Year to mark significant changes including new board chairman, CEO
January marks the start of a historic year for Sheppard Pratt Health System as it reaches a century and-a-quarter of front-line psychiatric care and prepares for shifts in key executive leadership roles, including chairman of the board this month.
“Mental healthcare treatment is a front-and-center political and public health issue today; but its rapid evolution has been our reality ever since our first patient was seen in 1891,” said Steven Sharfstein, M.D., Sheppard Pratt Health System’s president and CEO. “Moses Sheppard and Enoch Pratt blazed the trail, and even after 125 years, there is still much work to be done.”
As a pioneer and leader in the field, Sheppard Pratt Health System has evolved significantly alongside psychiatry. Some highlights include:
1853 - 1890: The Sheppard Asylum Incorporates
- Quaker merchant Moses Sheppard had a vision of humane treatment for individuals with mental illness, which did not exist in Maryland (many were confined to an attic, basement, local almshouse or jail). When Sheppard died in 1853, he left his entire estate of $500,000 ($15 million in today’s dollars) to create the Sheppard Asylum. At the time, it was the single largest bequest made to any mental health institution in America. He created the tradition of philanthropy that still exists today at Sheppard Pratt.
- Patients would be treated with respect and dignity – on soothing grounds with a window in each room to overlook them: “I wish everything to be done for the comfort of the patient,” Sheppard said.
- Using just the interest, not the principal of Sheppard’s gift as specified in his will, the Asylum officially opened its doors 38 years later in 1891.
1891: Patient Care Begins
- First patient is received, a 46 year-old woman with dementia.
- The stance is taken that patients should never be brought to the Asylum by deception. The health system believed that since patients almost always suspect it, patients will feel that those providing care are accomplices, and may decline to give them their confidence.
1896-1907: Stigma for Patients and Doctors is Recognized
- In 1896, Enoch Pratt — another of Baltimore’s early philanthropists — died, leaving $1.6 million (over $40 million in today’s dollars) to the asylum. With his gift, he made the request that the institution change its name to The Sheppard and Enoch Pratt Hospital in place of “asylum,” which to him suggested a place where the mentally ill could escape from the neglect, cruelty and mistreatment endured elsewhere. The concept marked a change to a place where medical treatment, rather than custodial care, would be developed.
- Young doctors planning careers to help those struggling with mental illness come to Sheppard Pratt for experience, as no formal program of psychiatric training for physicians exists during this time. A training school for psychiatric nurses is established at Sheppard Pratt in 1905.
1891-1911: 20 Years of Care - 2,369 patients seen since doors opened.
1911-1918: Occupational Therapy is Founded at Sheppard Pratt
- Twenty-nine year staff member Dr. William Rush Dunton coins the term for occupational therapy.
- A recreational casino is built away from the main buildings with the intent to allure patients out of their rooms into the fresh air, and included bowling alleys, billiards, gymnastics, looms, games, art and sewing, reading and smoking. There was also a golf course, tennis courts and a competitive baseball league.
1928-1941: The Depression Lessens Money, Not Care
Sheppard Pratt continues to contribute to the health and welfare of the country by staying full and maintaining a focus on patient care and research, despite waning funds.
1945-1958: Postwar Problems
- Between WWI and WWII, government spends $1 billion on service-connected psychiatric disabilities; a number that eventually triples!
- Sheppard Pratt recognizes the need to expand physician and nurse training, patient care and research to support the volume of psychiatric needs of the returning armed forces, and moves forward to do so.
- General hospitals begin to add psychiatric units.
1965-1973: Community Service and Patients as Consumers
- Sheppard Pratt’s community outreach programs with neighboring colleges, hospitals, the local Police Department earn national recognition through the American Psychiatric Association’s 1972 Gold Achievement Award for demonstrating how a private hospital can modify its traditional role and become a catalyst in the development of community services.
- The Hospital’s Comprehensive Drug Abuse Program (COMDAP) launches to serve the community.
- Sheppard Pratt becomes the only hospital in the country to sponsor community mental health center. The Northern Baltimore County Community Mental Health Program (NORCOM), provided outpatient crisis and emergency services 24/7.
- The American healthcare system shifts from responsibility on the provider to the age of outside regulation by the government, private insurers and consumer agencies. This is called “managed care.”
1974-1991: Special Education & Day Hospitals Begin at Sheppard Pratt
- The Mt. Airy School and the Bliss and Laverne Forbush Center therapeutic program for children with emotional disturbance join to form The Forbush School on Towson’s campus in 1978 with separate divisions for elementary, middle and secondary instruction to serve child and adolescent inpatients.
- “Day Hospitals” are introduced at Sheppard Pratt in 1977, and eventually a full continuum of care begins, allowing for crisis stabilization in an inpatient setting, and then a step down to a less restrictive level of care as quickly as possible.
1992: Changing Healthcare Landscape
- Dr. Steven Sharfstein, current president & CEO, takes over as fifth health system leader.
- Tough economic climate results in insurers dictating which services they’ll cover and for how long. (Psychiatry, being grounded in the philosophy that emotional healing is a slow process, was among the hardest hit of any medical specialty.)
- Leadership recognizes that the current 80-day length of stay at Sheppard Pratt was not sustainable under this model. Shorter lengths of stay meant the need for more admissions, and Sheppard Pratt begins accepting patients around the clock.
- With a renewed commitment to providing community-based care led by Sharfstein, the Sheppard and Enoch Pratt Hospital transitions to Sheppard Pratt Health System.
1993-2014: Reinvention of Sheppard Pratt
- Sharfstein proves to be the right man at the right time to shift strategy in the face of managed care:
- Sheppard Pratt quickly and strategically absorbs numerous affiliates and smaller behavioral health facilities to create a community-based affiliate agency structure.
- Sheppard Pratt acquires its second free-standing psychiatric hospital in Ellicott City, formerly known as Taylor Manor, in 2002.
- Mutually beneficial contracts are formed with hospitals like the University of Maryland, Greater Baltimore Medical Center and others.
- Telepsychiatry services are launched in 2004.
- The Gatehouse, which has served as the primary hospital entrance since the 1960s, undergoes a $1.5 million renovation.
- Average length of stay in 2015 is reduced to 10 days.
2015: Sheppard Pratt Enters New Phase
- Sheppard Pratt Health System is once again recognized as one of the nation’s top psychiatric hospitals by U.S. News & World Report for the 25th consecutive year and the largest private provider of inpatient psychiatric care in the country by Modern Healthcare.
- Dr. Byron Forbush, having led the health system as chairman of the board of trustees for 18 years, and having been on the board for more 40 years, will step down from his post at the end of 2015.
- It is announced that starting Jan. 1, 2016, The Honorable J. Frederick Motz, also a longtime trustee, will take the reins as chairman of the board of trustees.
- After 25 years in office, Sharfstein announces he will retire in July 2016.
A full timeline of Sheppard Pratt history can be provided upon request, and an overview will be viewable online January 1.
About Sheppard Pratt
Sheppard Pratt is the largest private, nonprofit provider of mental health, substance use, developmental disability, special education, and social services in the country. A nationwide resource, Sheppard Pratt provides services across a comprehensive continuum of care, spanning both hospital- and community-based resources. Since its founding in 1853, Sheppard Pratt has been innovating the field through research, best practice implementation, and a focus on improving the quality of mental health care on a global level. Sheppard Pratt has been consistently recognized as a top national psychiatric hospital by U.S. News & World Report for more than 30 years.