Children's Mental Hospital

Mental illness in a child often seems more strangely frightening than mental illness in an adult. An emotionally disturbed child is far more likely than an adult to act out his hostile and aggressive impulses, instead of merely talking them out, because deeds are more natural to him than words. In a mental hospital this sometimes makes the child patient* a demon of destructiveness, and many institutions refuse to accept him.

Last week bigwig psychiatrists from across the U.S. converged on Ann Arbor to help dedicate a monument to the proposition that more can and must be done for such children: the Children's Psychiatric Unit at the University of Michigan Hospital. Though the six-story, yellow brick building was barely finished, 30-odd children from the ages of six to twelve had been moved in. The unit's capacity: 75. That is sizable for a children's mental hospital, though many thousands of children in the U.S. need psychiatric hospital care.

Positive & Negative. Says Dr. Raymond W. Waggoner, the university's chief of psychiatry: "The design was governed. by two factors. The positive was to make a hospital for children as much like home as possible. The negative was to create a building in which the child could not destroy himself or other objects."

To achieve the negative, heat is supplied by forcing air over hot-water pipes in the ceiling--in an earlier building the children tore ordinary radiators apart. Walls are lined with rugged tile up to a height of seven feet. Thermostats are covered by grills. Door hinges are made so that they cannot be dismantled. Beds, like other furniture, are of rugged, 1 1/4-in. oak. "We tried steel beds before," says Dr. Waggoner, "and they only lasted a few months."

Basic plans for the new units were roughed out on the living-room floor of Child Psychiatrist Ralph D. Rabinovitch and his psychiatrist-wife Sara Dubo. (They have since resigned, will leave after the unit is in full operation.) In the planning, their first premise was that a mentally ill child has suffered a lack of something vital in his home life. It would only make things worse to keep him in an old-fashioned institution. So, despite all the precautions needed for damage control, they stressed what Dr. Waggoner calls the positive, made the atmosphere in the unit as little like that of a hospital as possible.

Talk & Schooling. Dormitory floors have no big wards, only rooms with one to four beds. One floor, for more tractable patients and those almost ready to go home, has 27 beds. Staff members, who outnumber patients almost two to one, wear no uniforms. To give a feeling of going from home to school, patients leave their dormitory floors after breakfast and go to a floor where there are classrooms, workshops, rooms for remedial reading--and a kitchen for smudging up fudge and popping corn.

Each child gets three to five hours every week with one of the 16 resident psychiatrists, besides an individually tailored program of schooling and shopwork. Most important, every child is encouraged and helped to develop family-like attachments to patients and staff members.

Average stay in the new unit is expected to be eight months. Average cost: $6,000 (although most patients are treated free). The hospital does not turn down even the toughest cases. It has taken in firebugs and killers (one boy who had killed his parents was admitted for diagnosis), helped them find useful lives in the world.

* Children's mental illnesses vary widely and cannot be pigeonholed into neat categories. To avoid sticking themselves with the pin on a diagnostic label, many psychiatrists prefer to lump all juvenile mental patients under the cliche heading "emotionally disturbed."

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