'Cuckoo's Nest' hospital rebuilt following abuses

[November 18, 2010]  SALEM, Ore. (AP) -- Oregon's state mental hospital has gained attention as the filming site for a movie about psychiatric abuses -- "One Flew Over The Cuckoo's Nest" -- and as a place where real abuses have occurred.

State officials are hoping to begin a new chapter for the Oregon State Hospital when they unveil part of a new hosital Thursday that will replace most of the decrepit building made famous in the movie. Patients will begin moving in early next year.

The old crumbling hospital had toxic paint, asbestos and a leaky roof. Forty percent of it was unusable, left to rot and collect piles of pigeon droppings.

"You can see the place where they showered. You can see their scratchings on the wall," said Oregon Senate President Peter Courtney, a Democrat who helped get money for the new hospital after touring the old one in 2004. "They lived there. And then often people forgot them. They just took them there and it was over."

In its place is a hospital designed to facilitate modern theories in mental health treatment, trying to mimic as much as possible daily life outside the institution. One area resembles a city's downtown and will allow patients to wander between a store, post office, bank, hair salon, gymnasium and library, along with classrooms, an art therapy room and group activity rooms.

Group treatment rooms are smaller so health providers have a manageable number of patients. Six acres of outdoor space will give patients more access to fresh air.

Along with the upgraded facilities, the hospital is hiring new staff and stepping up care to its patients, almost all of whom are involuntarily committed by a judge.

All patients will be required to get at least 20 hours per week of treatment. They won't have access to bedrooms or televisions during the day, hopefully encouraging them to take part in their treatment, officials say.

Meals will be cooked no more than a day before they're served; they're currently cooked and chilled three days ahead of time.

All the changes upgrade a facility that just two years ago was the subject of a scathing report by the U.S. Department of Justice. Federal investigators found mice in rooms, deaths from pneumonia and outbreaks of scabies, along with nearly 400 cases of patient-against-patient assault over one year.

One patient had been in seclusion for a year with no other treatment. Another patient with a condition that causes excessive thirst was left at a water fountain and gained 13 pounds in water weight in one day.

"The Oregonian" newspaper in Portland has reported extensively on abuses in the hospital, including the death last year of a 42-year-old man who succumbed to a heart attack in his bed hours before anyone found his body. Nobody checked on him even though he'd missed two meals and didn't show up for his medicine.

Although "Cuckoo's Nest" was filmed here, neither the movie nor the 1962 Ken Kesey novel on which it was based makes any specific references to Oregon State Hospital. Kesey drew on his experiences working at a veterans hospital in Palo Alto, Calif., and set his satirical story at an unnamed institution in Oregon.

For all the attention the move brought to abuses at mental health institutions, it was 30 years before enough support galvanized to demolish and rebuild Salem's decaying shrine to psychiatry's dark history.

It wasn't until state lawmakers toured the hospital in 2004 and were stunned by a grim discovery: the cremated remains of 3,600 patients locked away and forgotten inside corroding copper canisters.

The remains belonged to patients who died at the hospital from the late 1880s to the mid-1970s. During the earlier part of that period, mental illness was considered so shameful that many patients were all but abandoned by their families and left to whither in institutions.

[Associated Press; By JONATHAN J. COOPER]

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