Steven J. Schwartz, an attorney who vowed never to leave Northampton State Hospital until he could help close it forever.

Transcript

Steven Schwartz interview, Northampton State Hospital

[date unknown]

CHRISTOPHER J. SPARKS: So, I’ll start. So can you tell me your name and what do you do?

STEVEN SCHWARTZ: My name is Steven Schwartz. I’m the executive director of the Center for Public Representation. And the Center was the lead attorneys in the Brewster v. Dukakis or Northampton State Hospital lawsuit.

CHRISTOPHER J. SPARKS: Can you tell me how you first heard of or encountered the state hospital?

STEVEN SCHWARTZ: I was working in a legal services program in Greenfield and it—another attorney that I knew had started a case at the Belchertown State School and then had begun to visit some residents of the Northampton State Hospital. He was appointed as a faculty at Hampshire College and asked if I would take over his Belchertown and Northampton clients, because he knew I had an interest in disability law. So my first time at Northampton was in a visit accompanying him to meet a number of individuals that he was assisting at the state hospital. I went to law school just a couple years—before I came out to western Massachusetts. I went to law school at Harvard and while I was at Harvard, my brother had a—a significant psychiatric breakdown and as a result of that, I became very interested in disability law. So I took whatever courses were available at Harvard Law School—which was only one at the time—on disability law and I began to teach some disability rights courses at the McLean Hospital, which is a hospital in Belmont, Massachusetts, run by Harvard, and I also taught some disability and prisoner rights at a couple of different institutions—prisoner—jails and prisons in southeastern Massachusetts. When I came out to western Massachusetts, I started working for farm workers—migrant farm workers and one of my first projects was to bring a lawsuit on behalf of those farm workers who were deemed by the growers to have a psychiatric disability and no longer be able to work and were sent back to Puerto Rico without any funds. So I brought a case on their behalf, which settled, and the farm—the growers stopped that practice. The individual’s name is Oliver Folks(??) who had started working at the hospital—who went on to Hampshire—brought me to Northampton one day in 1972 and I—had never—I had been at private psychiatric hospitals; I’d never been at a public mental hospital before. So I came to Northampton the first day and I remember quite powerfully walking into the rotunda of the main building, which was painted a god-awful lime green and then walking down the corridors—he actually had a small cubicle office on the very first floor—and then he gave me a tour of the hospital, walking around. I walked into the rotunda, I turned left and I walked down what was the first floor, called first floor west, I think, and then began—at the end of that corridor—there were no—the first floor corridor west was all offices, although there were a small number of residents—patients who were allowed to mill around on that one—on that floor if they had what was called “grounds privileges.” The vast, vast majority of people were locked in upstairs. So I took a back stairway and came to the first doorway on the second floor, same corridor west—that’s 2 West—and the only way to get in would be to knock and ask for a nurse who had keys. I remember standing at one of the windows that had iron mesh through the window, looking in, and it was at that time that I sort of became almost paralyzed with—it wasn’t fear. It was a deep sense of pain. And I looked through there. There were a number of people who had their nose pressed to the window, wanting to get out. A nurse came, pushed them aside—gently—unlocked the door, and let us in. And by the time I had walked just back across there to what would be the central corridor, I had seen probably forty people. The vast majority of them were either lying on the floor—all in hospital gurneys or gowns. I don’t remember anyone having their own clothes. Some people were locked in rooms. There was a fair amount of screaming and noise. The stench was overwhelming. And it’s that time that I know, you know, that I—needed to stay. I took—I probably saw another ten or twelve wards. I went up all four floors. I covered east and west, and then there was a whole back section that broke off into another wing. So I probably saw the equivalent of fifteen or so wards. They were almost all the same, except some were men, some were women. There were a couple of wards where people were distinctively older or a couple where they were younger. And there were some that were obviously more intense in the sense that the suffering was even greater because people were locked in or tied down in rooms. I knew nothing about what the organization was—that is, who was on what ward for what reason. There was a sort of short explanation that it had to do with levels of care, but that didn’t make any sense to me, partially because I didn’t know what it meant, but partially because there didn’t seem to be any levels or differences, except on a fairly nuanced basis. You know, the experience was so uniformly painful. It was such pervasive and profound suffering and there were such an extraordinary number of people. At that time, there were about nine hundred people at the state hospital. So when I did leave and stood outside and took this vow, I agreed with Oliver Folks(??) to assume responsibility for a few clients, but only on the condition that I could represent everyone. And—so I asked him—that he was going to have to help me negotiate with the superintendent so there would be no restrictions on who I could represent. And it was about a month or six weeks later that I moved into the office and I didn’t move out until 1992. That was 1972.

