Citizen Participation Is the Key to Victory: An Interview with Melvin Whitley

What happens when employees decide to take a leadership role in telling government that they will fight to prevent the closing of a hospital? For 36 days in 1982 and 1983 a group of employees who were faced with the threat of losing their jobs and were concerned about the quality of care for the mentally ill in North Carolina rallied thousands of friends and supporters to do battle with the largest agency in state government. The Save Dix Committee did the research, planned the strategy and tactics, and organized for direct action to win the fight to save Dorothea Dix Hospital for the mentally ill. People around Raleigh, North Carolina remember Melvin Whitley and others who fought to save Dix. We think you will too, after reading this account of the struggle as told by Whitley, a former Dix employee now working as director of the Charlotte Organizing Project. 

 

What makes Dorothea Dix an effective mental health hospital? I think it's partly the pride employees have in their work. Dix is considered the fourth best mental health hospital in America. It has a training program that has turned out some world-renowned psychologists. Dorothea Dix serves 11 universities and colleges and has 11 professional programs with internships. 

When the North Carolina Department of Human Resources announced, in November 1982, its plans to close Dix, there were 363 students per year going through the medical program there. People came from all over the world just to practice there. I knew people from Africa, India, from China, and Mississippi, Detroit, Chicago — right there in the same place. But the majority of people working there were North Carolinians who had years and years of history at Dix. 

I went to work at Dix as a mental health technician in October 1981, about a month after I had returned home to Raleigh from Richmond, Virginia, where I had been active in politics. I had made a decision that if I could help build political bases in other parts of the country, then I could do the same thing at home. 

I heard the news about Dix closing from other employees who had read a story in the November 15 Raleigh Times entitled, "Medical School Anticipating Dix Shutdown." When I first saw the article, I thought maybe it was a story about medicine or medical schools. But sure enough, it was about right where I worked. It was about Dorothea Dix. They were getting ready to close the admissions wards by December 31 and eventually put 1300 employees out of work. The news hit everybody like a ton of bricks. 

In the article the state Director of Mental Health, Eugene Douglas, said deinstitutionalization was the reason for the closure. Deinstitutionalization was a process that was started in the early 1960s to place mentally ill patients in their communities, closer to their loved ones. 

We learned later that Douglas had a special interest in Dix's deinstitutionalization. He came to the Department of Mental Health from Southeastern Hospital in Lumberton, North Carolina; he had been Southeastern's director. He still worked at that hospital in his free time. And, along with two other doctors, he owned a mental health psychiatric clinic in Lumberton, where he kept up a private practice. 

If Dix was closed, more patients would have flowed through his hospital and gone from there to his private practice. So the reason he wanted to close Dix, pure and simple, was money." [Receiving money from these three sources was later referred to by the press as Douglas's "triple dipping."] 

When the employees first came to me (because they knew I was very politically active in the community) I started asking them very obvious questions, just to see what type of support I had — to see if they came to ask me to help them fight this or if they just wanted to get an understanding of what would happen next. We started making plans and taking on different task responsibilities. 

When I initially met with the employees I asked them to go out and find those people who were willing to work on this issue. Our initial step was to conduct a fact-finding mission to collect as much data as we could between then and the time we had our first mass meeting. We needed to gauge how many people wanted to have a meeting, and whether the day we set, December 1, was a good day to meet. 

In our first planning meeting on research we put up on a blackboard all the different questions that had to be asked, and we identified different "targets" — people and groups that were on the other side. The North Carolina Mental Retardation Association, led by Lillian Woo, had decided that Dorothea Dix should be closed. In that case, for example, we asked who made this decision, when was it made, and did the entire group support it? We had to know about the people we were up against. 

A couple days after my talks with the staff, on November 23, Sarah Morrow, the secretary of the Department of Human Resources, held a press conference. I'm going to tell you, by the time she finished her speech I didn't know if I should get up and applaud a champion of the taxpayers' money, or if I should question whether what she proposed was really going to help us. She talked about the 2000 patients we once had at Dix and said that now 1300 employees served just 562 patients. This was a cost-efficient decision, she said, and patients have a right to be close to their communities. Hey, I was for all these things. 

Morrow's press conference painted a picture that everyone could accept on the surface. The problem was that when you talked to people who actually worked with the patients, they weren't sure the plan would work. Dix had a large population of patients who couldn't take care of themselves. They demanded care 24 hours a day, and their basic needs were supplied or supported by others. 

There are statistics that show when these dependent patients are moved from one environment to another 20 to 30 percent of them die. Besides their own jobs, the overriding concern of the people who came to me was: What about those patients? Can you pick people up like sacks of potatoes and move them somewhere else without killing them, or hurting the quality of their care? 

