GN1138 - American Mental Health Counselors Association

Kings parK
Stories from an
American Mental Institution
a documentary film by Lucy Winer and Karen Eaton
Photo by Jason D. Brown
INSTRUCTOR’S GUIDE
KINGS PARK
STORIES FROM AN AMERICAN MENTAL INSTITUTION
INSTRUCTOR'S GUIDE
Written by
Adele Schwartz, EdD
Christina Pratt, PhD
Lucy Winer
Photo courtesy of Kings Park Heritage Museum
Acknowledgements
The authors gratefully acknowledge the assistance of the dedicated, highly experienced and wellinformed team of contributors and readers whose comments and suggestions shaped this document: Beth Filson, CPS, MFA, Nancy Tomes, PhD, and Laura Ziegler. In addition, Michelle A.
Spinelli, MA, a doctoral candidate, served as Editor for the Suggested Readings, under the supervision of Dr. Nancy Tomes. Researching texts, collating recommended references from all of the
authors and readers, and verifying their availability and currency, Michelle's work adds a critical
dimension to the value of this guide.
Design by Karen F. Eaton and Robin D’Amato
Copyright © 2014 Wildlight Productions, Inc.
New York City
KINGS PARK
Stories from an American Mental Institution
A documentary film by Lucy Winer and Karen Eaton
Photo by King Pedlar
INSTRUCTOR’S GUIDE
INTRODUCTION
KINGS PARK: Stories from an American Mental Institution is an award-winning documentary film that
offers an intimate look at the rapidly vanishing history of our state psychiatric hospitals, as well as the legacy of
deinstitutionalization. It asks the question, “How do our past decisions regarding the treatment of people with
mental health conditions influence and shape mental health care policy and practice today and into the future?”
This film has relevance for students, both undergraduate and graduate, either in interdisciplinary studies or
preparing to work in discrete professions, such as:
Psychology
Nursing
Social Work
Law
Journalism
Disability Studies
Sociology
Criminal Justice
Counseling
Government and
Public Policy
Theater and Film
History
General and Special Education
Medicine and Psychiatry
Music, Dance or
Art Therapy
Public Health
The issue of how society should respond to the needs of people with mental health conditions is a relevant concern across multiple academic disciplines. Kings Park challenges viewers to question the nature of “help” and to
ask to what extent the definition of what is “helpful” has changed today. This is especially important in light of
two emerging trends: 1. the tragic and growing reliance on the prison system to care for people with mental
health conditions, and 2. the hopeful movement to provide alternatives to the mental health system through peer
support services.
When concerns about people with mental health conditions become “news”, a concerned public seeks immediate
answers. Lacking awareness of the history of institutional psychiatric care, they may endorse forced treatment,
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long-term hospitalization and even imprisonment of individuals with mental health conditions as solutions to
the immediate problem. But, history has taught us a very different lesson.
Using personal narratives from former “patients,” family members and hospital staff, Kings Park reveals the
inhumane conditions in institutional psychiatric care of the past that contributed to the deinstitutionalization
movement and why so many members of these three constituent communities are now united in advocating for
more effective and humane models of recovery and community inclusion.
Kings Park can be used in college and university classrooms to explore broad themes, including:
• life in a state hospital and its lasting effects on former “patients”, families and staff;
• the victories and failures of deinstitutionalization;
• the criminalization of mental health conditions;
• mental health and public policy;
• the intergenerational impact of trauma;
• the toll of stigma;
• power disparities in mental health care;
• the power of recovery and peer support;
• the importance of personal narrative
FILM SYNOPSIS
They were very much alike - forbidding buildings and massive brick complexes - out of ear shot and hidden from
public view. These were the state psychiatric hospitals where individuals deemed “mentally ill” were compelled to
live out part or most of their lives. Established in 1885 and closed in 1996, Kings Park State Hospital on Long
Island, New York, warehoused over 9,000 patients at its height in the 1950’s. Lucy Winer, the film’s director, was
committed there in 1967 following several failed suicide attempts.
Kings Park offers an inside look at public mental health care in America by focusing on the story of this now
abandoned institution. The journey back begins with Lucy’s sudden decision, on the cusp of her fiftieth birthday,
to return to Kings Park for the first time in over thirty years. Determined to face her past, Lucy’s goals are purely
personal when the film begins. She soon learns, however, that in order to fully understand her own story, she
needs to learn about the institutional world in which she was once locked away. To this end, Lucy seeks out other
former “patients”, their families, and hospital staff, who share intimate accounts of their lives at Kings Park and
since. Shot on the overgrown and moldering grounds of the shuttered hospital, these first-hand accounts of a
vanishing world bear witness to the changes in treatment, policy and attitudes that have evolved over the past
half-century.
The film culminates with a vision of today. Stories are shared of the often brutally executed “emptying out” of
the hospital, and we follow Lucy in her effort to see how mental health care has changed since the hospital’s
close. Scenes shot at small community mental health centers and peer organizations committed to recovery
despite limited resources, let us see the kind of progress that is being made. In contrast, footage shot at a local jail
reveals a very different reality – where the penal system has replaced the state hospital as the default “provider”
for too many individuals with mental health conditions.
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LEARNING OBJECTIVES
1.) To view extended psychiatric hospitalization from the lived experiences of former “patients”, staff and family.
2.) To deepen an understanding of the role that trauma presents in the lives of those accessing care, their families, and service providers.
3.) To consider issues of dignity, human rights, power and harm in the context of institutions such as Kings
Park.
4.) To examine the power differentials within the hierarchy of the hospital staff and how that hierarchy
impacted the delivery of care.
5.) To explore the human costs of psychiatric institutionalization and deinstitutionalization. What are the
costs? What are the alternatives?
