National Alliance on Mental Illness
page printed from FaithNet NAMI

The Promise of Untilled Fields: Faith and Space in a Rural Hospital

by Kim Puchir, NAMI Communications Coordinator

Published in the FaithNet newsletter, February 2011

Over ten years ago, my first job out of college was working as a technician at Broughton Psychiatric Hospital, one of the four North Carolina state hospitals inspired by Dorothea Dix. North Carolina’s mountains are full of faithful people, and sometimes they end up on a psychiatric ward. One day I sat on a pew with a bunch of them to witness faith-based community working for people living with mental illness.

The stately old brick hospital whose first buildings were begun in 1875 was a study in contrasts and compromises. The admission wards where I worked for a  year always seemed full—of people, television laugh tracks or piped-in country music—while the sprawling grounds were nearly empty. One of the nurses recalled his childhood in the town where the hospital was an important source of jobs—some of the workers were second- or third-generation Broughton employees. “Patients in their overalls used to be a familiar sight around town,” he said. “The empty grounds used to be a working farm, and people would tend the crops, harvest them and take them to town to sell. At one time the place was almost self-sufficient.”

My co-worker said that times had changed and now it was deemed detrimental to people’s wellbeing to expect them to work outside. I remember he paused and we both looked at the chairs lined up in front of a daytime television show, the most available pastime for the majority who did not have grounds privileges. Time on the ward unfurled slowly, tangibly, in a ribbon of mealtimes, med lines and soap operas. One of the most sought-after jobs among long-term residents was to assist the gardeners who maintained the plants that brightened each of the hallways. There were simply more willing helpers with empty hours than there were plants.

I wondered whether all of these people in the early stages of their recovery would choose to stay inside watching Jerry Springer, or whether they would like to be outside planting, watering, digging and selling potatoes. Then, as now, I understood why laws exist to protect the wellbeing of people who are in the middle of a mental health crisis. But personally, I’d choose potatoes—and the therapeutic effects of fresh air and work—every time.

Modern mental health care is full of compromises like these, in which protecting one aspect of people’s wellbeing comes at the expense of another dimension of health. To me, Broughton’s unused grounds always symbolized an opportunity lost, the promise of a kind of healing never guided into a useful harvest. Faith is often one of these factors that is hard to fit in to today’s treatment picture and thus left unexplored. Like anything else personal or cultural, faith can make doctors who prefer to stick with the measurable feel uncomfortable. Rather than risking offending or excluding someone, it sometimes ends up that faith is too difficult address in our resource-taxed system. Yet I remember that Broughton was able to skate the sensitive terrain of faith very well, and the residents seemed to benefit from it.

On one occasion, I remember a sign-up sheet was passed around with great excitement. It was in the middle of a weekday, for no particular holiday, but everyone that signed up—which was nearly everyone on our ward—went down to the big old chapel for some gospel singing. The Broughton population was a pretty faithful reflection of the western North Carolina population, so there were probably African Americans and white Americans, Latinos and Native Americans, folks from the deep woods and people from the cities, all lining up in the pews. Looking around, I saw these people from varied backgrounds and different diagnoses had something in common--a great many knew the words to the hymns.

Of course, there were some people who were just happy to get a change of scenery, but the mood was more relaxed than that of the social events I attended, which could be stressful for people not asked to dance, or for those with substance abuse issues who associated social occasions with their choice of social lubricant. People were free to walk around in the aisles if they wanted to. Some talked quietly or were lost in thought, but the overall mood was friendly, even cheerful, which was in sharp contrast to the resigned air we had left behind in the inpatient unit.

After the singing there was a chance to get up on the altar and share about recovery journeys. One young man talked about his accomplishments while living with multiple learning disabilities. Other people discussed overcoming addictions or the hope they felt about their upcoming discharge from the hospital. Not everyone talked about specifically religious topics, but the setting was different than group therapy, occupational therapy or the on-ward 12 step meetings. People weren’t talking because it was some required part of their treatment, nor was it yet the outside world with all the stressors that had led them to the hospital in the first place. The church building was like a halfway house to society—always its own territory, always familiar. There was the sense that everyone knew what they were supposed to do.

Looking back, I think of that day in the chapel as bringing together some of the best that mental health treatment and faith-based community have to offer. The freedom to be there or not, and to participate in whatever way is most comfortable, whether that is rocking along with the hymns or singing in a loud voice. The people sitting in the pews, the white coats, as some of us wore, dotting the rows, were in the same condition as the people we cared for. We were all singing “The Lord of the Dance,” or clapping in a call-and-response.

One of the beautiful things about faith is that it unites us to a tradition, to all the people who have sung those same words before, to all the people who have sat on a wooden bench all facing forward and waiting for something to happen.  For many people living with mental illness, particularly if they are away from home with their lives turned upside down as my fellow singers were, ritual can be one road to return to the familiar. To begin the painstaking process of remembering who you are and putting one foot in front of the other again, which is what all people, no matter what their faith, are tasked with in recovery.