 

It was through our research that we found out about all the different plans various groups had for Dix once it was closed. Morrow had described the proposal to turn Dix into a prison. The city opposed that plan because we already had five prisons in Raleigh, more than any other city in the state, and the city didn't want a sixth. Besides, the city council wanted to see condominiums built on Dorothea Dix property. 

The Wake County Commission wanted Dix's buildings to stay as they were and Dix's land to be used for a farmers' market. The employees really didn't have any reservations about that. They remembered when our success rate with patients was enhanced when Dix had had a farm right there on the grounds. The patients made their butter and other foods then. It cut our costs and the patients learned skills. Some of the patients even became employees. 

It's almost hard to believe, but even the Labor Commission wanted something — a regional vocational center at Dix. John Brooks, the labor commissioner, had no sensitivity at all to 1300 employees being out of work. He was a buzzard, sitting on a fence, waiting for something to die. I hate to be so blunt, but it raised my political dander. 

So there were many different groups with many interests. Our outreach to other employees brought back the news that one group of doctors and nurses in the admissions ward had already decided to march on the Governor's Mansion. While we had just heard about it, somebody from their group had already taken a press release down to the newspaper. 

I said openly that everyone should have the right to advocate as he or she saw fit. If you wanted to be a part of a planned structure, we were setting that up. If you wanted to be part of an immediate action, the action was right at hand for you to participate in. I chose not to participate in the march, because I thought it was too soon. 

The march was on the same Friday the first mass meeting of employees and friends was held, December 1, 1982. The group marching was The Committee of Concerned Employees, headed by Barry Ostrow, a Dix psychiatrist. After the march, we held our meeting. The newspaper quoted us as having at least 300 people at the meeting; I would say at least 400. It was held at Dorothea Dix church chapel. To show you how young we were, we hadn't expected the press. I thought maybe a newspaper reporter might come. But I hadn't expected television and radio. We didn't even plan for it. I hadn't invited the press because I wanted the meeting to be as open and candid as possible. 

We worked out a compromise: they shot a packed church and I provided them with a statement in front of everyone. They taped the opening of the meeting and left shortly after. The other deal we cut was that somebody would get back with them and give them a press release from that meeting. 

The meeting was a success. In the beginning there was a little bit of apprehensiveness about whether we should be a Dix employee group and just deal with employees' concerns, or should be a group that would reach out to the total community, outside the hospital. Ironically enough, my press statement calmed the waters. I explained that there were many employees here, but also friends from outside the Dix community — which was important because we were only 1300 employees. If this was going to be a decision made by politicians, then we needed to show numbers. Politicians only respond to numbers. I knew that Governor Jim Hunt didn't care about 1300 employees. Somehow or other 1300 was going to have to blossom into thousands. 

We began to grow that night. We had the participation of nurses, doctors, employees, technicians, janitors, each department of the hospital — even patients who had some understanding of what was going on. One employee got up and said that he had just recently gotten married and he thought he was able to support his wife because he had a good job. Now he thought he might not have given her the best deal. Nurses got up and talked about their experience in watching patients transfer from one building to another, and how some of them just didn't make it. 

And then a hospital administrator got up to talk. He wasn't so sure it was cheaper to treat patients in the private sector than it was in public institutions. What I liked about that whole process was that people who were making reports were some of the same people who had been involved in our preliminary research. That was a successful organizing strategy — for them to collect research data and offer that information to the whole group. 

A lot of people left that meeting understanding that we had to have a research committee because they had more questions than when they came in. They knew they'd need a unified, organized group to work at this constantly. We named ourselves the "Save Dix Committee" that night. The group which had staged the march dissolved to become part of our committee; there was no tension in that decision. 

Different people volunteered for different tasks. Some people had to be coaxed by their friends, but from that mass meeting we got a research committee, an outreach committee, and a public relations committee. Public relations also handled fundraising. Outreach made contacts with different organizations and people who would support us. They wrote letters, they handled presentations before different groups, they made contacts with people who wanted to question us as well as people we wanted to question. The research committee gathered all kinds of data, without knowing at first how it fit together or what we were going to do with it all. 

Our data had to be accurate and given by good sources. We had volunteers who worked in admissions and in administrative offices, helping us collect whatever information they had at hand. We had friends downtown in the Department of Human Resources who had all the data the mental health director had, so that added to our support. And then there were people finding out what had happened in other states, looking up the meaning of "deinstitutionalization" and how it had been used in other cases. 

