Abstract
Indiana’s Central State Hospital (USA) provides a case study for understanding the relationship between labour and independence for psychiatric inpatients with intellectual disabilities. This study focuses on the years leading up to the hospital’s 1994 closure, examining work as part of institutional life and deinstitutionalization. We argue that changing work policies during the hospital’s phase-out and closure had inadvertent negative effects on patient perceptions of, and abilities to realize, their goals. We rely on patient-authored newsletters (1986–1993), oral history interviews conducted with former hospital staff, and newspaper articles and administrative records to reconstruct patient experiences within rehabilitative vocational programs, to define the patient work experience and provide insight into how staff who worked closely with patients understood the hospital’s policies around work.
“I’m Working at the Workshop,” DDU Review, September 1989, Indiana Medical History Museum (IMHM) archives, Indianapolis, Indiana. We have omitted the last names of patient-authors who wrote in the DDU Review because we have not been able to obtain the permission to identify individuals with their writings.
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Notes
- 1.
Our data set is defined by the holdings of the IMHM and the personal files of former DDU director, Mike Flores. The earliest issues of theDDU Review (October 1986–January 1987; March 1987–January 1988; February 1991, June 1991, and July–August 1992) have not been located. AllDDU Reviewarticles referenced in the present study are housed at the IMHM.
- 2.
Vickie Cole, oral history interview by Emily Beckman, Elizabeth Nelson, and Angela Potter, Indianapolis, May 3, 2018. Recording and transcript currently held at the Medical Humanities and Health Studies Program, Indiana University-Purdue University, Indianapolis (IUPUI), but will be deposited at the IUPUI Ruth Lilly Special Collections and Archives.
- 3.
J.W. Trent, Jr., Inventing the Feeble Mind: A History of Mental Retardation in the United States (Berkeley: University of California Press, 1994); S.F. Rose, No Right to Be Idle: The Invention of Disability, 1840s–1930s (Chapel Hill: The University of North Carolina Press, 2017).
- 4.
J. Abbas, “A Legacy of Exploitation: Intellectual Disability, Unpaid Labour, & Disability Services,” New Politics XIV-1, no. 53 (Summer 2012), http://newpol.org/content/legacy-exploitation-intellectual-disability-unpaid-labour-disability-services.
- 5.
University of Michigan Law School: Civil Rights Litigation Clearinghouse, “Souder v. Brennan.” Available at: https://www.clearinghouse.net/detail.php?id=15215.
- 6.
D. Safier and R. Barnum, “Patient Rehabilitation through Hospital Work under Fair Labor Standards,” Hospital and Community Psychiatry 26, no. 5 (May 1975): 299–302.
- 7.
D.B. Schwartz, “Expanding a Sheltered Workshop to Replace Nonpaying Patient Jobs,” Hospital and Community Psychiatry 27, no. 2 (February 1976): 98–101.
- 8.
United States Department of Labor: Wages and Hour Division, “Fact Sheet #39: The Employment of Workers with Disabilities at Subminimum Wages,” https://www.dol.gov/whd/regs/compliance/whdfs39.htm.
- 9.
Abbas, 2012; M. McDonald and S. Herr, “Case Studies: Which Clients Should a Sheltered Workshop Serve?” The Hastings Center Report 14, no. 5 (October 1984): 52–54. For a recent overview of this topic see, R. Beckwith, Disability Servitude: From Peonage to Poverty (New York: Palgrave Macmillan, 2016).
- 10.
“Statistical Survey of Public Assistance in Indiana: Special Study, Establishment and Growth of the State Institutions” (April 1938). Indiana Clipping File, Indiana State Library. By the 1930s, along with eight institutions for “mental cases,” Indiana also administered several prisons and reform schools, a veteran’s home, an orphanage, a tuberculosis sanatorium, and schools for Deaf and blind children.
- 11.
