For almost a century, nobody wanted to know what went on inside Byberry. But once Northeast Philly’s infamous mental institution got shut down in 1990, there was no keeping anybody out.
During its busy afterlife, the sprawling, decaying campus is said to have attracted all kinds of people: urban explorers, graffiti artists, photographers, ghost hunters, amateur Satanists, devout Santerians and people who just wanted to get drunk somewhere cool.
“By the time I went, there were 24 buildings remaining and I saw every square inch of every one of them,” says J.P. Webster, whose early visits to the site led to a decade-plus obsession and his just-published book, The Philadelphia State Hospital at Byberry: A History of Misery and Medicine (History Press, May 1).
“I couldn’t believe how laid-back it was. You could just walk right in. There was never any hassle.” Webster has made a hobby of exploring abandoned institutions. “Any other place that I tried to get into, there was security and it was a lot more protected.”
According to a 2006 City Paper article, “as many as 100” urban explorers were infiltrating Byberry on a typical weekend night. Security guards patrolled the grounds, and the cops were often called in — but, well, nobody was paying anybody enough to chase trespassers through the tunnels and across the rooftops of an abandoned mental institution.
“I had never, ever been to a place that was so uncared about by every single living soul around it,” says Webster, who still laments the city’s decision to finally tear down the condemned hospital in 2006. “Everybody wished it wasn’t there. Nobody wanted to acknowledge its presence. And it seems like that was the case from the very beginning.”
“All state institutions were really horrible places, but Byberry was probably the worst,” says retired activist Mary Hurtig, former policy director of the Mental Health Association of Southeastern Pennsylvania. “There are all kinds of patients buried on the grounds of the state hospital who did things like froze to death, ran away, were never heard from again. Or were brutally beaten and buried there. It [was] a real nightmare place, and most state institutions were similar.”
Originally opened in 1907 as a “work farm for the mentally ill,” Byberry mental hospital — later renamed the Philadelphia Hospital for Mental Diseases and finally Philadelphia State Hospital at Byberry — was plagued by allegations of abuse and neglect throughout its history. The institution was notoriously underfunded, understaffed, overcrowded, filthy and corrupt. The staff, by most accounts hardworking and kindhearted, was stuck trying to maintain a system built not so much for recovery as for containment.
Worst of all, the place was remarkably resistant to change. After conditions there were declared inhumane in the 1930s, Gov. George Harold Earle III signed over control of the facility from the city to the state. Within three months, new director Dr. Herbert C. Woolley declared that the situation at the “medieval pesthouse” was hopeless.
In 1945, Charlie Lord — one of several conscientious objectors to World War II who worked at Byberry in lieu of military service — snuck photos out of the hospital that exposed the horrors within. In one, labeled “Incontinent Ward, A Building,” dozens of thin, naked male patients are huddled together in the corner of a drab concrete room. Another showed a patient strapped to a busted-up mattress in the “Violent Ward” of Building B. In a third, a man sits hunched over a toilet, the words “for use by diarrhea patients only” scrawled on the wall behind him. Everywhere there’s rust and crumbling plaster, puddles and filth.
When Eleanor Roosevelt was shown Lord’s photos, she initially doubted their authenticity — surely these were from some Southern institution? — but eventually took up the cause of reforming conditions at mental institutions. The pictures went on to spark national, if temporary, outrage when they were published in Life magazine in 1946.
Not long after, crusading journalist Albert Deutsch was granted free rein of the hospital grounds and wrote about the what he found in a series of magazine articles and his 1948 book, The Shame of the States. He described the lack of treatment, unclean conditions and accounts of brutality at the hands of some attendants. “Byberry, along with too many of our state hospitals, can be compared only to Buchenwald and Belsen in its contempt for human dignity and human needs,” he wrote.
That may have been the lowest point in Byberry’s history, but most of its systemic problems were never solved. According to Hannah Kerena Jones, author of another new book, Byberry State Hospital (Arcadia Publishing, May 9), the institution was trapped in a cycle: “Terrible conditions, neglect and patient abuse, followed by a short-term, very public reform movement,” is how Jones describes it in an email. “And then over the course of a few years, the hospital would begin to backslide. Conditions would decline again, the buildings and expensive machinery used for therapy would fall into disrepair, and the whole cycle would repeat.”
By the 1960s, Byberry had become the ninth-largest institution of its kind in the country.
Of course, as bad as Byberry was, many of its problems were a reflection of the state of mental-health care. For one thing, these so-called asylums were often created as repositories for people society didn’t know what to do with: those with Down syndrome, seizure sufferers, alcoholics. “We used to just lock up people there for whatever reason,” says Hurtig.
For those who did suffer from mental illnesses — schizophrenia, depression and such — the development of anti-psychotic drugs brought about a sea change in the industry. While the early ones, like Thorazine and Haldol, had awful side effects, newer ones were developed and incorporated into a balanced treatment program that didn’t necessarily require confinement.
As a result, Jones writes in her book, “there was no more need for restraints, wet-sheet wraps, ice packs and tubs, electroshock, Metrazol shock, insulin therapy, or lobotomies.”
Furthermore, says Hurtig, the advent of drug therapy meant “we suddenly realized we didn’t really have to keep people all locked up.” By the 1970s, a deinstitutionalization movement was making inroads.
Still, it took until 1990 for Byberry to shut its doors, and this came only after a tremendous battle (in the headlines as well as the courtrooms) that seemed to require all the right chess pieces in place — among them, Gov. Robert Casey, state regional director of mental health Estelle Richman, Joe Rogers of advocacy group Project SHARE and Hurtig’s activist supergroup Coalition for the Responsible Closing of Philadelphia State Hospital.
Once closing was imminent, hundreds of the hospital’s former patients sued the state and were awarded community-based services for an amount of time equal to their stay at Byberry. It wasn’t perfect, but the city had a safety net for its deinstitutionalized population.
“It was an amazing settlement. Totally amazing. Unheard of. Nobody would settle that way anymore,” says Hurtig. “Because of that, and unbeknownst to you or to most people — because you still see people who are ill on the street, and we still have horrific incidences — Philadelphia then crafted the most progressive and integrated and community-focused behavior health systems,” says Hurtig. “Pennsylvania led the way for many, many years.”
What took so long? Part of it was the challenge of setting up an infrastructure of community resources and Medicaid funding to treat released patients as well as the “diversion population” — those who would’ve been admitted to Byberry were it still around. Another big part, says Maureen Cronin, executive director of Arc of Pennsylvania, an advocacy group for people with intellectual and developmental disabilities, was resistance to change: “Even as we learn better ways, we tend to hang on to our ways that are most familiar. With bricks and mortar you have a building, you have money, you have staff, you have unions, you have people who are invested in practices that are now outdated but have a hard time letting go.”
Byberry’s closing helped signal the end of several similarly troubled state institutions, including Haverford.
“We know that people with disabilities should never be segregated and separate’s never equal,” says Cronin. “It’s not how people thrive, it’s not how we want to live. And we know that people who are able to live regular lives in the community, with relationships, families, jobs and support, do so much better than when they’re in a segregated hospital-type setting.”
The merits of deinstitutionalizing the mentally ill, says Cronin, are plain. Except for people who are violent or criminal, she says, “Nobody needs to be in an institution. Ever.”
After all, she says, it wasn’t just the progress of science that pushed institutions like Byberry out of business; society had to change as well. No longer could we accept a system that locked people up simply for being mentally ill. “When we know better, we need to do better.”
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