CLIFTON T. PERKINS HOSPITAL CENTER
Maryland’s “only” Maximum Security Psychiatric Hospital
THE MAIN ENTERNACE
*Patients call it, “The Devils Mouth”
THE TREATMENT MALL
*The Patients call it, “The Main Hallway”
…because that’s all it is!
The History of Perkins
Tucked away among industrial buildings, Maryland’s only maximum security forensic psychiatric hospital sits on 45 acres in Jessup. Although the building has had many renovations and the program has undergone significant changes throughout the last 70 years, many of the initial struggles and difficulties remain the same.
A series of ten articles titled “Maryland’s Shame”, written by Pulitzer Gold Medal winner, Howard M. Norton, was published in the Baltimore Sun from January 9 to January 19, 1949. The articles written about the five state mental hospitals covered the inadequate care provided to patients and was considered “The Worst Story Ever Told By The Sunpapers”. The articles compared Maryland’s State Hospitals to the Worcester State Hospital in Massachusetts. In 1950, Dr. Clifton T. Perkins was brought down from Boston to become the first commissioner of mental health for the state of Maryland and to assist with the issues addressed in the articles. Dr. Perkins and his colleagues devised plans for a centrally located, maximum security hospital for the evaluation of people involved with the law. The site was initially chosen based on Maryland’s center for population as determined by the census.
“The Maximum-Security Hospital” was completed in late 1959 at a cost of 3 million dollars. Dr. Jacob Morgenstern, Director of Correctional Psychiatry for the Department of Mental Hygiene, was named the hospital’s first superintendent. Soon after completion of the hospital, the board of Public Works agreed to change the name to Clifton T. Perkins Hospital Center in honor of Dr. Perkins, who had died earlier in 1959.
Dr. Hamilton’s goal was to make the hospital more treatment oriented. More professional staff was needed to complete the change in programming from housing to therapeutic. At the time, the staff at Perkins consisted of five psychiatrists, one physician, two psychologists, three social workers, five registered nurses, eleven licensed practical nurses and six rehabilitation therapists. In 1967, 11,200 state employees left State service. The state only hired 4,223 employees, leaving almost 7,000 empty positions. Although the governor agreed to support a pay raise to help fill vacancies, the hiring problems at Perkins persisted. Citing the unfilled vacancies and low salaries, Dr. Hamilton resigned in August 1969. In particular, there were ten positions for psychiatrists but only 4 positions were filled. The State of Maryland refused to accept Dr. Hamilton’s resignation giving him a raise and agreeing to support raises for other professional positions.
In February 1971, Dr. Hamilton announced Perkins’ full accreditation by the Joint Commission on Accreditation. It was the first time the hospital had been granted the full two-year accreditation. Dr. Hamilton had begun the process of changing Perkins from a custodial institution with a prison atmosphere to a therapeutic institution with a hospital atmosphere, and Perkins was now a fully accredited hospital. Having made many positive changes at Perkins, Dr. Hamilton resigned in 1972.
By the end of the 1980’s, the hospital had fourteen psychiatrists, ten psychologists, fifteen social workers, and sixteen rehab staff. One major change in the 1980’s was the admission of women at Perkins. The Mental Health Administration felt that some women would receive more appropriate psychiatric care at Perkins than at a correctional facility or regional hospital. Women were not segregated but were housed on co-ed wards with male patients. Another major change were modifications made to the work adjustment program when it was determined that patients were required to be paid for all work experiences throughout the hospital.
In the 1990’s, psychology increased direct patient contact. In the original staffing of Perkins, the Psychology department was staffed with primarily Master’s level employees who provided IQ testing and information on personality characteristics for pre-trial evaluations. They were available for ITPs, individual therapy, and group therapy, but were seldom seen on the wards. Today the department also consists of all licensed psychologists with doctoral degrees, and currently trains interns and graduate students.
The late 1990’s also brought a change to the conditional release. Early discharge plans consisted of a written agreement between the patient and his social worker. Over time the agreements became more formalized eventually leading to the Maryland Conditional Release law. Patients were seen in an outpatient clinic located at the Hamilton House.
