"Everybody in town either worked there or knew somebody that did," said Kevin Rogers, the maintenance supervisor for the Waterbury complex.
Rogers grew up in Waterbury and knows every inch of the state hospital perhaps better than anyone. "We all heard all the jokes -- if you were bad you were going to get sent to Waterbury, but to us, we like being from here," Rogers said.
Rogers' father started in the plumbing shop and his mom was a medical records secretary. "I used to come to work with my dad, walk around with him on weekends to do odds and ends. If he got called in I would come with him, going into wards and -- it was a little scary when you were younger," Rogers said.
His first of many jobs over a 35 year career was as a custodian, working on the wards with the patients. He witnessed a remarkable time in the treatment of the mentally ill. Anti-psychotic drugs that came into use in the late 50's and 60's triggered a downward trend in patient populations. By 1978, the population was down to around 300. And the state, looking to capitalize on new real estate, moved the Agency of Human Services into the Waterbury complex.
But the skyrocketing costs of running such an old, outdated facility with a dwindling population were not sustainable. In 1986, Federal investigators visited the hospital and ultimately took away the hospitals accreditation. It wouldn't be the last failing inspection. A study that year was the first to recommend closing the hospital. "The patient care units were more like a prison than a hospital. They bore no resemblance to a modern hospital," said Robert Pierattini, Chair of the University of Vermont Department of Psychiatry.
"It was a gloomy kind of dark place. It wasn't a pleasant place where people would feel good about being there -- and that went for offenders and staff. It was just too damn old," said Con Hogan, a former AHS Secretary. Hogan took part in another study group that recommended closing the out-dated hospital and opening a new one. "We wanted to see how far we could go safely by reducing that population and I thought we were very successful," he said.
By 2005, after the hospital lost accreditation for the second time, the idea of closure had gained traction, but it took six more years and Tropical Storm Irene to get the job done.
Like the 1927 flood before it, Irene inundated the network of tunnels under the hospital -- leaving layers of mud and ruin in its wake and closing the hospital for good. "It was just a problem that never got solved, until nature took charge," Hogan said.
But the devastation and consequences of closing also left a gaping hole in the Waterbury community. "So when the flood came it became clear to me that we needed to have an event of some sort to commemorate the closing of it -- when the governor said we were never going back to Waterbury for mental health care," said Rep. Tom Stevens (D-Waterbury).
Last fall Stevens organized an elegy for the hospital, inviting former patients, staff and residents to an art installation in one of the old circular wards. "For some people they hate the place and other people think it was the best thing that happened to this town and they're sorry it had to close down," Stevens said.
Over the next two years, demolition crews will tear down all but the historical core of the Waterbury complex, leaving the hospital much as it was before the turn-of-the-century. State curator David Schutz has led an effort to preserve some of the artifacts from the early days. "We're talking about how Americans, not just Vermonters, responded to the challenges of dealing with mental illness. And that is a story that has not been fully told. it is a story that has often been swept under the carpet to some extent, with a bit of embarrassment," Schutz said.
Since the closure of the 54-bed hospital in 2011, The state's Mental Health infrastructure has been stressed to the limits. A shortage of beds has meant critically ill patients -- which in recent months has averaged around 40 -- have had to wait on occasion upwards of two days in Hospital Emergency Rooms before being admitted. In an effort to create a new model of community-based care, new facilities have opened in Morrisville, Brattleboro, Rutland and Middlesex.
Meanwhile, far from the floodwaters of the Winooski, a new $28 million state hospital is rising in Berlin. Designed to handle upwards of 25 patients, age-old questions remain -- will there be enough capacity?
"There's a lot of uncertainty. Right now we clearly have too few beds. We're waiting for 25 to be built for next spring. Whether that will be enough, we just don't know," Robert Pierattini said.
What's the right balance between community-based care and a specialized, stand-alone facility?
"There are a very limited number of people that we just don't know enough to deal with safely and properly outside that kind of supervision, so I think that's an important tool," Con Hogan said.
And what have we learned from the treatments of the past?
"I think we tend to judge to judge based on what we know today, and that's not always fair. I think a lot of times people were trying to do the best. And I'm not saying everyone's motivation was as good or the same, but I think a great number of people had all the best motivations," Rep. Anne Donahue (R-Northfield) said.
Lessons learned from a century of mental health care in the Green Mountains.