Thursday, October 23, 2008

Westchester Guardian/The Advocate.

Thursday, October 23, 2008

The Advocate

Richard Blassberg

Reflecting Upon Montrose Hospital Amidst
All Of The Controversey Over Its Future

In 1968, at age 27, together with my wife, 26, and my parents, in their early 50s, as well as our son, who wasn’t quite five years old,
we set upon a family enterprise, an exciting adventure, acquiring a 19-room Georgian Colonial home set on eight and a half acres of clear
land, the centerpiece of a 72-acre estate, for the specific purpose of opening a VA community-care home. Our Brewster adventure would
last more than 18 years, during which time some 47 different emotionally disabled veterans came to live with us from Franklin Delano Roosevelt Veterans Hospital at Montrose; the hospital whose fate is now the subject of increasingly heated disagreement.

At any given moment, there were approximately 1200-1500 veterans, most suffering with psychiatric disorder, living in the dozen and a half residence buildings on the Montrose campus. The overwhelming majority of patients were diagnosed with one form or another of schizophrenia.

The hospital, if memory correctly serves, had opened some time in the early ‘50s, and the availability of effective psychotropic
medications was merely a prayer until 1965. Early drugs, thorazine, stellazine, and the like, tended to turn those who had been acting out
into zombies, more manageable in some respects, but clearly not prepared to re-enter the community without close supervision, and, often
beset with serious physical and pschological side effects.

At its peak, The Community Care Sponsors Program from Montrose involved some 105 participating homes caring for, perhaps,
seven to eight hundred veterans, who continued to receive medical and social work services, on an outpatient basis, at “Montrose”, as the
hospital came to be known. The homes were opened in seven counties, gradually radiating out from the Peekskill area, where there
were several, into Westchester, Putnam, Dutchess, Rockland, Orange, Ulster, and as far away as Columbia County.

Our home in Brewster was unusual given the fact that my wife and I were as young as we were. Most of the homes in existence, when we
entered the program, were owned and operated by middle-aged couples, or individuals, many of whom were retired former nurses, social
workers, or caregivers of one sort or another. For some, such as the operator of a dude ranch in Dutchess County, the veterans were merely
warm bodies, steady tenants.

The homes essentially fell into two categories, small ones, with perhaps one to six veterans, and big houses, such as our own, with as
many as 20. Such large operations were more like communes, or boarding houses for purposes of zoning. Many of the larger homes saw their
share of interaction with local zoning and planning boards, and we were no exception.

With the coming of the ‘70s, the State Department Of Mental Health, and the personnel controlling the State Mental Hospital facilities,
in part because of the advent of psychotropic compounds, medications that could be self-administered or distributed by lay individuals, now responded to governmental and social pressures to virtually “empty out State hospitals across the state. They saw our successful VA program, and were determined to cut costs; and, in their haste, the State, unfortunately, did little to nothing by way of establishing post-institutional housing, or af-ter-care facilities, and programs for the thousands of long-term, chronically-ill, mental patients they proceeded
to release into unprepared communities across the state.

In the meanwhile, the VA Community Care Program would find greater resistance to the establishment of sponsoring houses, caused,
in large measure, by the enormous problems being generated by the State Department of Mental Health. Then, in 1976, the Montrose program misguidedly overreacted to the burning down of one of the older, less-well-maintained, homes in Peekskill, where, fortunately, there
was no loss of life.

Nevertheless, VA bureaucrats, without justification, suddenly went about pulling people from the larger homes, despite their compliance
with the National Fire Safety Code. That “cover their own” move was devastating to the larger homes in the program such as our own,
who had never so much as had a fire in a wastebasket.

A program that had been increasingly unrealistic in terms of sponsor compensation, now cast many of their finest community homes into
bankruptcy, homes that one year earlier were identified as models for emulation across the country by the VA Regional Office, were searching for ways to remain afloat. And, at the same time, the VA was failing veterans and their caregivers in other important areas as well.

