- Marlborough Psychiatric Hospital opened in 1931 and served up to 700 patients at a time.
- Many staff members have fond memories of trying to help people, but recognize that their legacy includes patient abuse, indifferent employees, and bribery.
- New Jersey closed Marlboro in 1998, diverting funds to smaller community services.
As alumni of Marlborough Psychiatric Hospital gathered this summer for the facility’s 25th anniversary celebrations, they remembered their colleagues and patients as if time had passed.
They remembered a multicultural festival held on the hospital grounds. First patient to receive the breakthrough antipsychotic clozaril. And the teamwork that kept the workplace safe and created an extraordinary bond.
“I traveled all over the state and my favorite job was Marlboro,” said Grace Moore-Matts, 59, a social worker who now lives in Bethlehem, Pennsylvania. “There’s a famous saying that everyone says: ‘If you can work at Marlboro, you can work anywhere.’ Our hearts were broken when we closed.”
Twenty-five years after the National Marlborough Psychiatric Hospital closed, closing its doors is a symbol of New Jersey’s behavioral health system, instead “deinstitutionalizing” treating mentally ill patients in the community. started the strategy. of the hospital.
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Few people think the decision to close the hospital was bad. Marlboro’s legacy includes patient abuse, indifferent employees and bribery. But 25 years later, New Jersey still puts mental health first and is still struggling with a cure for the disease, observers say.
“Our lives are much better than they were a few years ago, but finding treatments and resources is difficult,” said Dr. Rashi Agarwal, director of residency programs at Rutgers New Jersey Medical School in Newark. It can be difficult,” he said. “It’s gotten better. We know more. But it’s still hard to access.”
Moore-Matz can recall the date of his first admission to Marlborough Psychiatric Hospital, January 28, 1987. It was the beginning of her eight-year career there, during which she developed a very close relationship with her colleagues, to the point of spending vacations with them.
The hospital was one of seven state-run psychiatric facilities. Built on 468 acres of farmland in western Monmouth County, the facility opened in his 1931 to provide long-term care for residents at risk to themselves and others from mental illness. Most of the patients committed the crime unwittingly.
The hospital employed 1,400 staff, treated more than 700 patients at a time, and worked to improve the mental health of patients so they could leave the hospital and live independently. But some Marlboro patients spent the rest of their lives in hospitals in oblivion.
A month after Moore Matz took office, State Senator Richard Cody heard of the hospital’s poor condition and decided to investigate. Using the armed robbery’s Social Security number and the rapist’s name, he applied for a job and was quickly hired.
Cody said he worked several night shifts, but remembers overcrowded conditions and inattentive staff with little to do with patients. During his first shift, he saw a nurse lying on the couch watching TV.
Codey eventually introduced legislation that required state agency applicants to undergo background checks.
“Mental health and what that focus is now is very different than when I encountered that situation at Marlboro,” Cody said in an interview.
Towards a good direction?
“Much better, much better,” he said. “People aren’t afraid to say, ‘I have a mental health problem.'”
The scandal didn’t end there. The history of Marlborough Hospital includes stories of abuse, bribery and environmental pollution.
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By the time Codey’s report came out, advocates viewed psychiatric facilities as inhumane and costly. They said that with the advent of antipsychotics, patients may receive better services outside institutions, as long as they have access to housing and treatment.
Marlborough was subject to closure, and the state diverted most of the hospital’s $68 million budget to community services. Patients were transferred to other psychiatric hospitals and group homes, but most were discharged and started living on their own.
Greg Roberts, the hospital’s chief executive officer at the time, told classmates at a reunion. Here is his message: “Marlboro closed not because we were doing a bad job. Marlboro closed because we were one of two state hospitals in the central part of the state and the state Rightly so, we wanted to develop stronger community mental health services.” “
“It was a good plan,” he said in an interview. “I think it’s been executed well by a group of really talented people. And the question now is, 25 years from now, what’s going on?”
Roberts, who now lives in Oregon, could have asked the question in a different way. “How does New Jersey treat mental health in the first place?”
