Impact of Faith on Care of Mentally Ill People

April 13th, 2012 | 72 comments

Eastern Mennonite Seminary convocation 2011

Eastern Mennonite Seminary convocation 2011

The following are excerpts from “An Ethos of Faith and Mennonite Mental Health Services” by Aldred H. Neufeldt, professor emeritus of community rehabilitation and disability studies at the University of Calgary and past chair of Mennonite Mental Health Services. His article was originally published in the Journal of Mennonite Studies, (vol.  29, 2011, pages 187-202), along with many other articles on the history of Mennonite involvement with mental health, including a piece by Titus W. Bender ’57 that covered the 1942-1965 period (pages 45-60). The excerpts are published with permission.

That Mennonite development of mental health services in the post World War II (WWII) period was an intentional expression of faith in action cannot be doubted. The experiences of Conscientious Objectors (COs) working in state hospitals during that war . . . created an awareness within the larger Mennonite community not only about the dire conditions within those institutions, but also a concern that better forms of care and treatment should be available to its adherents and others experiencing serious forms of mental disorder.

As early as 1944 a proposal was put forward to the Emergency Relief Board of the General Conference Mennonites that serious consideration be given to establishing a Mennonite mental health institution, a resolution agreed to in 1945. A similar motion was adopted by the conference of Mennonite Brethren in 1946.
Henry A. Fast, one of the key actors in promoting these resolutions, later recalled:

Our dedication to the principle of nonresistance by itself did not inspire concern for the mentally ill. It did help to intensify our care about people and give meaning, direction and quality to the way we worked with the mentally ill.

These resolutions from two of the largest Mennonite conferences prompted Mennonite Central Committee (MCC) to undertake a study on whether or not to set up mental health services which, in turn, led to a “master plan” to develop a series of centers in the United States.

SEVEN CORE VALUES

The following seven values pertain to the development and provision of [Mennonite] mental health services:

1. Mutual aid. Mennonites/Anabaptists have a rich history of practicing mutual aid in a manner similar to that of the early church as set out in several letters by the Apostle Paul, where the community comes to the aid of the person or family experiencing a significant trouble or loss. Documentation from all MMHS [Mennonite Mental Health Services] centers indicates mutual aid to be the driving concern for their founding… [But] it should be noted that such services weren’t kept exclusive. All centers …almost immediately extended their services to include people in need from other faith and cultural backgrounds.

2. Christian compassion and love. This second value expressed by two related terms speaks to the motivation of personnel for being involved in mental health services. Both terms reflect a sympathetic consciousness of others’ distress together with a desire to alleviate it, and arise out of a tradition of seeking to live a life of discipleship… “Christian love” was the term used to describe the work of COs in mental hospitals and, later, was seen as a primary motivating value in developing of MMHS centers. In practice, the value from early on was expressed in terms of developing a “total milieu” with a Christian emphasis. The first Medical Director of Brook Lane spoke about the importance of “Christian Living” and the impact that staff had on people served: “I don’t see this as ritualistic but more fundamental, incorporating the concept of love, understanding, tolerance and empathy. Each and every member of our organization has a very definite moral obligation in this respect.”

3. Respect for dignity of the person. The phrase “dignity of the person” as an expressed value is relatively recent in origin, largely arising in the 1970s and ’80s in the secular context when disability advocates pursued development of service approaches that were sensitive to individual needs and interests. There is an argument to be made, though, that this value was at least an implicit, if not explicit, part of how personnel sought to relate to people receiving services provided by earlier Mennonite mental health or disability agencies. The theological view that each person is a child of God, no matter what their condition or state of life, has deep roots in Anabaptist tradition. One can infer the presence of such a value in the work by Mennonite COs in mental hospitals during WWII. These were young men and, later, a few women, by and large raised on farms, with little or no training or experience relevant to working in large mental hospitals. Yet, as documented in a recent book on the CO experience by Steven Taylor, they gained a reputation of being able to make small positive changes to life on the wards by showing genuine interest in the persons they served. It is reasonable to argue that an implicit understanding of the distraught, naked, long stay inmates of mental hospitals as each a “child of God” characterized the understanding of these untrained COs seeking to make such individuals’ lives just a little bit better.

