APPLICATION TO AN ALL MALE MAXIMUM SECURITY POPULATION

By David Jewell, Director, Activity Services

Directly across from the Chester Country Club one mile north of Chester is located Illinois' only maximum security mental health center. The facility, opened to residents only one year ago this past April 19, is unique in more ways than one. It is unique first of all by virtue of its modern structure which resembles a modern resort more than a maximum security facility. The only exterior giveaways are its twelve foot fence and electronic sensors.

The most unique feature, however, of the Chester Mental Health Center is its patient population. The all male population is in itself unique, yet other factors make the homogeneous population almost inconsequential. The residents at Chester are young (mean age-30.6 yrs.), for the most part literate (mean education—8.9 yrs.) and have a very low incidence of physical disability. All of the patients are at Chester for displaying aggressive, assaultive behavior with approximately 60% categorized as mittimus, or they have charges. The remaining 40% come to Chester from other state facilities after demonstrating the need for maximum security confinement and treatment. Of the total, 26% are at Chester for murder or attempted murder, 17% for robbery, 31% for assault, 8% for sexual acting out and 18% for other type of hostile, aggressive behavior (arson, attempted suicide, elopment, etc.). Seventy-eight percent are single, 6% married, and 16% divorced, separated or widowed. The average length of hospitalization is 18 months for the mittimus (charges) and 31 months for the non-mittimus (no charges).

The first and still most active of the treatment programs at the Chester Mental Health Center are those under the auspices of Activity Therapy Servies. At Chester, Activity Therapy is defined as a multi-faceted therapeutic service whose purpose it is, through physical and verbal interaction, to facilitate positive behavioral and social interaction and thought processes.

The specific goals of Activity Therapy Services at Chester are:

1) To help establish an atmosphere conducive to remission of inappropriate behavior precipitating hospitalization by utilizing individual and group Activity Therapy processes.

2) To augment or supplement formal psychotherapy and other therapeutic efforts by hospital staff on behalf of the individual patient.

3) To provide factual behavioral data for use in patient evaluations and diagnosis.

4) To contribute to and participate with other treatment staff in assisting the patient to bridge the hospital-community gap.

5) To provide opportunities for appropriate expression of physical and creative impulses.

6) To assist the patient in the development of positive leisure values and socially appropriate leisure interests and skills to facilitate facility and community adjustment.

In an attempt to meet the goals described several program areas have been provided. These include a gymnasium with a stage, an Arts and Crafts room, a music room, a pool room, a large outdoor recreation yard and on-unit activity areas. All of the off-unit areas are scheduled separately for each unit due to the size of unit population and the need to maintain security. Scheduling also guarantees that each unit has equal opportunity for area use.

With a ratio of 1:17 Activity Therapy Services provides numerous programs and opportunities for participation. In the gymnasium a full range of physical activities are provided, i.e., basketball, kickball, volleyball, dodgeball, racquetball, badminton, whiffleball, etc. The gymnasium is also

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utilized for special entertainment programs and weekly movies.

The music program is quite inclusive, offering band, chorus, music appreciation, musical drama, music lessons and music composition. The Activity Therapist responsible for music also conducts small group singing in each of the housing units and works in cooperation with the facility chaplain in supervising the church choir.

The arts and crafts program offers such media as oils, pastels, water colors, leather, decoupage, ceramics, copper enameling and sculpturing. The therapist in charge also provides materials and instruction for on-unit craft projects, those that do not present security or housekeeping problems.

The recreation yard is utilized an average of six hours per week per unit when weather and security staff availability permits. Softball, flag football, and "soaking up rays" are some of the more popular activities. The yard is also used for American Legion cookouts, unit cookouts and other special functions.

Due to structural limitation the on-unit programs are of a passive structure. Table games, ping-pong, bumper pool, record listening, on-unit movies, bingo, cards and shuffleboard are the primary program tools. It is in the unit that on-going leisure counseling is conducted with emphasis on leisure values and skills development. The unit activity therapists, besides providing activities, are also actively involved in treatment team functions. The primary purpose for their placement on the treatment units is to provide activities that are in keeping with the individual patient's treatment plan. This responsibility entails reporting to the other members of the treatment team on the patient's behavior and progress, conducting on-unit activities and coordinating activities with the central area.

The problem area that impedes A.T. programming to the greatest extent is the population itself. Three factors influence the implementation of programming—poor self-esteem, security measures required, and homogeneity of the population. In an attempt to minimize the influence of the first factor the A.T. program at CMHC provides programs which are void of external competitive pressures. The A.T. staff also attempt to establish a first name basis relationship from the time of the patient's hospitalization and attempt to convey to the patient their concern for his welfare.

The second factor, security requirements, can be quite frustrating to the novice, but the frustration lessens with experience. Becoming aware of patient histories and observing behavior makes the new staff member aware of the necessity for some of the limitations imposed by security. Yet, within the limitations there is a great deal of latitude,

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depending upon the initiative and creativity of the individual staff member.

The third factor, homogeneity of population, also becomes less frustrating with experience. There are certain mixer activities which are inappropriate at Chester, but the recent addition of numerous female staff has compensated somewhat for the lack of female patients. Also, expanding existing program areas has been of major benefit. Both have had a tremendous normalizing effect with respect to approximating community living. In summary, the Activity Therapy program at CMHC is valuable from two perspectives, as behavioral management and as an on-going treatment or therapeutic program. Dr. Terry Brelje, Superintendent, recently stated "In any institutional environment, particularly a closed one, there is a substantial need for a viable program which is able to bridge the gap between the analyst's couch and daily living. At Chester, the Activity Therapy program is the one which effectively meets this need. Programs are creatively integrated and implemented in such a way as to dramatically coalesce the clinical with the physical. I am sure that a large degree of the treatment success we have with our residents can be attributed to our Activity Therapy staff and their efforts. Our experience also indicated that the involved patient is less frequently involved in destructive or aggressive incidents. For such reasons, Activity Therapy receives a great deal of emphasis in our treatment planning."

Seminar held on park security—Nearly 100 representatives from park districts around the state Saturday attended a seminar on police powers for park commissioners and park policemen sponsored by the Illinois Association of Park Districts and held at the Holiday Inn. Among those present were, from left, Donald Earley, East Chicago park commissioner; Donald Palzer, president of the Kankakee Valley Park District; State Rep. Edward McBroom, R-Kankakee, who spoke at the luncheon; Norman Smalley, Elmhurst park commissioner, L. Patrick Power, Kankakee County state's attorney and Robert A. Stuart, general counsel, IAPD. Springfield. Earley and Smalley are members of the IAPD board of directors as is Palzer, who chaired the seminar. Power spoke on cooperative investigation between park districts and the state's attorney's office.

Illinois Parks and Recreation 23 November/December, 1977