“The Back” of St. Joseph’s inpatient psychiatric unit was a locked unit within a locked unit. If an individual patient was deemed to need constant supervision, then the “Constant” who sat outside the patient’s room day and night was not a Unit 3-6 staff member: it was a uniformed officer from the Security Dept. Leave your illusions at the door when you enter inpatient psychiatry: it is the prison unit. In Canada, inpatients on psychiatry are called inmates.
I don’t know how often they search the cells of criminal prisoners, but they do it every evening on Unit 3-6. All contraband is removed, especially cigarettes, matches and lighters. However, one night the search staff didn’t get it all. A patient locked in back was left with matches and started a fire.
The first I knew of this was when I read it in the Post-Standard, Syracuse’s only surviving daily newspaper. According to the report, there had been a minor fire and a vice president of St. Joseph’s Hospital said everything would be back to normal within a day or two. No big deal. Since I had been discharged just a couple days earlier, I still had friendly relations with some of the inpatients. I called one of them.
There are two pay phones in the hallway on the long leg of the T; this is our only contact with the outside world and it is exposed to all who pass by. When my friend was called to the phone, she said, “Hi, Anne.” When I asked about the fire, she became very agitated. It had been a very frightening experience; the patients were all terribly upset, but she abruptly refused to say anything more about it. A staff member had been passing by and when she heard the patient say my name, the staff member stopped near the phone. She was loitering to listen, and the patient knew from experience that if she said anything the staff member didn’t like then the staff member would terminate the call. There is neither privacy nor freedom of speech on inpatient psychiatry. You are under surveillance at all times.
A day or two later, I had an appointment with Dr. Ghaly and asked him about the fire. His eyes got big and he said, “Eh! It was terrible! They called me in to discharge . . .” The entire back section of the unit had been burned out. The staff had called all the doctors and told them to get in there and discharge or transfer their patients. People who were sick and needed treatment were put out on the street. Most of the seclusion rooms were unusable.
St. Joe’s had lost eight or ten beds, and the unit was not back to running normally in a couple days, as the vice president had said it would be. Most of the back section was shut down for about six months.
First, imagine the terror of smoke billowing down the hallway when the front door is locked and you can’t get out. Of course, steps were taken to secure the safety of the patients, but so what? They had been behind locked doors for days, weeks or months. “Locked in” was their reality. Many of them had tried—often desperately—to get out the locked door. They had no confidence at all that they would be freed just because smoke was rolling down the hall.
Second, the loss of these inpatient beds occurred in the context of a geographical area where there were never enough beds to meet the need. Losing eight or ten beds for six months meant that somewhere between fifty and a hundred people would be denied local treatment. If they had to be hospitalized then they would have to be sent to hospitals east, west or downstate. They would be at least a hundred miles away from meaningful contact with their families, case managers, pastors, employers and all other people who were significant to their recovery and return to normal life.
Third, the hospital’s vice president lied and the newspaper reported it as the truth. I called the newspaper and gave them contradictory information, indicating sources inside the unit. It didn’t make any difference.
Syracuse used to have the Post-Standard in the morning, the Herald Journal in the evening, and the Herald American on Sundays. They/it continue to refer to them/itself as “The Syracuse Newspapers” and they/it function essentially as the public relations agency for The Establishment. Statements issued by the executive director of the bus company, the commissioner of the county Dept. of Social Services, or a vice president of a hospital are all treated as gospel and printed without question or challenge.
Anyone with any kind of title in any of the established corporations—county or city government, manufacturing, schools, banks, hospitals—can speak and be heard without censure. Conversely, no local resident who has information that is different from the official version will get a hearing or see their side of the story in print. There will be no investigation. We don’t do that here.
My question is what do you do in your community? If there were a fire, or sexual abuse, or brutality, or hate crimes, or any other nasty thing going on behind the locked doors of your local inpatient psychiatric unit, how would you know? Who would tell you? Who would you believe?
If you don’t go behind the locked door yourself, you will never know.