Complete Annual Report of the Illinois Department of Public Welfare Manteno State Hospital - July 1, 1949 - June 30, 1950 The organization structure of Manteno State Hospital has been materially strengthened through the preparation and adoption of a new organizational chart. The following report is arranged in conformity with the new organizational pattern. As originally formulated in September, 1950, the public relations and education program was to include three broad general levels; (1) educational activities directed toward relatives and friends of patients; (2) contact with community organizations for educational purposes and to initiate volunteer activities for the benefit of the patients; (3) liaison with the local and Chicago press for the release of publicity material. Because of the lack of local precedent in the field, it has been necessary to establish policy while working out actual problems, and to crystallize direction of the program through trial and error. On the whole, however, the program has remained within the broad outline originally visualized for it, and considerable progress has been made in each important aspect. Shortage of personnel in most classification has continued throughout all services of the hospital. In the professional categories, such as physicians, nurses and social workers, the shortage has been most pronounced and persistent. Attendants continued to be recruited with varying degrees of difficulty and the availability lagged far behind our needs. The long delay in filing vacancies through the general office remains a serious obstacle to our efforts aimed at improving the care of our patients. Authority to hire locally, when requisitions cannot be filled through the general office, would provide the hospital with an additional and effective menas of replacing nursing service personnel. Despite the increase in industrial activity in this area, large numbers of qualified applicants continue to seek employment at this hospital by applying directly to the personnel office. A Protestant worship service was held each Sunday. A large portion of the time and work of the chaplain was spent in working with individual patients. A special group therapy project was initiated on the female treatment ward. The group consisted of 10 to 12 patients selected by the physician and chaplain. Purpose of the program was to give patients an opportunity to share and express their feelings in a group. The chaplain acted only as a moderator. Daily and Sunday Mass was conducted for Catholic patents throughout the period. The administration of the Sacraments to infirm patients totaled 1,500 last year. The chaplain visited the hospital every day at last once, and some days several times. Ward visits afforded attendants an opportunity to acquaint the chaplain with personal problems of the patients. The medical staff consisted of one physician III, two physicians II, five physicians I, one tuberculosis control physician, three psychiatrists II, and six psychiatrists I. We had four dentists and four dental assistants. During the biennium 4,146 new and 25,737 cases were examined. The radiology technical staff included four full time x-ray technicians and the division incorporates five units of radiographic equipment. Two electrocardiographic units are included in the x-ray department. In the biennium, 49,329 patients were examined and 50,469 examinations were made. The bacteriological laboratory has been approved by the state Department of Public Health for various examinations, and is now considered a branch of that department's laboratories. A program of research into the treatment of enteric diseases with antibiotics continued. The favorable response and frequent cures were encouraging. During the last year progress was made in all areas of social service work, due promarily to the trained psychiatric social workers who were added to the staff. The family care program during the last year emphasixes the placing of younfer people and the establishing of a complete rehabilitation program for these placements. In addition. continuous effort was made to place pateints who could pay for their care out of their own funds as well as younger patients who could earn the cost of their care. This section presented a class on personality development each week as part of the occupational and recreational therapy shcool. The staff participated at least once a month in the field supervisor's conferences at the University of Illinois. Two additional trained psychiatric social workers are needed in this section. A clinic record card containing all pertinent information is kept in the public health office for each syphilitic patient. Male and female anti-luetic chemotherapy clinics are conducted once a week. Newly committed cases, released patients and patients who have received intensive penicillin or fever therapy are reported to the department of public health. At the close of the biennium there were 355 patients in the tuberculosis units. 74 new cases were detected during the last year, 56 of whom were found among new admissions and 18 among previous residents of the institution. In the last fiscal year, 2,596 patients were admitted by commitment and voluntary application. Patients returned from conditional releases, family care placements and unauthorized abscences totaled 568. 21 were received as transfers from other state hospitals. A total of 1,333 were given direct discharges; 999 were released on conditional discharge, 74 on family care, 122 transferred to other state hospitals, 541 expired, and 159 were on unauthorized absence. The non-medical therapies, which include occupational therapy, recreation, industrial work, music and library service, carried on a coordinated program of activities during the biennium. The aims of these therapeutic services, as well as the type of activities employed, were determined by the type and condition of patients. Recreational activities included movies, chorus and community singing, afternoon parties, evening folk dances, social dances, roller skating, and soft ball. Special events were planned for the holidays. During the last year 63 students participated in recreational and occupational therapy training, representing all but one hospital of the Department of Public Welfare. Two of the students were from agencies other than this department. The clinical training program continued to be an important part of the school work. Students were assigned to work with patients each morning, either on one of the wards which were used as teaching centers or with classes conducted at the school. As of June 20, 1951, this institution employed 21 registered nurses and 334 female and 199 male attendants. Staff nurses showed marked interest in various educational programs by becoming members of recognized nurses organizations and by attending meetings and work-shops. A female attendant was selected as the outstanding psychiatric aide of the year for the State of Illinois. Plans for the nursing service include staff education for registered nurses, a clinical teaching ward for male attendants, and procurement of additional attendant and nursing personnel to adequately staff all cottages. A school of instruction, consisting of wight lessons, was held for employees in charge of ward dining room. Lectures were given on "Employee Rating" and "How to Work with Patients." Demonstrations were conducted on coffee making, the dishwashing machine, the refrigerator and ward management problems. Special training was also instituted for counter women in the employees' cafeterias, cooks, and employees in the two diet kitchens of the hospital. During the last year we were able to reduce the cost per meal slightly. This was partially due to the fact that we received considerable surplus commodity foods. Our total 66th biennium appropriation, including a deficiency appropriation for commodities, a post war appropriation of $677,253.73, and transfer of funds from other institutions, totaled $11,088,930.73. Expenditures for the fiscal year ending June 30, 1951 were $5,720,342.38, making a daily expense for the year of $15,672.17. On the basis of a patient population of 7,701 this means a per capita cost per year of $734.62. The Manteno State farm has 847 acres under cultivation, and this ground is valued at $175,000. All grain farming is conducted on a three-year crop rotation basis. Three hundred tons of limestone, 60 tons of phosphate, and 90 tons of commercial fertilizer were applied during the last year. Farm buildings represent a total investment of $40,000. Repairs to buildings and fences and new fencing cost $2,415 during the last year. An average of 50 patients worked in the garden department during the last year. Ten were employed in the swine and steer departments. In addition to routine maintenance operations, the maintenance department constructed several new all-weather parking lots. Fourteen hundred square yards of old sidewalks are being replaced. One hundred square yards of roads were paved and 400 feet of curb was installed. During the last year a brick and concrete addition to the sewage control house was completed. A new raw sludge pump of the screw type was installed. The fire department consists of a fire chief, assistant fire chief, two fire guards and 12 volunteers. Fire drills were held each week and the fire chief conducted training classes for the fire department and all new attendants.