From the Annual Reports of the Illinois Department
of Public Welfare 1947 - 1948
Manteno State Hospital
by Alfred Paul Bay, M.D.
Superintendent
Since the cornerstone of the first building
of Manteno State hospital was laid. Nov. 21, 1929, new
buildings have been added at intervals until now the
hospital has a capacity of over 7,000 patients.
During the year ending June 30, 1948,
2,042 patients were committed to this institution by
court action. An additional 317 others entered as voluntary
patients. Two hundred and fifty-five patients were transferred
to Manteno from Chicago and Elgin institutions and 150
more from Kankakee. The transfers were made in order
to reduce overcrowding at those places. Also, 419 patients
were returned from conditional discharge, 56 returned
from family care and 142 returned from unauthorized
absence. The average daily population for the past year
has been 6,891.265. During the past year 1,010 were
given discharges, 874 received conditional discharges,
100 discharged to family care, 220 listed on unauthorized
absence, 76 were dropped from the rolls, 19 transferred
to other institutions and there were 621 deaths.
Among the important services here is
the diagnosis and treatment of patients which continues
at an accelerated pace as demanded by the increased
number of admissions. The department of psychology has
been expanded by enlarging the professional staff and
incorporating additional testing equipment. The department
can now give intelligence tests. We are now associated
with the department of psychology at the University
of Illinois as a component of their regular teaching
program. Students in psychology have been extended a
residency program for clinical psychological study.
Dental department facilities have been
extended to include three fully quipped dental offices.
A ward service for dental care was inaugurated and a
dentist with a portable unit makes regular visits to
isolated units and infirmary wards.
The technical staff in the radiology
division includes four full-time x-ray technicians and
four clerical workers. The division incorporates five
units of radiographic equipment. The 500-milliampere
unit is located in the Singer building. A chest x-ray
is made of all new patients and employes. There is a
200-milliampere unit for general x-ray work and small
portable units for bedside radiography. The fluoroscopic
unit in the tuberculosis sanitarium is used in pneumothorax
and other forms of collapse therapy.
Mrs. Ruth Robinson heads the physiotherapy
department assisted by Mrs. Selma Bunch. The program
of shock therapy includes insulin, electric shock, electropyrexia,
malaria and typhoid fever.
The bacteriological laboratory is supervised
by Dr. John A. Vaichulis, bacteriologist II. The laboratory
is now approved by the division of laboratories, Illinois
Department of Public Health, examination of feces.
Dr. Vaichulis is supervising a research
program under the sponsorship of the Superintendent
for the treatment of enteric diseases with antibiotics.
The preliminary reports, with favorable response and
frequent cures, is very encouraging regarding the efficacy
of this antibiotic substance isolated by our resident
bacteriologist, Dr. Vaichulis.
Dr. Julius Grueneberg, a staff member,
and Dr. Leonard B. Shpiner, consultant endocrinologist,
are supervising the cancer research here. The effects
of steroids on breast cancer are being tried.
Public health office activities include
immunization of patients against smallpox, typhoid fever
and diptheria. The office also conducts anti-luetic
(anti-syphilitic) therapy clinics and other anti-luetic
treatment given in intensive therapy wards. Records
of all immunizations and laboratory reports are kept
by the office which also collaborates with other staff
physicians and hospital laboratories in the diagnosis
and control of communicable diseases.
The nursing department is responsible
for the nursing care of patients which includes attention
to their personal and physical needs. Some 50 additional
nurses are needed to provide one nurse on each shift
for the 20 wards housing bed patients. This is a minimal
requirement. Last year there were 296 additions and
278 separations from the nursing service leaving a net
gain of only 14 employes in this division against a
patient increase of 548 in the same period. On June
30, 1948, 581 employes were in this department. The
total number needed is 800.
On-the-job training for Supervising
Attendant II, as provided in the Serviceman's Readjustment
act of 1944, Public Law 346, was inaugurated at Manteno,
Feb. 12, 1947. Those who enroll receive training for
24 months in the care of mental patients and learn responsibility
and how to plan, assign and supervise the work of attendants
in all phases of patient care. Besides on-the-job training,
144 hours of related classroom work are required each
year.
Of the 42 veterans enrolled here under
this program, 14 have interrupted their training for
various reasons. At this time there are 28 veterans
successfully carrying on the work of this program.
The year in the social service department
began with 1,123 active cases carried forward from June,
1947. There was a total of 5,476 new and renewed cases.
Of these two groups, 5,330 cases were closed and July,
1948 began with 1,260 active cases in social service.
Critical overcrowding in mental institutions
necessitates administrative emphasis on depopulation,
and while it is a somewhat unusual procedure, our social
service has undertaken to co-operate in this activity
as a special project. Thus all releases are channeled
though the Social Service Office.
Exceptional progress was made in the
family care program. One hundred and three patients
have been placed out, which is double the previous year's
record. The increased number of placements in 1947-48
may be attributed to two factors: extended use of the
boarding out fund and additional personnel allocated
to family care service. The equivalent of two full-time
workers on family care has had the further advantage
of a more careful screening before placing patients
and closer supervision of those placed. The result has
been that in the last five months returns to the hospital
dropped almost 50 percent.
Conditional discharge supervision is
provided by the social service department for approximately
100 conditionally discharged patients monthly. About
on-half of these are released from our hospital into
our own zone. The others have been referred for supervision
from other state hospitals. During the first part of
the year, one social worker was assigned part-time to
visit released patients to secure "pre-parole" information
through home visits in our own hospital zone and from
other hospitals and to investigate cases referred from
other states via our deportation agent.
This year, the hospital was able to
increase the service given at the LaSalle community
clinic and beginning in February, 1948, two clinics
a month were held with a psychiatrist and social worker
from the hospital attending. Seventeen clinics were
scheduled during the year with 101 interviews with state
hospital patients and 24 community referrals. The social
worker for the clinic gives six field days a month to
the clinic.
