Having lived through the true madhouse days and afterwards becoming part of the process of change, I can tell you an amazing story not recorded elsewhere. If you think our system for treating the mentally ill is sadly inadequate now, you need only look back to earlier days nationwide for the apex of what has been called the snake pit era. I am not talking about Victorian times. I am looking back only to the 1950s, just a bit more than half a century ago when our state mental hospitals like Manteno were reaching their peak population.
     The 1950s was a time in our history when the main goal of conventional society was to get the mentally impaired patients out of sight and out of mind. It was a society that typically prided itself, however blinded and misguided, on what it generally perceived as sensible and benevolent treatment institutions for the mentally ill. But in fact they were not so kindly and benevolent. Very few people knew it at the time. But I knew, because I was there….

Recording Forgotten History
I Hospital of Horrors
II The Madhouse Scene
II The Path to Insanity
IV The Yellow Brick Road
V The Other End of the Chute
VI Manteno or Mars 57
VII What Would Freud Have Thought?
VIII Consequences of a Dirty Book
IX Sputtering Human Experiments
X Doing Something or Other
XI Joining the Battle
XII One Day at a Time
XIII Sex and Reality
XIV Fighting with Schizophrenia
XV My Consultant
XVI A Major Achievement
XVII Defeated and Weary
XVIII What Happened Next
XIX Life After Manteno

     Along the way I will relate the misfortunes of many patients. For some the misfortune at the time seems to have been due to the illness itself. For others the unfortunate outcome was the result of mistreatment or the lack of effective treatment. Although I will tell the real story, in every case I have made serious efforts through descriptive changes to conceal the true identities of individual patients.

     Because of the persisting bizarre, disruptive, and at times destructive or self-destructive behavior of long suffering mentally ill individuals, in past years even more than now their families, doctors, clergy, and social agencies didn’t know what to do with them. These very sick people were largely swept out of view into society’s closets, the state mental hospitals, deliberately designed to appear invisible to the rest of us. And there these patients languished, if not permanently then for very long periods of time. The state hospitals were our society’s final solution for what to do with the mentally ill.
     Manteno State Hospital, some forty miles south of Chicago and yet clearly a world away, was one of those closets. Thousands of patients were warehoused there waiting for their lives to pass. What passed as treatment was crude—often barbaric. Most of the time the patients did not improve.
     When I first entered the field of psychiatry, efforts at treatment were feeble, awkward, and all-too-often ineffectual. The starting point of our efforts at treatment and the process of change, now faded into an ugly past memory, may be difficult to grasp. But a record of treatment, even of hidden-away horrors, mistakes and cruelties, will not go away; and we need to have a sense of that horrendous record so that in our future efforts we can aim only for the best and avoid every aspect of the worst.
     It wasn’t that long ago that there really were ‘madhouses’ which served to hide away hundreds of thousands of the mentally ill. So called psychiatric treatment was primitive—often more like torture. Official records of that era are sparse and slanted, all-too-often minimizing or overlooking what really took place. There are almost no accurate accounts of what actually happened. But I was there, living at Manteno State Hospital in 1956, and I have a very clear idea of what transpired and my own written record to back it up. That record is a diary of events that were quite ugly. There is a bona fide Manteno Diary, still in my possession, that serves as the basis for this book. From time to time I review my diary to remind myself of where we have been and where we need to go.
     I lived through the madhouse days, and over subsequent decades I welcomed my role in the process of change. In recounting the facts that describe what took place then, I hope to catch the interest of readers who are curious about a painful and somewhat heartbreaking piece of the past. This book is also aimed at those who are considering a career or are already enroute to a vocation in mental health treatment. I would hope to inspire those young people to proceed with a spirit of therapeutic zeal. With energy, creativity, and tenacity, we can all advance the field of psychiatry and greatly reduce self inflicted death and incredible human suffering.