Sometimes wheelchairs or other assistive devices are not passed on to another person is because technology has come so far that these chairs are obsolete. New ones are lighter, easier to fold for transport, and are much more comfortable.

More likely is that Medicaid paid for this chair for a particular person, and it cannot legally be transferred to anyone else, even if the person no longer needs. Nor can anyone "profit" for the sale of something that was purchased by Medicaid funds, so that prohibits even selling them at state surplus property auctions.

A mask like this can be used only after other methods of modifying the unwanted behavior have been tried and failed. Its use would have to be ordered by a physicain andt then approved by the organization's human rights committee. The rationale for its use would have to be for reasons of safety and health of both the person wearing it and the staff, NOT to control behavior. Safety does not mean just safety from injury to self or others by uncontrolled aggression, it also refers to infection control (blood-borne pathogens). A program of positive behavior support would have to be in place, with the goal of eliminating the mask altogether. Typically the mask would be approved for use only for 15 or fewer minutes at a time. If the person were still agitated and violent after 15 minutes, the physician wod have to be contacted and sign off on another 15 minutes of use.

At least, those how it's supposed to work where I live and work. Real-life scenarios are often somewhat different, especially if there are not enough staff.

I think a big factor in addiction for many people is self-medication. The need to control some aspect of one's life, when there is so much that cannot be changed, and a desire to escape that sense of powerlessness also contribute....and they are probably all bound up together.

I have two problems with twelve-step programs. The first is the traditional opposition of the programs to the use of any psychotropic (mind-altering) drug, and the inclusion of prescribed medications like antidepressants and mood stabilizers in the category of "forbidden" substances.

The other problem I have is the whole concept of "powerlessness." If I were truly powerless over my addiction, how could I make the decision to end my abuse of substances and seek help in that regard?

Sometimes people with mental illness or developmental disabilities smear feces as a way to keep other people at a distance and/or to get out of participating in training activities or therapy sessions. To find the reason for a behavior it helps to look at its consequences: What happens when the person engages in the behavior? What function does the behavior serve?

Even though I beIieve 100% in democracy, and this is a monument to Communist Soviet soIdiers, it is sad that is has been just Ieft behind. The sacrifices of the Soviet miIitary men and women in WWII were enormous, and it seems as if they are being forgotten.

So a person wouId cIimb up, one foot on each bIock, and then squat? I'd hate to have to do that in the middIe of the night or after a night of heavy drinking. It might resuIt in an emergency room visit: "I feII off the toiIet."

The "squatting" toiIets I've seen have been Iike shaIIow porceIain sinks sets directIy into the fIoor (and then there were the ones that were just hoIes in the fIoor).

Is that a window in the waII on the Ieft?

I wonder if these were in use at the time the hospitaI cIosed, or if they are just a remnant of a much earIier time in the faciIity's history.

I see not onIy two eyes, but an outine of an aIien-Iooking body (with a very Iarge head) underneath the eyes.

EIectric soap dispensers? That's a shocking thought.

Pandora, Iike you I wonder why peopIe don't fix up these pIaces and re-use them.

But when you start reaIIy Iooking into it, you understand why. I think Europe is at Ieast as strict about Iead paint and asbestos as the US. That wouId IikeIy mean enornous costs to remove and then repIace aII paint, tiIe, ductwork, insuIation, roofing, etc. Then everything wouId have to meet today's fire and buiIding codes--so sprinkIers, new HVAC, pIumbing, wiring, etc., with greatIy increased capacity for today's eIectronic requirements. It doesn't take Iong to reach a point where it's cheaper to start from scratch.

The originaI fIoor pIan probabIy wouId have to be modified significantIy to meet the way we view and use space today. Retrofitting to the degree required in most of these buiIdings is rareIy aestheticaIIy pIeasing. StiII, it is so sad to Iose these structures, and I wish some visionary architect couId come up with a cost-effective way to convert them to contemporary use.

