Manteno - An Institution in Transition
(from Manteno State Hospital News,
Vol. II, No. 20, Friday, November 4, 1966)
Report of the Mental Health Commissioners
of the State of Illinois
to
The Honorable Otto Kerner
Governor
On September 9, 1966, you requested the Board of Mental
Health Commissioners, in accordance with its statutory
powers and duties, * to investigate charges of immorality
at Manteno State Hospital.
The Board and members of its staff visited Manteno
on Tuesday, September 13, Wednesday, September 14, Saturday,
September 17, and Friday, September 23.
Over thirty interviews were conducted with Manteno
staff; names of these staff members are detailed in
the Appendix.
In addition, the Board was supplied with data it requested
and met in Chicago on several occasions to evaluate
its findings and to make its recommendations. These
will be discussed in turn.
FINDINGS
Manteno State Hospital is an attractive, sprawling campus
of 350 acres containing 127 buildings, fifty miles south
of Chicago and three miles outside the town of Manteno
which has a population of 2200.
The Hospital houses 6300 patients, and has approximately
1850 employees. It is a major institution in the throes
of transition.
Ten years ago its population was 8,000 patients, and
until 1964 it still had 7,300 patients.
In line with modern health concepts, the old custodial
approach which resulted in the bitterly criticized warehousing
of our mentally ill, is gradually being phased out.
Manteno prior to the introduction of the Zone programs
was largely a closed hospital. It was a well-run custodial
institution tightly administered from the top.
The problem confronting the Zone Director under the
new program was that of converting such an institution
to newer methods which would permit Manteno to be administered
as an open institution.
REASON FOR CHANGE
The purpose of such a change is already well-known to
you. There is rapid evaluation of new patients, a more
intensive program for their vare while hospitalized,
an open door policy which permits patients as they gain
in health to assume more responsibility for themselves
under supervision, to have the freedom to come and go
in keeping with human dignity and in preparation for
their return to their home community.
Concurrently, staff works with their families to maintain
ties and open up new avenues of understanding and communication.
It is this approach which as you know is the hope of
avoiding the burdensome waste of humanity which the
older closed institution fostered, however humanely
administered.
COMPLEX REASONS
The change from the closed to the open door policy was
made more complex by reason of the fact that with the
concept of care geared to early return of the patient
to his home community, the number of admissions and
discharges increased though the patient population at
any given time was lowered.
As the community psychiatry programs began to be integrated
with the state hospital facility, a younger and more
active group of patients was being added.
These patients were, in larger number than previously,
members of in-migrant minority groups whose cultural
patterns were not familiar to the older aides and security
staff. For the most part this staff is drawn from a
population which includes more Negroes.
To compound the difficulty, the CIty of Chicago and
Cook County began to close out facilities which were
formerly used for such population; and Manteno, already
one of the principal resources for a large segment of
Chicago's mentally ill population, was additionally
burdened.
GENERATE PROBLEMS
The problems which this modernizing of the care of patients
generated were several:
-There is always some resistance to innovation and
change. It is clear that the change in admission and
discharge policy made many more demands on staff; it
also emphasized the lack of training, the inadequate
numbers of staff members and the undertraining of some.
-With the transition from a more authoritative model
and the imperative need for delegation of authority
to subordinates, there was some confusion as to here
authority rested. The open ward policy placed greater
demands on staff personnel.
-Staff members assigned to the newer programs had smaller
but more intensive workloads, but those who were not
assigned to new programs felt themselves unjustly saddled
with a less hopeful population and a larger number of
patients. The very real inadequacies in number and the
greater demands on their time seriously affected their
morale.
There is no question the programs in operation hold
out a great deal of promise, but they also require a
goof deal of time spent in education and communication
of these new ideas. It was this general situation which
gave rise to the charges which in turn led to the demonstration
and to the publicity about conditions at Manteno.
