WORKING THE WARDS | Part 1
A personal glimpse from the back wards of a West Virginia mental hospital in 1983 | PART 1 of 3 | June 2, 2025
WORKING the WARDS | Part 1 | June 2, 2025
WORKING the WARDS | Part 2 | June 3, 2025
WORKING the WARDS | Part 3 | June 4, 2025
By Douglas John Imbrogno | June 2, 2025 | On Thursday, June 5, 2025, the Culture Center in Charleston WV, will host the premiere of a 33-minute documentary I did with Bobby Lee Messer for the Developmental Disabilities Council of West Virginia, titled "COMING HOME: Before and After Deinstitutionalization in West Virginia." That is one long word in the subtitle, but it is a very important one, historically and also today as some lawmakers wish to return people to institutional settings. The film takes an unflinching look back at how West Virginia's institutions were routinely used as dumping grounds for people with developmental disabilities. It traces the struggle to close these institutions via unstinting and heroic legal and social activism, aiming to return adults, teenagers, and children hidden behind stone walls and locked doors to community and family life. And the film considers the question: Where do we go from here?
Register at this link to attend the free premiere of the ‘COMING HOME’ documentary on Thursday, June 5, 2025, from 6 to 8 p.m. (doors open 5:30 p.m.) at the Culture Center in the state Capitol Complex in Charleston, W.Va., or show up at the door. VIEW THE TRAILER at this link.
"COMING HOME” takes a deep dive—as well as a sometimes emotional one—into what it was like for patients consigned to back wards and hilltop hospitals, and for families separated from them, often by long distances. The film tracks the move to ‘deinstitutionalize’ patients—a cumbersome, yet apt word for the compassionate and challenging sea change that began to occur in the 1970s to 1990s, not just in West Virginia but across America. The complexity of this transformation—closing psychiatric institutions and returning occupants back to cities, towns, and rural settings with limited resources—led to its own issues. Some former state hospital residents fell through the cracks. Yet many more lives flourished in the move from understaffed and over-stuffed institutions to family and community-centered lives, as can be seen in the film’s testimonies from formerly institutionalized individuals and family members.
At one point, the documentary—whose script I wrote and narrate and which was shot and edited by Bobby Lee Messer—shifts to the front of the Mildred Mitchell-Bateman Hospital, a psychiatric facility formerly known as Huntington State Hospital. I recount how for three months in 1983 I went undercover there as a young reporter for the Huntington Herald-Dispatch, a seeming volunteer on the wards. Yet I was really seeking a first-hand look and better understanding of conditions in the hospital’s locked wards. This undertaking was part of a week-long series of articles published in July of that year, called ‘HOUSES ON THE HILL,’ examining the state’s psychiatric wards and the lawsuits to improve care or to close such institutions down.
I wrote the series at a time of heightened attention and legal wrangling over the often abominable conditions that adults, youth, and children sent to these facilities faced—sometimes for years, sometimes for lifetimes. ‘COMING HOME’ charts some of the advocates and attorneys (one of whom had motivation in her own family powering her legal work) whose efforts were key to the last of these warehouse facilities for people with developmental disabilities to close in the late 1990s.
In advance of the documentary’s premiere and to make more personal what drove this move to spring people from institutional settings, over the next few days I am reprinting in WestVirgniaVille excerpts from my diary-style Herald-Dispatch pieces describing what I saw in and outside the Huntington State Hospital wards in 1983. (I pause here to shower kudos on my H-D editors from back in the day—Don Hatfield, Charlie Bowen and Fran Allred, specifically—for old-school newsroom support for this months-long special assignment and trust in shoe-leather journalism).
A NOTE ABOUT THESE EXCERPTS: I have retained the original diaries’ language usage from a previous day, such as the no longer condoned phrase ‘mentally retarded’, among others. I have also made some light formatting and editing changes for ease of reading online.
INTRODUCTORY NOTE from the July 24, 1983 Huntington Herald-Dispatch article: ‘WORKING THE WARDS: A reporter’s diary”
Following are excerpts from a diary compiled by staff writer Douglas Imbrogno, who did volunteer work at Huntington State Hospital from March 15 through June 1. Hospital officials then were made aware of his role as a reporter. Working six to eight hours a week, he assisted in different wards and accompanied patients and staff in a variety of activities … The names of individual patients and staff have been changed. All comments by staff and patients along with the settings are factual. As a result of changes in past months, many wards and patients described have been relocated to bring the hospital in line with court-ordered improvements.
MARCH 15
Huntington State Hospital’s volunteer coordinator, Florence, leads the way up three flights of an outside metal stairway to Unit 4, the only ward building with no elevator. The right and left wings of the brick building were built in the round. It was built that way originally, she says, so patients couldn’t hit their heads against corners. Also, she has heard it said, so the devil wouldn’t have anywhere to hide. She takes a master key and opens the door to a men’s mentally retarded ward. Before she does this, she warns me not to be surprised by what I see.
