Quakers and Mental Healthcare

Image from Sunlight and Shade, Being Poems and Pictures of Life and Nature (1883), illustrations by F. Barnard. Image courtesy of British Library.

An interview with Carl Blumenthal is included in the October 2023 Quakers Today podcast.

Now 69, I have lived with bipolar disorder (manic depression) for 50 years and belong to a family with a history of mental illness and addiction.

During my most severe bipolar episode, I applied for membership in Brooklyn (N.Y.) Meeting on the high that God was speaking directly to me through the words in New York Yearly Meeting’s Faith and Practice. Then I withdrew the request when I hit bottom, and stayed away from the meeting for the next five years. No amount of coaxing from the Ministry and Counsel Committee could bring me out of my shell. Only the support of my wife and my therapist allowed me to heal.

As a straight, White, middle-class male, who is a member of Brooklyn Meeting of the Religious Society of Friends (Quakers), I am privileged. I have had a fine education, good jobs, and excellent private insurance over the years. I know how to use the mental healthcare system to my advantage.

Rich or poor, whatever one’s skin color or gender, no one should have to live with an untreated mental illness. As a peer counselor, I have learned that those without my advantages are several times more likely to face behavioral health challenges (mental health and substance use). Discrimination doubles the stigma of being marginalized.

Quakers’ Historical Witness on Mental Healthcare Reform

George Fox, who, with Margaret Fell and others, founded the Religious Society of Friends in the 1650s, discovered relief from long bouts of (spiritual) depression in a “voice which said, ‘There is one, even Christ Jesus, that can speak to thy condition,’ and when I heard it my heart did leap for joy.” Fox was credited with hundreds of healings during his ministry, documented in a long-lost Book of Miracles, including of many “distempered” or “distracted” souls.

So it was not surprising when, a century after Fox’s death, Quaker William Tuke started England’s York Retreat in 1796 for Friends, based on principles of “moral treatment” that continue to this day. As the Retreat’s website explains:

Treatment was based on personalized attention and benevolence, restoring the self-esteem and self-control of residents. An early example of occupational therapy was introduced, including walks and farm laboring in pleasant and quiet surroundings.

Quaker traveling minister Thomas Scattergood, known as the Mournful Prophet because he suffered from depression, visited York Retreat and was inspired to help establish the first American private psychiatric hospital in 1817: Philadelphia’s Friends Asylum. As related on the Quakers in the World website, “every patient was given a private room with a window. They would be free to walk about the wooded grounds and were encouraged to work in the gardens, on the farm and in the kitchens.”

Moses Sheppard was another Quaker who in 1857 founded a leading private mental hospital: Baltimore’s Sheppard Pratt. Today it offers expanded outpatient treatment and other community services to sites throughout Maryland and is still run according to Quaker principles.

Thomas Kirkbride and Thomas Eddy were Friends who helped run Pennsylvania and New York hospitals, respectively, treating people with both physical and mental illnesses. Kirkbride, a doctor, originated the design of the public mental hospitals built during the second half of the nineteenth century in response to lobbying of state legislatures by the Unitarian Dorothea Dix, who was influenced by British Friends’ moral treatment reforms. Unfortunately, the promise of the Quaker model was not realized when the original asylums expanded beyond Kirkbride’s recommended limit of 250 patients and became warehouses for thousands with psychological ills.

After World War II, Quaker, Brethren, and Mennonite conscientious objectors who had performed alternative service in state mental hospitals started the National Mental Health Foundation to improve the deplorable conditions they had encountered.

Since most of these hospitals closed in the 1960s, the country has struggled to replace them with community services, some of whose providers have rediscovered moral treatment as a guide.

York Retreat original building in England circa 1796, lithograph by Gemälde von Carve. Image from commons.wikimedia.org.