PICKETS AND PUBLICITY
Your request to the Board of Mental Health Commissioners
followed the publicity about picketing by off-duty employees
over a period of a week in front of the hospital gate,
by ADSCME Local 1563 (AFL-CIO) made up of about 600
members of Manteno's staff, and supported by AFSCME
Professional Employees Local 708 made up of about 107
members. Their picketing centered around nine points
of contention with management, but much of attendant
publicity centered disproportionately on Point Five
which reads as follows:
"No. 5. We suggest that steps be taken to improver
the moral climate of the hospital. It is becoming embarrassing
to the employees when we get criticism from churches
and general community that it is indecent to visit the
grounds or the wards because of incidents that take
place almost publicly on the grounds and on the wards."
We take up next the specific accusations that prompted
Point Five- the morality issue- in the union's charges.
1. ALLEGED SEXUAL ACTING-OUT
Policy with reference to conduct of patients had been
clearly spelled out in a memo issued May 19, 1965 to
all patients and employees, and this memo continued
to be in effect at the time of the unfavorable charges.
It reads as follows:
MANTENO STATE HOSPITAL
MEMO.
Date: May 19, 1965
Re: Use of Grounds Passes.
To: All Patients and Employees.
"The goal of the hospital program is to rehabilitate
people from their status as patients to the status of
responsible members of the community, As a part of this
program the staff attempts to provide a social environment
which as nearly as possible resembles the outside community
but at the same time has built-in features to aide the
therapeutic process. The primary feature is the desire
of the staff to understand and assist people in their
effort to rehabilitate themselves.
"One of the major therapeutic tools of the hospital
program is the grounds pass, which is issued to every
person who shows himself or herself capable of handling
this responsibility. Possession of a general grounds
pass (as opposed to special passes) means a person is
free to walk where he wishes within the hospital grounds
except for areas posted as off-limits to patients, except
after established curfew, and at times when there are
specific therapeutic assignments. It means he is free
to make responsible use of the commissary, pay telephones,
and the various offices which provide service s to patients.
A person possessing a grounds pass is expected to conduct
himself in a manner appropriate to the standards of
a community outside the hospital. In judging the appropriateness
of a person's behavior, the staff will take into account
such matters as age, marital status and emotional condition.
"Persons in the hospital as patients may not leave
the grounds without authorization nor drive automobiles.
"Patients or employees observing violations of the
above standards are responsible for reporting the incident
to Security, Security officers will return the patient
to his ward where the ward staff will take appropriate
therapeutic action."
(Signed) R.J. Graff, M.D., Superintendent.
JOINT STATEMENT
In the Joint Statement issued Monday, September 12,
1966 to the press by the Union and Manteno management,
the Agreement on Point Five was as follows:
"Item 5: After a thorough discussion of patient's overt
sexual behavior, it was clear that there were misunderstandings
and misinterpretations of Zone Director Dr. Benard Rubin's
philosophy and policy and that he had been misquoted.
It has been and is the Department of Mental Health policy
to teach that overt sexual or other wise inappropriate
behavior is recognized as a symptom of patients' mental
illness. It is the responsibility of all staff to help
the patient learn how to behave appropriately. Specifically,
the following actions will be taken:
"1. Involve Security to a greater extent in these matters,
including immediate response by Security when called.
"2. Develop more active part by Management to see that
necessary therapeutic and remedial measures are taken
to correct the patient with the expectation that he
will not repeat the incident.
"3. Acting-out patients who are confined to wards will
not have passes reissued until all staff involved in
the original decision to confine the patient, including
the Psychiatric Aide who cares for the patient, are
consulted.
"4. That Aides have the authority to exercise their
judgment on critical situations that call for immediate
action. Aides may make decisions as to the need to move
visitors out of a ward with or without the patient they
are visiting if in their judgment it is necessary for
the safety and security purposes."
REITERATE POLICY
The terms od this agreement spell out more specifically,
but do not really alter in any significant way, the
intent of the former and the present administration
of the hospital.
The policy by administrative management regarding proper
conduct was reiterated in a September 9th statement
by Dr. Martin C. Koenig, Acting Superintendent, the
Program Directors and Department Heads:
"We recognize the legitimacy of the Union's concern
regarding staff shortages and salary considerations.
"In response to comments about the so-called immorality
at the Manteno State Hospital, this statement is being
made to clarify our position.
