By Kathy Aney, East Oregonian, April 27, 2013

The article is the fourth in a series on mental health. In recent days, the East Oregonian has written about state plans to close Blue Mountain Recovery Center in January and local efforts to save the mental hospital from extinction. This story is a look at how treatment methods have changed in the center’s 100 years of existence.

Pendleton’s 100-year-old mental hospital wasn’t located by the railroad tracks by chance.

“Back in the day, people came here by train,” said Kerry Kelly, director of the Blue Mountain Recovery Center. “They’d get out, enter the hospital and live out their lives.”

The hospital’s moniker has changed over the hospital’s century of existence, beginning as the Eastern Oregon State Hospital and renamed Eastern Oregon Psychiatric Center and later Blue Mountain Recovery Center.

Mental illness was a hazy concept in 1913 when the Pendleton hospital began accepting patients. The term “schizophrenic” had just been coined. That very year the state hospital in Salem changed its own name from the Oregon State Insane Asylum to the Oregon State Hospital.

It was a time when medical professionals struggled to untangle physical, psychiatric and social symptoms and pinpoint root causes, said Dr. Rupert Goetz, chief medical officer at the Oregon State Hospital in Salem.

“In the 1880s, the leading cause of admission for men at the Oregon State Hospital was alcoholism,” he said. “The leading cause of admission for women was menopause.”

Even into the ’30s at the Pendleton hospital, adolescence, occult study, senility, epilepsy, drinking moonshine and syphilis remained reasons for committing someone into state care.

“Our knowledge of brain chemistry then was pretty rudimentary,” Kelly said.

Psychiatrists treated patients with chemically-induced seizures, hydrotherapy, lobotomy and other methods that eventually fell out of favor.

“The worst of it was the lobotomy, where the front part of the brain is separated from the back part with a blade,” Goetz said. “Nowadays, we think of that as barbaric, but a lot of people jumped on the bandwagon.”

It was a dark time for psychiatric treatment, he said, but also a time of discovery that eventually led to more effective therapies. For decades, however, many mental hospitals were like Hotel California — “programmed to receive.”

“At one time, there was the belief that people could never recover,” Kelly said. “The idea was custodial care.”

What a difference a century makes.

A banner in one of the Blue Mountain Recovery Center’s group rooms illustrates a radical shift in philosophy. The words are bold, brimming with hope — “You don’t belong here.”

Residents aren’t called “patients” any more. They are clients, most who are seriously ill with schizophrenia, bipolar disorder or major depression. Despite the severity of their conditions, however, most leave between 90 and 100 days. The center treats about 60 clients at a time and employs 117 staff members.

Most of the clients have violated some kind of societal norm. Kelly told of a woman who broke into a house where she had once lived.

The owners came home from church to find the woman had hauled all of their furniture onto the front lawn for a yard sale.

“The idea is to get them stabilized and back to their lives,” Kelly said.

Medication is usually prescribed, but therapists also teach clients to recognize early warning signs and arm them with strategies to control their illness.

“It’s a long process,” Kelly said. “It’s like a diabetic learning to regulate blood sugar or people with hypertension limiting salt.”

On the second floor of the aging building, psychiatric social workers Dawn Doran and Kathleen Lewis worked with a group of four female clients.

“What do you do when negative things happen?” Doran asked them. “What can you do to make yourself feel better?”

The women flipped through magazines, clipping out pictures of activities that help get them into happier frames of mind. They stuck pictures to paper with glue sticks. One client cut out a dog, river scene and a man building fence in a pasture. Another chose a sentiment she liked: “It’s never too late, you’re never too old, you’re never too sick … to start over again.”

Over the rustling of paper, the discussion blossomed.

Clients meet with psychiatrists and attend an array of other groups designed to teach them about their illness, give structure and provide coping skills. They work on self esteem.

“One of the hardest things for people with mental illness is battling the stigma,” Kelly said. “It’s easy to say, ‘I have diabetes.’ It’s harder to say, ‘I have schizophrenia and I hear voices.’”

The focus is recovery, Goetz and Kelly said, though that rarely means the mental illness goes away completely.

“They may never return fully to the way they were, but that doesn’t mean they can’t be very productive people,” Kelly said. “People with mental illness can lead very fulfilling lives.”