0
Community News
 DOI: 10.1176/appi.pn.2013.10b2
Farm Has Spent 100 Years Helping Those With Serious Mental Illness
Psychiatric News
Volume 48 Number 20 page 1-1

Abstract

Before the start of the deinstitutionalization movement, mental hospitals often had farm operations where patients helped with chores. There is still a place, however, where farms are helping people recover.

Abstract Teaser
Anchor for JumpAnchor for Jump

This building serves as headquarters for a farm in western Massachusetts that for 100 years has been helping individuals with serious mental illnesses recover. The farm has been a model and inspiration for treatment facilities throughout the world.

Even before the fog lifts from the Berkshire Mountains in western Massachusetts, and while the air is redolent with the scent of spruce and pines, adults with severe mental illness are up for breakfast before heading out to gardens, fields, barns, and a bakery. There are cows to be milked, pigs to be fed, and vegetables to harvest and prepare for lunch.

This is the way it has been for the past 100 years—ever since Gould Farm was established by visionary social reformer William Gould and his wife, Agnes, to help those with serious mental illness.

Gould Farm is all about recovery from serious mental illness and was so long before the recovery movement became popular in psychiatry.

“I think Gould Farm is an excellent place—superb!” exclaims Jeffrey Geller, M.D., a professor of psychiatry at the University of Massachusetts and APA’s Area 1 Trustee. Geller has also had first-hand experience at the farm, trying his hand at milking cows.

Anchor for JumpAnchor for Jump

It’s dinnertime for the cows on Gould Farm. Milking them is one of the guests’ chores.

The individuals who come to live and work at Gould Farm and stay for an average of nine months are referred by various sources—New York Presbyterian Hospital, McLean Hospital, the Menninger Clinic, among others. Many are college students who have had their first psychotic break or young adults who have had multiple episodes. In general they have mental illnesses with a psychotic component and have not responded fully to short-term hospital treatment.

The staff at Gould Farm works hard to make patients feel at home and get them involved. For example, they are called guests, not patients. When they arrive, they are asked, “What brought you to the farm?,” not “What mental illness do you have?,” Phyllis Vine of New York City and a member of the Gould Farm board, points out.

Residential Treatment Takes Many Forms 

Gould Farm isn’t the only residential treatment facility in the United States designed to further the recovery of individuals with persistent and serious mental illness, Jeffrey Geller, M.D., a professor of psychiatry at the University of Massachusetts and an APA Trustee, told Psychiatric News. Each of the others has its special atmosphere and philosophy, he said.

For instance, there is the Academy Street Community Residence in Poughkeepsie, N.Y. It has been caring for individuals with persistent and chronic mental illness since 1970. Another example is CooperRiis Healing Community in Mill Spring, N.C., offering both a healing-farm therapeutic community and an urban campus that feels like a recovery “college.” Other programs following the recovery model, he noted, are the Greystone Program in Philadelphia; Hopewell, a therapeutic farm community in Mesopotamia, Ohio; Lakewood Center in Fern Park, Fla.; and Rose Hill Center in Holly, Mich.

For more information about such centers, see the Web site for the American Residential Treatment Association—http://artausa.org/ .

“They are asked to give as well as to receive,” says Donna Burkhart, acting director of Gould Farm. Burkhart has been working at Gould Farm for some 30 years, along with her husband, Wayne, who serves as agricultural director.

All the guests work, and they have job choices. “The work is very serious,” says Geller. “You are expected to answer to supervisors, follow a schedule, and there are expectations about the quality of your work.”

At the same time that guests are working on the farm, they are also living there, as are many staff members and their families. They eat meals, socialize, and go on various outings together. “The Gould Farm staff does an excellent job in creating a community that engages guests, many of whom have great difficulty in successful social interactions,” Geller notes.

Anchor for JumpAnchor for Jump

Jesse Goodman, M.D., supervises patient care at Gould Farm. To learn more about his work, see information at end of story.

While the guests are at the farm, their psychiatric needs are carefully tended to. Psychiatrist Jesse Goodman, M.D., supervises their care and their psychotropic medications. Five social workers provide a combination of supportive, cognitive, and psychodynamic therapies. A nurse dispenses the medications. All of the staff members carefully monitor the status of each guest and log their observations.

“The program relies on the old-fashioned work cure of the early part of the century, but not for morality reasons,” Goodman explains. “It is because engaging in focused learning and productive activity facilitates growth, development, independence, and improvement in symptoms.”

Robert Patterson, M.D., a psychiatrist at Harvard Medical School and McLean Hospital, served as the program’s consulting psychiatrist for many years. The farm “is part of the mainstream in thinking about pharmacologic, behavioral, and social treatment of major mental illnesses,” he states.

On Wednesday afternoons, Burkhart runs a community meeting that includes everyone—guests and staff. During the meeting, there are announcements: “There will be a ski trip on Monday,” or “We’re going to have popcorn and a movie at our house tomorrow night, and all of you are welcome to come.” Sometimes there is discussion of issues that arise in the community. And there is a custom of expressing appreciation. Tom might say, “I want to appreciate Joe; he helped me gather eggs today.” And Joe might reply, “Thanks, Dude!” And it’s not obvious to a visitor whether Tom and Joe are staff members or guests. And whenever a guest is about to leave the farm, the appreciations go on overtime, Burkhart remarks. “There are tears, laughter, encouragement—good therapy.”

Anchor for JumpAnchor for Jump

At this roadside cafȳ, Gould Farm guests sell some of their products.

Guests can also enjoy their free time at the farm. There are spontaneous music gatherings, Berkshire-area performances, Passover seders, Christmas parties, bonfires, skating, skiing, yoga, and checking out a newborn calf.

Good things often come out of guests’ stay at Gould Farm. They may make friendships that will endure after they leave. They may acquire skills that will help them get a job. One young guest got so adept at cooking that he was accepted into the Culinary Institute of America. “I was in such a bad place when I got here,” he says, “but am now so excited, hopeful, and enthusiastic!”

In 2010, Gould Farm published its first outcomes study, of 450 guests, and learned some valuable information from it. For instance, a comparison of psychiatrist-rated Global Assessments of Functioning (GAF) of the guests at the beginning and end of their treatment showed statistically significant improvements. Former guests also reported what the GAF evaluations had shown—that the farm had helped them with their mental health, physical health, family relationships, and social relationships. And when the guests were asked what had helped them the most during their farm stay, they rated friends, family, and community most highly, followed by work and staff, then by therapy, activities, and safety/structure, and finally by psychotropic medications.

So many former guests cherish their time at the farm that they attended a Gould Farm centennial reunion in August. And as someone pointed out at a Gould Farm centennial symposium in April, “Recovery is a journey of the heart—not an outcome. The goal is to become more connected to what makes us human.” ■

More information about Gould Farm is posted at http://www.gouldfarm.org. To watch a video interview with Jesse Goodman, M.D., about his work at Gould Farm, go to http://youtu.be/G6RGpOhku2M.

Anchor for JumpAnchor for Jump

This building serves as headquarters for a farm in western Massachusetts that for 100 years has been helping individuals with serious mental illnesses recover. The farm has been a model and inspiration for treatment facilities throughout the world.

Anchor for JumpAnchor for Jump

It’s dinnertime for the cows on Gould Farm. Milking them is one of the guests’ chores.

Anchor for JumpAnchor for Jump

Jesse Goodman, M.D., supervises patient care at Gould Farm. To learn more about his work, see information at end of story.

Anchor for JumpAnchor for Jump

At this roadside cafȳ, Gould Farm guests sell some of their products.

Interactive Graphics

Video

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Articles
Articles