Philhaven Behavioral Healthcare Services nestles between a wooded ridge and
rolling farmland near Mt. Gretna, Pa. Philhaven's 24 psychiatrists and
800-plus other professionals each year care for 18,000 patients with a full
spectrum of diagnoses at 20 locations, using the same treatment approaches as
psychiatrists elsewhere. Yet Philhaven and its five sister institutions in the
Mennonite mental health system approach psychiatry with their own history and
The system grew out of one of the most significant moments in the history
of American psychiatry and today expresses a day-to-day care contemporary
psychiatric practice built on a religious foundation.
Care for people with mental illness has long been associated with religious
bodies. Some Catholic monasteries in medieval Europe offered refuge and care
for those with mental illness. Residents of Gheel, Belgium, have taken
mentally ill pilgrims to the shrine of St. Dymphna into their homes for
observation and care since the 13th century. Quakers helped establish the York
Retreat in England and the Friends Hospital in Philadelphia, two pioneering
19th-century institutions in psychiatric treatment.
For the last six decades, the Mennonites have practiced what they have
preached about mental illness. The Mennonite mental health system arose both
from the denomination's beliefs and from its members' response to the
conditions of American psychiatric care in the 1940s.
The system's deepest roots go back nearly 500 years, however. The
Mennonites are one of four main branches of the Anabaptist
movement—along with the Hutterites, Amish, and Church of the Brethren,
according to Donald Kraybill, Ph.D., a sociologist and senior fellow at the
Young Center for Anabaptist and Pietist Studies at Elizabethtown College in
Elizabethtown, Pa. There are about 860,000 Anabaptists in the United States
today, including about 360,000 Mennonites. Anabaptists separated from the
mainstream Protestant Reformation in 1525, mainly because they rejected infant
baptism. They emphasized the authority of the New Testament and, among other
tenets, refused to swear oaths, rejected violence, and demanded the separation
of church and state. Such views led many Anabaptists to reject military
service and embrace Christian pacifism.
In World War I, conscientious objection, even on religious grounds, often
meant imprisonment. However, by World War II, U.S. law made allowance for
religious objection to military service but required civilian public service
Over 1,000 Mennonites performed their civilian public service (CPS) work in
mental hospitals. For many, often from farms or small towns—with only
high school educations—the sights, sounds, and smells of the large
public psychiatric hospitals that predominated in 1940s America were a
sobering revelation (see facing page.
"No other church group ever had such a concentrated experience with
mental illness as the American Mennonites during World War II," recalls
If We Can Love, a history of the system. The Mennonites in civilian
public service "developed a vision of what might be done with rightly
motivated psychiatric aides and mental health professionals."
By the end of the war, the Mennonites working in mental hospitals began
discussing what they had observed. They published a magazine to educate fellow
psychiatric aides about their field and returned to their home congregations
after the war to recount their hospital experiences. The Anabaptist tradition
already included an ethos of service to people suffering from poverty,
conflict, oppression, and disaster. The Mennonite Central Committee, supported
by the Mennonites and Brethren in Christ, today has an annual budget of $60
million and deploys about 1,300 volunteers in 57 countries.
The Mennonite CPS men followed talk about changing psychiatric care with
action. They provided much of the information for the exposés of public
psychiatric hospitals that led to changes in that system following World War
II. They didn't stop there, however. The first Mennonite center, Brook Lane,
arose on a farm outside Hagerstown, in western Maryland, a site that had
housed a CPS soil conservation camp. Planning for Brook Lane began in 1946,
and the first patients were admitted three years later. Today, there are five
Mennonite mental health centers in addition to Brook Lane: Philhaven and Penn
Foundation (both in Pennsylvania), King's View (California), Prairie View
(Kansas), and Oaklawn (Indiana).
"The Mennonite mental health movement sought to create alternatives
to the prevailing custodial model," said Kraybill.
How does the Mennonite religious world view connect with current
Not by injecting religion into therapy, said Mim Shirk, vice president of
the MHS Alliance, the coordinating body of the system.
"We don't promote a religious point of view," she said."