6.) To develop culturally competent and unbiased systems of communication, interaction and record keeping
in regard to individuals with mental illness.
7.) To underscore the power of compassion and respect in relationships that support recovery.
8.) To reveal a growing reliance on the penal system for public mental health care.
9.) To examine how peer support can advance recovery.
10.) To learn how the history of the state hospital system impacts conditions in some of those hospitals today.
11.) To explore how the role of state hospitals today and in the future can be improved to more effectively serve
the needs of the community.
HOW TO USE THIS GUIDE
This Instructor’s Guide is designed for use with the documentary film, Kings Park: Stories from an American
Mental Institution. The film, viewed in its entirety, is 108 minutes long. It is divided into three distinct parts,
which makes it flexible for classroom use. Whenever possible, instructors are encouraged to screen the film in its
entirety, but may also choose to screen any one or a combination of the specific Parts of the film in one or more
class sessions.
PART 1: Going Back
PART 2: Stories from the Hospital
PART 3: After the Hospital
(38 Minutes)
(44 Minutes)
(27 Minutes)
For each of the three Parts, this Guide offers:
• A synopsis that can be used as an introduction to that Part;
• A “menu” of Before-Viewing cues from which the Instructor can select those most relevant to the
course/lesson objectives. The purpose of these cues is to provide students with structure and focus
as they watch the film.
• An array of After-Viewing discussion points and probes for in-class sessions.
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All suggested questions and discussion topics are intended as starting points, to be modified depending on the
focus of the course, the learning objectives and the needs and interests of the students.
The Instructor’s Guide also provides:
• A list of follow-up Activities and Assignments to extend and enhance the students’ learning process
• A list of Suggested Readings
PART 1
SYNOPSIS: In Part 1, we accompany Director Lucy Winer as she goes back - for the first time in over 30 years - to
the now boarded-up Kings Park State Hospital, the New York State psychiatric institution where she was committed
in the late 1960’s. (38 minutes)
BEFORE Viewing Cues
1.) Lucy is compelled to return to Kings Park State Hospital because, she says, “The past is not in the past –
not until you deal with it.” Watch for the different ways Lucy uses to “deal with” her time at Kings Park.
2.) When Lucy is finally allowed to read her case records, take note of the language used in the past to
describe her. Also, take note of her reactions to that language.
3.) Listen carefully when Lucy describes her parents’ trauma and challenges for clues to her own distress.
4.) Exploring various parts of the grounds and Ward 210 evokes vivid memories for Lucy of her institutional
experience. Pay careful attention to the most striking of these memories and what they represented to Lucy
in the past and now.
5.) Lucy comments that patients were treated as if they were “thrown away, disposable.” Watch for evidence
that either supports or refutes Lucy’s comments.
AFTER Viewing Questions and Discussion Points
1.) Filmmaker Lucy Winer returns to Kings Park State Hospital, 30 years after her discharge. Before entering
Building 21, she explains that “there’s a part of me that is still up there, that never left” whom she needs to
“rescue”. What do you think she means? Do you think she has other objectives for making this visit? How
do you think her return to Kings Park helps or hinders her objectives?
2.) What initial information does Lucy provide about the trauma and challenges faced by her parents, that
gives you some insight into her own mental health condition? Probe: (Her mother’s persecution and
escape from Russia; her father’s submission to his tyrannical father and his depression in later life.) What has
history taught us about trauma’s effects on children (and even on subsequent generations) after wars or
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other inhumane atrocities in modern history? Probe: (e.g. The Holocaust; genocide in Rwanda; the
Armenian genocide, etc.)
3.) Lucy has a strong reaction to reading her Kings Park records. What are those reactions? What is her
response to the memory of her teenage self ? What clinical language and perspectives, in particular, does
she object to? How can her comments inform the way mental health providers communicate with, and
write about, individuals with mental health conditions today? Probe: (How has the language of providers
changed and how has it remained the same? Compare the language society and mainstream media use in
regard to people with mental health conditions today and 30 years ago, as reflected in Lucy’s records.)
4.) When they meet for the first time in over 30 years, Dr. Schultz – the psychiatrist who admitted Lucy to
their town hospital prior to Kings Park – says this to Lucy, “The truth of the matter is that there are a lot
of times when we don’t know what to do. And some of those times we end up doing something that is
terribly hurtful, sometimes harmful. And that’s where my guilt and shame can come from. Because when
you’re in a position where you have control over somebody else’s life, that’s a very fearful position to be in.”
What is your reaction to that statement? What can we learn from it?
5.) Lucy says that patients were “thrown away, disposable.” What do you remember from Lucy’s most vivid
memories of her time in Kings Park that would have made her feel disposable? Probe: (No rights or
recourse, getting fingerprinted, locks and keys, loss of personal clothes and possessions and the requirement to
wear a state dress, no access to family and friends, inability to use a phone or send a letter, lack of treatment and
activities, absence of chairs in the day room, group showers and only once a week, etc.) What was it about these
memories that made Lucy feel disposable?
6.) Toward the end of Part I, Lucy sits on the floor of the day room and recalls a moment in which another
female patient warned her not to cry because “they will hurt you”. What does this reveal about the philosophy of care on Ward 210? Probe: (The use of fear and the threat of violence to exercise control, disempowerment of the person, isolation as “treatment”.) What is your opinion of the treatment and recovery value of
such a philosophy of care?