The Kingsbridge VA Hospital, in the Bronx, where veterans from the Montrose program were forced to go for any significant medical evaluation and/or surgical procedure, had deteriorated into a filthy, over-crowded bedlam, with raw garbage piled in hallways and patients infected and unattended for long periods. Veterans dreaded having to go there. Back in Montrose, although there were many dedicated nurses
and social workers who treated residents like family, it was also true that psychiatrists, physicians, and psychologists were often ncompetent, poorly trained, and poorly paid practitioners, many sticking it out for their government pensions. Many veterans receiving
outpatient care quietly understood and accepted the notion that their treatment was likely to be inferior to what they would have received
in a private hospital.

Orderlies and aides were another situation altogether at Montrose. While many were fundamentally decent, helpful individuals, there
were those who took advantage of veterans, both on the grounds and in the community.

The veterans who lived at Montrose, as well as in the communities serviced by Montrose, spanned many conflicts, from World War I
through World War II and Korea and, ultimately, in the mid-70s, from Vietnam. From a sponsor’s point of view, the Vietnam Vets were clearly a “different breed of cat.” I, for one, never accepted any to live amongst our residents. We were concerned, as were most sponsors, that those who came home from Vietnam had been exposed to drugs, and somehow would not fit in, socially with older men, many of whom had seen little, if any, combat, but had endured many years of institutionalization, some for 25 years and longer, without beneft of psychotropic medication. Vietnam Vets were clearly getting the short end of the stick in the Montrose program as well; and, they were more
savvy, more combative, with respect to their entitlements, than those who had come before them.

The vast majority of those who came through Montrose Hospital were veterans who never should have been accepted into the Armed
Services. The notion of “shellshock” was largely mythological. And, the old bugaboo VA concept of “service-connected vs. non service-
connected” as applied to whatever disability a veteran might muster out with, was often as mythological and nonsensical.

The second most heavily decorated veteran of the Second World War, Frederick W. Unger, lived with us for 16 years until we closed our
doors in 1986. Fred was a Front-Line Observer, who was documented to have killed more than 200 enemy soldiers in face-to-face combat
in both the First and Third Armies; having fought all through Africa and Italy with General George Patton, only to be transferred for service
under General Dwight Eisenhower, participating in the D-Day landings at Normandy, and walking halfway across Europe, to Berlin. He was
virtually a “killing machine” who went from Buck Private to Captain in a series of battlefield promotions. Fred turned down an early furlough, telling famous war correspondent Bob Considine, “I want to see this through with my men.”

When the war ended, he went back to work driving a bus for the City of New York for $1 an hour, six days a week. Because he worked
for more than a year before all that he had done finally caught up with him, causing his hospitalization, he was irreversibly adjudicated by the
VA as having a “non-service-connected” condition. Between 1968 and 1986, his monthly ‘pension’ went from $165 to $225.

Another of our veterans was clearly psychotic before entering the Army. He spent the entire Second World War in Fort Dix, New
Jersey, guarding German and Italian prisoners of war, often taking them to movies and other forms of entertainment. Upon discharge
from the Army, his condition was adjudicated “service-connected”. Between 1968 and 1986 his monthly tax-free disability check went
from $225 to $1895.

There were those sponsors who prided themselves in filling their homes exclusively with service-connected cases. However, we never
made our determinations based on a veteran’s ability to pay, but rather on how well they might fit, and how comfortable they might feel living with those veterans already in our home, and with our family. With respect to the current status of the Montrose campus, notwithstanding the proposal for private residential development, I would hope that services to veterans would be increased at the site
rather than chasing veterans in need of essential care all the way up the river to Castle Point. What, after all, is the logic of establishing
medical treatment and residential facilities in a location that is more sparsely populated and much further from the majority of veterans
needing such services?

For more than half a century, Montrose has been associated with veterans’ care and services. And, those services at that location are
now exactly what is needed, more than ever, to be expanded, and not curtailed and/or removed, to a more remote location.

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