Byberry remembered 25 years after its closure

Danny Butts was 23 and four years into a diagnosis of schizophrenia when the deinstitutionalization movement freed him from the infamous Philadelphia State Hospital at Byberry.

On Friday, at a meeting commemorating the 25th anniversary of the hospital's closure, Butts spoke of his year at the hospital - known widely as Byberry - in positive terms.

He said he made friends with the staff there and enjoyed the activities. "The only thing I didn't like was the food," he said. "The food was horrible."

Butts, who now lives on his own and has worked 14 years at an agency that provides training on mental health issues, might once have spent his whole life in a state hospital.

Friday's meeting, which attracted about 100 advocates, providers, and mental health consumers, was meant to look back on the Philadelphia closure and forward to the continuing needs of a population that too often lacks sufficient housing, substance abuse treatment, and support.

The meeting was organized by the Mental Health Association of Southeastern Pennsylvania and took place at Temple University.

It is obvious that leaving institutions would be hard for patients. Even Butts, who is seen as a "poster child" for the trend, required more hospitalizations until he found the right medication in 1995.

But several professionals who helped transition patients to community life and treatment said they, too, had to reject much of what they had learned about mental illness as their work moved from the hospital to the community.

"I was deinstitutionalized myself," said Dennis Fisher, who was a music therapist at Byberry for more than a decade before the closing and is now Butts' boss at Behavioral Health Training and Education Network in Philadelphia.

Joan Erney, CEO of Community Behavioral Health in Philadelphia, was involved in closing other hospitals. "There is nothing like going through a state hospital closure to change your thinking and your mind and your heart forever," she said.

No one, she said, ever told her of wanting to go back inside: "There is nothing good about being in a state hospital. Nothing."

While presenters acknowledged that too many people with mental illnesses are in jail and on the street, they emphasized the positive contributions of peer counselors and programs that focus on earlier identification of and help for the mentally ill.

The crowd was hostile to the recent suggestion by University of Pennsylvania researchers that the most seriously ill people could benefit from a return of mental asylums. There were no kind words for federal legislation sponsored by U.S. Rep. Tim Murphy (R., Pa.) that would weaken their rights.

Estelle Richman, a former secretary of the Pennsylvania Department of Public Welfare, helped engineer the transition of 500 Byberry patients to the community. "It set the course of change for the behavioral health system in Philadelphia," she said.

One reason the move was successful, she said, was that the money that had been spent on the hospital truly followed the patients. "This was the one time that a commitment was made and it was kept," she said.

Larry Real, a psychiatrist who trained briefly at Byberry in the 1970s and will soon be chief medical officer for Philadelphia's Department of Behavioral Health and Intellectual Disability Services, recalled intervening when a doctor tried to give a patient stitches without pain medicine. The doctor had been taught that people with schizophrenia did not feel pain.

Real said there were people who were trying to do good work, but that most patients were not getting effective treatment in warehouselike buildings with little privacy.

"It was a horrible place to live," he said. "It needed to go."

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@StaceyABurling