" We continue to support the treatment policy of the
hospital as explained in an official memorandum of Dr.
Richard J. Graff, former Superintendent, dated May 19,
1965."
ALLEGED SEXUAL ACTING-OUT
It is difficult to make a determination of whether alleged
sexual acting out had actually increased. There were
35 cases reported by Security for sexual behavior from
November 1965 to September 1966; but some of the informants
claim not all incidents are reported.
Some staff members with long service at Manteno believed
that the number of incidents had increased, but there
is no way of really evaluating this.
There is some reason to believe that a higher standard
of sexual abstinence was being applied to a mentally
ill population than to society at large. The Board must
be guided by the general consensus that there has been
an increase.
TURNOVER RATE INCREASES
To gain perspective on this problem, the turnover or
admission rate (3253 admissions from September '65 to
August '66) at Manteno has gone up though the figures
show the average daily population has gone down through
more rapid discharges (2756 discharges for the same
period).
With a more rapid rate of admission and discharge,
there will inevitably be a larger number of highly disturbed
people coming in for short periods of time.
According to our findings, the charge that there is
more acting-out behavior must be seen in proportionate
relationship to the number of patients flowing through
the institution and shorter length of stays.
Acting-out sexual behavior of all types on the wards
would undoubtedly be less with more adequate staff available
for supervision, and with more, not less, normal social
associations between men and women which is part of
therapy and is a concept with such proven successful
demonstration it cannot be abandoned in favor of the
old custodial care days when men and women were allowed
a few normal associations. This does not obviate, however,
control over those who according to their illness or
conduct need greater supervision.
II. LACK OF SUFFICIENT SECURITY
The security staff consists of fifteen men. With the
need for service around the clock, the number of security
men available at any time makes it clearly impossible
for them to be at all places at once on Manteno's large
campus. Recent programs, particularly the issuance of
many more grounds passes to deserving residents and
providing transportation to and from the Woodlawn area,
has created even greater demands on staff.
III. INDISCRIMINATE DISPENSING OF BIRTH CONTROL
PILLS
The charge that birth control pills are being purchased
in large quantity and indiscriminately dispensed is
wholly unfounded. We have checked this out with the
Springfield Purchasing Office, with the Manteno State
Hospital Business Administrator and with the Pharmacy.
No oral contraceptive drug has been requisitioned for
Manteno State Hospital. The only evidence uncovered
was a bill less than $5.00 for such pills for use by
one woman on her ward physician's medical prescription.
It seems reasonable to expect that medical staff has
the competence to prescribe such medication without
incurring unsupportable charges.
IV. PATIENTS BEING GRANTED HOME LEAVE IF PREGNANCY
IS SUSPECTED
There were fifty-six pregnancies from 1955 to the present.
Forty-one were cases of pregnancy on admission, ten
were pregnancies after a home visit, and five others
were of varying circumstances.
The fact that some "hospital" infants are born in a
community hospital is not a measure to hide facts but
an advanced and humane measure for the protection of
the infant on the birth record.
IMMORALITY NOT BASIC ISSUE
What stands out in our investigation is that sexual
immorality is not the basic issue. To view Manteno as
a whole from this one aspect of patient care would be
myopic. The perspective which we have sought to achieve
is to ascertain the problems that beset an institution
in the process of change.
The plain truth is that Manteno in transition is beset
with problems of operating a gigantic institution on
a skimpy budget designed 30 months ago before most of
the new programs began.
That budget is further sharply curtailed by inflation
and a burgeoning admission load.
The 1000 patient decline in average patient population
level (from 7300 to 6300 in the past two years) is eloquent
testimony to the impact of the new programs, though
they are only beginning to be extended to greater numbers
of patients. The Board especially notes the following:
Pre Admission Service: This unit attempts to intervene
with about fifteen to twenty percent of patients who
can be better cared for in their own community by outpatient,
day care, or sheltered care centers to which they are
referred. This service screens almost 50 percent of
patients representing voluntary walk-in patients; it
does not screen the larger patient load referred to
Manteno from CHicago State Hospital, the Michigan Avenue
Hospital, Illinois State Psychiatric Institute, Stone-Haven
Center, and the Chicago Mental Health Center. It is
interesting to note admissions are up 23 percent over
last year while discharges were increased by 24 percent.
