Dean Brooks at museum opening. Nurse Ratched (Actress Louise Fletcher in white behind him.)
A light snow was falling and motorists unfamiliar with slick conditions were moving slower than usual as I headed from Portland, Oregon, on Friday to nearby Salem to meet with Dr. Dean Brooks’s three daughters.
My friend, Dr. Brooks, died in July at age 96, after spending much of his life advocating for persons with mental disorders. He was best known for being the superintendent at the Oregon State Hospital when the movie, One Flew Over The Cuckoo’s Nest, was filmed there. Dean played himself in that classic film.
I was meeting with Dennie Brooks, Ulista Jean Brooks, and India Brooks Civey to tour a new museum that opened at the state hospital, in large part because of their efforts. More about the museum in a moment. First, I want to mention what I heard broadcast on the local National Public Radio affiliate as I was driving.
Several local reporters were discussing news events and because snowfall is unusual in Portland, one mentioned that the city only had 1,000 emergency shelter beds for the estimated 2,500 homeless persons living on its streets. She then mentioned that many homeless individuals were refusing to go into shelters despite the cold.
All of us have heard this before along with the explanation that the homeless actually prefer living outdoors under the stars to coming inside. This is nonsense. Having spent time actually talking to homeless individuals I can tell you that this explanation is more rooted in our desire to feel better about ourselves — for leaving them to freeze to death on the streets — then in reality.
Yes, people do refuse to go to shelters. But if you dig deeper, you will discover that many refuse to go to shelters because (a.) shelters are often dangerous (b.) homeless individuals who go into shelters often lose all of their earthly possessions because there is no place to put them in a shelter so they are left behind and often destroyed on the streets (c.) shelters don’t allow you to drink or use drugs and many homeless individuals have co-occurring drug and alcohol problems as well as underlying mental disorders and are immediately kicked out if they drink or use drugs.
Ask yourself if you would leave your house with all of its doors and windows open so that anyone could ransack it in order to go to a shelter with strangers, some of whom might be psychotic, if the heat stopped working in your house one night. Oh, I forgot to mention that your house is in the most dangerous area of town.
Rather than investigating why people are reluctant to go to shelters and then addressing those barriers, we prefer to blame someone who might have a valid reason for not going inside.
During that same radio show, another reporter complained about Obamacare, saying that he resented having to pay for health services that he would never use. When asked to be specific, he replied, “psychiatric services” and jokingly asked the other panel members if any of them thought he needed to see a shrink.
This is an example of how we look at mental illnesses differently from physical illnesses. Would this reporter have said, “I’ll never need coverage for cancer”? Of course not. Obviously, the threat of developing a mental disorder seems unlikely to him. Why?
According to the National Institutes of Mental Health:
Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.
Does this reporter believe such illnesses are trivial or only happen to people who are weak-minded? Does he believe Americans bring those illnesses on themselves, therefore he is immune? Unfortunately, no one asked him.
Thankfully, I arrived at the museum when that program ended. Dean’s daughters were waiting to give me a tour. They have done a fantastic job preserving the history of how Oregon has treated its residents with mental problems. This unique museum shows the good and the bad. Alongside displays of straight jackets, handcuffs and other restraints commonly used on patients were inspiring stories about patients who recovered and compassionate caregivers, such as Dean Brooks, who worked tirelessly to help those who were in need.
I’ve written about Dean’s actions before. Life magazine tagged along when he organized a rafting and mountain climbing expedition for Oregon state hospital patients in the 1970s. Fifty-one patients, who had been diagnosed with chronic and severe mental disorders, were paired with hospital employees for a 16-day outing. Dean took great delight in recalling how it had been impossible during that trip to tell who was the patient and who was a staff member. He was especially pleased in remembering how a psychiatrist had to depend on the steady hands of a patient with schizophrenia who was holding the ropes while the doctor dropped down the face of a 110 foot tall cliff.
Another classic Dean story happened when he told his secretary to always put letters and memos from patients at the top of his office’s IN BOX. One day, she mentioned that the governor had sent over an important note. Dean told her to put it on the bottom. He’d get to it, but first had to read the notes from patients.
The museum tracks how we have treated persons with mental disorders beginning with “moral care” and later the state hospital movement launched primarily by Dorothea Dix who demanded that people be treated for their disorders rather than abandoned in jails and prisons. Because of a lack of knowledge, spiraling costs and pitiful funding, many of our state hospitals became giant warehouses where patients were neglected, preyed on, forgotten and abused. We began closing them to save money under the guise of favoring community care. But we have never funded community care properly nor have we provided the wrap around services that we know can help people recover.
The result: stigma, ignorance, homelessness, dreary lives spent in substandard boarding homes and incarceration in abusive prisons and jails.
The snow was still falling after my museum tour and when I began my return trip to Portland, I switched on NPR once again. This time the program was a tribute to Nelson Mandela. A quote from him stuck in my mind.
“A fundamental concern for others in our individual and community lives would go a long way in making the world the better place we so passionately dreamt of.”
There have been bright stars. Dorothea Dix had a fundamental concern. So did Dr. Dean Brooks. Where is that fundamental concern today?
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