E. Dwyer, “Mental Health Care in Early Twentieth Century Indiana and the Limits of Reform,” Indiana Medical History Quarterly 9 (1983): 23–27.
- 12.
E.C. McDonel, E.C., Meyer, L. and R. Deliberty, “Implementing State-Level Mental Health Policy Reforms in Indiana: Closing a State-Operated Psychiatric Hospital and Passing Major Mental Health Reform Legislation,” International Journal of Law and Psychiatry 19, no. 3&4 (1996): 239–264.
- 13.
L. Dunlap, J.S. Bobbs, J. Blake, E.J. Peck, J. Wilkins, and S. Major, Report to the General Assembly of the State of Indiana. General Assembly of Indiana at Thirty-Third Session Commencing December 3, 1849, Part Second (Indianapolis: John D. Defrees, 1849).
- 14.
Mike Flores, “Employment Narrative: Central State Hospital,” Mike Flores, Personal Files. As of 2010, these facilities are called Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/Intermediate-Care-Facilities-for-Individuals-with-Intellectual-Disabilities-ICF-IID.html.
- 15.
Central State Hospital, 139th Annual Report, 1986–1987.
- 16.
Central State Hospital, 142nd Annual Report, 1989–1990.
- 17.
D.B. Schwartz, “Expanding a Sheltered Workshop to Replace Nonpaying Patient Jobs,” Hospital and Community Psychiatry 27, no. 2 (February 1976): 98–101; M. McDonald and S. Herr, “Case Studies: Which Clients Should a Sheltered Workshop Serve?” The Hastings Center Report 14, no. 5 (October 1984): 52–54; United States Department of Labour: Wages and Hour Division, “Fact Sheet #39: The Employment of Workers with Disabilities at Subminimum Wages,” https://www.dol.gov/whd/regs/compliance/whdfs39.htm.
- 18.
Rex Redifer, “Special Hospital Program Provides Useful Lives for Mental Patients,” Indianapolis Star, September 19, 1985, 27.
- 19.
Terry Duwe, Lisa Freeman, and Bonnie O’Connor, oral history interview by Emily Beckman, Modupe Labode, Elizabeth Nelson, and Angela Potter, Indianapolis, August 2017. Recording and transcript currently held at the Medical Humanities and Health Studies Program, Indiana University-Purdue University, Indianapolis (IUPUI), but will be deposited at the IUPUI Ruth Lilly Special Collections and Archives.
- 20.
Kathy Whyde, “Capturing Pride in Print,” The Indianapolis Star, April 9, 1988, p. 37.
- 21.
L. Ben-Moshe, “The Contested Meaning of ‘Community’ in Discourses of Deinstutionalization and Community Living in the Field of Developmental Disability,” Disability and Community 6 (2011): 241–264; Research and Training Center on Community Living, “Behavioral Outcome of Deinstitutionalization for People with Intellectual and/or Developmental Disabilities: Third Decennial Review of U.S. Studies, 1977–2010,” Policy Research Brief 21, no. 2 (2011): 1–11; K. Johnson, R. Traustadóttir, C.M. Bigby, and K. Kristiansen, Deinstitutionalization and People with Intellectual Disabilities: In and Out of Institutions (London: Jessica Kingsley Publishers, 2005).
- 22.
R. Porter, “The Patient’s View: Doing Medical History from Below,” Theory and Society 14, no. 2 (1985): 175–198; A. Bacopoulos-Viau and A. Fauvel, “The Patient’s Turn: Roy Porter and Psychiatry’s Tales, Thirty Years On,” Medical History 60, no. 1 (January 2016): 1–18.
- 23.
J. O. Ollerenshaw and J.W. Creswell, “Narrative Research: A Comparison of Two Restorying Data Analysis Approaches,” Qualitative Inquiry 8, no. 3 (2002): 329–347.
- 24.
D. J. Clandinin, F. M. Connelly, Narrative Inquiry: Experience and Story in Qualitative Research (Hoboken, NJ: Wiley, 2000).