“The mentally retarded are like children. And sometimes, like children, they don’t like to keep their clothes on and take them off.”
We enter and are met by a warm, stale smell, a smell of urine, sweat and smoke that seems to have soaked into the walls. A fat young man sits against a far wall. He wears a light brown foam helmet to prevent hurting himself by banging his head. Many patients pace the long narrow ward. Two men sleep on the bare floor. An older man, thin, naked, sits against a wall clutching his knees, rocking.
Another patient walks rapidly across the ward. He, too, wears a helmet, perhaps explained by the strip of his forehead that is bruised, swollen, chewed. His eye are slits amid the puffed, broken flesh.
Florence introduces me to three aides in a nursing station to one side of the ward. An aide is pleased with having help. Many patients need to get outside but don’t—lack of staff to supervise too many patients, she says. The patients need such one-to-one care but rarely get it often enough, she says. It is a refrain I’ll hear over and over again.
The aide points to patients with outside privileges. Abner is blind but could go outside, she says. Abner sits in a wheelchair facing the wall near where the naked patients sits. Abner is blind because of cataracts caused by Mellaril, she says. It is a possible long-term side effect of the medication, she says.
We leave a bit later, stepping into the cool March air and move on to Unit 3 and a ward for mentally ill elderly males. Many patients have gone to the recreation building on the opposite end of the grounds. The ward is clean but bare of any diversions. A middle-aged aide says she’s still waiting for supplies she wanted when she began working 18 years ago.
The walls are adorned with patient artwork—shamrocks for St. Patrick’s Day, strips of colored cloth loops she had patients make. She points to a small chalkboard on the floor leaning against a wall. It’s part of “reality orientation” and when mounted will list the day’s date, temperature and forecast. The ward may look bad now to someone seeing it and the entire hospital for the first time, she says, but, “Believe you me this is a paradise compared to what it was like 18 years ago.”
We leave and move on to Unit 11, wards 5, 8 and 7, where many improvements are going on to turn them into model treatment units for the hospital. An aide shows us individual treatment plans for each patient—previous behavior, problem behavior, special needs, drug dosages. The aide says he was part of the “cream of the crop” instructed to begin work in the unit recently. A driller’s whine nearly drowns out our voices as work on a nursing station continues.
MARCH 18
Bright sunlight pours through tall windows and onto the floors of a men’s ward. A patient sleeps in the bath of light, curled up on the floor like a cat. Two aides sit drinking coffee and smoking in the nurses station. There are only two aides on the floor today so activities are limited, says May, an aide. She has worked here eight years.
“These are our boys,” she says. “We’re not supposed to say that. They’re supposed to be ‘patients,’ or ‘clients.’” May says she has spent more time with these boys than she has with her own children.
Later, in the geriatric ward, a veteran aide of 18 years, Mrs. Smith, says, “We don’t have much to work with.”
She stiffens, “Mr. Haskell! Mr. Haskell!” she shouts, charging into the activity room. “Put your clothes on.” The patient has dropped his pants, taken off his shirt. “And put your shirt on Mr. Haskell!”
MARCH 18
Winter weather has eased and forsythias bloom on hospital grounds. I accompany an aide from the recreation building to pick up patients from the men’s ward. A line of patients from another ward snakes its way past us toward recreation. Two patients assist a third, who is crippled in some way, to walk. They grasp him by the arms on either side. He angles forward like a human propeller. All three shout greetings.
We climb the outside stairwell and the aide unlocks the door. Patients bound down the ward as we enter. A flurry of voices, touches. “Can I go to recreation?” “Do you have a cigarette?” “How are ya, buddy?”
Another aide hands us a pack of cigarettes each. The aide will instruct me in who to give them to when we leave. “That’s Milton,”she says, pointing out a little man who may be perhaps 30 years old, but has the demeanor of a confused 5-year-old. “He does not smoke cigarettes. He eats cigarettes.”
Later, as we walk down the steps to the basement game room in the recreation building, the aide says the mentally retarded ward “is pretty good about keeping them in coffee and cigarettes.”
Downstairs, I see what she means. A haze of smoke clouds the game room. Patients puff on cigarettes from packs or hand roll them from large packets of Bugler tobacco. Cigarettes are lit from the end of others as patients share a light. When one is done, another is lit. Patients bum cigarettes, stuff a butt out and if they don’t have another, ask the aide. Patients’ fingers tell more of the story—nicotine-stained fingertips, singed fingernails, and blackened flesh from cigarettes smoked too low.
