Wellmet: Harvard's Halfway House
Mission with Mental Patients Therapeutic for Students Too
In a rare moment of frankness, a Harvard student was talking about life in the dorm. "It's not so much that people appear self-conscious," he said, "though of course they are, but that people are devastatingly image-conscious. You are typed and categorized according to the front you present, and forevermore you are put in the arty set or with the heads or among the wonks or jocks. You can't stand naked before anyone but your roommates and your girlfriend. You are given an identity which you begin to believe in yourself, and once you're in that bag you're hung up for life."
Many students at some time have this feeling of impersonality, of being separately wrapped packages on a storeroom shelf. The resulting dissatisfaction drives some to drop out, to see a psychiatrist, or to resignation; others overcome it by finding new perspectives or new friends. One group of students have found a gutsy life in a cramped little house near Inman Square called Wellmet.
At Wellmet, Harvard and Radcliffe students live with mental patients and try to rescue them for society. How a student is motivated for so total a commitment is a fascinating question, just as are the patients' own stories.
One of the better-known courses at Harvard is Social Relations 120, a self-analytical discussion group which has been called "seeking academic credit for sadism." The course's intensity is tempered by its meeting only three hours a week; the imagination quails at the idea of a similarly piercing exploration extended to 24 hours a day, seven days a week. Yet that is what Wellmet sometimes seems like, with a difference--roughly half the group has spent up to 20 years in mental institutions.
Loosely termed a halfway house, Wellmet is unique both in its student staff and in its patients, carefully referred to as residents. The project was begun seven years ago by Harvard and Radcliffe volunteers on the Phillips Brooks House hospitals committee who decided that their efforts would be most useful with mental patients. The students moved from the psvchiatric division of Massachusetts General Hospital to the mammoth wasteland of the Metropolitan State Hospital for the Mentally Ill, where in all but a few wards the ratio of patients to psychiatrists is about 600 to 1. The volunteers discovered that patients' responses to individual attention were only sporadically encouraging, and, puzzled, ten of them decided to find out why. They got permission to live on the wards for ten days. Convinced by the bleak despair that human beings could only degenerate in such an atmosphere, the students became equally convinced that many patients' psychoses would burn off in the outside world. They raised funds, stirred enthusiasm, and established Wellmet's first house.
That first year was the roughest. Neither Harvard nor Radcliffe would let students live with the patients, and the house mysteriously burned down. But more funds were raised, the house at 11 Marie Avenue was bought, and first Radcliffe, then Harvard, capitulated. The students moved in, and Wellmet began to have a past and a future.
Visitors to Wellmet find a homey place strewn with ashtrays, records, clothing, and people. Despite the diversity of accents and ages, the occupants seem to have the chaotic cohesiveness of a family. Numbers fluctuate, as does everything at Wellmet, but usually there are six students and eight residents. The house parents, an ex-minister who teaches at Newton High School and his wife, live with their two children in the two first-floor bedrooms. The residents have the second floor and the third is reserved for the students.
What makes the place different from other halfway houses are the patients who live there. Contrary to the usual practice of taking people who have been in the mental hospital only a short time, Wellmet accepts people whom the hospital has given up as hopeless and whose families have forgotten them. Jean Carmel, the vibrant, charismatic executive director of Wellmet--herself a former director--says that most families with a mentally ill member have struggled so long with the problem that the patient's incomprehensible tantrums and truculence have become "a living thorn in their sides." Therefore when the patient is making no progress under therapy, the hospital can persuade the family to let him be consigned to a back ward and let his therapy be discontinued. Hampered by insufficient personnel, the hospital is often forced to give up on unresponsive patients.
Their chance of recovery almost irrevocably gone, these patients are doomed to years of lonely rotting under custodial care unless a volunteer or social worker takes an interest in them. Jean Carmel describes with pride one such woman who spent her days lying on the floor. During her first month at Wellmet she refused to leave her room except for meals, and then only after great coaxing. Eight months later she got a job and not long afterwards moved out on her own.