- 25.
J.H. McGrew, E.R. Wright, B.A. Pescosolido, “Closing of a State Hospital: An Overview and Framework for a Case Study,” Journal of Behavioral Health Services & Research 26, no. 3 (August 1999): 236–245; J.H McGrew, E.R. Wright, B.A. Pescosolido, E.C. McDonel, “The Closing of Central State Hospital: Long-Term Outcomes for Persons with Severe Mental Illness,” Journal of Behavioral Health Services & Research 26, no. 3 (August 1999): 246–261; B.A. Pescosolido, E.R. Wright, K. Lutfey, “The Changing Hopes, Worries, and Community Supports of Individuals Moving from a Closing Long-Term Care Facility,” Journal of Behavioral Health Services & Research 26, no. 3 (August 1999): 276–288; A. H. Lawson, E. R. Wright, S. Jaegber, J. McGrew, B. Pescosolido, The Central State Hospital Discharge Study: Tracking Report (Bloomington: Indiana Consortium for Mental Health Services Research, 2005).
- 26.
Creswell, J. W., Qualitative Inquiry & Research Design: Choosing among Five Approaches, 3rd ed. (Thousand Oaks, CA: Sage, 2013).
- 27.
J. O. Ollerenshaw, J.W. Creswell, 2002, 329–347.
- 28.
J. O. Ollerenshaw, J.W. Creswell, 2002, 329–347.
- 29.
“The Brass Rail Job I am Getting,” DDU Review, December 1988; “Job at Brass Rail,” DDU Review, February 1989; “I Have Two Jobs,” DDU Review, May–June 1992. The restaurant/canteen was named for an antique brass rail salvaged from one of the hospital’s historic buildings (“The Brass Rail,” The Indianapolis News, November 12, 1985, 6).
- 30.
“What Happened to Vicki at APS,” DDU Review, April 1989.
- 31.
“Sheltered Work New Years [sic] Party,” DDU Review, January 1989; Vickie Cole, “APS News,” DDU Review, September 1989.
- 32.
“[Redacted Name]’s New Job,” DDU Review, June 1989.
- 33.
“My New Job,” DDU Review, March/April 1992.
- 34.
J. Fahy, “APS Industries Befriends Mentally Ill,” The Indianapolis Star, December 24, 1995, A7.
- 35.
“My New Job at APS,” DDU Review, May–June 1992.
- 36.
“Rushing at Work,” DDU Review, July 1991; “APS News,” DDU Review, November/December 1991.
- 37.
“The Brass Rail Job I am Getting,” DDU Review, January 1989.
- 38.
“Darin Goes to Noble,” DDU Review, April 1990.
- 39.
“Rushing at Work,” DDU Review, July 1991.
- 40.
“I Have Two Jobs,” DDU Review, May–June 1992.
- 41.
“APS,” DDU Review, November 1988; Vickie Cole, “APS News,” DDU Review, September 1989.
- 42.
“APS News,” DDU Review, September 1991.
- 43.
“News at APS,” DDU Review, March/April 1992.
- 44.
“Working at the Brass Rail,” DDU Review, February 1989; “I’m Working at the Workshop,” DDU Review, September 1989; “Rushing at Work,” DDU Review, July 1991.
- 45.
“Back to Work,” DDU Review, March 1990.
- 46.
“Me Getting Better,” DDU Review, June 1990; “My Staffing,” DDU Review, July 1991.
- 47.
“What do You All Think About Job Club?” DDU Review, April 1989.
- 48.
“Labor Day,” DDU Review, September 1988.
- 49.
“Barbara Leaves,” DDU Review, May–June 1992.
- 50.
“Job at Brass Rail,” DDU Review, February 1989.
- 51.
“Labor Day,” DDU Review, September 1988.
- 52.
“Back to School,” DDU Review, August 1989.
- 53.