7.) To what extent do the adverse conditions that Lucy describes still exist today? What conditions remain in
the past? Probe: (In state hospitals and throughout the healthcare system, people with mental health conditions are still often seen as incapable of recovery and viewed as a diagnosis or a set of symptoms rather than a
human being; punitive attitudes and stigma can still prevail and undermine care; people are still unfairly
locked away, sometimes with little regard for safety; people are still put in seclusion and restraint; staff education and compensation can still be inadequate, compromising the quality of care. However, today people receiving services in state hospitals have rights, there are activities, and therapy is much more available; there is furniture that is meant to look inviting and the surrounds are more attractive.)
8.) At the end of this segment, Lucy asks, “How had a hospital become so much like a prison? What crime
had we, as patients, committed to inspire this kind of treatment?” How would you respond? Probe: (A
reflection of the societal ignorance and view of individuals with mental health conditions, fiscal priorities and
realities, the role of fear, stigma and the need for social control, too little knowledge about how to treat people
with serious mental health conditions, legacy of 18th and 19th century asylums)
9.) How does policy for mental health service provision evolve? Who identifies mental health needs? Who
enacts laws and regulations in response to identified needs? How are mental health services funded?
Where do mental health services stand in the hierarchy of government spending? If citizens do not have a
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belief that recovery is possible, how would that influence the position of mental health services in the hierarchy of public concern and spending?
10.) How do mental health care practices evolve? Probe: (Peer leadership and advocacy; the role of research
and researchers; public and not-for-profit agency change; breaking the silence that stigma causes; personal stories of recovery; parent/family involvement and advocacy.)
11.) What might have been the factors and conditions that were used to justify the way individuals with mental
health conditions were perceived and treated in the 20th century? Probe: (ignorance, limited knowledge
of treatment models, the legacy of hundreds of years of ‘asylums’, economic influences, political influences, media
misinformation about mental illness, lack of public awareness, stigma, etc.)
12.) Do you have any further thoughts or comments about Part I?
PART 2
SYNOPSIS: In Part 2 the focus shifts from Lucy’s personal story to the story of the hospital itself. The people we
meet – other former patients, a family member and hospital staff at different levels – share memories and speak
from diverse perspectives about life at Kings Park. (44 minutes)
BEFORE Viewing Cues
1.) Institutions like Kings Park State Hospital influenced the lives not only of the people admitted, but also
the lives of family members and the staff who worked there. Watch for signs of how Kings Park affected all
three groups.
2.) In Part 2, we learn surprising details about the different reasons people wound up confined to Kings Park.
Be sure to make note of these.
3.) Listen carefully for evidence of the hierarchy and power differentials that existed between different levels
of hospital staff. Notice how this hierarchy functions and how it impacts quality of care.
4.) Take note of how different people in the film reflect on the closing of the hospital and the era of deinstitutionalization.
AFTER Viewing Questions and Discussion Points
1.) In Part 2 we meet Elizabeth Oranges and Ron Jackson, both former Kings Park “patients”. What is it about
their memories of Kings Park that are most vivid for you? How do their memories compare to Lucy’s
memories? Probe: (Lizzy, who was lied to about her commitment to Kings Park; she also credits a recreation
counselor for “saving” her; Ron, whose punishment for running away from foster care was to be admitted to
Kings Park where he was sexually molested, brutally restrained and never taught to read or write.)
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2.) What do you think the emotional costs of hospitalization were for Lucy Winer, Elizabeth Oranges and
Ron Jackson? Probe: (Loss of identity; battering of self-esteem; abject fear; lack of family connection and
support; isolation and loneliness; inability to see a future; loss of educational access; lack of socialization;
removal from community.)
3.) What did you learn from the daughter of a former “patient” about the emotional impact on her family of
her mother’s hospitalization?
4.) What do you think the emotional costs were for people who were on staff at Kings Park before it was
closed? Probe: (King Pedlar, an attendant who feeds the cats and is bound to the institution as “home” and
refuge; Richard Farrell, an attendant who describes the hospital as “crazy” and speaks of the need for patients to
ingratiate themselves to survive; Pat Stansky, a nurse, whose Irish immigrant father worked at Kings Park
before her, reflecting generations of local families for whom Kings Park constituted a source of steady employment; Bob Wertz, an attorney assigned to Kings Park to singlehandedly protect the rights of over 5000
patients; Hannalore Lehnhoff, staff psychiatrist; Seymour Weisman, Chief of Psychology; Alan Weinstock, last
Executive Director before the 1996 closing of Kings Park, etc.)
5.) How would you describe the hierarchy among staff as implied by the narratives of different staff members
in the film? Probe: (Sy Weissman, former Chief of Psychology says the Psychiatrists had almost all the power
and almost no contact with the patients vs. the Mental Health Therapy Aides who spent almost all their time
with the patients with very little authority or power; Dan Boone, former Attendant, says the closer the staff
worked with patients, the less they were listened to and the less valued they were professionally.) How do you
think this kind of hierarchy impacted the quality of patient care at Kings Park? Probe: (Limited communication and the impaired flow of important information about patients among staff; loss of multiple perspectives; conflicting and siloed perceptions and beliefs about patient status.)
6.) It becomes clear that there was very limited oversight or accountability for treatment of patients at Kings
Park. What examples do you see of this? Probe: (Dr. Lehnhoff ’s story of her patient’s death; Ron Jackson’s
stories of the straight jacket; Lizzy’s description of patients being ignored by staff; Doctors faking patient records;
the incidence of sexual and physical abuse.) What does that say about mental health policy and practice at
that time? What, if anything, is different today?
7.) Lucy says that she and the attendant, King Pedlar, shared deep feelings of being bound to Kings Park, but
she is bound by fear and he is bound by comfort. What was it in institutional life that evoked these different feelings but similar outcomes, i.e. feeling bound to the hospital?
