oge~ee THE MICHIGAN DAILY MAGAZINE
Sunday, November 17, 1957
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Children's Psychiatric Hospital
It Treats the Disturbed, Helps Them Adjust to a Normal Society
By GERALD LUNDY THE EMOTIONALLY disturbed ture of the child's illness. Data Is
W HAT HAS our society done - child, due to various environ- collected from those people who
indeed, what is society doing mental factors, is an individual are in closest contact with the
-- to adjust the psychologically who possesses attitudes and com- child in his associations, such as
disturbed child to a normal com- plexes which make conformity teachers, parents, neighbors and,
munity life? and adjustment to society a dif- in some cases, doctors.
ficult and trying process. According to Rebecca Anthony,
versity in the Neuro-Psychiatric This is the child, who, according case work supervisor, talking with
Institute, to the hospital's chief psycholo- other people is the.only way such
In this Institute, which reaches gist, Dr. Anna Elenon, "runs into material can be obtained, since a
int mhsnstuiuewitheafiedsdifficulty conforming to the psychological illness is not easily
ito many studies n the fields norms of the adult world. perceptible.
of peychiatry and psychology,'"Of course, meeting the adult All data is collected in the of-
there is one branch which par- world is all in the process of fices of the case workers. The in-
ticularly deals with emotionally growing up - something which f o r m a t i o n is either received
and psychologically d i s t u r b e e every child wants to do - but, through interviews conducted in
children between the ;1eS of five depending on how he has been the presence of the prospective
and fourteen - children who find handled, he may rebel" against patient's parents, with people fa-
it difficult to adjust to the social the society that fostered him. miliar with the attitudes of the
environment. This branch is the This inability to adapt oneself child, or it may be in the form of
Children's Psychiatric Hospital' can rise from a numnber of envir- written and signed statements. No
Under the leadership of direr- onmental conditions; from the information is ever gathered by
tor Stuart M. Finch., M.D. and home, school, comunity and telephone, since it might destroy
associate directors William R. many other sources. the confidential nature of the re-
Keeler, M.D., and Saul I. Har- The hospital's chief aim is to port.
rison, M.D., this hospital has be- return the child to community life After all information is col-
come a leader in the treatment of at the end of the curative pro- lected, it is turned over to the
psychologically and emotionally cess, a goal which is attained hospital's clinical team of psy-
disturbed children. through diagnostic aid and thera- chologists and psychiatrists for
Located in the midst of the Uni- peutic treatment. Depending on evaluation+
versity's expanding medical cen- the gravity of the child's illness,
ter, the hospital is supported by he may be accepted in residence ACCORDING to Dr. Elenon, the
state appropriations and patients' at the hospital as an in-patient concern of the psychiatrist is
fees. It contains four ward floors or treated as an out-patient, not chiefly with therapy, while the
with a capacity ol 75 patients. in residonce. psychologist, in addition to ad-
Each of these ward floors con- ministering therapy, is also con-
tains bedrooms, in addition to 0UT-PATIENT therapy is a cerned with test appraisal and
play areas, libraries, kitchens, and clinical service which is much research possibilities.
dinette facilities. There is also on the order of child guidance In test appraisals, the psycholo-
an area for special schooling, services, only on a more extensive gist gives various mental tests to
woodcraft, sewing and a gymna- basis; the child visits the hospi- the incoming patient. Thus the
sium - all parts of the hospital's tal at regular intervals for treat- psychiatrist can better know how
recreational and occupational ment. Out-patient service is the to begin treatment of the child
therapy programs. Other such larger of the two treatment serv- according to the results of such
facilities include a swimming pool ices. tests.
and playground. If the distance involved is too Then the child's readjustment
great to travel, or the child's ill- process begins. As a patient lse
rJ'lHE HOSPITAL, like other such ness is not so severe as to warrant will begin to face up to the reality
institutions, is a place where his acceptance for in-patient of his problem and learn how to
the disturbed child can find treatment, he may be referred to cope with it. He will be shown
"someone who cares" - a some- child guidance facilities near his that lie must learn to live in har-
one willing to help him with home. many in the society in which he
problems he can't solve. For him Children in both groups arrive was born -he will be taught that
there is always someone to lend at the hospital through many dif- his society in many ways is for his
him guidance when he needs it, ferent circuits. They may be re- benefit and not his suppression.
someone who will be like a par- ferred there through other medi- When the child enters the hos-I
ent to him, but will offer him as- cal institutions or guidance serv- pital, further work is carried onj
sistance that none but the ex- ices, through schools and courts, by the psychiatric case worker. If
pert can give. or through their parents or the child is cured, it follows that
Here is an institution devoted guardians. But referral through he should not return to the same
solely to treatment of such chil- one of the above sources isn't environment which was instru-
dren, an institution whose pri- all that is needed for treatment or mental in the formation of his
mary goal when possible is to re- diagnostic services at the hospi- anti-social t e n d e n c i e s. Some
turn the child to community life. tal; this is just the first step. changes have to be made. But
Of course, to accomplish this After referral has been made, surely the entire community can-
end, services of many profession- the hospital steps into the picture. not be patterned to fit the dispo-
ally trained people are needed. It has means of determining who sition of the child. What, then, is
The staff of CPH is composed of needs to enter, and on what basis. to be done?