4. Community. The communal ethic is widely recognized as a defining characteristic of Anabaptists. Various writings as well as personal observation identify a number of practices in the various Mennonite mental health services that seem consistent with this ethic: placing emphasis on building relationships, trusting others to do “what is right,” sharing resources, seeking to build consensus whenever possible, “servant leadership” and so on…. More recently developed programs continue to strive for a communitarian emphasis, both in their internal programs (transdisciplinary teams, with blurring of lines between professions, were evident within the MMHS and other centers well before they became accepted within the public sector MH programs), as well as in their relationship to the sponsoring Mennonite community and the larger geographic communities within which they exist.

5. Integrity and ethical rigor. An emphasis on integrity and ethical rigor is evident in literature on the earliest Mennonite mental health services to the present. There was an obvious commitment to provide services in such a way that it is above reproach, and to doing what is right and being trustworthy in all relationships… For example, one noted psychiatrist-educator from the New York state mental health system who became familiar with MMHS centers observed: “The staff…whether they were Mennonite or not – were approaching their jobs with a commitment and dedication which I have found to be unique to the programs of the MMHS…although the words were the same, the music was different…. Whether Mennonite or not, personnel were approaching their jobs with a dedication and commitment I have found unique to MMHS.”

Titus Bender

Retired EMU sociology professor Titus Bender '57 wrote "The Mennonite Mental Health Movement and the Wider Society in the United States, 1942-1965" in the fall 2011 issue of Journal of Mennonite Studies.

6. Pursuit of high quality programs by incorporating knowledge-based evidence with values. In North America the MMHS centres were preceded by careful study of leading programs in Europe and North America by an MCC Mental Health Study Committee in the years 1945 and ’46.

7. Peace and justice. The young farm COs found that physical and sexual abuse of patients was not uncommon. But far more common was the immense neglect in wards of grossly over crowded institutions where there often was only one paid attendant for 100 to 200 “patients.” According to Steve Taylor’s recent study, somewhat different strategies were used to confront such systemic practices, depending whether COs were of Quaker or Mennonite background. Those of Quaker background gravitated towards active public advocacy, including public exposes of abusive conditions in such national media as Life magazine and others, and prompted development of a highly effective advocacy organization in the USA known as the National Mental Health Foundation. Mennonites felt that tackling systems change was too complex and would not change conditions very easily, and so decided instead to see about changing conditions in small ways on the wards during the war, and on the war’s conclusion to set up their own small mental health facilities. Value statements on peace (i.e. non-violence) and justice (promoting the common good) continue to be present in values expressed by current Mennonite mental health programs, sometimes expanded to emphasize programming that focuses on peace within families.

MENNONITE-STYLE LEADERSHIP

Editor’s note: Aldred H. Neufeldt’s reflections on the history of the mental health movement included observations on the importance of employing leaders committed to Mennonite values, rather than professionals committed mainly to mental healthcare:

The MMHS experience also suggests that if a program had difficulty in finding and retaining key executive and clinical leaders with Mennonite/Anabaptist values, almost invariably its linkage with the sponsoring community seemed to deteriorate with consequent negative impact on their internal social cohesion and ability to deliver quality programs.

That most Mennonite mental health services in the USA have survived and thrived for a period of up to six decades in what surely is one of the most turbulent of human service environments anywhere, with almost none either closing or leaving their Mennonite connections, is a tribute to their ability to retain key leadership, many of whom continue to relate to each other through Mennonite Health Services….

It is useful to remember that the dominant leadership model for mental health services in North America and Europe up until the 1970s was for the senior psychiatrist to be the hospital director. Mennonite programs were amongst the earliest to separate administrative leadership from professional leadership… [The] administrative leaders of the first MMHS centers all had personal experience as COs, and thereby the credibility to launch the first mental health services.

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