Friends’ Current Witness

While Friends Journal has only published about 20 articles and book reviews about behavioral health in the last 20 years, half (on addiction) appeared in 2020—a promising sign. Unfortunately, mental illness and substance abuse are absent as concerns from the websites of the four branches of Quakerism. Among the many Quaker service organizations, currently only two seem especially interested in the issue. American Friends Service Committee campaigns against the terrible impact mass incarceration has on the behavioral health of people in prisons, especially those in solitary confinement. Quaker House, near Fort Bragg in Fayetteville, North Carolina, provides counseling on domestic violence, sexual assault, and moral injury for active and past military members, their families, and former partners as part of its mission to support service members questioning their role in the military.

Friends Counseling Service consists of therapists active in Philadelphia Yearly Meeting who provide services to other Friends, and Friends Counseling Center, whose main office is in Wabash, Indiana, offers a faith-based approach to mental healthcare. Also, the annual Friends Conference on Religion and Psychology at Pendle Hill, the Quaker retreat center in Wallingford, Pennsylvania, is “one of the oldest conferences in the United States dedicated to individual spiritual exploration with a focus on in-depth psychology, specifically Jungian psychology.”

Quakers in Britain have renewed their historic witness on mental health with several conferences, workshops, publications, and films. They formed the Quaker Mental Health Group in 2015, consisting of Quaker Action on Alcohol and Drugs, Quaker Disability Equality Group, Quaker Life (focused on the quality of Quaker meetings), the York Retreat, the Retreat Benevolent Fund, Woodbrooke (the equivalent of Pendle Hill), and Young Friends General Meeting. A new group called Quaker Voices on Mental Health is starting to bring the concern for improved behavioral healthcare to the policy and political arenas.

Friends Hospital in Philadelphia, Pa., 2010.  Photo by Michael E. Reali Jr. on commons.wikimedia.org.

Faith and Practice of Quaker Mental Health Professionals

How important is it that the dozen Friends I interviewed who work in the field know little or nothing about this history? As an advocate for better care, with an emphasis on community rather than institutional treatment, perhaps it is natural that I would learn about the Quaker model and promote it. As a peer counselor, I try to find that of God in everyone I work with, whatever their stage of recovery. The same is true for several Friends and their clients.

Helen B. Mullin, a lesbian and member of Brooklyn Meeting, has worked as a social worker for 29 years in public and private settings:

When I was introduced to Quakerism in 2000, I began to change my view from “service” to “seeing.” The “seeing” was about seeing that of God in everyone with whom I worked. I guess I also began to see myself as a sojourner with my clients as well. I would redirect their inferences that I was the “expert” to my being a fellow traveler who might be able to help with their journeys.

Hayden Dawes is an attender of Durham (N.C.) Meeting whose intersectional analysis has attracted him to a liberation psychology that would enable Black people to deal more effectively with racism, including stereotypes as criminals. He wrote in an article for Medium: “White therapists, I invite you to ask your clients about how racism affects their daily lives and your therapeutic relationship.” He noted that White mental healthcare providers’ mistreatment of Black folks has historically created mistrust. In a 2020 QuakerSpeak video, Dawes, a 34-year-old, gay, Black married man, professed:

Being a Quaker makes me a better therapist, and being a therapist makes me a better Quaker. Learning to see that of God in everyone, I think, helps me to sit in the distress that others might bring in. And also for my own distress, it helps to have a Quaker meeting to hold all that might be coming up for me in my own life, so that I might be able to hold the suffering of others.

Beth Kelly, a chaplain at a private hospital in Brooklyn who spends part of her time “ministering to people of any faith or no faith at all” on the inpatient psychiatric unit, helps people find spiritual strength in the midst of crisis. This White, queer, cisgender woman and member of Brooklyn Meeting uses poetry, art, and music as stimuli, and explained:

Folks are clever, innovative, and insightful. They organically figure out how to get Spirit to come alive if they don’t already have a practice.

Because some have religious concerns that are hard to separate from their illnesses, she elaborated:

Their notion of God may not be mine, so I have to be open-minded about it and remember that Quakers listen for a message from God in meeting for worship. I ask, “If God has a mission for you, is it a mission you want to sign up for? If you accept it, how can you do it and not end up in the hospital again?”

