The United States spends more than $100 billion annually on mental health care, but most of the mental health dollars go toward prescription drugs and outpatient treatment.
By Paul Hicks
The United States spends more than $100 billion annually on mental health care, but most of the mental health dollars go toward prescription drugs and outpatient treatment. There has been a shift away from inpatient spending that began as far back as the 1960s, when states began moving away from institutionalization for the mentally ill.
According to a recent New York Times Magazine story, the Community Mental Health Centers Act of 1963 provided for more treatment in community settings rather than in state-run, psychiatric institutions. The author noted: “But in the decades since, the sickest patients have begun turning up in jails and homeless shelters with a frequency that mirrors that of the late 1800s.”
In colonial America, the Quakers were the first to take an institutional approach toward caring for the mentally ill, which previously had been the responsibility of families, alms houses and jails. In 1752, the newly-opened Pennsylvania Hospital in Philadelphia provided rooms in the basement where patients could be shackled to the wall, if necessary.
Forty years later, New York Hospital opened a separate ward for “curable” insane patients, and in 1808, an independent hospital was built for the humane treatment of the mentally ill.
The Bloomingdale Insane Asylum, opened in 1821, was a private hospital for the care of the mentally ill, founded by New York Hospital and located for many years in Morningside Heights on the upper West Side. It was named for the road leading from lower Manhattan to the asylum, which was called Bloomingdale Road in the nineteenth century and is now named Broadway.
When Columbia University purchased the Morningside property in 1892, the Bloomingdale Asylum (commonly known as “Bloomingdales”) moved to a new campus in White Plains. Its relocation followed a trend of large municipal hospitals moving their psychiatric patients to more quiet and secluded suburban sites. In its new location, Bloomingdales was named the Payne Whitney Psychiatric Clinic in honor of William Payne Whitney, who left more than $20 million to New York Hospital for “psychiatric and neurologic work.” It is now known as the New York-Presbyterian Hospital/Westchester Division (NYP/WD).
In a recent newsletter published by NYP/WD, the Medical Director, Dr. Philip J. Wilner reported that, in addition to their services as a teaching hospital, they recently launched a new effort to increase community access to their clinical services and specialists. They are also developing programs with local colleges to help students with serious psychological problems.
Not far behind NYP/WD in length of service to mental health patients is St. Vincent’s Hospital, located in Harrison, which will celebrate the 140th anniversary of its founding in 2016. The Sisters of Charity purchased 96 acres on North Street and in 1879 opened a facility called St. Vincent’s Retreat for the Insane. By 1918, eight buildings were built to accommodate an increasing number of patients and live-in staff.
J. Thomas Scharf’s History of Westchester County, published in 1886, noted that the “Four pavilions for the insane recall nothing of the dingy mad-houses of our fathers…Plenty of light and space and thorough ventilation contribute to the comfort of the patients…Up to the present time only female patients have been received.”
In 1920, the hospital’s name was changed to St. Vincent’s Retreat for Nervous and Mental Diseases and in 1953 to St. Vincent’s Hospital of Westchester County. The 1950s brought many changes to St. Vincent’s, including its first male patients, a residency program, the development of an outpatient program, and a modern pavilion to replace the wood frame structures.
Today, the hospital offers a full continuum of psychiatric and substance abuse care, including inpatient, outpatient, and continuing day treatment as well as emergency psychiatric evaluation. After a long affiliation with St. Vincent’s Medical Center in New York, St. Vincent’s is now a division of St. Joseph’s Medical Center, which is based in Yonkers. Among the long-serving medical staff at St. Vincent’s is Dr. Richard Milone, a resident of Rye who retired as Medical Director two years ago.