CHRISTOPHER J. SPARKS: Right.

STEVEN SCHWARTZ: Over the next four years, from the end of 1972 until—it was early 1973 that I started—until 1976 on December 7^th when we filed the lawsuit, Brewster v. Dukakis, I represented upward of a thousand people at the state hospital. I started a—this, the volunteer project and I started a advocacy project through Hampshire and UMass so that students would come and work at the hospital and also I would have some assistance. So by 1975, I had six people who were now—five people who were working with me. Many of them were students, so it was part-time. All of the people who worked there did essentially the same thing. We, over time, earned the trust of the superintendent. We were able to get keys to the wards. And we would go on most of the wards every day, visit different people, offer legal advice and legal assistance. People had rights that were, of course, not known to them, written down in some law book some place, so we would help explain to people what their rights were, advocate for a full enforcement of those rights, like the ability to talk to someone or visit with a relative or go to church. But mostly what we did was to try to get people out. And the way people got in to Northampton State Hospital, like the way they got into every state hospital in Massachusetts, had to do with a law that is called the Civil Commitments Statue. It’s a process by which a doctor can sign a piece of paper that rescinds the person involuntarily to a state hospital. Police or an ambulance will transport the person from wherever the doctor sees them to the state hospital, and under that law, they were required to stay there for ten days, and at the end of ten days, the hospital had to make a decision whether to release them or to file another paper that would result if—in a court hearing, and if they were civilly committed, they had to stay there at least another six months and the process repeated itself every six months thereafter. So—the vast, vast percentage of people at Northampton were there against their will, and so they had these hearings and we undertook to represent people to provide them a legal representation at the civil commitment hearings. So over the course of the next three years, I probably did about five hundred hearings with help from various students, and what became clear throughout that experience, repeatedly, was that most people did not need to be in the state hospital. Most people were being committed, not because they were really dangerous to anyone, but because they had nowhere else to go and there were no community services and supports for them. At one point, I encountered a gentleman from Springfield whose name is David Brewster, and David was at that—an African-American man who, at the age of sixteen, was riding a bus to high school and, while on the bus, he sat down next to a white woman and, during an interchange with her, put his hand near her leg. She got upset. She yelled. The bus driver stopped. They took David off the bus and eventually he was charged with an assault. Because David had some learning and intellectual disabilities, they sent him to Northampton State Hospital for an evaluation of whether he was competent and during the competency evaluation, some doctor decided that he should stay at Northampton for twenty days. I met David two and a half years later—after his admission and at that time, David was so institutionalized that he would not venture outside of a ten-by-ten foot cubicle where he shared a space with four other gentlemen. I represented David in the civil commitment hearing and a psychologist came and said that there was actually—that David didn’t even have a psychiatric disability, but he was now so institutionalized that the only way we could get him off his cubicle and off the floor—off the ward would be to provide a set of community supports because he couldn’t live alone. So I represented David in the hearing. David got committed because we didn’t have the community supports and David and I made an agreement that we were going to bring a lawsuit. So the lawsuit was filed with David as the—what’s called the lead plaintiff. That’s why the case is Brewster v. Dukakis. The defendant is obvious and the lawsuit was filed on December 15, 1976. The lawsuit claimed that David Brewster and a number of other people who were part of what was called the plaintiff class were being institutionalized against their will and without the need—without any clinical need for ongoing hospitalization. The case said that there were various federal statues as well as the federal constitution that was violated by David’s unnecessary institutionalization and it asked that the Commonwealth create a network of community support services throughout all four counties of western Massachusetts so that people like David and thousands of others could go home. The lawsuit went on for about a year and a half, at which point, the then-Governor Dukakis decided that he would engage in settlement discussions. Through the settlement discussions, we designed a plan for creating an entire system of community mental health services in western Massachusetts. The plan was a few hundred pages long. It had a lot of details about the types of programs and their costs and staffing and a number of other aspects. And the plan was—it was my hope that the plan would be agreed to by the governor and therefore made part of a settlement. At the last minute, after the plan was done and the governor was considering whether or not he would adopt it, he had a number of complaints about—a number of concerns: it was too detailed, it might be too expensive. He lost the primary to then—Edward King and it was clear that he was not going to be the governor anymore. So in the sixty days between the primary and the general