Hyde Park-Kenwood and Woodlawn Projects: These three
communities were chosen first because they rank high
in priority for the needs of services in the entire
state. Rapid intensive treatment programs such as these
are in the early stages. Staff works with patients in
the hospital and with their families and other resources
in their own communities. This is referred to as a catchment
are program, designed to capitalize on keeping people
close to the resources available in their home area.
Chronically Regressed: Beginning to function is this
50-bed unit which seeks to re-motivate chronic long-stay
patients. The aim is to rehabilitate them and with community
support to help them to live with their own families,
foster families, or in situations of sheltered care
where better functioning could make their lives more
rewarding. School for Living: This is an alternate rehabilitation
project for chronically institutionalized women to help
them to adapt to re-socialization requirements for living
in sheltered and some non-sheltered care settings.
Geriatric Admission Unit: One of the new programs offers
immediate diagnosis and intensive treatment of newly
admitted older patents. The effort is to return them
as quickly as possible to family, job and community,
with supportive hep from the home community to prevent
the adverse effects of rapid deterioration resulting
from institutionalization. This is less damaging than
the alternative of custodial mass care. Elderly people
coming in need immediate attention directed at short-term
stays. As you well know, for far too many the state
hospital has been the end of the line.
Since 60 percent of the patents in Manteno Are in the
aging population 50 years of age and over, including
physically impaired patients, the first treatment unit
activated 18 months ago was staffed with highly skilled
personnel to work intensively with the geriatric patient
at point of admission to help him regain a place in
society so that his later years may become more fruitful.
This program may become a model for other hospitals
to study.
Admissions Service: This is another intensive treatment
program. In general, the shift at Manteno from a tightly
secure custodial facility to a treatment center is most
dramatically seen in this program. Here a patient is
given every possible therapy and the earliest possible
return to the community is effected.
Many patients who come are able to stabilize and return
to a home situation without serious brake of relationships.
Those who require longer treatment may be placed in
an open ward. The number of patients who some voluntarily
early in their illness is increasing. They are treated
as other persons seeking help in a general hospital.
The Group Not Covered by Intensive Programs: Possibly
4000 or more patients in residence have only minimum
staff for their care. Some of these because of the limited
staff and other resources have not had the opportunity
as yet to participate in the relatively small programs
for re-motivation. This is a difficult problem, and
that their care is relegated to under-trained and overworked
staff is a matter of concern to relatives and friends
of patients, to the administration, and to this Board.
ENCOURAGE RESPONSIBILITY
Persons in state mental institutions are there to be
treated for their disturbed or sick mental states. In
society in general, with freedom goes commensurate responsibility;
and the goal in the state mental health program is to
encourage personal responsibility as much as possible.
Granting freedoms or restraints in a benevolent framework
is a logical step on the road to improved mental health.
This is socially acceptable freedom, not irresponsible
liberty. When individuals abuse their freedom, they
should be firmly dealt with on an individual basis within
a treatment milieu.
Where a trend may be observed toward abuse of freedom
by any persons on particular wards or programs. or it
may suggest to administrators and clinicians giving
intensified attention to contributing conditions and
more precaution to remedy the situation, without endangering
the deserved freedoms of the many.
DIFFERENT GOALS
However, it must be recognized that there are different
goals, needs, and distributions of categories of illness.
If there is a variance in incidence of misconduct on
different wards it is not wholly surprising, though
nonetheless to be dealt with.
The hospital administration must continue to take the
responsibility for protection of the innocent and the
singling out of persons who cannot handle the responsibility
of commingling in a socially acceptable manner.
RECOMMENDATIONS
In the course of the Board's investigation, i found
many problems impinging not only on the morals issue,
but also relating integrally to the hospital operation
as a whole.
The following recommendations are deemed by the Board
as some of the steps necessary to stabilize the present
situation which will hopefully lessen the fragmentation
of the hospital's forces presumably all working for
the same goal-the good of the patients:
1. The Board believes the mingling of sexes is a measure
deemed by able psychiatrists to be therapeutic. We cannot
go back to the custodial "locked wards" era where normal
social activities between men and women were largely
cut off.
