Rehab, Recovery and Re-Entry: the role of Institutional Library Services in Washington State

Presenter:

Kathleen Benoun – Western State Hospital Patients Library

Over the ages, many have flown over the cuckoo’s nest.  People who have been hospitalized for psychosis include philosopher Fredrich Nietzsche, King George III, singer James Taylor, Mary Todd Lincoln, Vincent Van Gogh and sci-fi writer Philip K Dick

That changed in the early 1970s, when the State Library agreed to provide full library services and staffing at the major institutions of Washington State.   For a short and wonderful time, institutional libraries were well-funded and staffed.  Western State Hospital had two professional librarians, 3 to 4 library assistants and many patient clerk/pages.  Western also had two separate and distinct library collections: one for the patients and one for the professional staff.  But times changed.  The budget cuts began in the mid 1980s.  Library contracts with smaller facilities, such as the Soldiers Home in Orting and Interlake School and Lakeland Village in Medical Lake were not renewed.  Collections and staff were absorbed by larger institutions.  It was a trend that has not stopped.  The most recent budget casualties include the libraries at Rainier School in Buckley,   Fircrest School in Seattle and research libraries at the two state psychiatric hospitals.  And all this has happened during a Washington State population boom.  

So what is it really like to work inside a major psychiatric hospital?  If you believe that art and literature can elevate the human spirit, then a career in ILS is for you.  Sometimes ILS life is lonely, but it is never boring.   And work in ILS might be the most satisfying job you’ve ever had.  I serve the same patron that the public and academic library serves, but with a big difference.  I serve them “in sickness and in health.”  I am in a position to know the whole person, something typically denied the public librarian who typically meets people with non-medicated psychiatric illnesses.  

Who are the mentally ill?  Mental illness can occur anytime during the life cycle and has no preference for gender, social class, ethnicity or I.Q.  And there are more life events that can result in hospitalization.  They include traumatic brain injury or brain damage due to drug overuse.  Personality disorders, such as Borderline Personality Disorder, can result in repeated hospitalizations because such thought disorders are  not treatable with medication.  Some patients are committed by the courts, some are voluntary.  Some will stay weeks, or months, or years.  Some will come and go over a lifetime.

Today’s psychiatric hospital is modeled on the “treatment mall” concept.  Basically, imagine a college campus where a team of advisors create a curriculum based on patient needs.  A patient may need education about finances, drug education, stress management skills, relapse prevention, etc.  Visits to the library are covered in leisure education groups.  When they come to Eastern or Western State Hospital they will find a library very similar to that of a small public branch.  We purchase popular magazines,  fiction and non-fiction on a variety of topics.  And we specialize in lay literature regarding psychiatric and psychological disorders.  We provide interlibrary loan service so that patients may have access beyond the institutional walls.  We provide a lot of reference work.  We serve those who walk in and those who are confined to their wards.  The hottest check-outs are movies and music.  Especially music!  Music is so popular on campus that we have listening stations at the two psychiatric hospital libraries.  This attraction draws a lot of walk-in traffic!  We also offer supervised internet access at the two hospital libraries.  Psychiatric patients must be supervised at state-owned/state-maintained internet stations.  Prison inmates have no such access. 

I mentioned before that the ILS branches are staffed by one full-time person.  The branches also employ and train inmates and patients who are paid from institutional funds.  They are trained to shelve material, process new material, assist customers in finding material on the shelves and other tasks as needed.  The host institutions value this vocational training very highly. 

Our lives are made all the more interesting by the fact that we are employed by the State Library in a state institution with its own rules, policies and traditions.  I keep a radio by my side to summon security officers in case of trouble.  Yes, there is trouble from disgruntled patrons from time to time.  But most calls for help are for medical emergencies, such as seizures.  Like public libraries, additions to our collection may be criticized. The most challenged materials at the hospitals are the movies.  Some wards will not allow any R-rated film to be shown in the common area.  At this time, we are contracted to provide lay material for leisure, education and recovery at the hospitals.  Hospital staff would dearly love to supplement their curriculum needs with our budgets, and that has been quite a diplomatic challenge. The good news is that the hospital values the library and supports it with enthusiasm.  And WSH hospital staff is responsible for 30 percent of our total circulation figures! 

 Does an on-site institutional library really make a difference?  Many years ago, there were three library staff at Western State Hospital and I used to visit the wards to present fun library programs.  One day, I was visiting a ward with elderly residents.  An old man confined to a geri chair beckoned me to him.  He told me that he loved libraries and that his father had been a famous archaeologist.  He had inherited some of the artifacts his father had brought back from his digs.  Would I like to see them?  I was not sure at all that this man was telling me true facts, as I had enough experience by then to know that many of my library patrons repeat delusional beliefs.  But I told him I’d be honored.  He insisted that I give him my name and a phone number.  Later that week, I received a phone call.  Not from the old man, but from his wife.  Yes, said she, her husband had a rare collection of antiques from archaeological digs her father-in-law had collected between 1900 and 1920.  And she’d be pleased to bring them to the hospital for viewing.  I was stunned and I told my boss about the offer.  We held a special library program and filled every chair.   Mrs. Murphy brought fantastic museum quality exhibits and told stories about her father-in-law.  Her husband was in the audience.  From time to time, he would correct her on a point or statement.  After that event, Mr. Murphy dramatically improved and was discharged home. 

Laura was one of those visitors to the library who was quiet and non-demanding.  Her stay at the hospital was fairly short as her family had the resources to provide private care.  Her diagnosis was manic depression.  Laura was discharged and I didn’t hear from her for years.  The next time we met, Laura was the new hospital consumer affairs officer, a very important liaison job.  She met me while touring all patient areas on campus.  Laura told me that she had been surprised and happy that there was a library on the hospital grounds during her stay.  Reading magazines and books encouraged her to go back to school and complete her education.   And she has been a strong library advocate ever since.

Brian was hospitalized for about 5-7 years on one of the forensic wards.  That means that he committed a felony during a psychotic episode and was sent by the court to the state psychiatric hospital for treatment rather than into the prison system.  He was one of our big readers and did his share to keep those circ figures high.  Brian improved and was released from the hospital.  I did not hear from him for three years.  Then he walked in one day to the library and placed a book on the counter.  “I’m a published writer!” he told me.  And he was.  He told me that his years in the hospital had not been wasted in sorrow and grief for his past.  He had spent his time reading and practicing fiction writing. 

             Library newspapers, magazines, and books allow the locked up & locked in — to keep in touch with the outside world.  Laura Sherbo, ILS manager, has created a new re-entry resource guide to help patients and inmates connect with community resources.  So many are required to start lives anew in communities where they are strangers.    The Re-Entry Resource guide provides information about housing, employment, apprenticeships, spiritual fellowship, and advocacy organizations.