Through our research data we figured out how many patients we really served. It was amazing to us that Morrow would talk about how few patients there were at Dix now compared to 20 years ago. She knew full well that when the hospital was designed, if there was a room for each person that was called "humane" and "modernized." Twenty years ago patients were treated in dormitories and workers used a hose to give them baths. Today, they have separate rooms. They have separate personal space. I think the standard is 80 feet per patient. At that rate we were operating at 91 percent of our capacity. If we didn't provide that much space, we would be breaking state and federal guidelines on patient care. Morrow was being very misleading. 

Morrow also talked about 1300 employees taking care of 562 patients, not mentioning to the public that you have three daily shifts. These patients are in the hospital because they need fulltime care. And part of the employee population included the hospital's administration and the medical/surgical unit. All three of the other existing state hospitals transferred patients with life-threatening illnesses to Dorothea Dix. These are things that were left out. It was a kind of forgetful speaking. 

Soon we learned that even the basic data Morrow had used was incorrect. We had 657 patients at Dix, not 562 as she said. Was it true that we had jumped that many patients from November 23 to December 2? We started keeping the hospital census data that came out every day. We found out the annual cost per patient. In her press conference, Morrow gave the impression that it cost $49,000 per patient per year at Dix. Well, when you looked at Dix's annual budget and added all the different programs together, then you came to $49,000. But when you take out non-psychiatric services, you find out very quickly that you are talking about only $32,000 per patient. 

 

The Save Dix Committtee had very limited resources. We began with no treasury. We had a donation from the first meeting of about $50. With that $50 we set up a bank account and the public relations committee started fundraising. We started off with bumper stickers, and we put buckets for donations in different buildings and businesses around Dix. We had ads in the newspapers about saving Dix. If you wanted to save Dix, you could write the addresses listed in the ads and express your support. 

One way we tried to get our story out was through outreach letters. One letter targeted civic associations not connected with mental health. This letter stated the facts: we had admitted 3,240 patients in the previous year; admissions in the second quarter of the year were up by 13 to 18 percent; geriatrics admissions were up 30 percent in the past year. 

We pointed out that a sizeable number of Dix employees would have to be transferred with patients in order to maintain the same standard of care. If they did not go with those patients, their salaries would be recreated in another hospital. So where is the savings? We made sure that our letter focused on these kinds of facts, so readers could compare them to what they had already heard. 

Another letter written by the Outreach Committee was sent to newspapers, radio stations, and other media. In this letter we said that Massachusetts, New York, Pennsylvania, and California had already created mentally ill ghettos in their states by moving too fast to deinstitutionalize. We asked the questions: Where is deinstitutionalization working? How much does it cost? Which other states are satisfied with it? Needless to say, a lot of news and press people began asking those same questions. 

One important press event was a talk show taping by Channel 11 in Durham. They had me, a pro-Dix person, against the Director of Mental Health Facilities, Pat Webb, my boss. I remember when Channel 11 called and asked if someone from the Dix Committee would do this program. No one volunteered, so I decided I had to do it myself. It meant going home and boning up. I collected everybody's research data and had people role play — what if they ask this question and what if they ask that question? I know I must have worn a couple of people's nerves thin. 

The taping was a complete success. I knew it was. By the middle of the debate Pat was saying, "Yes, Melvin, you're correct," which is a no-no in any type of debate. He was more or less following me instead of responding. I was able to talk about our concerns and raise important questions for the public to start asking. 

After the taping, Webb told me I was better prepared than he was. I think he was very shocked to know I had all this data. It was my strategy to go in there as the country bumpkin. I like to dress, but on this day I put on white socks. I also had on a black suit and a colorful tie that would appeal to the media. I wanted to give the impression that I was indeed the employee. I also wanted them to see that we didn't have the resources that the largest agency in state government had — that we were the underdogs. 

After that taping we decided that we needed to increase the groundswell all over the state. We started getting support from precinct chairmen in Wake County and from party chairmen across North Carolina. We had placed newspaper ads that included a coupon that people could sign and mail in. More and more of these were duplicated by citizens. Our original goal was to have 5,000 of these delivered to the governor. By the end of the campaign we had 30,000. 

I stayed in constant contact with different people who had an ear in the governor's office — from secretaries whose names I don't want to mention, to politicians and campaign workers who were very close to the governor. 

The governor had appointed my mother to different boards and commissions, and my father had worked in both his campaigns. I was very active in the 1982 campaigns — congressional and county commissioners' races — and I had a political profile. It was easy for me to work my way in, to say, "I support the governor, but I want to help him make a good decision." 