This is not an evangelistic endeavor, but we are motivated by a spirit
of Christian concern for patients. The difference is primarily infused in the
culture of the organization.
"Organizationally, we are fundamentally committed to the people who
need these services. We are there to figure out how to make things work, even
when things get difficult. You can't shut down when a program starts to lose
money. Walking away is not an option."
Each hospital's board members are usually nominated by local church
conferences and formally appointed by the MHS Alliance. The Alliance provides
no financial support but shares information and offers strategic planning and
consulting services, said Shirk.
Brook Lane and the other centers began with much volunteer enthusiasm
generated by the returning CPS men, but they soon realized that professional
medical direction was essential for carrying out the mission they had set for
"If the Mennonites were going to do it right, they needed the best
professional people, but those people needed to carry the same values,
too," said Shirk.
"The religious orientation is expressed in compassion, empathy, and
collaboration with the community," said Francis Sparrow, M.D., a child
psychiatrist and medical director of Philhaven, in an interview. Most of the
patients and staff are not Mennonites, he said. Philhaven offers inpatient
services; it also has satellite facilities in Lancaster, Harrisburg, and York
and provides services in schools and patients' homes.
There's also a willingness to try new things and integrate them with
accepted therapies, he said. For instance, Philhaven adopted a recovery model
before many other institutions had and moved to biological treatments early
enough to earn, for a while, the nickname "Pillhaven."
"It's a very flexible organization," said Sparrow. "We
try to find new ways to do things better."
Brook Lane now focuses more on behavioral and educational interventions
than on psychiatric services and includes school programs on and off its rural
Maryland campus. Its 44 inpatient beds and outpatient services offer the only
comprehensive child and adolescent programs in the state west of
Brook Lane's size may be an advantage, said Medical Director David
Gonzales, M.D. "Being smaller allows us to be more responsive and use
therapeutic approaches others have given up."
The Mennonite service ethos comes into play when evaluating possible
programs, said Brook Lane CEO Lynn Rushing. "We've sometimes approved a
financially borderline program that fills a need." He cites Brook Lane's
provision of counseling services in the schools of nearby Frederick County.
The program has never turned a profit in its eight years of existence, and
Brook Lane has covered the difference out of general operating revenues. But
as margins on inpatient services have tightened and a local shortage of social
workers has driven up staff costs, filling that gap has become harder.
"Staffing is something you constantly struggle with," said
Rushing. "It's hard to offer salaries to compete with general acute
hospitals, so you have to look for staff whose heart is into treating mentally
ill patients. We're serving others in need, but we're also serving the needs
of employees to have a livable wage. It's a tough balance."
Of course, as at other medical institutions, pastoral services are
available for patients who want them, said Philhaven CEO LaVern Yutzy, who has
worked at the facility for almost three decades. "For some patients,
faith is an important part of the healing process, so we build on
Some patients still may view mental illness as a form of moral weakness or
abandonment by God. "Many patients who come from a religious background
may think that God is punishing them," said Kraybill. However, this
attitude may not represent stigmatization but rather a use of familiar
religious symbolism and language to represent their condition. At Philhaven,
the staff works with patients to explain the origins of psychiatric disorders
and tries to persuade them not to blame themselves (or God) for their
Spiritual issues are raised in only three of the 150 questions asked on the
intake questionnaire, said Cornell Rempel, M.Div., associate director of
clinical pastoral education at Philhaven: "How important is faith to
you? Is there a spiritual issue troubling you at this time? Will you let us
tell your clergyperson that you are here?" The last question has
additional value for the future continuity of care and for ascertaining the
patient's social contacts in the community, he said.
Whatever a patient's personal religious viewpoint (if any), the system
continues seeking to integrate a long-standing tradition with contemporary
"The role of religion is more philosophical than therapeutic,"
said Philhaven's Yutzy. "Good medical treatment meshes with the
Mennonite view of the world, so this is a way to live out one's faith rather
than just talk about it."
Further information about the MHS Alliance, Brook Lane, and
Philhaven is posted, respectively, at<www.mhsonline.org/>,<www.brooklane.org/>,