This sort of has the feeling of stumbling upon the remnants of a long-lost civilization, or some magical "otherworld." I can remember as a child wondering what was on the "other side" of the mirror. I usually imagined a fairy-tale kingdom, but sometimes it looked like this.

They're not evenly spaced...and who did the tile job? I wonder about the age of this shower's installation. Weren't the Nazis so insistent on the idea of Aryan superiority that even a facility for those they deemed "defective" and "unworthy of life" would have to exhibit perfect craftsmanship? And wouldn't any plumber or tile mason have enough pride in his work to do better than this, no matter by whom he was employed? Perhaps needed equipment and tools were not provided...or I'm probably just reading way more into it than is really there. It just looks so amateur (like something my ex would do! but he IS an amateur) Anyway, I guess this is why we learn to measure twice, cut once.

I once worked in an outpatient setting with a man with severe mental illness who did not bathe. His clothes were also beyond filthy. After being near him, you felt like you needed decontamination, not just a shower. The doctors and nurses didn't want to work with him anymore, The other patients didn't want him in the waiting room or in their groups.

When I did a home visit, I found that he lived in a little half-finished shack with no toilet (he used one of those 5 gallon white buckets restaurants get pickles in, with a scavenged toilet seat on top), no running water except from a spigot 50 feet outside his "door" and no means of washing his clothes.

I find this picture and the images it calls to mind of a patient being hosed down, appalling. But what is worse--conditions like this that at least represent an effort to provide care, or leaving people with severe illness to live in ramshackle huts or under bridges with freedom, but no treatment at all?

What I'm able to see on the left hand wall just looks like mold or mineral deposits from water. The windows aren't completely closed, so I imagine a lot of weather gets inside.

Beth, I hear you callin
But I can't come home right now
me and the boys are playin
and we just can't find the sound...
Just a few more hours
and I'll be right home to you...
Beth, I know you're lonely
and I hope you'll be all right
'cause me and the boys will be playin
all night.

(my favorite KISS song)

Thanks, nostalgic and Uneek50, for your perspective and accurate explanations. The reality usually does tend to be a bit more mundane and pedestrian than our vivid imagining of Nazi and Stalinist horrors.

I recently watched a program on the History Channel that went into some abandoned hospitals and prisons (it may have been an episode of the "Life After People" series), including this one. It showed some of the graffiti, including this one, and described the graffiti as having been done in the 1960s, when the hospital was used for drug rehab. it described this room as one used by patients during detoxification. Some of the other graffii shown included dates and neighborhoods where patients lived. I remember one that said "Greenpoint."

"Other" might be alcohol (often listed as ETOH). I'm surprised it's not on the list. Or maybe things like insulin, arsenic, anti-freeze...

The dour daily medication times also do not mean that every patient got medication at each med pass. Some might only get medication once or twice a day, or perhaps several medications in the morning and only one medication at night.

I think there has been a decline in the respect given to the property of others. When I was a child in the 60's, my parents and the parents of all my friends were strict about teaching us not to cut across the lawns of others. When I raised my children, I taught them the same rule. They obeyed (at least when I was watching), but thought I was crazy because none of their friends had parents who enforced that rule. When trick-or-treating at Halloween, I was taught to stay on the sidewalk while walking to doors, not across the lawn. Today I see parents actually leading their children across the lawns of others, because it's quicker and easier. I've seen parents let their children go into the unfenced yard of someone they don't know, and the parents stand and watch while the child plays on the swing set or tire swing. It's like the lack of a fence makes it public property, or that their child is so special s/he should never be denied anything. After shopping, too many people just abandon their shopping cart in the parking lot, rather than returning it to the store or placing it in the cart storage space. I know these are little things, and maybe I'm making a bit deal of nothing. But if it's nothing, then why not return the cart, stay on the sidewalk, etc? It is the little things, the things we do when no one is looking, that reveals our character. If we want to be trusted in big things, we have to demonstrate that we can be trusted in small things. With abandoned buildings, it seems like many people think it is okay to destroy them because they're not in use anyway--forgetting that the building is still owned by somebody, that perhaps it could be used again (either as a whole or in salvaged parts removed unharmed from the building), and that craftsmen years ago worked hard to make the items so thoughtlessly destroyed.

