Activity therapist loved her two decades on Bull Street
The first time Kim Grant took a tour of the SC State Hospital, she wanted to run far away.
It was January, 1979 and she was a senior enrolled at the University of Georgia. She’d driven the three hours east to interview for a student internship set to begin on Bull Street that March, but a tour of the gargantuan Babcock Building had left her shaken. The stench was thick as she walked past patients lying on the floor, moaning and reaching towards her with cigarette-burned fingers. When the interview process concluded, she ran across the busy street to a nearby payphone and called her father back in Thomson, Georgia. Crying and frantic, she explained to him that maybe the facility wasn’t the right place for her after all.
Certainly, Grant never would have guessed at that moment she’d spend the next 22 years working on Bull Street and loving every day of it.
Despite her initial trepidation, Grant took the internship and worked in the state hospital’s Activity Therapy program from March to June of that year. Assisting an experienced therapist, her days were spent with female patients in the Allan and Saunders buildings at the back of the campus. She helped organize cookouts, exercise classes and gardening sessions for them and frequently took them across campus to Bennett Auditorium where they could enjoy movies, dances and other leisure activities they loved.
“I feel I had a good internship and learned a lot from so many therapists,” she says.
Indeed, that three-month stint transformed Grant’s perspective of the hospital from horrific to hopeful, and she committed herself to a career there. When the internship concluded, she rushed back to Athens to collect her degree in therapeutic recreation then returned to Columbia a week later as a full-time activity therapist.
“I started (on Bull St.) June 22, 1979 and my starting salary was $10,736,” she recalls. “I thought I was rich, I really did. I had no complaints.”
Grant also had no complaints about her job requirements, which this time involved working with older men who lived in the Allan building and hailed from the state’s Pee Dee region. One of her first projects with them was planting a garden just outside the ward. That summer, they grew squash, cucumbers and tomatoes and sold them by the pound to employees across campus. By August, they’d raised about ninety dollars, which Grant spent taking the men to lunch at the Hilltop Restaurant off St. Andrews Road.
Shortly therafter, the hospital administration decided to build a large greenhouse at the back of the Bull Street campus.
New Way to be Observed
As the ‘80s dawned on the SC State Hospital, the institution’s 40-45 full-time activity therapists continued to play a pivotal role in patient treatment. For one thing, patients genuinely enjoyed the leisure activities Grant and her colleagues offered. On campus, there were regular birthday parties, miniature golf tournaments, talent shows, fashion programs, dances, movies and cookouts. The therapists also produced programs for every holiday, including an annual Christmas play and what Grant describes as “the best Halloween carnival ever.”
“The Benet gym was transformed with walls of colorful streamers to make booths for games that were created and made by the therapists,” Grant recalls of the carnival. “We had a wheel of fortune, a turkey shoot, a cakewalk, skeetball and putt-putt just to name a few.”
Indeed, the Benet Auditorium near the front of the campus was, what Grant calls “a crown jewel” for therapists. It offered a large gym, a clubroom with pool tables, TV and board games, and a full-service library with newspapers, books and magazines. The auditorium’s downstairs was a designated clinical space for ceramics, crafts, fitness, woodworking and music. It allowed therapists to teach and observe specialized referral groups.
But as much as the patients enjoyed Benet, it was the off-campus recreational trips they seemed to love most. Grant got her commercial driver’s license (CDL) so she could drive her patients out to fast food restaurants, discount stores, the flea market and barbecues at nearby Sesqui State Park. Then there were the longer excursions that required more supervision and planning – fishing tournaments at Fort Jackson, strawberry picking at Cottle Farms and trips to the zoo and state fair. Grant even started a bowling league for her guys, taking them to the alley every week and giving them an awards banquet with trophies at season’s end.
Occasionally, activity therapists would take patients on all-day trips to Santee State Park. Once, Grant even took them all the way to Myrtle Beach. Even after all these decades, it’s a trip that remains etched in her memory.
“I’ll never forget the eyes of one of the patients who had never seen the ocean,” she reflects. “The awe on her face when she felt the water on her toes was amazing. She was probably in her 50s and had been at the hospital pretty much her entire life.”
One particular trip to Sesqui State Park proved unforgettable for a much different reason.
“One of the saddest things I ever saw while working there happened at a picnic at the park,” Grant explains. “We had a patient that left the group and walked into a pond and drowned. They found him late that afternoon. That was a sad day for all of us. Probably 6-7 months before that, the patient had tried to escape but security had found him and brought him back. I always wondered if he just lost hope for going home.”
Grant claims that incident afforded therapists and leadership the opportunity to change accountability policies on field trips, assuring that patients were better monitored and protected.
After all, everyone at the state hospital realized that off-campus excursions were critical when it came to gauging patient behavior.
“I think our service provided the patients with a new way to be observed,” Grant explains. “Their behavior on the unit might be completely different from what they would display in the community off the unit. It gave them a chance to interact with each other and with staff in a more relaxed environment where I felt we could really get to know them and what was bothering them.”
Because of the unique insight they were able to provide, activity therapists were an integral part of a treatment team assigned to each patient. They worked in conjunction with the other members of the team – a nurse, social worker, doctor and psychologist – to conduct a monthly review of each patient. The team would score each patient in areas such as daily living, hygiene and group attendance to determine their eligibility for all off-campus trips.