CAREFUL EVALUATIONS
It is critically important that the clinical decision
to grant grounds passes be reviewed with careful evaluation
on a regular basis.
Testing out a patient;s ability to handle freedom is
part of treatment but this ability to handle greater
freedom mist also be carefully evaluated on a regular
basis. The better therapy in a few cases is denying
privileges which are abused.
Insofar as there may exist misunderstanding on the
part of personnel with reference to the policy of the
Director of Mental Health, Zone III Director, and Superintendent,
on overt sexual activity by patients, the Board recommends
that the Zone Director, clearly and specifically, again
instruct the Superintendent of all institutions in his
Zone as to that policy (previously set forth herein)
and direct them to promulgate and have implemented clear
instructions designed to prevent, insofar as is reasonably
possible, violation of the policy.
This would seem necessary in addition to the union-management
agreement. Corrective measures being taken by the hospital
to minimize occurrences of inappropriate public behavior
should be carefully explained, followed and evaluated.
MSH FOR ELDERLY
2. The Board believes one of the most pressing needs
in Chicago metropolitan area is extended care services
for older people.
Perhaps the Department of Mental Health could give
serious and considered attention to the possibility
of using Manteno as an extended care nursing home for
those elderly people who will not require intensive
psychiatric services, leaving Madden Zone Center and
Tinley Park Hospital as the treatment facilities to
absorb new admissions.
Manteno Hospital has a beautiful campus ideal for ambulatory
elderly as well as facilities for the bedfast. The skill
requirements of staff would be somewhat different and
their deployment might also be different and more economical.
3. The Board believes the real issue is how well the
hospital is being run, It recommends the early appointment
of a Superintendent so his authority and leadership
can be brought to bear in clarification of goals and
procedures.
Also there needs to be more clarification and employee
understanding of the Zone Director's advisory and guiding
role as it relates to the program and administration
of the hospital.
4. The Board recommends there be a formal re-educational
program for all employees to better orient them toward
the goals of treating and caring for patients according
to the concepts of modern psychiatric insights.
5. The Board recommends it be mandatory for the Institutional
Workers to come under Civil Service at the end of their
training curriculum period, that the present curriculum
be changed so that their requirements, role, and salary
be differentiated clearly from that of the Psychiatric
Aide series, and that the Civil Service examination
be re-designed to test them on the new curriculum according
to their sphere of functioning as "general aides."
By this we mean that an Institutional Worker be permitted
to use his talents in the carious areas of the hospital's
programming , rather than be limited to sub-nursing
capacities.
GUILT CONSCIOUSNESS
6. The Board believes the Executive Council of Manteno
Hospital should meet regularly together and take a hard
look at staff deployment for the whole hospital, and
that department heads and program directors be involved
in the patient care aspect for all wards, at the same
time giving primary attention to their specialized programs.
The Board wishes to emphasize that the near abandonment
or minimal care given 4000 or more of the patients not
in the special programs has promulgated a guilt consciousness
acknowledged and testified to repeatedly by every staff
echelon connected with the hospital.
It is a fact which must positively be dealt with through
added workers, possible redeployment of present resources,
or any other means the Executive Council can determine
to relieve this dearth of basic care.
DISCUSSION
The new programs inspire hope for reducing a chronic,
regressed despairing population. In time, given the
necessary resources, intensive programs will be used
fore all patients and integrated with community zone
programs close to the patents' home base. The eventual
goal is movement away from larger institutions to zones
and sub-zones.
COMMUNICATION NEEDED
The hospital has made progress with these programs.
It may be that too much is being attempted, but no one
should be criticized for attempting too much.
The Zone Director has had tremendous burdens not only
at Manteno, but at Tinley Park, and he is also faced
with the need to assemble staff for the new Madden Zone
Center.
In attempting to do all these things there has not
been the time to communicate horizontally and vertically,
but this is essential and must not be postponed.