Initially, social workers worked with patients while at Perkins and after their release. Over the years, the services provided by social work have changed.
More ward-based services have been added, and services are no longer provided by Perkins’ social workers after discharge. Currently, social work services include assessment and reassessment; individual, group, and family therapy; case management; and discharge planning.
In 2001, the hospital successfully completed a JCAHO survey under the leadership of Dr. Richard Fragala. The hospital has since remained a fully accredited institution.
Although many of the issues that have plagued Perkins throughout its history continue to be issues today, especially the low wages and vacant positions, many positive changes have occurred since Perkins was built.
The hospital was built to provide diagnostic and evaluation service to the courts and to provide treatment and care for committed, penal, and hospital-transfer patients. Throughout the years the language of the operational mission has changed as the language in the laws and judicial system have changed. Today’s operational mission is to ensure a safe secure environment for the treatment of patients: Adjudicated Not Criminally Responsible (NCR); Adjudicated Incompetent to Stand Trial (1st); Certified from Confinement Facilities (IVA); NCR/IST/IVA Regional Hospital Referrals; and Circuit Court Referred Pretrial Evaluations.
The staffing problems that existed throughout the other state mental hospitals plagued CTPHC in its first years of existence and have continued throughout Perkins’ history. Dr. Morgenstern blamed the “shoestring budget” for the low state salaries of professional and non-professional staff. When Perkins first opened, attendants were hired without high school diplomas and were put on the job with minimal orientation or training. The average take home pay was $55.00 a week compared to $65.00 at Patuxent. Perkins was authorized to have 193 staff members.
The physical building has undergone several changes since the hospital was built. Initially the hospital was two levels with six wings jutting into a recreation yard and surrounded by a large wall. Three dorms were built on the hospital grounds. Rooms were rented to hospital employees, ensuring enough staff on grounds to handle any unforeseen issues. A block wall surrounding the hospital was made higher after two major escapes made headline news in the first two years. A medium and minimum-security building at Perkins was cut from the budget in 1963 when Governor Tawes stated that adding minimum and medium security units to Perkins Hospital would have the effect of “converting Perkins Hospital into a general mental institution like Spring Grove. and the others”. Between 1972 and 1984, three additional wings were added to the hospital: the Administration Building, an eighty-bed medium security wing, and a Rehabilitation wing. The Stuart B. Silver wing was completed in 1994 replacing the original structure. The Silver wing houses the admission ward, five additional wards, a medical clinic, dining facility, chapel, library, conference center, family visiting rooms, and the gymnasium With this completed renovation, the original wards with their iron barred windows were now replaced with wards that offered a more therapeutic setting. Before the end of the 1990’s, a greenhouse was added for the introduction of horticulture therapy, an O.T. kitchen was built to teach patients daily life skills, and a laundry program was added to the patient work programs. The Rehab wing was renovated and reopened in 2003. The north wing renovations are tentatively scheduled to begin in 2021.
Many of the renovations were necessary as the atmosphere of the hospital became more therapeutic and less correctional after Dr. John Hamilton was named Superintendent of Perkins Hospital in 1965. Dr. Hamilton was the fourth superintendent in the first five years of Perkins Hospital. Dr. Hamilton held a family day, started an in-service training program for Nursing Service personnel, and expanded social work services to include services to patients, both during hospitalization and in follow-up care. Dr. Hamilton ordered the closing of the seclusion ward and the placement of approximately twenty “problem patients” on residential wards. Perkins began providing education services so patients could complete their high school diplomas, gym and yard activities, ceramics, painting, and leather crafts, and added a small library next to the classroom.
End of Article and photos by, Ms. Mindy Lawson
WOW! What a story. But from the first time I read it (as a patient), I couldn’t help but wonder… “how?” Here, let me try to explain. As noted in paragraph 1, author and longtime C.T.P.H.C. employee (Mindy Lawson) sums up in a single sentence just about all I could ever have possibly hoped to convey about the conditions/practices of Maryland’s psychiatric hospitals (operated by the Maryland Dept. of Health). [sic] “Although the building has had many renovations and the program has undergone significant changes throughout the last 70 years, many of the initial struggles and difficulties remain the same.”
