Quakers and mental health: Mike Wash, former trustee director at The Retreat, speaks his mind

‘The spirit of William Tuke is still alive.’

by Mike Wash 3rd March 2023

In 1796, after a Yorkshire Friend named William Tuke made a financial appeal to British Friends, a new hospital was built in York to care for the mentally ill. Its creation came out of dissatisfaction with the mental health care of the time. The new Retreat Hospital’s practice of ‘moral treatment’ was to become a model of care for many throughout the world.

In his book about the subject (Description of The Retreat, 1813) William Tuke’s son Samuel wrote about one case that epitomised the regime of care. He described how a man in his forties, of ‘herculean proportions’, presented at the front entrance of The Retreat in sackcloth and chains, having had a history of violent mania. He was welcomed into what was then a homely environment. His chains were removed; he was bathed, and invited to sit with other patients and attendants for supper. He was given his own room, and received clear parameters about what behaviour was acceptable. Apart from an occasional outburst of verbal threat, from which he was calmly talked down, he became increasingly positive and active in the home life of The Retreat. He was discharged four months later. There was no restraint and no medication, only kindness, respect, and a recognition that, by relating to this man as a whole person, appealing to his positive sense of self, he could be helped back to a healthy life.

In 1986 I co-authored Psychiatric Nursing Skills: A patient centred approach. It became one of the most-used psychiatric nursing text books of its time, and is still used today. The book was written out of some dissatisfaction with texts that focused on a medical model. We wanted to ensure that the patient was the centre of all care. The message we wanted to get across was that people are not synonymous with their diagnoses. Although there maybe common sets of symptoms, each person’s experience of these is unique, and should be treated as such. Seeing the person as a whole – mind, body and spirit – is essential.

At some point in our lives, most of us experience some form of mental disease. I for one have battled with stress, depression and intractable grief. As many of us do, I kept it hidden, and remained lonely in my pain. We have come so far in general medicine, yet the pain of our mind still remains a mystery – and the help available can seem remote.

The Retreat is now an outpatient centre, in York and Manchester. Quaker principles are still interwoven into its philosophy of care, and it has a predominantly-Quaker board. The Quaker Mental Health Fund (established in 1919) offers grants for Friends who find it difficult to access the right mental health care. It also helps fund Quakers who lead projects that lead to better mental health outcomes for anyone (not just Friends).

Quaker Voices on Mental Health is a group that was created to bring together a national network of Friends who had concerns about mental health. Through it they give witness to the cause – the spirit of William Tuke is still alive.

Mental distress can bring despair, but it can also offer insights, and a multitude of different perceptions of how the world is seen – if we take the time to listen. These unique interpretations of life can be colourful and rich. A deep understanding of self, of one’s own spirituality, and of how one relates to the world, often comes out in paintings, storytelling and poetry. My sister, who, for many years suffered from drug addiction and depression, was an avid writer of poems. Reading these now tells me how important it is to listen to what’s behind what is presented.

It seems to me that a Quaker view of mental health has not changed a great deal over the last 224 years. Treat any person in distress with respect and kindness. Listen not just to words but to the whole person. Welcome them into a homely environment, and give them space to be themselves without restraint or fear. Include them equally with others, and build on their strengths, so they can grow with confidence to live a peaceful life in society once more.

So, Quakers have a long, understated history in influencing the quality of care for those in mental distress. There have been significant improvements in available therapy, and patient-centred care. But there are still too many lost souls – individuals hiding alone behind walls, parents shocked by their children committing suicide, and tormented minds imprisoned in our justice system because of the lack of alternatives.

I leave you with one true but unbelievable experience I had as a young psychiatric nurse. I was working in a large mental institution. It was Easter weekend, and I received a call from reception to come and talk to a young man who had presented himself as Jesus. He was asking for a place to sleep that night. I immediately thought it was some form of joke, but when I arrived there he was: a young man in shorts, T-shirt and sandals. He was looking dishevelled and agitated, standing rigid upright with arms outstretched, and claiming to be Jesus. We of course welcomed him in. After a while it became apparent that he was having some form of delusional, manic experience. He proceeded to wander the admission ward wrapped in a sheet. He took to laying his hands on other patients – much their distress – and shouted words from the Bible.

In those days, the first form of treatment was medication. This quickly had an effect of moving the man into a form of depressive solitude. Eventually, though, after gentle persuasion and encouragement to join in various activities, and visits from his family, he became well. Indeed, he was a wonderful companion to anyone who cared to engage with him. After four weeks he was discharged and I will never forget what he said as I shook his hand to say goodbye: ‘God is in us all, you know!’

Comments

For those wishing to follow up elements of the above article
The Retreat York https://theretreatclinics.org.uk/

Quaker Mental Health Fund https://www.quakermhfund.uk/

History of the QMHF ( Retreat Benevolent Fund )
https://www.quakermhfund.uk/lib/page-content/History of the Ben Fund.pdf

Quaker Voices on Mental Health https://www.quakermhfund.uk/Quaker-Voices-on-Mental-Health 
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Psychiatric Nursing Skills. Dexter and Wash Second edition Chapman and Hall 1986/1995

Description of The Retreat an Institution near York of The Society of Friends, Process Press1813. Samual Tuke

Simon Miles ( an example of creativity through Mental Health alternative view of the world )
https://theidentityparade.org/about-the-identity-parade/

By Mickrick on 2nd March 2023 - 9:47

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