Lakeshore Mental Health Institute served as a hospital and a home to thousands of patients for more than a century. Mystery and stigma once surrounded the West Knoxville facility. Today a popular community park stretches across the grounds and youth teams play on the sports fields there.
Still, many have never been inside the walls.When the state closed it down this summer, about 100 patients moved to other treatment programs. But a dozen stayed on the site receiving a different kind of care through a new Helen Ross McNabb Center program. It's care that's come full-circle-- where Helen Ross McNabb first developed compassion to help the mentally ill.
Lakeshore's fortress-like building likely intimidated generations. But a young girl was drawn to it and the people inside.
"I think a lot of people are kind of scared of them, she always was for the underdog," said McNabb's daughter Ellie Kassem.
A lifetime dedicated to the mentally ill started in 1914 with a simple walk near McNabb's childhood home.
"When she was about five, she went down with her nanny to see one of her nanny's friends that worked at Lakeshore. There were bars on the windows, there was a certainly a smell," Kassem recalls.
McNabb grew up less than a mile away from what was once Eastern State Hospital for the Insane. Images of a prison-like facility stuck with her throughout her life.
"It was just her goal. She absolutely had a vision for how she wanted to help them," Kassem said.
In 1948, McNabb founded the Mental Health Center of Knoxville, later named in her honor. Now, there's a new season at Lakeshore inspired by McNabb's vision.
"This is what would make her so happy to see these people not cooped up like animals really," Kassem said. "They're having a chance to be out, and not in a hospital."
When the state-run hospital closed earlier this year, the Helen Ross McNabb Center took over care for 12 of the previous patients.
"What they've experienced different is increased independence," said Leann Human-Hilliard, Vice President of Adult Services at HRMC. "When an individual is ill, and there's only out-patient services that are available, then the only next thing a patient can do is go to an in-patient hospital. So for a long time, that was the only choices the community had."
Human-Hilliard says this new program, Intensive Long-Term Support or ILS, offers something in between. It's a kind of care that provides patient treatment and a new way of life.
"They've been able to pick the sheets on their bed and the comforters, and the meals that they have each day, which that's something new for them," Human-Hilliard said.
Something else that's new-- not wearing a hospital ID bracelet for the first time in years.
"For somebody that's been in the hospital 10, 20, 30 years, that is a big life change," Human-Hilliard said.
The patients got their bracelets cut off when they moved in to the fourth floor of the Chota Building at Lakeshore. It's the temporary home of the program. At the end of 2012, the patients will transition into a smaller, home-like building, nearby on the Lakeshore property.
"We've been able to take the residents down to the Willow Cottage and look at it so they can start to pick out their rooms and things like that," Human-Hilliard said.
Although the patients are in a new environment, Human-Hilliard says they're still getting structured care. She says they have individual sessions and group session. A psychiatrist and a nurse practitioner also come to offer services, as well as a master's-level clinician on site.
"I think it's incredible that we have this program right there where it all started, where her vision started," McNabb Center Board Member Susan Conway said.
Conway has also volunteered her time to visit with the ILS patients.
"To see them go from being kept up, locked up in a sense. I hate to use that word, but it's kind of the way it is. And now they're out, they're free to go out and really just enjoy being outdoors, and having all these new experiences," Conway said. "One of the guys out there was telling me he's really good with a grill. And you know, here he has been in the hospital. And now, he's going to be able to help grill food. I think Mrs. McNabb would say that's the way mental health treatment should have been for many, many years."
"This is what she would have loved," Kassem said "She's just a jewel and I know she's looking down on us."
For dozens of other former Lakeshore patients who still need hospitalization, Human-Hilliard says they're getting care they need. Five other facilities in East Tennessee provide in-patient services and are filling gaps left when Lakeshore closed. Those facilities are Peninsula Hospital, Ridgeview, Woodridge Hospital, Moccasin Bend Mental Health Institute and Middle Tennessee Mental Health Institute. All have seen a spike in admissions and tell us they've been able to accommodate the increase. The state has also pumped more funds into other community-based programs.
"The reason this has worked so well I think the community here really stepped up, all facets of the community," said Doug Varney, the Commissioner of the Tennessee Department of Mental Health and Substance Abuse Services. "We've had a lot of support. Of course, it was hard on the employees and I want to say about the employees who worked at Lakeshore, to the last day they worked there, they really put patient care first."
As for the future plans at the Lakeshore site, the city of Knoxville is in talks with the state to take over more property there.
"There's still a lot to do. But the exciting part is that we have an opportunity to build on what is already a really wonderful park for the entire city of Knoxville. We have an opportunity to make it even better," Knoxville Mayor Madeline Rogero said.
The Helen Ross McNabb Center signed a contract with the state to run the ILS program on the property for the next five years. That could be extended in the future.