The analogy between meeting for worship and therapy is another theme. Jenn Coonce, a White, cisgender woman who belongs to Brooklyn Meeting and lives in New York City, has been a psychoanalyst since 2010 and has family members facing mental health challenges. She told me:

Attending Quaker meetings trained me to tolerate and even enjoy silences in the treatment, and to listen closely to what those silences might be communicating. In addition, one of the things a therapist must learn to do is create a holding space for the client’s feelings—something that can be learned from Quaker process as well.

Social justice has been an important motivation for others. Margaret Carne, a resident of Jersey City, New Jersey, and member of Summit (N.J.) Meeting, recalled a memory that shaped her: visiting a “poor house” near her hometown in Cornwall, UK, during World War II with her dad, a convinced Quaker and pacifist, gave her “a wonderful feeling that never leaves [her]” because he knew and cared for the people who lived there. Also, her activism in fair housing and school integration in the 1960s influenced her to become a social worker, still practicing at the age of 86.

And Barbara Menzel, a 74-year-old, recently retired widow in a new relationship and a member of New Brunswick (N.J.) Meeting, said that her anti-Vietnam War and Civil Rights activism led her to Quakers and psychology.

Since 2011, Melissa Minnich has been running supportive housing programs in New York City for formerly unhoused people living with mental illness. “The six years I spent working one-on-one with formerly homeless and incarcerated adults (the majority of whom were people of color) were made up of countless hours pulling out their life stories [of racial trauma] as the unseen and forgotten among our society, validating their lived experiences as no one had before.”

The Friends I interviewed work or have worked with diverse populations or are striving to be more inclusive. Their clients include BIPOC (Black, Indigenous, People of Color), members of the LGBTQIA+ community, low-income residents, immigrants, people in prison, those in foster care, folks who are unhoused, and others with substance use challenges.

Helen B. Mullin told me, “When I misgender a transgender person, their response is generally, ’That’s okay!’ I have begun to say, ‘No, it is not okay. I need to be more respectful of you and to use the pronouns that you have named. That is my blindness getting in the way of our work together.’”

Psychologist Karen Way, of Middlebury, Vermont, said she “was shocked to discover how poor people live and struggle. My Quaker understanding of social issues was now illustrated by real people and real situations. My patients of Color taught me the system of racism; and my White patients shamelessly demonstrated their bigotry, assuming I would agree.”

Sheppard and Enoch Pratt Hospital Gatehouse in Baltimore, Md., December 2009. Photo by Pubdog on commons.wikimedia.org.

The Pandemic’s Higher Risks

I have also learned there is a fine line between being helpful and helpless. We are all codependent, in a sense, and mutual aid based on the Quaker testimony of equality can be just as healing as the injunction to be thy brother’s and sister’s keepers. Amidst the COVID-19 pandemic in June, I had a leading to come out of retirement. I now work for NYC Well as a volunteer for the city’s mental health and substance-use hotline (1-888-NYC-Well).

The number of contacts with NYC Well has steadily increased since the pandemic began. In the seven months before, we averaged 25,000 a month; we went up to 38,000 in October 2020. According to Kelly Clarke, program director of NYC Well, the nature of the contacts has changed from mood disorders, interpersonal concerns, stressful life events, and anxiety to (in order of descending frequency) anxiety, stressful life events, mood disorders, and interpersonal concerns.

Thalia Llosa, a Hispanic female member of Brooklyn Meeting, is a social worker for a program that treats senior citizens. She told me that the pandemic has made her team transition from “a solution-focused short-term treatment modality into more of an extended grief-and-crisis support modality serving a diverse population of seniors. There have been multiple traumas impacting those experiencing loss of loved ones.”

The number of Americans reporting anxiety symptoms is three times the number it was at this same time last year, according to the Centers for Disease Control. This report predicted a “second mental health wave [which] will bring further challenges, such as increased deaths from suicide and drug overdoses, and will have a disproportionate effect on the same groups that the first wave did: Black and Hispanic people, older adults, lower socioeconomic groups and health care workers.”