8.) What are some aspects of the hospital’s history mentioned in in this segment? Probe: (the initial vision of
the hospital as a rural refuge away from the stresses of the city; the overcrowding and warehousing of patients that
happened instead; functioning as a self sustaining community; patient labor; living conditions; physical and sexual abuse of the patients; working conditions for the staff; changing “treatment” practices.) Which aspects of the
history did you find most startling? Which have the most relevance for policy and practice today?
9.) What did you learn about the many different groups of people other than those diagnosed with a “psychiatric disorder” who were admitted to Kings Park? Probe: (People who were poor, homeless or vagrant;
immigrants who could not adjust to life in the U.S.; people who were elderly or had chronic physical conditions;
people who used substances and even an abandoned 18 month old infant.) What does this say about the hospital’s role besides its function as a psychiatric hospital? What might have been the Historical (Political,
Social) roots of these practices?
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10.) When attorney Bob Wertz tells the story of the so-called “illiterate” patient, he underscores the practice
and the danger of faking records. How would you describe these dangers? Probe: (Because the first doctor
concluded that the patient could not read, for years this assumption was never questioned – even though the
patient was highly literate; records being written with great authority but with only one contact; records not
revised as staff became more familiar with a patient.)
PART 3
SYNOPSIS: In Part 3, the film asks and answers the question “Where are the people who were once in Kings
Park?” Some of the victories of a stretched community mental health care system are contrasted with our growing
reliance on the penal system. (27 minutes)
BEFORE Viewing Cues
1.) As you watch Part 3, identify the specific kinds of supports that people who left Kings Park would need to
succeed in their communities.
2.) Listen for the ways that the stigma of a mental health condition influences the recovery
3.) Watch carefully for how the penal system can be the default provider for many individuals with mental
health conditions.
4.) You will see footage in Part 3 about an organization called Hands Across Long Island (H.A.L.I.). This is
an example of a Peer-Run organization, meaning an organization largely run by people with lived experience of mental illness and recovery. Be prepared to speak about how peers might run an organization in
ways that are different from how professional staff might run a similar organization.
5.) At the end of the film, listen carefully when Lucy discusses the way her feelings for her parents and about
herself have changed.
AFTER Viewing Questions and Discussion Points
1.) Consider an individual returning to the community after discharge from Kings Park. What might it take
to enable that individual to return to a full and inclusive life in the community? Probe: (Housing,
financial means, independent living skills, skills for social interaction and recreation, career/job skills, community and family support, health care and mental health care, identification of goals, access to higher education
or career training, identification of goals, dreams and aspirations, programs to enable the realization of those
goals and dreams.)
2.) Several people in Part 3 talk about how stigma influenced their recovery. In what ways do their stories
reveal stigma as destructive? Probe: (Elizabeth Oranges “Nobody wants to be around a bunch of mentally
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ill people” believing the stigma of mental illness will cause others to be afraid of her and shun her; Pat Parry, a
social worker at Riverhead Jail, who says “Who wants to step forward and stand up in public and say, ‘I have a
mentally ill sister, son, daughter… I need services’” which fosters a culture of silence that allows budget cutbacks
and underfunding; in the group at H.A.L.I., the library student describes how her self image as “mentally ill”
threatens her chance of succeeding in graduate school; in the same group, Charlie describes how the harsh judgments of former Kings Park nurses and aides continue to echo in her head, causing her to harm herself.)
3.) In the film, Hands Across Long Island (H.A.L.I.) stands as an example of a Peer-Run organization, meaning an organization largely run by people with the lived experience of a mental health condition and recovery. Many people today believe that in a Peer-Run organization, new opportunities open up for building
trust and sharing experiences that promote recovery and resilience. What experience, if any, do you have
with peer support? What do you see as the advantages? The drawbacks? How might peer support be effective in dealing with the impact of stigma? Probe: (Peer support as a means of promoting accountability;
“Been There, Done That”; Peers eliminate the “you do not know what it’s like” belief; Peer support as a means
of promoting trust; Peers are often more willing to share their real issues, concerns, hopes, and dreams with
another peer; peer support as a means of promoting Whole-Health Self-Management; peer providers serve as
models of self-managing both physical and mental health.)
4.) Ellen Healion, Executive Director of H.A.L.I., and a peer in recovery, explains that at H.A.L.I., members
learn to “…live life on life’s terms - and life is messy - and that’s O.K.” What does that statement mean to
you? What implications would this statement have for people with mental health conditions, as well as for
people who work in mental health?
5.) According to Sheriff Vincent de Marco of Riverhead Jail, the jail has become the largest provider in his
county for individuals with mental health conditions. But in his opinion, individuals with a psychiatric
diagnosis need help and services that are not available in the penal system. What are your thoughts and
feelings about the imprisonment of people with mental health conditions? What stood out for you?
Probe: (20% of people in jails and prisons in New York have serious mental health conditions and as much
as 50% in California prisons; for people with mental health conditions, sentencing for minor crimes and misdemeanors can lead to jail time because judges “don’t have any other options”; existence of mental health practitioners within the penal system.) Is this an issue in your community? What would you like to see change?
What actions do you think should be taken?
6.) In the scene at Riverhead Jail, we meet Stephen White, a former “patient” at Kings Park with a diagnosis of
schizophrenia, who was arrested for sleeping on the lawn of a local church. Because he couldn’t meet the
minimum bail of $250, Stephen White was sent to jail. How do you feel about this chain of events? In
your opinion, what role, if any, do race, class and poverty play in the criminalization of mental illness?
7.) A theme that runs throughout Part 3 is the way in which our society tends to view mental health conditions as a crime, or at least a serious moral failing. In Lucy’s narration at the end of the jail segment, she
asks the question, “Is this the best that we can do?” What do you think she is implying? What are your
thoughts on this issue?
