The Case Of Fred

Fred Rattray, one of five adopted children of the David Rattray family of Dearborn, is 19 years old. Fred had already suffered brain damage when he came to the Rattray's, and he had been in special schools prior to being admitted to Ypsilanti State Hospital. "We had tried everything," his father says, "but he made little progress until he was placed on Cl-3. I don't think Fred could stay in society. We had him at home until he was almost 13, but it got to be too hard on my wife and my 15-year old daughter. What my wife went through nobody will ever know. "All through the years my daughter has also taken the brunt of Fred's blow-ups - although he likes her. But it has been hard on her, left emotional scars on her. "Now she's at an age when some things he does are embarrassing to her. Things he does in front of her friends. 'I've often thought I'd rather have him at home all doped up instead of out there (YSH). I used to be optimistic. Always thought I could keep him at home, but I've always been discouraged. I finally saw that they (the YSH staf f) were right and resigned myself to it. "That doesn't mean I want him to be deprived all through his life. And it doesn't mean that I don't care to be involved." Fred made progress on Ward Cl-3, Rattray believes, and now that the ward is going to be closed, he's worried. "The program seems to be on its way to be eliminated. I know the economic crunch is on, but I get discouraged when I I hear about legislators who want to redecorate their offices at I the taxpayers' expense. "It's only as people become aroused that anything can be I done. Fred has up and down cyeles. With a change in care, I he'll regress. That's happened with other programs he's been I in. "And I feel he's getting better care on the training unit I ward. It's not as crowded and they can watch him more closeI ly." Wendy Hovey, clinical social worker on Cl-3 agrees with I much of what Rattray says. "Fred is sometimes very violent and can be extremely destructive," she notes. "During those times he needs to be I locked up. "Besides being brain damaged, Fred also has seizures, is diabetic and has terrific ïonfra probléms," says Hovey. -"■ "In this ward we've put him on a token program in which ■ he could earn a certain number of points for behaviors ex-m pected of him - such as getting out of bed on time, attendingl nis O.T. (occupational therapy) sessions, going to meals, ■ thing and dressing properly. "Then he could 'spend' his points for certain privileges - al meal out in the community with a social worker, a day'sH leave (Fred occasionally goes home for the weekend). Fred's family has been very cooperative and helpful." The focal point of Fred's token program, according to 1 vey, was a room of his own. Ward Cl-3 had several former ■ clusion rooms that were available as private rooms. Fred, whose condition makes him acutely sensitive at times ■ to noise, movement and other stimuli, particularly needs a I place where he can retreat. He had earned the room once, but he had to continue I ing the points each week to keep it, and he lost it because of I poor behavior. "There were months when he was depressed, angry, I tremely destructive," says Hovey. "Finally, somehow, he I gan to take the program seriously, earned points and got his I room back." Two months ago, when he had had his room back for close I to six months, Fred learned that Ward Cl-3 was to be closed. I Two days later, he totally destroyed his room, ripped out the I ceiling tiles, knocked ud his locker and barricaded himself I into his room. "Sometimes we can nip that kind of thing in the bud - I with time and staf f paying close attention to him, noticing that he's getting high and diverting him, talking him back down," says Hovey. On one occasion, she noted for example, a staff person took him on a bike ride and he biked off his anger. At 1 a.m. on the morning after a federal district judge refused to issue a temporary restraining order to prevent the closing of the ward, Fred again barricaded himself inside his room. This time he set it afire. The next day, though Fred was receiving concentrated attention from the Cl-3 professional staff, he was at liberty on the ward and even able to receive a visitor. A fellow patiënt, commenting on the incident and the fact that Fred was not in seclusion, asked simply: "If we can't teach him manners, who can?" ____