A novel question

July 22, 2022 5:43 PM

In the novel (NOT the movie) Ordinary People, Conrad is sent to a psychiatric facility for 8 months. Two questions about that.

This is strictly about his stay there. I am not asking for opinions or analysis of the novel itself or the characters.

I want to know if 1.) Stays of 8 months were common when someone was committed for attempted suicide in the late 70's and early 80's and 2.) Why does the novelist have her character Conrad sent to a Southeast Michigan psychiatric facility, when he lives in the state of Illinois, near Chicago?

Likely I could research this on my own, but I am not sure where to start looking about mental hospital stays in the Midwest in the late 70's and 80's, not being in the psychiatric field, not being in the Midwest, and this not being the 70's and 80's. Google doesn't turn up much. It bugs me mainly because it seems like an excessively long stay for someone like Conrad, and because surely they had mental hospitals in Chicago where they could have sent him.

I am strictly interested in how realistic this might have been for the time and place. Not in all the social issues surrounding the topic, because I am trying to get this question answered without it being deleted as chatfilter.

Thanks.

posted by Armed Only With Hubris to Media & Arts (10 answers total)

Eight months or a year would not have been an unusually long period for people going into fancy residential facilities like McClean or the Institute for Living or Menninger's. I know because some of my family members have been treated in those places. And going out of state would not be uncommon at all. It's more surprising to me that someone from Lake Forest wouldn't be going to one of the really well-known places in the East, or to Menninger's.

I'm pretty sure a psychiatrist who's been around for a while could fill you in further.
posted by BibiRose at 7:08 PM on July 22, 2022 [2 favorites]

I haven’t read the novel. However, some context might be provided by Susanna Kaysen’s memoir, Girl, Interrupted. Ordinary People takes place in 1975, while Kaysen’s memoir tells of her 18 months at McLean starting in 1967 after a suicide attempt. So the extended stay doesn’t seem out of proportion. Kaysen and Conrad are both older teenagers.

As for the location, some psych facilities are going to be nicer and safe than others and medical professionals at the time might refer their upper middle class teenaged patients to “better” facilities and I could see those being farther away. I don’t know the Midwest but for example, McLean mentioned above, has attracted a celebrity clientele. (Silvia Plath stayed for 6 months in the 50s, David Foster Wallace only stayed 4 weeks, Marianne Faithfull and Ray Charles both stayed there despite not having real connections to the area.)
posted by vunder at 7:10 PM on July 22, 2022 [2 favorites]

Yeah, Conrad’s experience may be different than a working-class kid’s at a state-run hospital might have been.
posted by The Underpants Monster at 7:15 PM on July 22, 2022

Best answer: I know because some of my family members have been treated in those places.

Can concur in terms of McLean. Many of the nicer places would have people traveling from out of state. I've had close family who have been in McLean for something not quite as severe as suicide and severe depression (and more recently than the 1970s) and they were there for months. The speed of everything was also just less of a thing on the 1970s. The place Conrad is staying has "lifers" as well as people who leave and it's possible when he was admitted--it's been so long since I read the book-- they weren't sure which one he would be.
posted by jessamyn at 7:30 PM on July 22, 2022 [2 favorites]

It's also just a few hours' drive between SE Michigan and Lake Forest.

Back in those days insurance wasn't trying to get everyone discharged every single day.
posted by praemunire at 8:18 PM on July 22, 2022 [2 favorites]

Best answer: Psych meds have also evolved a huge amount between now and then. Partially as a result of that, in the ~80s there was a huge push towards treating psych disorders in the community vs. in inpatient facilities- this is what led to the closing of a lot of the big state mental hospitals. There were some pluses and some huge minuses to that movement (the biggest I think being the total failure to create an outpatient infrastructure of therapy, supportive housing, etc. that could meet the need in the community).

I think the psychodynamic approach to therapy, which tends to involve a lot of therapy over extended periods of time, has become less popular since the 70s and has been replaced by shorter course, less intensive approaches like CBT. Also not a value neutral change, depending on who you ask, but could help explain why longer inpatient psych stays were more common back then.
posted by MadamM at 8:29 PM on July 22, 2022 [3 favorites]

I believe a stay of several months at a hospital in a distant city was not uncommon. My mom tried to commit suicide in the late seventies. She was admitted to a large psychiatric hospital in another city and stayed for three or four months. There was lots of psychiatric therapy involved, lots of time spent trying different medications to see if anything made a difference. She also had electroconvulsive therapy. This was before SSRIs or any of the modern antidepressant miracle drugs. Dad couldn't cook so we spent the whole time eating fried hotdog sandwiches (don't ask). Eventually she came home and seemed pretty happy.

I guess things changed a lot in healthcare after that. Prozac, Zoloft, etc. came on the market. Psychiatric care moved away from therapy and more toward prescribing pills (according to my psychiatrist at the time, who was unhappy about the shift because he liked 'talking to people'). The large psychiatric hospitals were closed down.

The sad bookend is that my mom tried to commit suicide again in 2000. She was sent to a local hospital for a few weeks. The doctor prescribed her a pill and released her, and she killed herself the day after she got back home.
posted by jabah at 6:14 AM on July 23, 2022 [5 favorites]

Response by poster: This is all very interesting. The part about the shift to medications explains a lot. Also relevant is that the hospital mentioned in the book actually closed in 2003, and was torn down in 2018.

Thanks for all your answers.
posted by Armed Only With Hubris at 11:58 AM on July 23, 2022

The long stay in a remote mental hospital occurs in other works of that period. I am thinking of the Natalie Wood character in Splendor in the Grass and Joanne Greenburg/Hannah Green in I Never Promised You a Rose Garden.
posted by JonJacky at 1:53 PM on July 23, 2022 [2 favorites]

And it was the insurance companies who helped the closures by cutting off reimbursement; ah, those glory days in 1989-1992 when they cut the number of inpatient days for drug addicts from 9 months to 10 days.
posted by Melismata at 4:27 PM on July 23, 2022