8.) Lucy tells us her story by describing the challenges faced by her mother and father in their lives. By choosing to tell her parents’ story rather than her own, what do you think she wants the viewer to know about
the legacy of intergenerational trauma in her family? What are the implications of this idea for mental
health care practice?
9.) Throughout this film, we meet people living in recovery who were once committed to an institution.
Many were seen as beyond hope. Who are some of these individuals? How can each individual’s narrative
inform your attitudes and awareness in regard to individuals with mental health conditions? Probe:
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(Lucy Winer, filmmaker; Elizabeth Cleary, Clubhouse member; H.A.L.I. group participants; Ellen Healion,
Executive Director of H.A.L.I.; Ron Jackson, retired sanitation worker; Elizabeth Oranges, living independently in the community.)
10.) In the last scene, Lucy and Lizzy compare how they would “speak” to the hospital about their lived experiences at Kings Park State Hospital. Did either woman’s response surprise you? How do you explain their
very different reactions? If you had lived through similar experiences, what do you think you would say to
the hospital?
11.) What else do you take away from Part 3?
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FOLLOW-UP ASSIGNMENTS AND ACTIVITIES
Again, these assignments are only suggestions that can be modified to meet course objectives.
1.) Select two first-person narratives written by individuals with mental health conditions. (See Suggested
Readings.) Prepare a review of both books in which you compare and contrast the lived experiences of
each of these individuals, being sure to consider:
• Context, including factors like where each author lived, their age during the book’s time frame, family
description, support systems if any, socio-economic status, etc.
• What, if any, treatment each author received and the outcomes of that treatment
• Factors identified by the authors as contributing to their recoveries; factors that postponed or
interrupted their recoveries.
2.) View two films (fictional narrative) about individuals with a mental health condition. Write a synopsis of
each film. Then, compare and contrast the two films, being sure to provide your opinion of how accurately
(or inaccurately) the filmmakers portray individuals living with a mental health condition.
3.) View two documentary films (other than Kings Park) about individuals with mental health conditions.
Write a synopsis of each film. Then, compare and contrast the two films, being sure to provide your assessment of how the filmmakers depict individuals living with mental health conditions.
4.) Imagine that you had a mental health condition in your teens as Lucy did. Write a paper in which you consider these issues:
• How would each of your parents react? Your grandparents? The extended family?
• Considering your family’s financial status during your teenage years, what kind of treatment, if any,
might you have had?
• How would a mental health condition in childhood have altered your relationship(s) with your
sibling(s)?
• How might your self-perceptions and identity been influenced by experiencing a mental health condition in your teens?
• How might your education have been affected?
• How might your goal setting have been affected?
• How might your social experiences have been different?
• In what other ways might your life have been different from your life today?
5.) Write a research paper choosing one aspect of one of the following topics:
A. How has U.S. public policy for people with mental health conditions changed from colonial times
through today? In what ways has it improved? In what ways has it not improved?
B. How has medical treatment of individuals with mental health conditions changed in the past 100
years? In what ways have they improved? In what ways have they not improved?
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C. Individuals with mental health conditions in theater and film: A comparative review
D. Individuals with mental health conditions in fiction: A comparative review
E. How newspapers and social media portray individuals with mental health conditions
F. The impact of stigma on the lives of individuals with mental health conditions
G. An analysis of funding streams for mental health services in the U.S. in the 21st century: Who pays for
mental health provision? How has mental health care been covered under third party insurance plans?
H. How lack of public awareness and stigma influence public policy on individuals with mental health
conditions
I. Opposition to the forced use of psychotropic medication for individuals with mental health conditions:
Pros and cons
J. Model programs for recovery: Identifying best practices
K. Mental health conditions and their effects on family dynamics: A review of the research
L. The effects of intergenerational trauma on mental health: A review of the research
M. The roots of the criminalization of mental health conditions: A historic view
N. Criminalization of individuals with mental health conditions: Current trends
6.) Interview three staff members (in three different positions) at a local state psychiatric center or hospital.
Considering today’s services, write an analysis of the interviews, including:
• Nature and duration of working in the field
• The discrete roles of staff (e.g. psychiatrists, therapists/counselors, nurses, etc.) in the treatment
• Current treatment practices available at that agency or center that your subjects deem most effective
• Treatment practices, at that center or others, that they deem least effective
• Average length of service for individuals accessing services in that hospital
• Intervention and support for transition and return to community
• Oversight and accountability of hospital or agency practice
• The nature of family connection and involvement in treatment
• How could the center/hospital better serve the clients?
7.) Case Study: A Peer-Run Mental Health Center (To include at least one visit and two interviews) Write an
analysis of your findings, to include:
• The philosophy of peer-run mental health programs
• The benefits and challenges of peer-run mental health programs
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• The nature of staffing, including discrete roles of staff
• Communication and collaboration among/between professional and peer staff
• Outcomes in serving the recovery goals of members
• How the staff hierarchy compares to traditional mental health agencies today
• Oversight and accountability of peer run programs
• The nature of family connection and involvement
8.) Celebrity and Mental Health Conditions: Write a biographical summary of the lives of four well-known
individuals (living or deceased) who revealed that they were living with mental health conditions. For
each, describe:
• What was the personal intention for disclosing?
• What was the public reaction to their disclosure?
• What influence, if any, did their disclosure have on public awareness and the lessening of stigma?
• What influence, if any, did their disclosure have on their recovery and well being?
9.) Attend a peer conference (national, state or local) about some aspect of mental health and recovery. Write
a summary of the experience.