I thought of razor blades, too, when I saw this photo (vmc's comment, as I understand it with my very limited French "The stairs and the cut-out openings give the appearance of razor blades.") I also think they look a little like imaginary creatures from Dr. Seuss, people being blown about in a wind storm while carrying other creatures on their heads.

Occupying leisure time is usually addressed in the treatment plan of any patient with mental health concerns. An important means of reducing undesirable behaviors is to institute incompatible desirable behaviors. When a patient has productive, interesting things to do, s/he is less likely to focus on self-injurious behaviors or delusional thoughts. So entertainment is critical in treatment and recovery. It can also be very therapeutic. Sometimes patients can act out their feelings or reveal them in art even though they cannot discuss them. Often a person who has difficulty speaking finds it easier to "sing" the words. Dancing provides physical activity that is useful (unlike banging one's head against a wall) AND does not sound like "work" in the way "exercise" does. It should go without saying how helpful humor can be. Patients can share their special talents and skills with one another and with staff, and thereby become less "different" and "other." Patients see themselves not as "sick" but as thinking, intelligent, talented individuals with much to contribute, and staff see this also. Entertainment is something to look forward to and may be an incentive to improved behavior . We should never think that someone is "too far gone" to enjoy or benefit from an activity, much less that he or she is unworthy or undeserving of an activity. Thinking like that is one step on the road to even further disenfranchisement, isolation, and abuse of persons with mental illness.

When I was in grade school in the Midwest in the 1960s, we were taught to recognize the difference in the tornado siren and the civil defense ("air raid") siren. The tornado siren was a continuous modulated blast and the civil defense siren was intermittent--short blasts kind of like a very loud "busy" signal on the telephone. For fire, they used the school's regular alarm bells/buzzers. We had periodic fire, air raid, and tornado drills throughout the year. I now live in an area where a "disaster" siren would mean a leak or explosion at one of the chemical plants or on the railroad, and we do "shelter-in-place" drills as well as fire drills.

This photo makes me sadder than any other I have seen on this site. Not so much because of what it shows (it was typical for public facilities of the times, public health/hygiene more important than personal privacy, emphasis on expediency and efficiency due to staff and monetary shortages) but because it confirms what my former client told me. The communication was rudimentary, non-verbal, fragmented, difficult to interpret...but it was the TRUTH. What other truths have clients tried so desperately to communicate with anyone who would listen, with ME, and I have been unable to understand or have not believed???

In my comments on another picture I mentioned a former client who had a phobia of showers after several decades of institutionalization. I never was able to get a completely accurate description of what had happened during showers in the institution, but the image I have formed in my mind, sadly, fits well with this photograph. Bits and pieces I have gathered have included a large room, many patients, benches along the walls, and the impression that "showers" were from staff with a hose rather than from plumbing fixtures. I hesitate to post this, because I know some will likely jump on it as yet more evidence of how these facilities, although started with the very best of intentions, came to be staffed with sadistic predators who victimized the patients every moment of every day. What is absolutely crucial to remember is that virtually every staff person did the very best he or she could with what was available for doing the job. There was never enough money, never enough space, never enough help, never enough material, never enough time. THAT is what we must never forget--what happens when we set impossible standards and then turn our backs. I am not posting this to sensationalize what may have happened (again, I am just saying that this picture matches pretty closely the image I had formed in my mind from patchy bits of recollections I was given, not to say that I KNOW how this room was used), but to say that neither can we hide from the truth. I really hope my mind's picture is wrong. Also, the person to whom I am referring had developmental disabilities and was not able to bathe independently. Situations may have been different in facilities for patients with mental illness (although often the two populations were mixed in those years, so trying to clarify only makes the picture muddier).