“Reporter of the Month,” DDU Review, October 1988; “Reporter of the Month,” DDU Review, November 1988; “Reporter of the Month,” DDU Review, May 1989; “My Future,” DDU Review, November–December 1990.
- 54.
“I Like My Job Because It Will Get Me Out Quicker,” DDU Review, September 1989.
- 55.
Mike Flores, oral history interview by Emily Beckman, Elizabeth Nelson, and Angela Potter, Indianapolis, May 16, 2018, and May 21, 2018. Recording and transcript currently held at the Medical Humanities and Health Studies Program, Indiana University-Purdue University, Indianapolis (IUPUI), but will be deposited at the IUPUI Ruth Lilly Special Collections and Archives.
- 56.
Flores, oral history interview.
- 57.
Flores, oral history interview.
- 58.
Dale Marion, quoted in Redifer, 1988.
- 59.
Vickie Cole, oral history interview.
- 60.
Vickie Cole, oral history interview.
- 61.
“Rules are Changing at APS Workshop,” DDU Review, 1st Quarter 1993.
- 62.
“New Staff at APS,” DDU Review, 1st Quarter 1993; “New Boss at APS,” DDU Review, 2nd Quarter 1993; “New Schedules on Ward 37,” DDU Review, 1st Quarter 1993.
- 63.
“APS Moved,” DDU Review, Holiday Edition.
- 64.
Joe Fahy, “Program Provides Ex-Mental Patients a Working Solution,” Indianapolis Star, December 24, 1995, A1, A7; Fahy, “APS Industries Befriends Mentally Ill,” Indianapolis Star, December 24, 1995, A7.
- 65.
“[Name Redacted] is Working at Fridays,” DDU Review, 2nd Quarter 1993; “[Name Redacted]’s New Job,” DDU Review, 2nd Quarter 1993; “A Job at Galayan’s,” DDU Review, 2nd Quarter 1993; “We Work at Galayan’s,” DDU Review, 2nd Quarter Edition, 1993; “My Boss is Going to Get Me a New Job Off Grounds,” 2nd Quarter 1993; “Supportive Employment,” DDU Review, 2nd Quarter, 1993.
- 66.
“[Name Redacted] is Working at Fridays,” DDU Review, 2nd Quarter Edition, 1993; Fahy, “APS Industries Befriends Mentally Ill,” A7.
- 67.
Fahy, “APS Industries Befriends Mentally Ill,” A7.
- 68.
Fahy, “Program Provides Ex-Mental Patients a Working Solution,” A7.
- 69.
Vickie Cole, oral history interview.
- 70.
Vickie Cole, oral history interview.
- 71.
Doug Crandell, “Activities Of Daily Living,” The Sun, November 2016. Online: https://www.thesunmagazine.org/issues/491/activities-of-daily-living.
- 72.
Central State Hospital Discharge Study Tracking Report, Indiana Consortium for Mental Health Services Research, Institute for Social Research at Indiana University, 2005.
- 73.
Vickie Cole, oral history interview.
- 74.
Central State Hospital Discharge Study Tracking Report, Indiana Consortium for Mental Health Services Research, Institute for Social Research at Indiana University, 2005.
- 75.
Central State Hospital Discharge Study Tracking Report, Indiana Consortium for Mental Health Services Research, Institute for Social Research at Indiana University, 2005.
- 76.
Vickie Cole, oral history interview.
- 77.
Vickie Cole, oral history interview.
- 78.
Vickie Cole, oral history interview.
- 79.
Gary Bond, psychologist and specialist in the assessment of supported employment programs, personal communication, 2019.
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Beckman, E., Nelson, E., Labode, M. (2021). “I Like My Job because It Will Get Me Out Quicker”: Work, Independence, and Disability at Indiana’s Central State Hospital (1986–1993). In: Ellis, R., Kendal, S., Taylor, S.J. (eds) Voices in the History of Madness. Mental Health in Historical Perspective. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-69559-0_9
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