10.) Website Study: Visit 15 informational websites designed for individuals with mental health conditions and
their families. Prepare a spreadsheet that allows a visual comparison of factors such as target site visitor, primary objective or mission, range of information on mental health conditions and treatment, advocacy,
laws, fiscal or service entitlements, etc. (column headings to be approved by Instructor in advance) Using
the spreadsheet as a guide, write a brief analysis of the nature, depth, breadth and quality of information
via the Internet for people with mental health conditions and their families.
11.) Young Adult Literature Review: Identify 5 books written for the Young Adult genre (middle and high
school students) that include characters with stated or implied mental health conditions. Write a synopsis
of each book. Then, analyze how people with mental health conditions are portrayed in fiction for the
Young Adult book audience. Include how the portrayal of characters with mental health conditions might
influence childhood, adolescent and, later, adult attitudes.
12.) Group Project: Create an oral history project by interviewing former “patients,” staff and family associated
with a psychiatric hospital or center in your community. Via film or audiotape, record their memories and
perceptions of life associated with that hospital or psychiatric center at least 15 years ago or earlier. (The
center may be closed or still open.) Include:
• The duration of each subject’s involvement with the center
• The nature of each individual’s role
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• A description of the physical plant (space, furnishings, aesthetics)
• How would they summarize the philosophy of treatment
• Interaction among/between staff at various levels
• The nature of services that could be accessed
• The kind of activities (if a hospital) available
• What you would want your community to know about life in that hospital or center
• How that hospital or center compares with Kings Park
• What changes would have made that hospital or center better at that time
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Kings Park: Suggested Readings
The following is a list of readings that are relevant to topics and issues presented in the film. These
readings were a collaborative effort, compiled from suggestions made by the authors and our team of
expert reviewers. The list is neither comprehensive nor exhaustive; it is intended to support the use of
Kings Park in a college or university classroom. The readings do not necessarily reflect the filmmakers’
viewpoints.
Part 1: Going Back
Lived Experience: First-person Narratives and Biographies
•
Bassman, Ronald. A Fight to Be: A Psychologist’s Experience from Both Sides of the Locked
Door. Albany, NY: Tantamount Press, 2007.
•
Beers, Clifford Whittingham. A Mind That Found Itself. [S.l.]: Stonewell Press, 2013. [First
published in 1907.]
•
Bly, Nellie. Ten Days in a Mad-House: A True Story of Brutality and Neglect. Charleston, SC:
CreateSpace, 2014. [First published in 1887.]
•
Casey, Nell. Unholy Ghost: Writers on Depression. New York: Morrow, 2001.
•
Geller, Jeffrey L., and Maxine Harris. Women of the Asylum: Voices from Behind the Walls,
1840-1945. New York: Anchor Books, 1994.
•
Grobe, Jeanine. Beyond Bedlam: Contemporary Women Psychiatric Survivors Speak Out.
Chicago: Third Side Press, 1995.
•
Hirsch, Sherry. Madness Network News Reader. San Francisco: Glide Publications, 1974.
•
Hornbacher, Marya. Madness: A Bipolar Life. Boston: Houghton Mifflin, 2008.
•
Jamison, Kay Redfield. Night Falls Fast: Understanding Suicide. New York: Knopf, 1999.
•
Jamison, Kay Redfield. An Unquiet Mind: A Memoir of Moods and Madness. New York:
Vintage Books, 1995.
•
Kaysen, Susanna. Girl, Interrupted. New York: Vintage Books, 1993.
•
Lewis, Mindy. Life Inside: A Memoir. New York: Atria Books, 2002.
•
Nasar, Sylvia. A Beautiful Mind: A Biography of John Forbes Nash, Jr. New York: Simon &
Schuster, 1998.
•
O’Donoghue, John. Sectioned: A Life Interrupted. London: John Murray, 2009.
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•
Peterson, Dale. A Mad People’s History of Madness. Pittsburgh, PA: University of Pittsburgh
Press, 1982.
•
Saks, Elyn R. The Center Cannot Hold: My Journey Through Madness. New York: Hyperion,
2007.
•
Schiller, Lori, and Amanda Bennett. The Quiet Room: A Journey Out of the Torment of Madness. New York: Warner Books, 1994.
•
Schroeder, Stephanie. Beautiful Wreck: Sex, Lies & Suicide. New York: Creative Evolution,
2012.
•
Sheehan, Susan. Is There No Place on Earth for Me? Boston: Houghton Mifflin, 1982.
•
Steele, Ken, and Claire Berman. The Day the Voices Stopped: A Memoir of Madness and
Hope. New York: Basic Books, 2001.
•
Styron, William. Darkness Visible: A Memoir of Madness. New York: Modern Library, 2007.
•
Susko, Michael A. Cry of the Invisible: Writings from the Homeless and Survivors of Psychiatric Hospitals. Baltimore: Conservatory Press, 1991.
•
Vonnegut, Mark. The Eden Express: A Memoir of Insanity. New York: Seven Stories Press,
2002.
•
Vonnegut, Mark. Just Like Someone Without Mental Illness Only More So: A Memoir. New
York: Delacorte Press, 2010.
•
Wood, Mary Elene. The Writing on the Wall: Women’s Autobiography and the Asylum. Urbana, IL: University of Illinois Press, 1994.
Part II: Stories from the Hospital
The Asylum: Then and Now
•
Beam, Alex. Gracefully Insane: The Rise and Fall of America’s Premier Mental Hospital. New
York: Public Affairs, 2001.
•
Berger, Lisa, and Alexander Vuckovic. Under Observation: Life Inside the McLean Psychiatric
Hospital. New York: Ticknor & Fields, 1994.
