Science in Christian Perspective
From: JASA 14
(March 1962): 29-30.
One of the most interesting attempts at building a modem mental hospital, using the latest concepts in treatment and environment is being made at Le Mesnil St. Dennis, near Paris, in an old castle.
Having made arrangements to visit with Dr. Swadon, the medical director, we arrived about 2:30 on Saturday afternoon. The French have very different ways of doing things. This is especially noticeable on weekends. Saturday is just another day to them. Schools meet Monday to Wednesday, are off on Thursday, then go on Friday and Saturday. Most stores close from 12:00 to 2:00 or 3:00, and sometimes 4:00 p. m., and stay open until 8:00 or 9:00 at night. Therefore, the strange time for an appointment with the director at 3:00 p. m. Saturday was not unusual.
The first impression one gets in this hospital is that of peace. The setting is large-200 hectares or about 500 acres. Landscaped gardens of a formal type take up most of the space in front of the castle. Pools, greenhouses, basketball courts, etc. were in evidence alongside the garden.
To the left as you go into the castle, is a large forest, criss-crossed with paths. Again the predominant impression is peace and quiet. As we were early, we looked over the grounds thoroughly. The castle and inner court itself is surrounded by a moat.
Dr. Swadon was in his office as we returned from our stroll. He had just arrived from Paris where he was opening a day center for mentally ill patients who stay at home and spend 8 hours a day in the clinic, undergoing treatment.
It took some time before the picture of this unusual hospital became clear. It is established by the Mutuelle Generale de PEducation Nationale-which according to our best understanding was like a teachers and professors trade union, that provided hospital care for its members. This was but one unit of a rather large group of hospitals. Some funds likewise come from the government. However, control of this particular hospital is pretty much in the hands of Dr. Swadon.
Actually the hospital is only four years old, and has 90 patients. The modern plant is in process of being built. Plans have been completed and some of the new buildings are nearly finished. The castle itself will not be a part of the hospital proper, but will be used as a school, and as guest rooms, when the plant is completed. The total number of beds will be 300.
This hospital is a model one, which was planned with the World Health Organization. There are to be three main "villages" where the patients will live. The first one is rather compact, four buildings making a square. Within this square are smaller squares. The idea here is that when the severely disturbed patient comes in, he first finds security within his room. As he improves, he can venture into a larger sphere, but with the limits still carefully defined. As he gains security here, his horizon expands to a larger area composed of several buildings, but still confined, and clearly structured.
His next vista is the rehabilitation shop which is still part of his "square." Here he meets patients from other "villages," and as he again gains security, he is led toward the social center, a part of a much larger social and environmental area.
When the patient's growth is such as to merit it, he is transferred to another "village" which has less structure. As a final stop, he goes to the third village where there is an attempt to duplicate the crowded atmosphere of the actual village or town where he was from. The small community nearby is drawn into the picture through the sports area, and the recreation units. He thus begins to feel a part of the community before leaving the hospital. A special school will be constructed nearby where the mentally ill, and by now nearly cured, teachers will spend time observing and gradually participating. Thus the break from the hospital to community and the job will be very gradual.
In connection with the above is the hospital's "hospital." Severely disturbed patients may start out here. Any illness or emergency operations will be taken care of here as well. Any stay in this part will be only temporary.
In this "hospital," treatment of various types wi 11 be utilized. Hydrotherapy, physiotherapy, chemotherapy and in some cases psycho-surgery may be used. In most cases patients will come for treatment but will remain in their own rooms for the greater part of the time. The rooms are built in such a manner that they can be used in a flexible manner with the maximum use of personnel involved. Two, three or four rooms may be joined by an open corridor where one nurse may have ready access and observation.
As has no doubt already been surmised, the hospital operates on an "open door" principle. There are no locked doors, and patients are free to come and go at will. It is hoped that the security of the hospital is of greater attraction than the surrounding woods or open fields! The primary type of therapy used is in small groups, although individual therapy is also utilized.
The hospital is not a typical French one, but it is one that is fascinating to see. If anyone of you comes near at any time, be sure to include it in your itinerary.