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In the wake of Marlborough’s closure, experts said New Jersey’s mental health system includes public, private and nonprofit organizations that provide treatment in a changing field. Therapists use telemedicine to expand coverage. The school will bring in a therapy dog. Primary care physicians ask patients about depression and anxiety.
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In some ways, New Jersey is doing well. For example, the state has the lowest suicide rate in the nation. And while states have three-quarters of psychiatrists in need to treat demand, government data shows the shortage is not as pronounced as in countries with only one-quarter of psychiatrists in need.
Other indicators show that the state’s residents face the same challenges as the rest of the country. For example, death rates from drug overdose have doubled over the past decade and are now nearing the national average, said the Centers for Disease Control and Prevention.
But more people are starting to work on mental health, which is straining the country’s system, health care providers and advocates say.
A 2022 study by the New Jersey Mental Health Association found that patients in central and northern New Jersey seeking outpatient care have to wait an average of six weeks or more for their first appointment. Meanwhile, 25% of outpatient facilities are not accepting new patients.
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“We’re getting a lot of inquiries from more knowledgeable people as more people realize they can take the first step before a crisis hits,” said Joseph Galasso, psychologist and CEO of Baker Street Behavioral Health. says Mr. , based in Franklin Lakes. “In terms of utilization, it’s been going up quite a bit. But I think people still don’t fully understand what we’re doing. There are a lot.Myself, I’m going to meet someone.I may have tried two or three online services before I got to my office.”
As for involuntary hospitalizations, there are signs that New Jersey continues to seek solutions. Governor Phil Murphy recently overcame opposition from some liberty and mental health groups to allow hospitals to involuntarily admit mental health patients for three to six days, allowing health care providers to receive appropriate care. Signed a bill to increase the time to decide the law.
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“I didn’t put it together properly in the first place”
Providers are trying to fill that gap. Part of a program known as The Clubhouse, Long Branch’s Shore House provides residents diagnosed with mental illness with a place to meet during the day and on holidays to learn social and work skills.
The New York-based program launched its Rumson chapter in 2010. And with a nearly $500,000 grant from Monmouth County and a $100,000 grant from the nonprofit Impact 100 Jersey Coast, the organizers purchased a 3,000-square-foot home in Long Branch, Refurbished. . Reopened in June.
Executive director Rich Ambrosino said the aim was to prevent long periods of isolation that could lead people with mental illness back to hospital. However, the group does not provide clinical care, is not reimbursed by insurance, and relies primarily on private donations.
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Ambrosino said the money was well spent. “Readmission rates are much lower than those without club access,” he says.
Some supporters argue that New Jersey continues to take a tiered approach to mental health among its residents and would do better to invest in prevention.
Elena Kravitz, senior staff advocate and investigator for the New Jersey Disability Advocacy Group, said it was difficult for people to find stable, affordable housing in a state with declining inventories. is one of the biggest concerns. The number of homeless people in New Jersey topped 10,000 for the first time since 2015, according to recent reports.
“There are going to be people trying to fix things that aren’t actually fixed,” Kravitz said. “They were never assembled properly in the first place.”
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New Jersey is nearing the end of its environmental cleanup after it demolished Marlborough Mental Hospital in 2013, said Marlborough Mayor Jonathan Hoenig. The land will become part of the Monmouth County Park System.
Nearly 130 former hospital workers gathered at Jumping Brook Country Club in Neptune this summer. Despite all the scandalous headlines, they took pride in their work until closing day.
Grace Moore-Matts said she felt a stigma associated with the facility. Neighbors will ask how you can work there. But deep down, she knew she was making a difference in people’s lives.
She kept thank-you letters from the families of the patients she cared for, anonymously to protect their privacy, and reminded them of their support.
Sometimes she said, “It wasn’t until someone had a mental health problem in their own or a family’s life that I realized the importance of what we did in the hospital.”
Michael L. Diamond is a business journalist who has written on the New Jersey economy and healthcare industry for over 20 years. You can contact him at his firstname.lastname@example.org.