Comments and Questions From Readers: Why Did You Write That? Community vs State Hospitals?

(3-18-19) Reader comments and questions.

Dear Pete: Your photo essay on the state hospital in Georgia was well done and thoughtful. However, the dubious distinction of largest of its type actually goes to a facility that was near my home town in New York – according to Wikipedia.  See below.

Pilgrim Psychiatric Center, formerly known as Pilgrim State Hospital, is a state-run psychiatric hospital  located in Brentwood, New York. At the time it opened, it was the largest hospital of any kind in the world. At its peak in 1954 it had 13,875 patients. Its size has never been exceeded by any other facility, though it’s now far smaller than it once was. “Pilgrim Psychiatric Center”

We were also told, if we misbehaved as children that we would go to Pilgrim State. 

My reply:  My information also came from Wikipedia, which noted that Georgia’s Central State Hospital’s rival was Pilgrim State Hospital. I should’ve cited that too! Here’s that Wikipedia reference:

Central State Hospital. By the 1960s the facility had grown into the largest mental hospital in the world (contending with Pilgrim Psychiatric Center in New York). 

Pilgrim Psychiatric Center cir 1938.

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The World’s Largest Mental Asylum: From The Horrors Of The Back Wards To Today’s Jails and Prisons

Photos by Pete Earley

(3-15-19) I recently spoke at a nursing symposium at Georgia College in Milledgeville. I took advantage of my trip to visit Central State Hospital on the edge of that community. During the 1960s, it was the largest state mental hospital in the world with more than 12,000 residents.

It is difficult to walk its largely deserted grounds and read its history without feeling an abiding sadness. While there were periodic efforts to treat patients humanely, the hospital never received sufficient state funding or had adequate staff to care for those confined there. Nor did its doctors know how to help most patients. Thousands died and were buried in unmarked graves. The state announced it would close the hospital in 2010, but instead now uses parts of it to house forensic patients.

The asylums are nearly gone, replaced by jails and prisons. Is this progress?



MILLEDGEVILLE — The first patient came to Georgia’s first insane asylum on Dec. 15, 1842, chained to a horse-drawn wagon. Tilman Barnett, described as violent and destructive, diagnosed as a “lunatic, ” never left. Barnett, a 30-year-old farmer from Bibb County, died six months later of a malady termed “maniacal exhaustion.”  –Alan Judd, writing in The Atlanta News

Parts of the majestic Powell Building stood when General Sherman’s troops camped on the grounds en route from Atlanta to the sea. Once the center housed administrators, with patients in two giant wings. Today only a fraction of the building is in use, accommodating state staff and employees of a redevelopment authority. – Doug Monroe, Atlantic Magazine

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A Virginia Family’s Story Of Recovery: Sadness To Hope

Ray, Connie and Andrew Neil Maternick  (Family photo used with permission)


Dear Pete,

I’d like to tell you about how far our family has come since a hot July day in 2013 when our middle son, Andrew Neil, experienced a psychotic episode and thrust a kitchen paring knife into his younger brother, Kyle’s forearm.

Andrew was committed into Virginia’s state hospital system for three years. The long term and quality treatment that our son received made a positive and transformative difference in his life and in ours.

It has not been all roses. But in the end, consistent treatment and therapy worked for our son.

Our son’s recovery story is one that I want to share to give others hope and document what worked.

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New Study Links Parasite To Mental Illness: Who Will Continue Investigating Causes Of Schizophrenia?

(3-8-19) Could we be ignoring a likely cause of schizophrenia?

For the past two decades, Dr. E. Fuller Torrey has argued that we have. More than eight years ago, in an article entitled The Insanity Virus, he argued that schizophrenia does not begin as a psychological disease but as an infection.

Now new research led by the Copenhagen University Hospital in Denmark suggests that a parasite may, in fact, be a “contributing causal factor for schizophrenia.” The study—the largest of its kind—was published in the journal Brain, Behavior and Immunity. 

The study contradicts one done in 2017 that found no link between cats and mental illnesses.