I got special help from a champion on the Wake County Board of Commissioners, Larry Zieverink. Larry and I talked at least every other day and sometimes every day. I have a great deal of affection for Larry because he gave me the political coaching I needed to help me through those troubled waters. It was Larry who first said to me, "Melvin, if you've got any illusions that you're fighting Sarah Morrow, forget that. You're up against the governor." 

Eventually I got the feeling that the governor needed to see a groundswell of support to keep Dix open. That way he could make a decision to save Dix and look like a hero. He needed to know that it was a statewide issue — he needed to have reports coming in from different parts of the state. So we got a list of all the newspapers in North Carolina. We targeted newspapers that had circulations of over 2,000. We wanted articles to appear where others were planning to run for public office — to make this issue as popular as apple pie and as visible as unemployment to those who were running. 

When we thought the visibility was there, we decided to meet with the governor while we were riding this crest. (The North Carolina Medical Association, with its 10,000 members, had just come out in support of saving Dix.) The decision was made to talk to Governor Hunt. We let Frank Jeter, Hunt's former campaign press secretary and a member of a group called Friends and Family of the Mentally Ill (FFMI), know about it. I never mentioned it to Frank, but I appreciated his political connections. The members of FFMI were our strongest allies. 

By the time I started dropping my seeds, the governor had decided he wasn't going to meet with just one group. He was going to meet with the city of Raleigh, the county commissioners, different politicians; but he would meet with us first. 

There were nine or ten employees in our meeting with the governor. They had agreed I would be their spokesperson. They'd each make their statements, and mine could cap it up. But our strategy didn't really focus on the governor at all, it focused on the press. We knew that just about every major radio and television station would be at the governor's office when the meeting took place and that it would give us another opportunity to go beyond Wake County and ask people to help us. 

Secondly, we knew we didn't want to have an audience with the governor and come out talking about our disagreements. It was calculated that we would have some way to box Jim Hunt up in a corner but give him a way out. 

Our position was that a fair audit of all four state hospitals and the community-based or private hospitals should be done before any decision was made to phase down Dix. We told the governor that the cost per patient per day in other hospitals was much higher than at Dix. At Wake Memorial it was $154 per day, at Southeastern $151, at Wilson $166, and at Duke $266. At Dix the highest possible cost per day was $127. We got those figures from our good friends in other admissions offices. 

Our meeting with Hunt on December 22 lasted 50 minutes. I commented afterwards to Daniel Hoover, a Raleigh News and Observer reporter, that I believed Jim Hunt would make a fair decision. What I really meant was if he made any other decision, it would be unfair. Jim Hunt cut the article out and sent me a copy of it. At the bottom he wrote, "I enjoyed meeting with you all and I appreciate this kind of comment. Jim Hunt." 

 

The Save Dix Committee held a public rally in support of Dix on January 3, 1983. One day later, Dave Flaherty, chairman of the state Republican Party and former Secretary of Human Resources, responded to a letter from Melvin Whitley by writing, "You can rest assured that I support your cause and welcome the opportunity to be of any assistance. . . . Dorothea Dix Hospital, as originally planned, should remain the principal hospital in our mental health system. . . . If you need any help, let me know." Melvin made sure that the appropriate people knew about this letter. 

 

On January 6, 1983, the Save Dix Committee won its fight to preserve Dorothea Dix Hospital as a public mental health facility. Hunt presented an alternative plan to consolidate Dix programs on the east side of the campus and house prison inmates on the west. This was to take place sometime in the future. Eugene Douglas was asked to nominate an advisory committee to consider how to implement Hunt's plan. When Douglas "stacked" the committee with Dix opponents, the Save Dix Committee revealed what it had discovered about Douglas's "triple dipping." This revelation stimulated numerous newspaper editorials and triggered the loss of Douglas's credibility. Douglas continued to make various proposals for eliminating beds and lowering the budget at Dix. Yet in the spring of1983, the staff of Dorothea Dix celebrated the hospital's 127th birthday. Hunt's plan has not been implemented, and the hospital is still open today. 

 

Of the many stories Melvin Whitley tells about this time in his life, he especially relishes one: 

 

One Dix employee had worked there for 20 years. When the Dix fight began, this guy had on the back of his truck a rebel flag bumper sticker that read "The South Shall Rise Again." Later, I noticed he had put a "Save Dix" bumper sticker over his rebel flag. He stopped me in the hospital hallway soon after our victory and said, "Mr. Whitley, I got to say something. I never thought I would support a colored man doing anything. But you done made a believer out of me. Anytime you needs help, just give me a holler." Later on, he managed my campaign for vice-chairman of the State Employees Association.