The Christmas season is a time for returning; to home, to family, to friends; to remembrances of Christmas past.
It is also the time of the year when a small group of outpatients returns to St. Elizabeths Hospital for a brief readmission.
"These are people who are known to us, who are on our rolls as being out there," said Dr. James Brown, acting director of admissions at the huge federal mental hospital that serves the District of Columbia's poor. "They want to come back home, and to a lot of them this is home.
"They know that here they're going to have a Christmas tree, they're going to get a present - something - they will be acknowledged in some ways, small things, but it's something," continued Brown.
On the outside, many of these patients "feel they're by themselves. They look at the holiday as a family thing," said the psychiatrist. "It's a jovial time of year and everybody's together."
Most of the 25 per cent increase in admission to the hospital during the week before Christmas comes from the ranks of those who are family members, rather than from those who are single, a group traditionally thought to be the most lonely over holidays.
"They are supposedly part of a family or something but they feel they're not part of it," explained Brown. "New Year's is altogether different. You won't see the increase. It starts at Christmas and then drops off immediately. New Year's is part of the same season but it's not the same thing. It's not a gathering thing. New Year's is something we do on our own."
The Christmas rush at St. Elizabeth's brings in three basic types of patients, said Brown - the depressed, the paranoid and the suicidal.
"We see an increase in the number of people who are paranoid, who are being gradiose," he said. "They may fee they're Christ." According to Brown, the hospital gets a few Christs every year. "We also see more people going to the White House" where the Secret Service routes them to St. Elizabeths.
Admissions of persons who first showed up at the White House gates have dropped off since Richard Nixon resigned the presidency in 1974, said Brown. Where the hospital used to get one or two White House, admissions a week during the Kennedy, Johnson and Nixon administrations, during the Ford and Carter administration the number was closer to one per month. However, said Brown, it is beginning to start back up again.
Brown said that the complaints of the sick persons who attempt to get in to see the President depend upon "how the public views the President. It's the impact on people who are suggestible.
"This is the man who runs the country, and to most people, the most important man in the world," said Brown. "To people who are grandiose, they want to take his place."
While most would-be White House gate crashers traditionally want to replace the President, those who attempted to get into Ford White House were of a different sort. "The people I would see (sent by White House guard to the hospital) really wanted to help Jerry," said Brown. "They felt sorry for him."
They do not, however, feel sorry for Jimmy Carter. "They complain about Carter's relatives, about Billy . . . And they complain about inflation. But they don't want to hurt Carter, they just want to take his place," Brown continued.
We have one patient we've seen about twice a year for the last six or seven years. She's paranoid and thinks she's the Queen of Peace. She goes down to the White House and demands to take her seat. She's never violent, and once's she's back on medication she's fine. She'll say, 'Doctor Brown, I've told them I belong there.' I expect to see her again around April."
Brown said that while admissions are up at all mental hospitals and psychiatric hot-lines are always jammed over the Christmas season, the poor, who make up the majority of St. Elizabeths' 2,800 inpatients and 2,700 outpatients have special stresses at Christmas time.
"They're frustrated," he said. "That's not unique to the poor, but it's more prevalent. They just can't do anything. They've come to a brick wall and they can't get through it. They can't get over it. They just keep battling and battling and then they give up."