Since 1990 the Stanley Medical Research Institute, that Dr. Torrey founded with funds from philanthropists Ted and Vada Stanley, supported research and treatment trials to find better mental health medications.  Dr. Torrey looked in areas where others didn’t.

The Institute funded numerous research studies overseas and more than 300 trials.  The deaths of the Stanleys, unfortunately, has caused the Institute to reduce its spending. The pharmaceutical industry also has significantly reduced its support of research and treatment trials for schizophrenia, leaving only the National Institute of Mental Health to investigate schizophrenia. Dr. Torrey has criticized its director for scaling back those trials and focusing only on traditional assumptions.

Which makes one ask: who will look outside the box?

Massive study links mind-altering cat parasite to schizophrenia

Reported by Fiza Pirani, in the Atlanta Journal-Constitution

More than 40 million people in the United States may be infected with the single-celled cat-borne parasite Toxoplasma gondii, according to the Atlanta-based Centers for Disease Control and Prevention.

The infection typically occurs by eating or handling undercooked, contaminated meat or shellfish; drinking contaminated water or accidentally swallowing the parasite through contact with cat feces.

Most infected individuals don’t have symptoms, but pregnant women and those with compromised immune systems are at heightened risk of a flu-like illness or serious eye and brain damage. Prenatal infection may also cause abortion or a congenital syndrome involving seizures and intellectual disability.

While very few infected individuals are known to experience the physiological symptoms associated with a Toxoplasma infection, some studies have found the parasite can alter the psychological behavior of mice and possibly, alter human cognition.

In 2012, a study of more than 45,000 Danish women found those infected with T. gondii were 1.5 times more likely to attempt suicide than uninfected women. Other studies have argued against any “overblown” psychological fears.

» RELATED: Can your cat cause mental illness?

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It’s Official: First Jail Accredited As A Mental Health Facility. Need Help? Get Arrested! Outrageous!

Unfortunately, the caption on this photograph is incorrect. Georgia jail accredited as a treatment facility.

(3-4-19) We have hit the tipping point.

The Chatham County Detention Center in Savannah, Georgia has become the first jail in the United States to be accredited for mental health services by the National Commission on Correctional Health Care.

I’m grateful that Sheriff John Wilcher has made mental health a priority since he was elected. The Detention Center now has a full-time psychiatrist, more counselors, upgraded mental health first aid training, and an improved screening process for those coming into the jail.

But I am also horrified with this announcement.

Providing mental health services in a jail will certainly be more humane, but it is another sign of our failure to help people by providing treatment services in state hospitals and in community settings. By drastically reducing treatment beds, refusing to adequately fund community mental health services, and stubbornly refusing to intervene until someone becomes dangerous, we have reached a point where we are officially linking treatment to incarceration.

This is wrong.

Can you imagine telling cancer patients that they must be in jail to get help?

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Want To End Stigma? Stop Spending Time and $ On Changing Minds & Fund Research

(3-1-19) We spend much time, money and effort fighting stigma. Charles Goldstein, a parent of an adult son with a serious mental illness, a doctor and a mental health advocate recently questioned the value of such efforts. Put simply: Is it worth our time and money? Here’s a copy of a speech that he gave before the Council for the Advancement of Global Mental Health Research at Columbia University.

Mental Illness, Stigma and Leprosy 

To whom it may concern (and I believe that would be everyone).

My name is Charles Goldstein, I’m a retired emergency physician who’s worked in Phoenix Arizona in a busy metropolitan ER for over 40 years. I’ve worked with the mentally ill who were brought to or dropped off at my emergency room, usually inappropriately, because that’s one of the least helpful environments people with mental illness can be in. Almost none of the time that I was dealing with people with mental illness was I treating them, but more was trying to facilitate an appropriate discharge from the ER to someplace that might help them, a Herculean effort in and of itself. In addition, I have had the good fortune to work with very dedicated people striving to help people with mental illness. For the last 4 – 6 years or so I have become quite involved with organizations that do this good work; through this experience and because my wife, Laurie, and I personally have raised a child (now man) who has serious mental illness, I have a few things to say on the subject.

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