some experts in their respective To make such a determination,
fields. There are psychiatric research into the history of the HE CHILD'S immediate envir-
nurses, psychologists, psychia- prospective patient is essential. onment must be modified
trists, psychiatric case workers, This is the job of the hospital's somewhat, and the starting point
occupational and recreational psychiatric case workers. for this modification begins with
therapists; psychiatric aides, and An out-patient evaluation is the child's parents. For long-
a teaching staff holding certifi- held after the psychiatric case range treatment to be effective,
totes qualifying them to instruct worker has collected all data es- parents must cooperate with the
diturbed children, sential to understanding the na- case worker in amending those
difficulties in the home which
may have prompted rebellious
notions.
This investigation of the child's
home life may lead to discovery
of parental attitudes which might
have affected negatively the
child's ideas concerning his so-
cial surroundings. Such attitudes
must be erased-if not, the child,
after being cured, could be re-in-
fected with the notions he pos-
sessed before entering the hospi-
tal. Therefore, it is necessary, in
some cases, to give parents out-
patient psychotherapy.
An additional service provided!
by the department of psychiatric
case workers is "follow up" on the
patient after he is released fromj
the hospital. This is not a parole
action; it is merely a notification
to parents and other interested
parties, such as his school or guid-j
ance clinic, that the hospital's
services are always available in
the event of complications,
AFTER the preliminaries of case.
evaluation by the psychologistj
comes the child's introduction to
the psychiatrist. Consultation and
observations of other staff mem-
bers will supplement the doctor's
knowledge of the child's problem
lifter therapeutic treatment has
begun.
Throughout the child's day at
the hospital, he will be observed
by staff members. His behavior-.
isms and reactions, from the
classroom to recreational activi-
ties, will be noted.
Often these observations are
written on sheets of paper and
later turned over to the doctor in
charge of the child on whom the
note was written. In addition to
being a source of supplementary
information on' the child, these
slips also tell whether or not the
physician is succeeding in the
therapy which he has chosen to
apply, or what further steps need
to be taken in the youngster's
treatment.
Also of importance are confer-
ences where all staffs meet to-
gether to discuss the problems of
one particular child. Here, nurses
and psychiatric aides, in addition
to other hospital personnel in di-
rect contact with the child, get
wider views of the child's disorder
and what the doctor is attempt-
ing to accomplish in therapy. In
such meetings all staff members
pool ideas on the child's treat-
ment and report thei' observa-
tions of the child's significant ac-
tions. These meetings are held
once weekly.
Other conferences, on a lesser
scale but of equal importance, are
held each day for the benefit of
psychiatric aides, most of whom
are University students who assist
the nurse in carrying out her su-
pervisory duties.
In these conferences, held each
day with the change in shifts, in-
coming aides are briefed on the
tenor of the day and told of any
cases which should bear special
observations and consideration.
In essence, it is the job of the
aide to keep tabs on the children
-to supervise them in their ac-
tivities and to observe them in
their work and play.
T HE NURSES and aides, along
with all hospital personnel,
strive to establish relationships
with the child which he will
value; thus he is drawn closer to
the adult world from which he
cringes. He learns that adults
may not always be cold and indif-
ferent to him and his problems,
and feels that he is appreciated
and cared for. Such relationships
are important in the child's ad-
justment to society.
Group relations are part and
parcel of the process of social
adaptation. This social adapta-
tion for many is initiated within
the walls of the hospital; a ready-
ing process for the patient's even-
tual exposure to a society beyond
the hospital.
This "hospital society" differs
radically from the one outside its
boundaries, known so well for its
crises and conflicts, rules and
regulations. The CPH society is
referred to as a "protected so-
ciety," one which is shielded from
those decisions and problems of
that complex whole in which oth-
er men live.
The CPH society is "protected"
in that adjustmnent to a society
is a thing which must be carried
out gradually; the child cannot
be shoved into it. With the small
scale society at the hospital, thbre
is a gradual adjustment to rules
and regulations and the develop-
ment of respect for one's fellows.
EDUCATION of those children
in residence at the hospital is
not neglected. There is an ac-
credited school within the hospi-
tal's organization composed of
specially trained teachers. The
school has grades from kinder-
garten to junior high school.
There are ten study groups with
from six to eight children in each
group. These groups are arranged
according to type of illness, since
it is not wise to place children of
differing attitudes in the same
class, due to conflicts which may
arise in a clash of personalities.
Such arrangements exist in all
group relations between the
young patients.
Before entering, all children are
given tests to determine to what
See CPH, page 18