I was in nursing school in the late 1960’s in Brooklyn. Part of our training rotation involved going to a huge mental institution called Manhattan State. It was my first up close and personal view of mental illness.
There were three tall buildings on an island in the river reached by bus. Staff members were instantly recognizable by the keys jangling at their waist. Those keys opened not only doors to units full of the mentally ill but they also opened the elevator doors on the top floors where the most uncontrollable patients were housed. This was a safety issue.