Interpretation of the hospital's work
to organized community groups had proceeded on a limited
basis, such as talks made to a class of students from
the University of Illinois, to Joliet High school teachers
and to the Flossmoor guild of St. John's church. Psychodynamic
staff meetings, classes in general semantics and lectures
by staff members have been available, as well as educational
motion pictures and medical meetings.
The addition of two supervisors to our
staff has allowed more adequate supervision of the social
workers, as well as permitting them to attend meetings
and conferences of educational value away from the hospital.
Our non-medical therapies department,
which includes occupational therapy, recreation, music
and library service, is carrying on a co-ordinated program
of activities. We are working with patients in every
division: the receiving service, intensive medical treatment
service, chronic service and pre-industrial service.
Two of the occupational therapy classrooms
are now in basements where 230 patients are being treated.
We find that patients attending these classrooms are
more irritable, less willing to take part in activities
and do not show as much improvement as the same type
patient who attends classes in rooms on first and second
floors. Basements are depressing to normal people and
there is a marked reaction in the mentally ill.
The recreation program is greatly hampered
since the recreation hall is being used for religious
services. The hall could be put to good use with groups
or classes of patients. If the institution could have
a chapel, a greater number of patients would benefit.
Many object to attending services in the hall because
of its size.
Properly housed and manned, the occupational-recreational
therapy department could cover the entire population;
dormant abilities in patients could be developed, new
interest and skills instilled, helping to stimulate
a desire to be productively active. This would help
prevent an increase of non-productive patients.
It is necessary to have continuous in-service
training classes because there is a large turn-over
in aides. In the past fiscal year, we have had 29 new
employees, 15 resignations, 10 transfers to other departments
and one on a year's leave of absence. Fourteen of those
who left service this year came to us before July 1,
1947. A Recreational Worker II, an Occupational Therapist
II and at least four Recreational Workers I and two
more Occupational Therapists I are urgently needed.
The chief problem for the dietary department
is to provide an adequate and appetizing diet for the
four groups - the general patients, the working patients,
the isolated and the infirm. For the working patients,
about 500 sandwiches are made daily and served with
hot coffee during winter months and with iced fruit
drinks on hot days. One of the isolation wards is for
typhoid carriers, some of whom have been there seven
or eight years. A new type of treatment is being used
which combines surgery and drugs, and the dietary department
is co-operating by maintaining two serving rooms, the
one in the clean area using paper dishes.
Cafeteria counters have been installed
on two more wards which enable the dining room people
to see that each patient gets his fair share of food.
Boosters have been put on all the dishwashers so that
dishes may be sterilized.
A training course was organized for
dining room workers. It consisted of six lessons, and
covered attitude toward patients, use of equipment,
cleaning, reports, attractive counter and tray service
and preparation of vegetables from the gardens.
The total 65th biennium appropriation
was $8,845,322 and an additional $16,000 has been received
for boarding out state wards. On June 30, 1948, end
of the fiscal year for the present biennium, $4,500,327.41
or 50.878 percent had been expended, from which it would
appear the appropriation for the period was ample. However,
such is far from the truth, as there is a surplus in
some appropriations and a deficit in others, and an
additional two and one-half to three million dollars
will be needed for commodities appropriation to close
the present biennium.
There are 900 acres of farms at Manteno
and the land is valued at $148,500. Farm improvements
totaling $32,487.26 were made during the past fiscal
year. Farm and garden equipment is valued at $17,526.31.
This year, 253 acres of the farm were in garden. A soil
improvement program has been in operation and 250 tons
of limestone were applied, 120 tons of phosphate, 60
tons of commercial fertilizer and 40 acres of clover
and timothy were plowed under. 45 acres of red clover
for hay and 25 acres were in alfalfa. Many improvements
have been made to the farm buildings and several rods
of tile were installed in various poorly drained parts
of the farm.
A new sprayer has been put into operation
to treat the corn borer and a few tests have been made
on weed killing. An intensive fly and insect eradication
program has been in operation during the year with good
results.
The mechanical department has made many
improvements in maintenance. A new stoker is being installed
and the architect's office is relieving us by placing
a new contract to use the exhaust steam on more buildings
as this is now going to waste. This will mean better
fuel consumption. A new machine has been delivered to
unload coal for storage. The maintenance department
handled 3,176 orders.
General improvements were made to the
kitchen and the dining rooms have been painted and redecorated.
A new extractor, press ironers and dry tumbler were
installed at the laundry from the power plant. All buildings
on the male side have been painted.
The hospital edition of The Manteno
News was first published on August 9, 1946, and has
been continued each week thereafter. The purpose of
the publication is to bring subjects of interest to
employes, friends and relatives of the patients as well
as to the patients themselves.
Toward the close of 1947, two employes
were assigned to reducing hazards to patients' and employes'
safety. One worker is employed full time to inspect
buildings for hazards and unsafe operation practices
and in the education of employes in safe ward and industrial
practices. The other works part time in the investigation
of circumstances surrounding injuries which may have
occurred.
Words...
electropyrexia - artificial fever induced
by electrical means
anti-luetic (anti-syphilitic)
Servicemen's Readjustment Act of 1944
Signed into law by President Franklin D. Roosevelt on
June 22, 1944, this act, also known as the GI Bill,
provided veterans of the Second World War funds for
college education, unemployment insurance, and housing.
tim·o·thy
Inflected forms: pl. tim·o·thies
Any of several grasses of the genus Phleum, especially
P. pratense, native to Eurasia, and P. alpinum, of North
America, having a dense cylindrical inflorescence of
compressed, one-flowered spikelets and widely cultivated
for hay.
