Riverview Hospital for Children and Youth. Richard J. Wiseman

      FOREWORD

      …

      Historically, state-operated mental health systems are not noted for innovation. Funding limitations, staffing issues, political realities, and the slow speed at which public systems often operate mitigate against cutting-edge treatment approaches no matter the good intentions of those in charge. Images of public mental hospitals pervade the movies and literature, promoting visions of large brick and stone buildings with barred windows and locked doors. Patients are imagined to shuffle about wearing faded, institutional pajamas. Rooms look bleak, beds uncomfortable, and personal items absent. Sadly, this portrayal isn’t far from the mark. And our children were once a part of this system. Even after mental health reform began, children were treated like adults. Eventually, however, came the recognition that children are not small grown-ups. Children need to be treated differently.

      For numerous reasons, Connecticut lagged behind much of the nation in this movement. This book tells the story of Connecticut’s initiative to develop a state-operated children’s hospital that treats children as children, adjusting to developmental, learning, and experiential differences. It’s a story told from the perspective of those who were intimately involved by the individual who was at the center of our work. It’s a story of how this vision drew in others of like mind and put together a work family that revolutionized children’s mental health care in the public sector.

      Richard “Doc” Wiseman imbued his work with the notion that the children who needed mental health services should be treated most basically as children. Along with individual, group, and family therapy, the program at Riverview Hospital encouraged play and recreation. Children wore their own clothes, and it was not uncommon for staff members to purchase clothes that were a little more trendy so that a child could better “fit in.” Kids were encouraged to decorate their rooms and participate in community activities. This is not such a big deal now, but it was quite remarkable in 1974.

      Certainly Doc was supported by the academic environment at Yale, the state legislature, and numerous mental health and children advocates. Even with this support, however, children’s mental health reform in Connecticut occurred only because people with courage and determination pushed hard. Doc Wiseman had the ability to identify people with commitment and to nurture that quality. He always fostered new ideas and gave people the latitude to work on areas of interest or concern. In times of fiscal deficiency, political strife, and organizational inertia, he held their dream together with charisma, determination, force of personality, and hard work. He and others named in this book have improved the lives of thousands of children. I’m privileged to have known and worked with many of them.

      At the time of this writing, a spotlight has been turned on the issue of mental health. With the horrific events of December 2012 that claimed twenty-eight lives at Sandy Hook Elementary School in Newtown, Connecticut (including those of the disturbed perpetrator and his mother), attention has turned to mental health services and needs. A task force was established, co-chaired by a psychiatrist and a physician, to examine and make recommendations regarding access to mental health services for youth. In addition, legislation has been passed requiring that the Department of Children and Families develop a plan to create an integrated mental health service delivery system involving six state agencies.

      As a start, these efforts are laudable. However, caution is necessary. To not repeat the mistakes of the past, it is important to be reminded that children are not small adults. As this book documents, children’s services must be developed and provided in a different way than adult services. Since adult mental health issues tend to be discussed more frequently in the media, any crisis and/or threat to public safety could result in children’s services losing resources.

      Finally, there is a natural tendency for policy makers to move on to the next problem of the day. It is up to us to hold the focus. By writing this book, Doc Wiseman helps us keep one eye on the successes and failures of children’s services in Connecticut’s mental health system as we move forward. It is incumbent on those of us in the mental health field now and those who choose to serve in the future to keep the needs and concerns of children always in the forefront.

       Louis Ando

       Middletown, Connecticut, 2014