‘We Work in their Home’
Just as Grant found her first tour of Babcock deeply unsettling, her first elevator ride in the building also unnerved her. It was the first day of her internship there and she still had her suitcase in hand when she got on to take it to her fourth floor bedroom. Before the doors closed, a peculiar looking patient got on behind her.
“He had an obvious limp and a platform shoe on one foot,” Grant recalls. “He was chanting a song, snapping his fingers and peering at me above his sunglasses. I did not think I would see the fourth floor that day, but when the elevator stopped on the third floor, he exited to his ward, gave me a wink and hobbled off. The next day, I described him to my new coworkers, who told me that everyone knew him. He was harmless and sort of the king of the campus. I guess it was at that moment that I decided not to fear these patients but to get to know them, love them and provide activities for them.”
Years later, Grant kept a quotation hanging on her office wall that read “The patients don’t come to our office. We work in their home.”
Indeed, for most of her patients, the state hospital had been their home for years. Some had even lived there most of their adult lives, and a few were there from the day she arrived until the day the hospital closed in the early 2000s. Grant says some felt like peers while others felt like her own children. She’d even work weekends completing her paperwork so that she could have more time with the patients during the week.
“I just had a good rapport with the patients,” she says. “I never had one try to attack me. I think the key to that was that I always tried to treat patients the way I wanted to be treated. I always tried to give them a concrete answer, not a vague answer. I used real concrete thinking with them and I think that helped.”
Suffice it to say, it also helped that Grant was an activity therapist, representing a fun diversion from the hospital’s institutional routine.
“It gave them something to look forward to. It gave them hope,” she says. “I really feel blessed because every day I put my feet on the floor, my mind was already thinking about what I was going to do that day.”
Teaming with other activity therapists, Grant worked constantly to come up with fresh ideas. Perhaps their single biggest accomplishment was starting a “Family Day” where relatives could enjoy food and fellowship with patients. Much effort, time and forethought went towards the event, which took place on a Saturday in May. The afternoon’s entertainment was held in the Benet Auditorium and varied year-to-year. One family day, Grant and her colleagues put on a production of “Let’s Make a Deal.” Another year, they produced a play for the occasion. By all accounts, the event was a major success, eventually attracting over 300 family members to the hospital in a single day.
Like We Went Backwards
By the 1990’s America’s deinstitutionalization movement was in full swing, and the SC State Hospital was downsizing rapidly. The Gibbes, Lieber, Wilson, Babcock, Parker and Laborde buildings were all emptied and the patient population, which had numbered over 3,000 when Grant arrived, had dropped to about 500. Despite that trend, Grant says Bull St. had made significant strides when it came to patient treatment and overall campus environment.
“There was an emphasis on updating furniture to a more home-like look,” she explains. “Bright colors and fabrics replaced metal chairs and vinyl coverings. Window treatments, blinds and fresh paint made the wards more welcoming and patients wore nicer clothing.”
But even with those overdue improvements, time was not on the state hospital’s side. The institution began shutting down in 2001, and by the following year, all adult patients were out. For Grant, it was a sad moment in SC’s mental health history.
“I don’t think you could have told me that place would ever close until it did,” she says. “I thought it was probably the best program that could have existed for the treatment of the mentally ill. When it closed, it took a big chunk of treatment out and it’s almost like we went backwards. I felt like we weren’t making progress anymore.”
In 2001, the state department of mental health (DMH) moved its Forensics program from Bull Street to its Crafts-Farrow campus a few miles away. Grant was offered a job as supervisor of the unit and immediately accepted. With the help of several former state hospital therapists that accompanied Grant to Forensics, most of the Activity equipment and supplies were relocated to Crafts-Farrow. Until her retirement, Grant was able to continue working as an activity therapist, taking patients on field trips and preparing them for eventual return to public life.
And even though Crafts-Farrow was more overcrowded and less picturesque than Bull Street, Grant continued to enjoy her work.
“I loved Forensics because the patients were eager for new activities,” she says. “They loved to do things and I think the psychiatrists there did a great job stabilizing them with medicine. They could just do a lot more and were a fun group of people to work with – very respectful, very nice and very appreciative.”
That the patients were so well behaved illustrates how far psychotropic medication had come. The forensic patients had, after all, committed serious crimes but been ruled mentally unfit for trial or not guilty by reason of insanity. While many continued to judge them for their deeds, Grant made a concerted effort not to, knowing they suffered from grave mental illnesses at the time they committed them.
“To me, they were there for mental health treatment,” she says. “I never looked at it like I was treating them for their criminal behavior. I was not. I just decided I was there to treat them for their mental health issues and provide for them what I could to give them the best life that we could give them while they were there.”
There were close to 200 patients in the state’s forensics program and Grant knew almost all of them by name.
In 2017 she finally retired after working for the DMH nearly four decades. These days, she still lives in Columbia and continues to lament the premature closing of the Bull Street hospital where she spent some of her best years.
“I think we closed the best place for the patients to be,” she says. “I feel like a lot of patients did actually end up on the street. I went through downtown Columbia about six months ago and I saw one of my old patients lying on the sidewalk by Main St. A woman was trying to get him up so the police wouldn’t come.”