The campus of Hopewell in Mesopotamia, Ohio. Photo by Molly Nook

 

Just about everyone agrees that there is something peaceful about the countryside. Being surrounded by long, verdant expanses away from the constant din of modern life offers a refreshing change of pace for folks used to cities, suburbs, and exurbs, and for some such tranquility perhaps even can be therapeutic.

“Work is considered a key element to the recovery process for our model. People feel reward and return on their efforts in seeing a job well done,” says Richard R. Karges, LISW, ACSW, Hopewell's executive director since October 2007. “We see people really growing through the work experience.”

The seed

Therapeutic farming communities have roots in the 18th century.

In 1792, Quaker merchant William Tuke founded a “retreat asylum” in Liverpool, England. The retreat was modeled after a simple family farm and focused on emotional and spiritual recovery instead of restraints and punishment. Tuke combined this “moral” treatment with the Quakers' emphasis on a homelike setting, garden walks, reading, sewing, and good food.

After spending more than a year at the retreat, American Dorothea Dix was inspired to advocate for more humane conditions for people with mental illness. Although similar retreats did open in the United States at Dix's urging, by the late 19th century medically oriented state institutions were replacing them.1

Yet the concept didn't disappear. In 1913, William J. Gould founded Gould Farm in Monterey, Massachusetts, now the oldest therapeutic farm community in the country. According to Cory Loder, Gould Farm's program director, Gould was influenced by the moral treatment movement, his interest in creating an “intentional” community, and his religious convictions. Decades after its founding, one man's stay at Gould Farm planted the seed for Hopewell's development.

In the 1980s, a mentally ill family member of Cleveland-area philanthropist Clara T. Rankin stayed at Gould Farm. She was so impressed by how the experience changed him that she decided Northeast Ohio needed a therapeutic farming community. Rankin assembled a board of directors and purchased a farm that also had been a bed-and-breakfast, and in 1996 Hopewell admitted its first resident. Most of Hopewell's residents have come from six counties in Northeast Ohio.

A place to learn and recover

Hopewell has a sliding fee scale of between $150 and 250 per day based on a family's financial status, although more than 90% of residents receive financial assistance (totaling $899,000 in 2007). Hopewell does have government payers, including the VA; Illinois State Board of Education; Ohio county boards of mental health, county boards of mental retardation/developmental disabilities, and child/family service agencies; and the Ohio Bureau of Workers' Compensation. Hopewell notes that its fees are less than half of state hospitals' and as little as 15% of private hospitals' charges.

During their stay, residents participate in daily kitchen, grounds, cleaning, garden, and farm crews. The farmland actually is cultivated by Amish farmers who share the bounty with Hopewell, and about 75% of the food served to residents, including meat, comes from the property.


Hopewell residents can swim and fish on the property. Photo by Molly Nook

Walnut Lane leads Hopewell residents to more than 300 acres of woodland paths. Photo by Molly Nook

Residents can explore hiking trails, fish for largemouth bass or bluegill, or enjoy a refreshing swim. Karges, who lives on campus with his family, takes residents on trips to a local Amish store, restaurants, and sporting events.

“From an exec's standpoint, that's where some of the real payoffs are…versus struggling with a budget or dealing with a policy or procedure,” he says.

And Karges emphasizes that residents make their own decisions.

“Individuals have their own plan that they put together when they come here, and we want to help them reach those goals as effectively as we can,” he notes.


Hopewell's David Cutler Conservatory, designed by architect Richard C. Kawalek, is scheduled to be completed this spring.

In the evenings most residents retire to one of two cottages (housing is also available in a more independent setting on-site as well as in a mixed-use building). Most have a private room equipped with a dresser, bed (each resident receives a new mattress), nightstand, desk, and mini-fridge, as well as share a bathroom with another resident. In keeping with Hopewell's emphasis on nature, its buildings use geothermal heating.

Hopewell has been actively monitoring its residents' outcomes to measure its success. Staff collect data every 3 months, at discharge, and at 3, 6, and 12 months after leaving Hopewell. Data are collected using the Brief Psychiatric Rating Scale, Camberwell Assessment of Need, Global Assessment of Functioning Scale, and an internal outcome worksheet and resident satisfaction survey. Hopewell reports:

• 92% of residents said they were very or moderately satisfied with their stay;

• 85% of discharged residents live in unrestricted settings (e.g., group homes, their own apartments, or with family members); and

• no residents discharged since June 2006 have been rehospitalized.

One of Hopewell's two cottages. Photo by Hyatt Bolden

Still growing

Hopewell is building the David Cutler Conservatory (scheduled to open this spring). The 2,000-square-foot building will include meeting/training space and a greenhouse with a meditation garden. A day program also is in development. The organization would like to build a third cottage (They don't anticipate having more than 50 total beds), and some residents and families have asked if permanent homes in a condo-like arrangement could be built on the property for those who do not wish to leave the community. Karges understands why: “Hopewell is a very amazing place…. My sense is that it's a model that really works.”