the power of the AFL-CIO and the public employes union."
Her recollection of the meeting in Kline's office is supported by Dec. 4, 1974, memorandum to her from Dr. James R. Harris, who was also present at the meeting. It said:
"We're beginning today a national recruiting effort for a new superintendent, as this is an urgent nexessity, even if Farview is to be phased out."
The "national recruiting effort" ended with the selection of Dr. Franklyn Clarke of Norristown State Hospital, as acting superintendent at Farview on a part-time basis. He was followed closely by Dr. Ulysses E. Watson, of Eastern Pennsylvania Psychiatric Institute, who served as part-time acting director until Robert J. Hammel became part-time acting superintendent in October 1975. Hamell remains as acting superintendent.
In fact, a state statute was enacted in 1975 to allow a person with no medical degree to be a superintendent, because, officials say, no physician would take the job at Farview.
This problem, too, is related to Farview's remote location.
'An excellent idea'
Oddly enough, one of those who think that Farview ought to be closed is Dr. Bernard J. Willis, 21-year veteran of the hospital and now its assistant superintendent and clinical director.
In an interview last week, Dr. Willis said he thought it was "an excellent idea" to abolish Farview as a maximum-security mental hospital.
"I think the state would build two similar hospitals, one near Pittsburgh and one near Philadelphia, and move these patients out of here," he said.
Many others – former patients brutalized at Farview, administrators, attorneys and state officials – agree with that conclusion, and have for years. But the political and economic pressure to make no changes are great.