election—actually, it was a little less—forty five days between that time, Governor Dukakis agreed to sign this as a consent decree. Consent decree is a legal, binding court order that people agree to do—to take certain steps that are designed to remedy the legal violations that were at issue in the lawsuit. So Governor Dukakis agreed to take the plan and we then drafted a legal agreement that, in so many words, said that the Commonwealth would implement the plan; they would do so in three years; as a result, they would phase down, but not phase out, the hospital; they would look at whether the hospital should continue and what would happen to the land and the employees if it didn’t continue. But they didn’t make a commitment to close the hospital in the consent decree. They did make a commitment to evaluate that. And then the commit—the consent decree also included a number of specific targets, like people who were elderly and people with intellectual disabilities—mental retardation—would leave first. Our interest was to be able to both have the people who were least appropriate for state hospitalization go first, but also people who the Commonwealth thought of course needed to be locked up in a hospital. And we wanted to be able to demonstrate that the people who were the most needy, who had the greatest challenges and—were able to live in the community, because we thought if we could succeed with them, then we could succeed with anyone. So the consent decree was finalized and signed by the governor and by myself and submitted to the judge on December 6^th. On December 7^th, the judge held a hearing at which he approved and signed the consent decree, and so one December 7, 1978, just eight days less than two years after we filed the lawsuit, the case officially was now in what they call implementation stages. Well, there were essentially three phases to the implementation. The first phase, which was the honeymoon, lasted for approximately three years, two and a half years. There was a huge momentum on the part of the Department of Mental Health to start up new programs, to take the plan that we had designed and to implement it, including filling in lots of technical aspects of it. The legislature appropriated all the requested funds, so the state could do that, and essentially, the plan got divided into three years and year one, year two, and about half of year three was implemented in substantial compliance with the court order. At the same time, the—during this honeymoon period, we negotiated with a department in an entire set of regulations about client rights, about a grievance procedure, about treatment planning, about family participation, about consumer control, and about—and policies and procedures about how all the new programs would run. So at the same time that the Department of Mental Health was implementing the plan, it was really negotiating many sub-plans that became part of the infrastructure of the entire community mental health system. In 1980—the beginning of 1982, the then-Governor King and two or three legislative leaders decided they had had enough of this case and they decided to close down as much they could—the case—so they stopped asking the legislature for money, they started fighting back with the court, and opposing many of the reforms that either they had agreed to or that had subsequently been negotiated. So phase two began in—early or mid-1982. It lasted for the next three or four years, during which time, we spent an extraordinary amount of energy, money, and my time in court—in federal court. We held the governor in contempt. The court of appeals issued four different decisions, two in our favor, two against, all of which dealt with under what conditions the legislature could be required to go along with and fully implement the consent decree. During those three or four year periods that are the second phase of implementation, very little positive happened. A small number of people did leave the hospital. The great majority of people had left, but a small number of those who remained did leave. Community programs were able to take a breath, because the first phase of implementation happened extraordinarily quickly. They were able to get better management and internal practices, but for the most part, it was a kind of frozen period of time in which—for people with disabilities, nothing happened, and for lawyers, a great deal happened—lawyers and governors and presidents of the senate. In approximately 1986, Michael Dukakis came back, became the governor again, and both because of his personal commitment to the consent decree that he had signed, as well as some of the public officials that he appointed to head the Department of Mental Health and other agencies, we moved into phase three. Phase three was essentially picking up where we had left off in 1982 and getting the rest of the job done. The rest of the job essentially meant that the remaining people—residents of the hospital who had not yet left, which included a number of elders—seniors—and people who had the most challenging psychiatric disabilities were provided probably more expensive, more robust, better staffed programs in the community so they too could return home. A second big thing that happened in the third phase was that we were able to negotiate arrangements with various community hospitals—Franklin County and Cooley-Dickinson, Baystate—hospitals that agreed to open small, local psychiatric wards that could ultimately replace Northampton and through the combination of those two things, the hospital population decreased below a threshold that it made any sense to keep the hospital open. Prior to that, there were plans on the table—in fact, architects had been hired and paid for—to design a new Northampton State Hospital that would serve about two