Such a metamorphosis is no more dramatic than the change patients face in leaving the hospital behind to enter the "total environment" of Wellmet. Some are terrified. As Mrs. Carmel says, "They've been out of this world for years." All social contacts are nerve-wracking, and there is the constant threat of regression into old problems. The residents, mostly in their 30's and beyond (but lately younger), usually receive no real therapy, the reasoning being that it's best to leave capped what they have capped. But the house has a psychiatrist and a psychologist as consultants. They come to the weekly discussion periods, prescribe medication, and are generally available, but nevertheless are on the periphery. According to Mrs. Carmel, they are there as much to learn from the students as to teach. The residents work their problems out in real situations instead of in the artificial confines of the psychiatrist's office.
Wellmet's immediate practical concern is to find the patient a job or to bring him to the point where he's ready for a job. The theory is that a patient must have a job to survive in the outside world; he must avoid becoming too dependent on the students, and he must learn to fend for himself. Mrs. Carmel says that the most sensitive problem is matching the person to the right job. Some residents are afraid to exercise their full potentiality, taking a dishwasher's position when they are suited to a responsible and creative job, while others develop impossible aspirations from associating with the students. Usually a compromise is worked out which, in the words of another staff member, "may not be a glorious, wonderful life, but still is the best a patient is capable of." Once past the tough stage, Mrs. Carmel says, residents are good workers. "They're sodamned glad that someone has given them a chance."
The house is not so ecstatic about its failures. A student says, "we feel guilty when we fail with someone...we don't want to leave anyone in the bin. We do all we can to bring them back." If a patient cannot be on his own after three years at Wellmet, the group tries to make other arrangements for him in a family care home, the city infirmary, or a place for disabled people. A recent resident, a 15-year-old girl, had to be sent back to Met State when the house could not keep up with her constant demands for attention which culminated in a pretense of taking an overdose of pills. But the group hopes to be able to accept her again in the fall.
Another incident was precipitated when a resident surprised everyone by signing himself back into the hospital. The students decided that henceforth each would involve himself with a particular resident so as to be able to predict storms. Fortunately the patient returned three days later. The students found that structured relationships were not so successful as the normal give-and-take, but the experience was useful for all concerned.
The house's major decisions are made in the Wednesday meetings. There are two, the first closed to the students, patients, and staff, and the second consisting of students, staff, and anyone else--except patients--who wants to attend. Ae Wellmet's only formal institution, the meetings are sometimes brutally frank. "Sometimes I dread Wednesdays," one student says. "My head is absolutely squishy after the meetings," a staff member comments.
The upstairs meeting of students and staff is spent evaluating patients' progress, analyzing incidents, and making plans. Recently the group was discussing a new resident, and indecision brought about an articulation of the project's aims.
"Wellmet tries to teach how to use people."
"No, how to trust people."
"No, how to be closer to people."
Judgments are made of the patient. "Is he sick enough for Wellmet?"
"What will the impact of living in Wellmet be on him and his life?"
"Will he go back and always make the shell that always cracks again?"
How much will he depend on the students? The extent of a resident's demands is a crucial factor in determining his acceptance. Too little, and the project's reserves are wasted. Too much, and the students are drained.
At first glance, life at Wellmet for a student might seem to be a continual draining. How can a student cope with academic and personal problems when residents intrude on him with requests to hear a poem, to amuse them, to reassure them, to discuss their troubles? What keeps the students going through the constant frictions, the harrassments not only of the residents but also of the other students in the crowded quarters? How can they resist the barrage against their emotions and personalities?
The students speak of escaping the alienation they feel elsewhere, of negating the impersonalization. But these are big words for an accumulation of small satisfactions. Jean Carmel thinks that because the students spend their semester at Wellmet in an atmosphere of real tragedy they are forced to draw upon their own deepest experiences to respond to and exercise judgment on residents. The responsibility is similar to that of determining the fate of a family member. "Certainly they possess idealism and altruism," she says, "but their most striking characteristic is a belief that they can find answers themselves. They do. They get back tenfold what they give."