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Wards for profoundly retarded children are no better. By night, the children, many of whom have physical handicaps as well, sleep in closely spaced cribs. By day, they sit strapped into special chairs, recline in two-wheeled wagons that look like peddler's pushcarts or lie listlessly on mats on the floor. Some of the youngsters weep or grunt unintelligibly; most make no sound at all. A few children with severe physical handicaps but normal intellects share the accommodations; families unable to care for them have made them wards of the state.
Conditions in some of the men's wards would have made Bedlam look inviting. One ward holds 40 seriously disturbed adults, some of them violent. The ward is staffed by two attendants, one a woman; they have all they can do to keep their patients from hurting themselves or each other. They cannot always keep their patients healthy. Hepatitis, which thrives on poor hygiene, is rampant at Willowbrook. Many of the patients have diseases and defects that will ultimately kill them. Some die of other causes: ten years ago, a measles epidemic swept through the institution and killed 250. Of the 125 patients who died of various causes during 1970, nine choked on their own vomit before attendants could reach them.
Conditions at Willowbrook were not always like this; seven years ago they were even worse. When Dr. Jack Hammond, the present director, took over the institution in 1964, the patient population was up to 6,500. "It was both inhuman and unhealthy," says Hammond. "They were literally packed in here like cattle." To relieve the overcrowding, Hammond persuaded the state's department of mental hygiene to halt admissions except for special cases. But Hammond, with a budget of $33 million a year, has not been able to relieve Willowbrook's gross understaffing. In December 1970, the state imposed a hiring freeze on all institutions. Willowbrook, which then had 274 staff vacancies, is now 900 short of its authorized roster of 3,628. For sections housing the most retarded, the recommended staff-patient ratio is 1 to 4; in some of Willowbrook's worst wards now, it is actually 1 to 20.
Waiting List. Some relief is in sight. The department of mental hygiene's 1971 budget of $580 million had been threatened with a $20 million cut in the coming fiscal year. Responding to public pressure, Governor Nelson Rockefeller has canceled the cut, announcing that the department's budget will instead be increased by $20 million. That will allow Willowbrook to fill at least 300 vacant positions. But it is unlikely to improve conditions at the institution. "Attendants aren't enough," explains Hammond. "We need to get 2,000 patients out of here."
Such an accomplishment seems impossible. Most of Willowbrook's patients are there because there is nowhere else for them to go. Nearly all experts in mental retardation argue for small centers where patients can receive intensive attention from doctors, therapists and teachers. They also recommend day schools that allow all but the most seriously afflicted to live with their families but still have care. In most states such facilities are simply nonexistent. Willowbrook, despite its well-advertised horrors, has a list of 1,000 awaiting admission.