hundred people. That’s about how many people we had in 1983, when the case went into deep freeze. And so these architects came, designed a very attractive mental institution, if you could have one, and the hospital—and we knew that if we didn’t get the case restarted and the population down so that it was significantly below two hundred and these plans would look stupid at some point, we knew we were in for a new state hospital, so that’s why phase three became such a strong push on the part of the Department of Mental Health and myself. By 1988, we had finished the agreements with—the hospital population was down, below a hundred and forty. We negotiated what was called “replacement beds” or arrangements so that approximately fifty—there would be approximately fifty beds across all of western Massachusetts. And at that time, the final push came at the end of the phase three to be able to place the difference, about seventy or eighty people, in the community so that the total hospital population would be at or below sixty. That occurred in 1990. We were able to hit that and then the Commonwealth said, “I think we’re done.” I said, “I think you are, though it would be wonderful if you could officially barricade the place.” So we had, at the end of the very last phase, discussions about what would happen with the facility and after a variety of other efforts to try to keep it open failed, we were able to barricade the front door. When I went to the hospital for the first time in 1972, it was clear that although the hospital was less than a mile from downtown Northampton, it was—it could have been a hundred thousand miles from City Hall or the court where the judges sat. The hundreds of civil commitment hearings that I did between 1973 and 1976 all happened at the state hospital. People in the state hospital never went downtown to go to court. The court came up to them. I brought a lawsuit in—a separate lawsuit in 1975 to try to enable residents of the state hospital to vote in the general election. Until that time, no one who lived at the state hospital was ever registered to vote, whether they had been there for four weeks or forty years, whether they were quite capable and read famous novels or had limited English speaking abilities. No one ever voted. And that’s because no one in town thought about anyone at the hospital as being a resident of Northampton. When we brought the lawsuit in 1976, one of the most fundamental goals of the case was to make the people of the Northampton State Hospital visible. Until that time, they were truly invisible to the residents of the hospital—of town. Occasionally, someone might escape and that became, obviously, a very newsworthy event, but for all other respects—and, of course, a lot of people in town or the neighboring towns worked at the state hospital. It was, by far, the largest employer in the city. But other than being an employment opportunity for people, it had nothing to do with integration. It had nothing to do with community living. It had only to do with invisibility. So we were greatly motivated by a underlying goal of trying to bring people who—the nine hundred people who lived at the state hospital—to bring them alive, to bring them home, and to make them visible. Shortly after the consent decree was signed, there was an effort to locate a new community residence—a group home in one of the wards of the town of Northampton. And there was huge opposition. The not-my-backyard syndrome surfaced and although the hospital had provided employment opportunities for thousands of workers, and was, in many ways, a source of great economic prosperity for the town, the idea that eight residents of the hospital would live in the town of Northampton created a furor. There were town meetings and screaming and fighting and mayor’s involvement and all of those things that, you know, you may have heard of that characterize some towns. So I thought, actually, that this was going to be a long haul, and particularly a long haul with the city of Northampton. Three years later, when the Senate refused to appropriate money for the next phase of the consent decree implementation, I walked downtown and I was just going under the trestle where the railroad tracks are and I looked up and I saw a sign hand-painted on there that said “People have the right to live in the least restrictive alternative.” Now, the least restrictive alternative is the legal theory that the Brewster lawsuit was based on. It was based on a constitutional right that people cannot be confined against their will except in what would be the least restrictive, the least intrusive, the least segregated setting, and Northampton State Hospital, we said, could never be the least restrictive alternative. In fact, we had—when the consent decree was signed, we had the folks who worked on the case had t-shirts made up that said, “People have the right to live in the least restrictive alternative.” on the front and on the back, “Northampton State Hospital can never be the least restrictive alternative.” And there was this sign that was painted on the overpass and it was a sign that everyone who came into the city of Northampton saw. And I realized that at least we had succeeded in making people visible and now the town was talking about people at the state hospital as having rights and I knew that when they thought that people had rights, that we had won the case. We had won the principle and that the town had turned around. And actually, I’ve come to see that Northampton State Hospital has not only broken down the wall that it kept up for close to a hundred years between the hospital and the community, but it has welcomed people into the community in ways that almost no city in the United States has ever done.

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