Back When Good Republican Patronage Ran Intellectual Disability Facilities

J.P. Webster, The Philadelphia State Hospital at Byberry: A History of Misery and Medicine. Charleston, S.C.: Histry Press, 2013.

This is an analysis and history of a long standing intellectual disability center. It was made famous for it many tragedies and instances of poor care of those in need. This book provides insights into what went wrong in the past, how people historically have viewed people with intellectual disabilities, and how these views and practices of care have changed.

This book will well serves those interested in historical aspects of care of people with intellectual disabilities and of local and state government and how their interference and lack of support created and increased many of the problems those attempting to provide good care faced. The following are notes more directed for use by public policy researchers.

As of 1830, an almshouse in Philadelphia had about 200 men and women deemed insane intermixed with the destitute, orphans, and people with contagious illnesses. The growth in this population led to creating separate facilities for those with different types of concerns, In 1833, Philadelphia Hospital began taking permanent residents. This hospital had athletic facilities, greenhouses, and a fountain. Within decades, there were several mental health and insane asylums throughout Philadelphia.

A scandal erupted among managers of several intellectual disability facilities in the mid 19th century. Financial discrepancies ere uncovered. Outrage at some practices led to strengthening a law prohibiting the sale of dead bodies.

The Pennsylvania legislature in 1887 created the Bullitt Bill (named after State Sen. William Christian Bullitt, Sr.) which developed a state government system of corrections and charities, including almshouses and serving people with intellectual disabilities. In 1903, the Bullitt Bill was altered by separating charities and corrections.

The management and corruption of Philadelphia administrators  discouraged the state government officials form providing greater funds to local Philadelphia charitable organizations from 1904 to 1938.

Byberry was purchased from farmers disgruntled over rising city taxes. Byberry was turned into a prison farm. Initially, there was space for 40 “mildly insane” prisoners.

Corrupt practices were exposed at Byberry. Record keeping procedures were installed to help combat this corruption.

Byberry was one of the 20th century intellectual facilities built without a patient cemetery. The practice then was a family member had 36 hours to claim a decreased patient’s body. Unclaimed bodies were used for medical dissections.

A City Controller study in the late 1930s uncovered that the patients were being used for administrators’ personal uses.

Suspicions arose after three different accidental deaths happened at Byberry. A lack of staff was blamed for one death where a patient choked from her restraints. Concerns over poor food, fire hazards and overcrowding grew. A lack of staff was observed as there were 15 physicians for 5,400 patients with only 2 physicians for 2,300 female patients. Pharmaceuticals were handled by 1 part-time employee. Alcohol was reportedly sold to patients although it was sometimes prescribed then for some medical conditions.

The Works Progress Administration paid for Byberry improvements during the Depression.

J. David Stern, a newspaper owner, and State Sen. Harry Shapiro called for reforms. Stern printed photographs of Byberry’s conditions. There were patients without clothing. Some patients lived amongst their own bodily wastes, the smell of which was noticeable in nearby buildings. Some patients were transferred, yet they went to facilities operated by people with political connections.

In 1938, Sen. Shapiro held committee hearings which led to observing that Byberry had 5,400 patients which was 300% over capacity. It was reported patients were often beaten and that the beatings were condoned by administrators. The state government sought to take over Byberry. The city resisted. Pennsylvania Welfare Secretary Charles Engard arrived at Byberry with 12 state troopers and 25 health professionals and had Byberry’s Superintendent removed. A court decision gave the state government control over Byberry. Shapiro’s efforts also allowed 13 other hospitals operated by city government be transferred to state government control.

Herbert Woodley was named Byberry’s Superintendent. He had reduced overcrowding elsewhere in a year. After being a Byberry for one month, Woodley declared Byberry “medieval” and “hopeless”. He stated it needed to quickly have new buildings constructed. He implemented more recreation and activities for the patients. Music concerts were held at Byberry.

The Coroner was suspicious of five deaths under the care of one caregiver at Byberry that had been labeled as accidental. It was discovered the caregiver was on parole. All Byberry employees were fingerprinted and underwent a criminal background check. A subsequent beating death and testimony about beatings led to criminal charged and plea bargained guilty pleas. Over 200 employees were removed for mistreating or abusing patients.

Attendants described their work with so many patients, many of whom were violent, as similar to a war zone.

World War II drained Byberry of many of its attendants.

In 1943, First Lady Eleanor Roosevelt was shown photographs of conditions at Byberry. Her first reaction was disbelieve that such horrendous photographs were real. She then worked to improve conditions at Byberry.

Byberry had 6,300 patients in 1962, including 400 convicts placed there by court order.

The Community Mental Health Centers Act became Federal law in 1963. this created smaller treatment centers and moved away from large institutions such as Byberry. In 1964, Pennsylvania passed its Mental Health / Mental Retardation Act that created centers by county and according to population. Philadelphia was divided into 13 units.

Byberry had several hundred senior citizens without intellectual disabilities. They were there as they could not afford nursing homes, had nowhere else to go, and Byberry could not turn them away.

In 1965, Auditor General Grace Sloan claimed Byberry’s Superintendent used security personnel for personal purposes. She also criticized that there were 337 patient escapes including 40% of court ordered patients.

Circa 1966, patients were moved from the deteriorating buildings at Byberry into other Byberry buildings. Governor Raymond Schafer visited the facilities and recommended they be closed. Yet no alternative was offered as to where the patients should be.

A woman was released after spending 47 years at Byberry. She had been admitted for “babbling”. It was discovered her babbling was Ukrainian.

State Reps. Milton Berkes and James Gallagher toured Byberry. They observed noticeable stench. They noted Byberry received $8.20 per patient compared to $21 to $35 per patients that other hospitals received. Gov. Schafer investigated Byberry. Razor wive was installed around the building for violent offenders. One building was condemned. After a female employee was raped, streetlights were installed.

Rep. Frank Salvatore became critical of Byberry’s Superintendent using state time and resources to write book. Salvatore also later criticized the closing of chapels at Byberry.

Byberry began transferring patients out of its facilities. Some patients were discharged to “family members” who turned out to be landlords. Byberry had about 600 patients by the mid-1980s. The infrastructure was badly deteriorated.. Shackled dangerous patients were often set free by other patients.

Governor Robert Casey in 1987 has a Blue Ribbon study look into Byberry. Upon reading their report, Casey decided to close Byberry. Twelve attendants were fired, resigned, or transferred for abusing patients. The patients were all transferred into  state hospitals, nursing homes, and community centers. The last five Byberry patients left the facility of June 21, 1990.

The Byberry buildings contain asbestos It would cost millions of dollars to tear them down or refurbish them. The site was purchased in 2006 with the intentions of becoming senior citizen housing.