A phonograph plays old 45 rpm records, among them a Seals and Crofts song with the lyric, “I want a little peace, peace of mind.” The aide dances with patients. The walls are decorated with colorful patient artwork and some patients wear buttons made during the evidently active art program. “Ernie Loves Art,” says one.
Patients play pool and ping pong at ratty tables or hover about. A young man, Benny, who shakes his hips like Elvis when he dances, asks if I want to play pool. “I like you. I want to talk to you more,” he says afterward.
Later, the aide pulls me aside and tells me to be careful what I say. He’ll take it and blow it out of proportion, going back to the ward and telling everyone he expected you to visit and “blowing up” if you don’t, she says. He’s in the hospital for sexual molesting, she says. “Little children,” she says, holding her hand out at waist level.
When I’d asked Benny where his home was, where his family lived, he said, “I don’t got a home, don’t have a family.”
Later, on Ward 5, a patient named Dana shakes and shivers as if from cold. Another patient gives her a coat, but the shivering continues. It wracks her head, her hands, her whole body from head to toe.
“What are you on, honey?” asks a fellow patient whose coat Dana now wears. “Are you on Lithium, honey?” She had been on the mood-stabilizing drug once and didn’t like it, she says, after getting a blank stare from Dana.
A chalkboard lists two patients’ names under this warning:
“Clients who do not participate in assigned activities will be restricted to the ward for 24 hours each day. This includes recreation, canteen and meals.”
MARCH 23
Going through a woman’s ward on the way to the men’s ward, I pass a frail old woman in a sky-blue cotton shift scooting across the floor on her behind.
Posted in the nursing station of the men’s ward is a detailed activity schedule. The Wednesday 9:30 a.m. slot calls for WORD RECOGNITION. May, the aide, says we might round up a couple of patients and try word and object recognition. She unlocks a small activity room crowded with an old stereo, broken toys, a dozen puzzles. She dumps the contents of a colored block set on a table.
Frank, a bright patient who often mimics conversations, sits down along with a deaf-mute who May says she has been unable to to get to do things yet. The hospital has wanted to start behavior modification programs again, she says, adding she really doesn’t have the training.
“We should probably do more activities,” May says.
“We should probably do more activities,” Frank says.
Frank, with a little direction, manages the block game but others decline to play and May gives it up. “It’s hard to get them to do anything after they’ve smoked,” she says, suggesting I take Frank and another patient to the canteen.
“You can have a pop or coffee and a cake or candy bar,” she tells him.
“I can have a pop, a candy bar, a coffee, potato chips, a cake, a pop, a candy bar, a cake, coffee,” Frank says. “Do you like coffee? I like coffee.”
In the small canteen, where patients buy everything from cheeseburgers to shampoo through a voucher system, Frank darts out a back door. He is found urinating in the corner of a back room. A swift order and he stops.
Later, in the male geriatric ward, 15 or so patients sit in chairs backed up against the four walls of an activity room about the size of an average living room. Outside, a rooster crows from a house near the hospital grounds. The activity this morning for most of the patients—it is just past 11 a.m.—is waiting until the next smoking hour comes around. A hand-lettered sign on the wall says: ‘SMOKING HOURS: 8-10, 12-2.’
A white-haired elderly man slouches in a chair, an unlit hand-rolled cigarette already in hand. All around the room as noon approaches cigarettes from packs or hand-rolled, flash from fists and fingertips like silverware. Ms. Smith says they try to limit smoking to the hours listed because so many of the patients “just cough, cough, cough, cough.”
MARCH 26
In the geriatric ward, I ask Ms. Smith about a man who appears quite young, maybe in his mid 30s. Why is he on a geriatric ward? Patients are spread everywhere in the hospital, she says, “They dumped them anywhere” in the years she has worked in the hospital, she says. She points to two elderly men who she says don’t belong on a ward for the mentally ill.
All that will change soon when they reorganize patients by mental disability and change wards around, including introducing co-ed wards, Ms. Smith says.
“Going to be some women on the ward,” she says, tapping the stomach of a smiling, blue-eyed patient nearby.
I’d spent most of that morning walking with Timmy, a severely retarded patient from the men’s ward. Timmy, who can’t speak, is “good” outside, the aides had said. He played with stones, as they said he would. Inside the ward, apparently, is another matter. Timmy is a”a kicker,” an aide says. The previous weekend he kicked down a large wooden door to a dorm room.
Chalked onto the sidewalk in front of a sidewalk in front of a ward building as Timmy and I strolled was the message: ‘HARPER CHECKS OUT IN SIX DAYS.’
I never use my substack address…
andyridenour@gmail.com
Extraordinary piece. As you know, I have a special interest in mental health. I will share it on my page probably tomorrow. I am in the process of transferring everything to my new computer.