An institution, no matter how gifted or creative its
top qualified professional staff may be, is only as
good as the Psychiatric Aides, for it is the latter
group who have continuing and most frequent contact
with the patients; care. Further, even the best educated
and excellently trained attendants cannot be effective
if they are overburdened.
SENSATIONALISM
It is to be regretted that the difficulty of recruiting
additional personnel has been compounded by the tactics
of the union in introducing sensationalism in their
charges as a technique for gaining collective bargaining
ends.
That this kind of charge may come from uninformed laymen
is understandable.
But it is difficult to understand how a labor union
which consists of professional and non-professional
employees, committed to providing the best mental health
program for patients, should lend themselves to the
promulgation of exaggerated and in certain cases unfounded
accusations. This is hurtful to patients and their families
and discouraging to administrators who are trying their
best to bring about changes against considerable odds.
The hospital and the union could have reached the same
agreements without this tactic. In the present instance,
publicity has been tragic for the patients. As one phrased
it: "It is bad enough to be labeled a mental patient
without labeled immoral mental patient."
The more we focus on sin and immorality with a population
already disturbed and carrying a burden of guilt, the
less we accomplish from a therapeutic standpoint. Estimates
are that it will take a year to repair the damage done
to the patients and their relatives, and to restore
their pride and that of the employees.
CRITICS NOT STIFLED
These remarks are not a plea to stifle criticism-in
a community of 8,000 people related to a giant mental
health institution as patient, employee or executive,
there will always be a broad range of matters to criticize.
The essence of change is mobility. In the process there
is a certain amount of trial and error.
It is always a satisfying demonstration of public conscience
when there is discussion and concern about programs.
But this is only true when responsible and valid criticism
with supporting facts is so directed in such a way as
to be constructive and to preserve the goals of the
institution: the best care and treatment that time,
staff and money available will allow for patients under
state care.
"OPEN DOOR" POLICY
Uneasiness and lack of understanding about the "open
door" policy is widespread. An open door hospital is
not open in the sense of anyone being able to come and
go as he pleases with no authority., It is on in which
the minimum amount of restraint is used to protect the
patient and the community. Passes are permitted to patients
when indicated. Mental health authorities agree that
the "open door," or "open ward" policy is far more beneficial
to patients than a system of locked wards.
The necessity for the patient to experience the dignity
of freedom, albeit somewhat limited, and the opportunity
for him to develop relationships with others deemed
"normal" by society is of vast importance to recovery
and mental health.
The best modern authorities are also in accord that
a prison-like atmosphere in a mental hospital engenders
more violence and disturbance than a benign atmosphere;
the "open door" policy presents some risks, but overall,
this is the best system for the patient and the community
as well.
SEXUAL ACTING-OUT
Although it cannot be denied that incidents of sexual
acting-out are to some extent an outgrowth of this policy
with the greater accessibility of the sexes to one another
which is one of the natural results of the "open door"
policy, the incidence is not so great as to justify
reversal of a policy which is deemed a therapeutic benefit
to the majority of patients.
This Board does not, of course, condone such occurrences
any more than it would condone them on the grounds of
a private hospital or in society in general.
The Board recognizes that to a great extent the problem
lies with the insufficient number of security personnel
available for thorough supervision of the grounds to
prevent such behavior.
To this may be added the problem of insufficient help,.
inadequate training of some staff, and the inability
of the state to compete with industrial pay scales.
"CLOSED DOOR" RESULTS
On the basis of its investigation, the Board is keenly
aware of the problems of understaffing and difficulty
in recruiting, and the heavier patient load placed on
Manteno by a more rapid turnover.
Even so, the Board would recommend against abandonment
of the "open door" concept of treatment. It is true
patients will occasionally get into trouble, but it
is doubtful whether the incidence of this type of behavior
is greater than that which would occur in any hospital
population of such dimensions.
The choice is between accepting this risk, or insisting
on the "closed door" policy which, it is agreed, retards
recovery and would put the Illinois mental health program
back 25 years.
The consequences of a "closed door" policy are well-documented.
No only are individual patients impeded in their return
to the community as functioning and productive citizens,
but there is also an increased burden to the state from
the longer stay at hospitals.