•
Deegan, Patricia. “Lead Shoes and Institutional Peonage.” (August 30, 2011).
https://www.patdeegan.com/blog/posts/lead-shoes-and-institutional-peonage
•
Disability Justice. “Right to Self-Determination: Freedom from Involuntary Servitude (Employment).” http://disabilityjustice.tpt.org/right-to-self-determination-freedom-from-involuntary-servitude/
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•
Goeres-Gardner, Diane L. Inside Oregon State Hospital: A History of Tragedy and Triumph.
Charleston, SC: The History Press, 2013.
•
Grob, Gerald N. From Asylum to Community: Mental Health Policy in Modern America.
Princeton, NJ: Princeton University Press, 1991.
•
Lael, Richard L., Barbara Brazos, and Margot Ford McMillen. Evolution of a Missouri Asylum: Fulton State Hospital, 1851-2006. Columbia, MO: University of Missouri Press, 2007.
•
NASMHPD. The Vital Role of State Psychiatric Hospitals Technical Report. ( July 2014).
http://www.nasmhpd.org/publications/NASMHPDPublications.aspx
•
Penney, Darby, and Peter Stastny. The Lives They Left Behind: Suitcases from a State Hospital
Attic. New York: Bellevue Literary Press, 2008. (See also: http://www.suitcaseexhibit.org)
•
Rothman, David J. The Discovery of the Asylum: Social Order and Disorder in the New
Republic. New Brunswick, NJ: Aldine Transaction, 2011.
•
Sitton, Sarah C. Life at the Texas State Lunatic Asylum, 1857-1997. College Station, TX:
Texas A & M University Press, 2012.
•
Tomes, Nancy. The Art of Asylum-Keeping: Thomas Kirkbride and the Origins of American
Psychiatry. Philadelphia: University of Pennsylvania Press, 1994.
The Architecture of the Asylum
•
Gray, John, and Mark Gerrity. Abandoned Asylums of New England: A Photographic Journey.
Woburn, MA: Uni-Graphic Press, 2004.
•
Johnson, Heidi. Angels in the Architecture: A Photographic Elegy to An American Asylum.
Detroit: Wayne State University Press, 2001.
•
Payne, Christopher, and Oliver W. Sacks. Asylum: Inside the Closed World of State Mental
Hospitals. Cambridge, MA: MIT Press, 2009.
•
Ramseur, Michael. Haunted Palace: Danvers Asylum As Art and History. South Harwich,
MA: ARTSHIP, 2005.
•
Yanni, Carla. The Architecture of Madness: Insane Asylums in the United States. Minneapolis,
MN: University of Minnesota Press, 2007.
Evolving Treatments: The Changing Faces of “State of the Art”
•
Braslow, Joel. Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the
Twentieth Century. Berkeley, CA: University of California Press, 1997.
•
Breggin, Peter Roger. Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock, and the
Psychopharmaceutical Complex. New York: Springer, 2008.
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•
Dowbiggin, Ian Robert. Keeping America Sane: Psychiatry and Eugenics in the United States
and Canada, 1880-1940. Ithaca, NY: Cornell University Press, 2003.
•
El-Hai, Jack. The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the
World of Mental Illness. Hoboken, NJ: J. Wiley, 2005.
•
Scull, Andrew. Madhouse: A Tragic Tale of Megalomania and Modern Medicine. New
Haven: Yale University Press, 2005.
•
Shorter, Edward, and David Healy. Shock Therapy: A History of Electroconvulsive Treatment
in Mental Illness. New Brunswick, NJ: Rutgers University Press, 2007.
•
Stastny, Peter, Peter Lehmann, and Volkmar Aderhold. Alternatives Beyond Psychiatry.
Berlin: Peter Lehmann Publishing, 2007.
•
Swingle, Paul G. Biofeedback for the Brain: How Neurotherapy Effectively Treats Depression,
ADHD, Autism, and More. New Brunswick: Rutgers University Press, 2010.
•
Valenstein, Elliot S. Great and Desperate Cures: The Rise and Decline of Psychosurgery and
Other Radical Treatments for Mental Illness. New York: Basic Books, 1986.
The Changing Criteria for Psychiatric Diagnosis
•
Caplan, Paula J. They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide
Who’s Normal. Reading, MA: Addison-Wesley, 1995.
•
Greenberg, Gary. The Book of Woe: The DSM and the Unmaking of Psychiatry. New York:
Penguin, 2013.
•
Metzl, Jonathan. The Protest Psychosis: How Schizophrenia Became a Black Disease. Boston:
Beacon Press, 2009.
•
Schrag, Peter. Mind Control. New York: Pantheon Books, 1978.
•
Schrag, Peter, and Diane Divoky. The Myth of the Hyperactive Child: And Other Means of
Child Control. New York: Pantheon Books, 1975.
•
Solomon, Andrew. The Noonday Demon: An Atlas of Depression. New York: Scribner, 2001.
Psychiatric Medication
•
Bass, Alison. Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on
Trial. Chapel Hill, NC: Algonquin Books of Chapel Hill, 2008.
•
Kirsch, Irving. The Emperor’s New Drugs: Exploding the Antidepressant Myth. New York:
Basic Books, 2010.
•
Read, Jim. Psychiatric Drugs: Key Issues and Service User Perspectives. Basingstoke, Hampshire: Palgrave Macmillan, 2009.
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•
Valenstein, Elliot S. Blaming the Brain: The Truth About Drugs and Mental Health. New
York: Free Press, 2000.
•
Whitaker, Robert. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. New York: Crown Publishers, 2010.
Madness, Culture, and Society
•
Cohen, David. Challenging the Therapeutic State. New York: Institute of Mind and Behavior, 1994.
•
Cross, Simon. Mediating Madness: Mental Distress and Cultural Representation. Houndmills, Basingstoke, Hampshire: Palgrave Macmillan, 2010.
