Human Warehouse

By name and locale, Willowbrook State School seems a pleasant enough place: a teaching institution on a 400-acre bucolic tract on Staten Island in New York Harbor. Actually, Willowbrook, the world's largest institution for the mentally retarded, is a school in name only. It is instead a grim repository for those whom society has abandoned. What sets Willowbrook apart from similar facilities in other states is sudden exposure. Parents, legislators and newsmen have recently made headlines by attacking the system that allows such a place to exist. In the process, they have won some small sops for Willowbrook's pathetic prisoners. More important, they have shown how hopeless and archaic is the custodial approach to the problem of mental retardation.

The battle of Willowbrook began last December when two staff members, Dr. Michael Wilkins, 30, and Mrs. Elizabeth Lee, 29, a social worker, began urging parents of Willowbrook children to campaign for better conditions. The two, who were later fired, triggered an emotional avalanche. A local daily, the Staten Island Advance, took up the cause with a damaging series of articles on the institution. New York television stations dispatched camera crews and gave generous amounts of air time. Politicians also visited the institution. All reached the same conclusion: conditions at Willowbrook were intolerable.

Odor of Despair. Built in 1941 to house 3,000, Willowbrook now has a population of 5,200. Half the "patients" are under 21, and at least three-quarters are classified as "profoundly" retarded (IQ under 20) or "severely" retarded (under 36). For a handful of its residents, the school lives up to its name: it has a clean, new and well-staffed education section where "moderately" (IQ from 36 to 52) and "mildly" (from 53 to 68) retarded children live in small brightly decorated dormitories. These youngsters, considered trainable, attend classes that teach reading and self-care.

But for most of Willowbrook's residents, the institution is a warehouse, a place capable of providing only shelter and the barest essentials, for those whose families are either unwilling or unable to care for them. One building designed to accommodate 188 currently houses 250 severely retarded and seriously disturbed adolescent girls in conditions so crowded that one bed must often be moved in order to reach another. Training of any kind is nonexistent, though recent experience elsewhere has shown that seemingly hopeless cases can benefit from professional attention. The girls spend their days sitting, standing or lying in a large, marble-floored room that resembles Sar tre's vision of hell. Bare and highceilinged, its walls covered with flaking green paint, the room is redolent of sweat, urine, excrement--and despair. Many of the patients are incontinent; the few attendants are kept busy changing them or putting clothes back on those who keep tearing them off. There is no time left to carry out rehabilitation programs. "It just kills me," says one attendant. "We're so busy that we can't do anything that really helps them."

Wards for profoundly retarded children are no better. By night, the children, many of whom have physical handicaps as well, sleep in closely spaced cribs. By day, they sit strapped into special chairs, recline in two-wheeled wagons that look like peddler's pushcarts or lie listlessly on mats on the floor. Some of the youngsters weep or grunt unintelligibly; most make no sound at all. A few children with severe physical handicaps but normal intellects share the accommodations; families unable to care for them have made them wards of the state.

Conditions in some of the men's wards would have made Bedlam look inviting. One ward holds 40 seriously disturbed adults, some of them violent. The ward is staffed by two attendants, one a woman; they have all they can do to keep their patients from hurting themselves or each other. They cannot always keep their patients healthy. Hepatitis, which thrives on poor hygiene, is rampant at Willowbrook. Many of the patients have diseases and defects that will ultimately kill them. Some die of other causes: ten years ago, a measles epidemic swept through the institution and killed 250. Of the 125 patients who died of various causes during 1970, nine choked on their own vomit before attendants could reach them.

Conditions at Willowbrook were not always like this; seven years ago they were even worse. When Dr. Jack Hammond, the present director, took over the institution in 1964, the patient population was up to 6,500. "It was both inhuman and unhealthy," says Hammond. "They were literally packed in here like cattle." To relieve the overcrowding, Hammond persuaded the state's department of mental hygiene to halt admissions except for special cases. But Hammond, with a budget of $33 million a year, has not been able to relieve Willowbrook's gross understaffing. In December 1970, the state imposed a hiring freeze on all institutions. Willowbrook, which then had 274 staff vacancies, is now 900 short of its authorized roster of 3,628. For sections housing the most retarded, the recommended staff-patient ratio is 1 to 4; in some of Willowbrook's worst wards now, it is actually 1 to 20.

Waiting List. Some relief is in sight. The department of mental hygiene's 1971 budget of $580 million had been threatened with a $20 million cut in the coming fiscal year. Responding to public pressure, Governor Nelson Rockefeller has canceled the cut, announcing that the department's budget will instead be increased by $20 million. That will allow Willowbrook to fill at least 300 vacant positions. But it is unlikely to improve conditions at the institution. "Attendants aren't enough," explains Hammond. "We need to get 2,000 patients out of here."

Such an accomplishment seems impossible. Most of Willowbrook's patients are there because there is nowhere else for them to go. Nearly all experts in mental retardation argue for small centers where patients can receive intensive attention from doctors, therapists and teachers. They also recommend day schools that allow all but the most seriously afflicted to live with their families but still have care. In most states such facilities are simply nonexistent. Willowbrook, despite its well-advertised horrors, has a list of 1,000 awaiting admission.

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