The question is “how?” How can an organization funded with hundreds of millions annually (i.e., The Maryland Dept. of Health), which has existed under one name or another for the past 70+ years, still struggle with many of their initial difficulties? To me, a patient, the answer to that question has become painfully obvious. So “obvious” that even a patient could answer it. So, please allow me, in the form of an op-ed I’d written 3 months after I was admitted (approx. 10/20/2019). And (in advance), don’t think for one second, I was surprised that the Baltimore Sun didn’t run it. I mean let’s face it, The Baltimore Sun… hell, “MARYLAND” has become a mere shadow of what it once was in the 1950’s. Now, dark blue, steeped in the “lunatic lefts” Marxist ideology and a state that literally puts the “O.K.” in w’ok’ism! But more on that later…
*Michael’s Article to The Baltimore Sun
Please Send Help!
When I was a child I had this reoccurring dream that I was alone on a deserted island. Consumed with fear and uncertainty about my life, I apparently conjured a message in a bottle. Something to the effect of, if you find this… please send help! But in the dream, standing there before that seemingly endless ocean, the thunderous surf crashing before me and the perceived odds, I simply became too scared to throw it. Today I’m not!
My name is Michael Kapneck Sr. and I’m a patient at Clifton T. Perkins Hospital Center, Maryland’s only maximum-security psychiatric facility. Housing for who those in the know call “The Worst of The Worst”. Although, I vehemently contest that title. Truth is, I’ve never seen a more fragile, displaced, indigent group in my life. Sure, you have your exceptions, but this article isn’t about the spectrum of cases here, It’s about the conditions and continuity of care. Something that should give -pause- to any reasonable citizen of this fine state. Why? Because that’s where the majority of these men and women are returning to upon release.
I’ve heard it said that a building is a reflection of the builder. But what about the sculpting of a person? Often shattered. With parts you can’t buy at Home Depot. Who is to credit for that? The pharmaceutical companies that sell the pills, the scientists that invented them. Perhaps a breakthrough during a therapy session. Maybe a little life experience offered by a security guard. The list is long. But back to banal cliches. It truly does take a village to raise a child, or in this case, to rehabilitate a man or woman.
The State of Maryland allots nearly 80 million a year to this hospital for that very purpose. Yet I’m here to share that the main form of therapy is cable t.v., coloring, gym time or listening to music. More of a basketball camp then a place of restoration. Services like psychotherapy, vocational training, schooling, mental health education or teaching real world life skills are nearly nonexistent. Thereby cultivating what I’ve come to call “The Vegetable Garden”. Feeling more like a sedated prisoner than patient. Trapped in a place of deprivation and desperation rather than restoration. Is that the intended modality? To create a vast body of dependents rather than independents. It would appear so. At approximately 22K a month per patient, not including medication and a plethora of other services. That seems to make cents. And the stream doesn’t start or end there. My research has revealed roughly 10 other facilities owned and operated by the Maryland Dept. of Health. Producing a conservative budget of 600M a year to address the mental health of someone’s loved one. Or better yet, a future neighbor.
So, what’s really going on you may ask yourself? Further, why should we listen to a patient? I’ll tell you why, because I live on this island and I know its soft white under belly. Echoing sociologist Ervin Goffman’s supposition, in his book Asylums, that mental institutions have an in-built tendency to operate for the benefit of the employees vs. the patients. An environment rife with dangerous distractions, unethical practices, patient neglect and complicity amongst staffers that would make the talking heads upstream stop talking. And it’s for those and a myriad of other reasons I feel the article run in The Baltimore Sun Newspaper (December 2nd, 2019), titled Working Conditions Unsafe at MD Psychiatric Facility would have been more appropriately headed “Employees” Make Working Conditions Unsafe at MD Psychiatric Facility
If you find this message, please send help!
