Butler Hospital - Ri

Butler Hospital for the Insane was founded in 1844 and opened in 1846.  It was designed in the Late Gothic Revival Style/Colonial Revival Style, and includes a 1731 farmhouse that stood on the property when it was acquired by the hospital (Wiki, n.d.).

After the visit from D. Dix, and further funding, a 2 story building, 290 feet long, divided into a main building with east and west wings was built.  This accommodated 100 patients. 

I chose to research Butler Hospital because it’s in my home state but was surprised and delighted to read that Dorothea Dix was involved shortly after it was opened and highly praised.  Their present day campus was purchased with her support.  Local citizens donated as little as a dollar each (which would be approximately $28 in current money) to see the hospital construction through to completion.  Butler was Rhode Island’s first exclusively Mental Health Hospital.  A sum of $30,000.00 was left by Nicolas Brown (d. 1941) to be appropriated towards the establishment of a hospital for the insane, “where that unhappy class of our fellow-beings who are, by the visitation of Providence, deprived of their reason, may find a safe retreat, and be provided with whatever may be most conducive to their comfort, and their restoration to a sound mind.” (Ray, I., 1948).  The initial charter application to the state was for the “Rhode Island Asylum for the Insane.” (Archives, 1926, p. 5)

Cyrus Butler, an industrialist, donated heavily to the hospital, thus the naming of the hospital in his honor.  Dr. Isaac Ray was the first Superintendent at Butler and a “national champion for the legal rights and humane treatment for the mentally ill.” (Asylum Projects, n.d.)

As this hospital is still in operation, patient confidentiality is of utmost importance and highly guarded information.  The most I could glean of previous patients is some names of family members from benefactors back in the late 1800’s, early 1900’s.  There is a publication from 1926, entitled “The Butler Hospital, Its Story”, (Archives, 1926) published by the Trustees and Superintendent listing all the benefactors from 1844-1926, which includes statements such as “A gift of $2,000 from W.H. Sanford for the building was significant, in that the sum was given to express Mr. Sanford’s appreciation of the care given his wife when she was a patient at Butler Hospital.”  All financial gifts are listed in the writing but it’s difficult to distinguish which were from families of patients.

There is a comment within “The Story” that when Dorothea Dix arrived in RI, she found that “there existed in the City of Providence a small asylum, conducted on wise and humane principles, but totally inadequate to the demands made upon it.” (Archives, 1926, p.6).  With her help, and the philanthropy of Cyrus Butler and others, they expanded the facility.  At Butler, they felt that outdoor activities such as Tennis and Horseback riding were beneficial to convalescence. 

The pervading atmosphere at the hospital is described as rest.  For all patients arriving, the first three days, the prescription is “rest.”  The halls are quiet, the view is delightful; everything inside and outside is designed to calm you while you are monitored closely by a nurse.

            There is great care taken to ensure there is no feeling of confinement.  When patients are new and unknown, they are constantly monitored but no mention of restraint of any kind is used.  They prefer to keep the patient in his/her ware by persuasion rather than by mechanical means and state that the results have proven well worth the additional care and expense.

            Jump nearly 100 years into the future and I’ve got an article published by a Recupero, et al., (2015) at Butler Hospital addressing R&S (restraint and seclusion); discussing strategies to minimize risk.  It might appear their treatment strategies changed with the prevailing models, however they do address this treatment on their website, and state: “Mental health providers that value and respect an individual’s autonomy, independence and safety, seek to avoid the use of restrictive interventions at all times.” (Butler.org/Quality, n.d.)  I’m glad I took the time to check their website before I lost all faith in their humanity.

In the early days at Butler, it sounded much more like a place of rest, as if you were going to a Spa to relax.  It was not just for the wealthy though; patients were asked to contribute financially to their care, even if only partially because they felt that if the patience was invested in their care, they would participate more fully.  Back in 1926, “The Story” indicates they offered recreation that included a putting green, a horseshoe court, a baseball field and tennis courts outdoors as well as a well-equipped gymnasium indoors.  Upon searching the current website, there is no indicating of any recreation facilities at all.  Previously hydrotherapy was thought to be an effective treatment as well, but not even that is offered any longer. 

With regard to their patients, Butler no longer has children’s programs as those were taken over by Bradley Hospital in East Providence.  All else remains the same.

Current reports give no indication of any numbers or statistics.  Thanks to “The Story”, I can share with you that in at the end of 1921 they had 136 patients and at the end of 1925 that number had risen to 150.  Also in 1925, 131 patients were discharged from the hospital.  Of these 131, 37 were “recovered” and 57 were “materially improved.”  This begs the question of the stability of the remaining 37 in my mind at least.  Was there no hope for them and they just wanted to go home? 

Currently, Butler Hospital employs approximately 950 full-type and part-time, clinical and non-clinical staff, in addition to more than 50 volunteers who assist in nearly all areas of the hospital (Wiki, n.d.)

I found it difficult to find any negative information.  They’ve done an excellent job controlling their media releases; they are uniform across all fronts.  I did find a snippet about lobotomy’s still being performed sometime near 2003 in an article entitled “The Brain-Butchery Called Psychosurgery” by Ramsay, W., J.D. (WayneRamsay.com); “According to Dr. Benjamin Greenberg, professor of psychiatry at Brown University and chief of outpatient services at Butler Hospital in Providence, R.I., "We don't like to call it psychosurgery anymore ... It's neurosurgery for severe psychiatric illness" (quoted in Benedict Carey, "New surgery to control behavior", Los Angeles Times, August 4, 2003, & mindfully.org)”.  This is fairly appalling and I found no further information to indicate if this has been discontinued or continue to this day.  However, thankfully, this was the only negative I found and I searched high and low.

Perhaps one of the reasons I'm so vested in this institution is that one of my aunts stayed there on more than one occasion having been diagnosed as manic/depressive back in 1976.  She passed away about 10 years ago.  Her son now works there as a drug and alcohol counselor, having recovered there himself many, many years ago.  

Butler Hospital in 1850 and today:

References:

Butler Hospital, n.d.. Retrieved from: https://en.wikipedia.org/wiki/Butler_Hospital

Ray, I. (1948). American Journal of Insanity. Retrieved from Psychiatry Online: http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.5.1.1?journalCode=ajp

Butler Book. (1926)  The Butler Hospital, It’s Story.  Retrieved from:  https://archive.org/stream/butlerbook/butlerbook_djvu.txt

Recupero, P. et al., (2015). Journal of the American Academy of Psychiatry and the Law Online.  Retrieved from http://www.jaapl.org/content/39/4/465.full

Butler Hospital. ( n.d.). Quality, Restraint and Seclusion, retrieved from:

                http://www.butler.org/quality/Restraint-and-Seclusion.cfm