INCREASE BUDGET
7. The Board recommends that Manteno's budget be substantially
increased in the next biennium and exploration be made
of H.B. 708 in Cook County and Chicago for developing
services. The load of responsibility for care has increased
faster than tax support so that the state can hardly
keep even. But the state cannot afford to fall behind
or other states will pre-empt our greatest resource
- personnel - for their own more progressive programs.
Added to this there needs to be realistic co-responsibility
with Chicago and Cook County which are not carrying
their share of the load. Compare the following spent
for mental health services by New York City, San Francisco,
and Chicago:
New York City '64-'65 budget for Mental Health:
$17,103,162.00-from tax levy
2,017,973.00-from private sources
14,145,574.00-from state funds
$33,266,719.00-Total
San Francisco has just now approved referendum for
$34,000,000 to operate five regional clinics.
Chicago January 1, '66-December 31, '66 budget for
Mental Health
$2,079,000.00-from city funds
300,00.00-from state funds
53,000.00-from federal funds
$2,432,000.00-Total
RECOMMEND HIRING 480 MORE
It is self-evident that Chicago has lagged in assuming
a larger portion of the responsibility for the care
of Chicago citizens. It is hoped your office can be
instrumental in focussing public interest and awareness,
and cooperation with other governmental agencies in
this regard.
8. The Board recommends that your office permit the
hard-pressed institutions of Manteno, Chicago State,
Kankakee, and Elgin State Hospitals which now carry
the heavy burden of the metropolitan area of Chicago,
to draw against the general revenue fund up to the amount
of $6,000,000 to be covered by a deficiency appropriation.
Manteno's share will be sufficient to employ 480 additional
patient care personnel. This would provide the desperately
needed staff immediately for the care of those who are
ill right now.
Respectfully submitted,
ILLINOIS BOARD OF MENTAL HEALTH COMMISSIONERS
Alex Elson, Chairman
Mrs. James L. Holland, Rockford, Vice Chairman
Mr. Willard L. King, Chicago, Secretary
Rabbi Ralph Simon, Chicago
George Borden, M.D., Quincy
Mr. Curtis Small, Harrisburg
Professor John A. Zvetina, Chicago
Mrs. L. Trimble Steinbrecher, Executive Secretary
October 20, 1966
APPENDIX
The following persons, as well as several psychiatric
aides and patients, were interviewed by members of the
Board of Mental Health Commissioners during Sept. 13,14,17
and 23 visits to the hospital:
Information representative Richard G. Bergman, acting
chief nurse Aline Bourland, R.N.: Catholic chaplains
Francis T. Czerwionka and Joseph L. Donahue, Jewish
chaplain Rabbi Harry Simon and Protestant chaplains
Thomas Merrill and Claude Rousch, Th.D. Business manger
Noble Emde, cheif social worker Jack Emmons, program
directors Dr. Mehdi Golchini, Dr. Leon Jacobs, Dr. Joseph
Zemgulys, Troy Mayr and Fred A. McCormack; volunteer
services supervisor Mrs. Annabelle Haigh. AFSCME Local
Union 1553's president, Charles Hungate; acting superintendent
Dr. Martin C. Koenig, business administrator John Kuhn,
psychology chief William Morgan, saftey and protection
sercice chief William Oldham, medical records chief
Mrs. Norine Osman.
Medical staff members Dr. George Rivera and Dr. Raul
Sierra, clinical director Dr. Annemarie Rohan, Zone
III director Dr. Bernard Rubin, personnel officer Eugene
Thomas and nursing education director Miss Alison Young,
R.N.*"Investigate on its own initiative or when directed
by the Governor or the General Assembly, into the condition,
equipment, facilities, personnel, management and policies,
of the entire system of the Department as it concerns
mental health and welfare, institutions or organizations
of the State or any institution related thereto, including
institutions and organizations under the supervision
and inspection of the Department of Mental Health and
to make public and report to the Governor or the General
Assembly, and such other persons it deems proper, its
findings and recommendations." (Illinois Revised Statutes,
Chapter 127, Section 6.04A.)
