Where Are the Straitjackets?

Five days a week, amiable Roland J. Brand, 57, is out of bed by 4:15 a.m. He walks his Doberman pinscher for half an hour, gulps his breakfast (nothing but cold black coffee), picks up a couple of sandwiches that his wife has made for his lunch, and catches the 5:10 streetcar from his home in West Allis, a Milwaukee suburb. From 6:20 a.m. until 3 p.m. Brand works at a job which many people would call tough, unpleasant and underpaid.

Brand is a $220-a-month* attendant at the Milwaukee County Asylum. There, he is responsible for a 70-bed dormitory and a ward of 124 male patients who are "disturbed," i.e., violent, potentially violent, or criminally insane.

No Restraint. To encourage good work by attendants, the National Mental Health Foundation last year began naming a "Psychiatric Aide of the Year." This week the 1948 award ($500 and a citation) went to Milwaukee's Brand. Chief reason why he was picked by a board of judges that included Author Mary Jane Ward (The Snake Pit): he has stopped using "restraint" (hospital lingo for straitjackets, "camisoles," belts, wristcuffs, etc.). In his ward, Brand has been trying kindness and reasonableness instead.

World War I Veteran Brand, a onetime shipping clerk who lost his job in the '30s, has been a hospital attendant since 1935. In 1947, after observing for a week at an Illinois state hospital, where the law forbids restraint, he got permission to try the method. In his own ward at the Milwaukee County Asylum, 32 patients had been tied up. He took the restraints off every one. Says he: "The freed patients were like horses that were tied up for years in the barn. Let them go and they run and kick. So I let them. They were happier than they had been for years. I figured there'd be lots of fights. But there weren't any." One of his patients, who had been in constant restraint for eight years, is now in charge of a ward bathroom and is proud of his responsibilities.

Just Hang On. When Brand began his experiment, he hid the straitjackets to keep other attendants from using them. Now, he says with a grin, he has forgotten where he hid them. There is also less need, he finds, for "chemical restraint" (sedative drugs). When a new patient arrives, often in a straitjacket, Brand has a technique: "I give them a good talking to. 'This is your home,' I tell them. 'It's up to you if you are going to have a new life.' Most of them really understand me. Not one has ever tried to strike me." But even if patients should hit an attendant, Brand says, the attendant should not strike back, but "put them in a side room and tell them to lie down."

With some of his award money, Brand expects to pay off a $200 balance on a new bathroom and get the house painted. The award, he thinks, is a fine thing: "It will make attendants work hard and feel they are getting recognition for their work."

*Pretty good pay, comparatively. Attendants in U.S. hospitals make as little as $80 a month for a twelve-hour day. In a very few institutions, the starting pay is as high as $2,000 a year.

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