•
Gamwell, Lynn, and Nancy Tomes. Madness in America: Cultural and Medical Perceptions of
Mental Illness Before 1914. Ithaca, NY: Cornell University Press, 1995.
•
Goffman, Erving. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books, 1961.
•
Grob, Gerald N. The Mad Among Us: A History of the Care of America’s Mentally Ill. New
York: Free Press, 2011.
•
Okin, Robert. Silent Voices: People with Mental Disorders on the Street. [Place of publication
not identified]: Golden Pine Press, 2014.
•
Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac.
New York: John Wiley & Sons, 1997.
•
Whitaker, Robert. Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill. New York: Basic Books, 2010.
Part III: After the Hospital
Deinstitutionalization/Transinstitutionalization
•
Cramer, Clayton E. My Brother Ron: A Personal and Social History of Deinstitutionalization
of the Mentally Ill. Charleston, SC: CreateSpace, 2012.
•
Earley, Pete. Crazy: A Father’s Search Through America’s Mental Health Madness. New York:
Berkley Books, 2006.
•
Koyanagi, Chris. Learning from History: Deinstitutionalization of People with Mental Illness
as Precursor to Long-Term Care Reform. Washington, DC: Henry J. Kaiser Family Foundation, 2007.
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Community Mental Health Care
•
Dobransky, Kerry Michael. Managing Madness in the Community: The Challenge of Contemporary Mental Health Care. New Brunswick, NJ: Rutgers University Press, 2014.
•
Doyle, Alan, Julius Lanoil, and Kenneth J. Dudek. Fountain House: Creating Community in
Mental Health Practice. New York: Columbia University Press, 2013.
•
Rosenberg, Jessica, and Samuel Rosenberg. Community Mental Health Challenges for the
21st Century, Second Edition. Hoboken, NJ: Taylor and Francis, 2013.
•
Rowe, Michael. Classics of Community Psychiatry: Fifty Years of Public Mental Health Outside the Hospital. Oxford: Oxford University Press, 2011.
•
Winerip, Michael. 9 Highland Road: Sane Living for the Mentally Ill. New York: Vintage
Books, 1994.
Peer Support and Recovery Movements
•
Blanch, Andrea, Beth Filson, and Darby Penney, with Contributions from Cathy Cove. Engaging Women in Trauma-Informed Peer Support: A Guidebook. April 2012.
http://www.nasmhpd.org/publications/engagingWomen.aspx
•
Chamberlin, Judi. On Our Own: Patient-Controlled Alternatives to the Mental Health System. Lawrence, MA: National Empowerment Center, 2004.
•
Davidson, Larry, Matthew Chinman, David Sells, and Michael Rowe. “Peer Support
Among Adults with Serious Mental Illness: A Report from the Field” in Schizophrenia Bulletin 32, No. 3 (2006): 443-450. http://schizophreniabulletin.oxfordjournals.org/content/32/3/443.full.pdf+html
•
Mead, Shery. “Peer Support as a Socio-Political Response to Trauma and Abuse.”
http://www.intentionalpeersupport.org/wp-content/uploads/2014/04/Peer-Support-as-aSocio-Political-Response-to-Trauma-and-Abuse.pdf
•
SAMHSA. “The History of the Mental Health Consumer/Survivor Movement.”
http://promoteacceptance.samhsa.gov/teleconferences/archive/training/teleconference12
172009.aspx
•
SAMHSA. “Recovery to Practice: Bridging People, Knowledge, Tools & Experience.”
http://www.samhsa.gov/recoverytopractice/
•
Shimrat, Irit. Call Me Crazy: Stories from the MAD Movement. Vancouver: Press Gang Publishers, 1997.
•
Tang, Patricia. “A Brief History of Peer Support: Origins.”( June 7, 1013). http://peersforprogress.org/pfp_idea_exchange/a-brief-history-of-peer-support-origins
•
Tomes, Nancy. “The Patient as a Policy Factor: A Historical Case Study of the
Consumer/Survivor Movement in Mental Health” in Health Affairs 25, No. 3 (May 2006):
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720-729. http://content.healthaffairs.org/content/25/3/720.long
•
Travis, Trysh. The Language of the Heart: A Cultural History of the Recovery Movement from
Alcoholics Anonymous to Oprah Winfrey. Chapel Hill: University of North Carolina Press,
2009.
The Criminalization of Mental Health Conditions
•
Canales, Christina. “Prisons: The New Mental Health System” in Connecticut Law Review
44, No. 5 ( July 2012): 1723-1762.
•
Pfeiffer, Mary Beth. Crazy in America: The Hidden Tragedy of Our Criminalized Mentally
Ill. New York: Carroll & Graf Publishers, 2007.
•
Slate, Risdon N., Jacqueline K. Buffington-Vollum, and W. Wesley Johnson. The Criminalization of Mental Illness: Crisis and Opportunity for the Justice System. Durham, NC: Carolina Academic Press, 2013.
Patients’ Rights and the Law
•
Bazelon Center for Mental Health Law. See: http://www.bazelon.org/Where-WeStand/Community-Integration/Olmstead-Implementing-the-Integration-Mandate.aspx
•
Failer, Judith Lynn. Who Qualifies for Rights?: Homelessness, Mental Illness, and Civil Commitment. Ithaca, NY: Cornell University Press, 2002.
•
Perlin, Michael L. The Hidden Prejudice: Mental Disability on Trial. Washington, DC:
American Psychological Association, 2000.
•
Saks, Elyn R. Refusing Care: Forced Treatment and the Rights of the Mentally Ill. Chicago:
University of Chicago Press, 2002.
•
Stefan, Susan. Unequal Rights: Discrimination against People with Mental Disabilities and
the Americans with Disabilities Act. Washington, DC: American Psychological Association,
2001.
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