Perhaps the greatest case for a new empathy toward those with such challenges is that so many more U.S. Americans are learning firsthand how much stress can diminish life. This raises the query, How do Friends support other Friends who experience behavioral health concerns?

To determine if you are experiencing symptoms of a mental health condition, visit Mental Health America at mhascreening.org for a free, anonymous, and confidential test. And if you are in crisis, call the National Suicide Prevention Lifeline, 800-273-TALK (8255).

Carl Blumenthal was interviewed by QuakerSpeak in 2023.

Carl Blumenthal

Carl Blumenthal is a member of Brooklyn (N.Y.) Meeting. He earned a masters in environmental health science and worked in healthcare for 25 years. He writes for City Voices, a journal by and for people living with behavioral health challenges.

2 thoughts on “Quakers and Mental Healthcare

  1. I am a Friend who has been working with the mental health of traumatized people, particularly asylum seekers, refugees, war victims, and other victims of violence since 1988. There is an enormous need for this kind of work. We are training people within their own communities to become “peer counselors”, also known as “barefoot therapists”. We see psychological reactions to these enormous traumas as one cause of conflict, and see the reactions being transmitted across generations. If people are interested in what we do, please see our website, http://www.cwwpp.org and/or write to me at cwwppsummer@gmail.com. I would be interested in being a part of and/or helping to form a Quaker working group on these issues. I am a member of Northeast Netherlands Monthly Meeting, which is a part of Dutch Yearly Meeting.

  2. Thank you, Carl for lifting up this important aspect of Friend’s history regarding our testimony of community. For Friends, the early discovery that a caring and compassionate community was able to help psychologically distressed persons recover their sense of wholeness and strength led to the development of Quaker moral treatment for the mentally ill.

    While moral treatment as a healing modality worked well in small settings, such as Friends Hospital and York Retreat, it was not effective in the larger state hospitals developed in the 19th century which became “deplorable” as you note.

    After WWII and the development of psychotropic medications, (which led to the massive deinstitutionalization movement of the 60’s and 70’s) the ideas behind moral treatment transformed into the Therapeutic Community Movement: a highly effective means of healing from the trauma of mental illness (and moral injury) and the restoration of mental health and wholeness. Up until its change to a university training hospital, Friends Hospital maintained a therapeutic community program called the Sanctuary Model founded by Sandy Bloom.

    Sanctuary is “a trauma-informed, evidence-supported template for system change based on the active creation and maintenance of a nonviolent, democratic, productive community to help people heal from trauma. It addresses the marginalization of specific cultural groups through exposure to trauma.” It is important to note that the seeds of Quaker moral treatment continue as a witness to the healing power of community into the present through this work. ( https://www.nctsn.org/interventions/sanctuary-model)

    The changes at Friends Hospital led to the creation of the Thomas Scattergood Foundation (https://www.scattergoodfoundation.org/) which is committed to funding innovative community initiatives in behavioral health. For many years, Scattergood has funded The Pulse a local NPR weekly radio broadcast (WHYY) focused on issues of mental health and wellness. It is among dozens of community-based behavioral initiatives supported by Scattergood that utilize a social entrepreneurial approach to ameliorating local community issues and concerns.

    And, thank you for mentioning the PYM (my YM) Friends Counseling Service which dates it founding to the late 1940’s. It is an important resource to Friends involve in supporting the pastoral care and nurture function at our meetings. I serve PYM as its Care & Aging Coordinator and as a licensed clinical social worker my career work has been centered in therapeutic community.

    It is interesting to note that current psychological researchers are once again discovering the correlation between mental health and being part of a vibrant caring community. As our communities breakdown and fracture due to severe economic, environmental and social pressures, including income inequality, environmental devastation and racism, anxiety and depression increase. It is important to remember that Friends have something vital to offer as a remedy: a vision of a place where trauma and dislocation can find healing: blessed community.

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