The director of the state Department of Mental Health challenged the nation's mental health system Thursday to undergo holistic reforms already active at the more than 1,000-patient Napa State Hospital, stressing that recovery from serious mental illness is possible.
Dr. Stephen Mayberg said much of the nation's mental health system is "in shambles" and called for more acceptance of mental illness as part of overall physical health, more patient-centered treatment and earlier identification of serious mental illnesses — recommendations stemming from Mayberg's involvement in a 2003 presidential commission on the subject.
The recommendations are also part of the driving force behind a five-year plan at Napa State to redo treatment models. In the last year the actions have reduced the amount of time patients are placed in restraints, among other changes, and convinced regulators to spare the hospital from a round of penalties over allegations of poor care.
"We really underestimate the power and strength of the human soul," Mayberg said, touting the ability of the hospital to turn psychotic illnesses like schizophrenia on their heels. "People used to say (schizophrenics) would never amount to anything."
His remarks rallied a crowd of about 300 hospital staff, patients and community members on hand for the hospital's 130th birthday celebration. Napa State patients later rose from the audience to perform musical routines with taiko drums, play in a blues band and treat guests to a hand-clapping full-throated gospel choir.
Guests later took tours of the facility's less institutional areas, like the patient fine arts program and vocational programs where patients can earn money, learn work skills and gain self-esteem doing things like reupholstering fine furniture.
Mayberg said the medical science used at Napa State is drastically improved from the 1800s when fresh air and farm labor were used as treatment, but in some ways the hospital's mission had not changed much since it opened Nov. 15, 1875.
"Our mission and our role is to get people and give people skills so they can move back into the community," he said.
The celebration was also a chance to look back at Napa history, when in the days before wine tourism, the original Napa State asylum wowed valley visitors with its seven gothic towers. Hospital officials displayed a collection of century-old postcards with the old "castle" complete with messages on the back from 19th and early 20th century visitors scrawled in cursive.
According to the book, "Napa Valley: From Golden Fields to Purple Harvest" by Denzil and Jennie Verardo, the original asylum was the brainchild of Dr. Edmund Wilkins after he toured 149 mental institutions around the world in the early 1870s.
The state chose Napa as the sight to build the 192-acre asylum because it "offered good land at reasonable rates." The early asylum was nearly self-sustaining, with live-in staff, vegetable fields, orchards, cattle, a bakery and a wharf on the Napa River to receive supplies that couldn't be made at the hospital.
"The occupational therapy programs proved successful and the fresh air and outdoor environment seemed to have healing powers," the Verardos wrote.
The state demolished the old castle structure in 1949 to make way for more modern facilities, many of which are still standing today.
The hospital hit its patient peak in 1960, when it housed 4,991 patients, but in the same decade regional and county programs took some of the burden away from the hospital and admissions declined. Today, state law allows the hospital to house 1,300 patients.
Dave Graziani, executive director of Napa State, said the future of the hospital lies in its new recovery model, which aims to work at the speed individual patients need, rather than a pace imposed by outside deadlines.
Part of the change is in creating what are called "treatment malls" that offer recreational, educational and work choices outside of residential dorms, so patients can have a routine separate from their residential life, more in line with what average working people experience.
The new model also seeks to incorporate patients' family members into the treatment program and use things like religious faith or spirituality as a key component of recovery.
Mayberg said one of the most powerful ways to motivate patients to work hard toward recovery was to find ways to give them hope.
"We start building on strengths, we start building on hope," he said.