A Place Of Hope

Budding photographer Amanda Wagner has lived at Hopewell for two years.

“I was in and out of in-patient, out-patient hospitals since I was 16 because I was very depressed,” Wagner said. “I was diagnosed with schizoaffective [disorder] when I was 21 years old and my father passed away. So that really just put a downfall in my head really… took away my life, pretty much.”

A life she’s trying to rebuild at this tranquil site about a mile outside the hamlet of Mesopotamia, Ohio, where horse-drawn buggies share two-lane roads with pickup trucks and neighbors are few.

Approximately 1 in 5 adults in the United States experiences mental illness in a given year – that’s 46.6 million people. But only 41 percent of those adults with a mental health condition received mental health services in the past year, according to the National Alliance on Mental Illness (NAMI).

There is no typical story about how or why a person gets to Hopewell, which is the sole facility of its kind in Ohio and one of only five therapeutic farm communities in the United States, each with its own focus and approach. But for most of those here, Hopewell is not their first residential treatment situation.

“For many of our residents, coming into a facility like this a really just a proverbial breath of fresh air,” said Laura Scarnecchia, Hopewell’s admissions director. “They’ve been in and out of treatment facilities, they’ve been in and out of hospitals, many in restrictive or lock-down units, and a lot of people are tentative about exploring Hopewell because that is precisely the environment they don’t want to be in. They’re looking for something freeing, something where they can engage in a meaningful community.”

Creating a sense of community is key to healing at Hopewell, according to its staff. People come to the farm with a desire for treatment – a facility requirement – and an interest in learning more about their diagnosis, how to cope with it and how to live with and get along with others, explained Daniel Horne, the facility’s clinical director.

“Most folks who come to us, by the time they come to us, they’ve lost all sorts of connections to the community,” Horne said. “They’ve lost work, the ability to work. They’ve lost the ability to be in school. They’ve lost connections at church, they’ve lost connections to family – quite frankly, lots of family members start getting scared and pull away from people with mental illnesses.”

“They come in – this is going to sound so dramatic but – shattered,” he said.

Residents are at least 18 years old, usually with a primary diagnosis of a mood or thought disorder such as schizophrenia, schizoaffective disorder, bipolar disorder or major depression. Stays typically last between five and nine months, but are tailored to individuals’ treatment plans, progress and needs.

Hopewell stresses four pillars of treatment:

• the healing power of nature;
• meaningful work;
• participation in a therapeutic community; and
• clinical engagement, including individual and group therapy and adherence to prescribed regimens of psychiatric medications.

“Medication remains critical,” Horne said. “These mental illnesses cause significant brain challenges and the medications can help. They can put them in a state of mind that allows them to take advantage of what we have to offer here at Hopewell.”

Hopewell’s approach to therapy reflects a detailed and deeply-researched, 24/7 care strategy, currently overseen by Executive Director Jim Bennett. Hopewell residents have a true sense of well-being about what this place does, Bennett believes, “because of the supportive environment that we’re absolutely committed to, each and every one of us who are here.”

“Another way to describe it is a total change of environment from where they were before: isolated, by themselves psychologically and often feeling alone and not connected with people. And here they are connected to people all the time. They sleep in the cottages, they dine together. They do work groups together. And so the human fabric is stitched together here to make that healing environment.”

Hopewell’s 60 full-time, part-time and associated clinical staff outnumber the residents, about 30 or so during our visit in the summer of 2019. Every one of those employees has a special skill set.

Some prefer to use their hands in other, still therapeutic, ways.

Like joining Hopewell’s house band.

Called “Musical Journey,” its rotating cast of musicians mostly includes residents, but on guitar is Jim Miller, band leader and Hopewell therapist.

Miller says his players bond and learn responsibility from behind their drums, keyboards and other instruments. The group chooses three or four songs, rehearses for about an hour a week and does shows for the rest of the farm.

“Music, I think, is the greatest therapy,” Miller said. “Number one, you forget all your troubles when you’re working on it. You have to concentrate and work on you and the music.”

Music helps heal more than just the residents, Miller said.

“There's a lot of group therapy and a lot of individual therapy here and a lot of recovery. So anything to do with that is also incorporated in the Musical Journey group. And the name says it all,” he said. “And I've shared some things about myself with my partners here and so and I've done some recovery myself. And that's sort of also what music is about and music therapy.”

“And then there’s this sense of accomplishment. So not only is the time spent, maybe the three months we spend working a process that is in many ways spiritual and in many ways healing, but it’s a great sense of accomplishment for everybody. ”

The visual arts are also a therapy option.

Mary Cassidy runs Hopewell’s art therapy program. She loves having the artists create while outdoors, which Cassidy says helps residents express themselves.

“I explain it to folks as sort of having a conversation with your subconsciousness or your unconsciousness,” Cassidy said. “So it gives you an ability to maybe learn a little bit more about yourself, maybe build some insight or awareness into some things that are happening in the moment while you’re in recovery and while you’re going through this oftentimes challenging and difficult healing journey to have it have a way to just kind of get out.”

Sam Silverman is one of the artists who made it through that “challenging and difficult healing journey.” He left Hopewell five years ago and says the months he spent there made a huge difference in his artwork and in his life.“I was struggling with mental illness,” he said. “I was wandering a lot. I wandered around the West Coast, which is actually what gave me a lot of the inspiration for my artwork and the style that I create with my visual art, so it wasn’t all bad. But I think I was pretty lost and Hopewell helped me to find my place.”

At the peak of his mental illness, before Hopewell, Silverman said he had lost his drive and motivation for creating art – a dark place to be for someone who had been playing piano since around age 5, composing music at 13 and making visual art all his life.

The coping techniques, contact with nature and sense of community at Hopewell rekindled his creative spark, Silverman said, and at the same time, he learned to do more than accept his diagnosis and learn to deal with his mental illness: “I came to kind of embrace it.”

He carries on that sense of community from Hopewell in NAMI programs and with the group of artists he is now part of in Cleveland. He makes art that brings together his music composition and visual art skills.

“My artwork is most music-based because I have something called synesthesia, which means that I see sounds and I hear shapes and colors,” Silverman said. “My number one goal is to be interesting. I want my art to be something interesting to look at. I call them sound worlds, the term that they came up with to describe these visual maps of sound that I create.”

And spreading the hope he found at Hopewell to anyone who needs it.

“Hopewell was really just an amazing thing for me,” he said. “That's the best way that I can say it, because things really just turned around for me in general from being at Hopewell and I think they can for other people, too. So yeah, I want to say that if you're struggling with mental illness that there is a place that you can go out in nature where you can recover and be among other people who are struggling with the same things that you are.”

But is there more than anecdotal evidence that this emotional healing, manifested through hard work and service, actually helps?

Dr. Martha Schinagle of University Hospitals crunches the numbers from Hopewell and tracks its alumni.

“Some people I’ve continued to follow and work with a handful of people after they’ve left Hopewell. And I can tell you that, I mean they do great. The people that I’ve seen do great,” Schinagle said. “It’s not like instantly they come out and everything’s good. The first year is a big adjustment and hard work to get sort of settled into life outside of Hopewell. And to find their way. But they learned the tools and the skills while they’re at Hopewell.”

About 50 percent of Hopewell’s alums go back to live with their families, she says. Between 20 and 30 percent end up in group homes and the rest often live independently, which can be seen as a pretty big accomplishment for some, depending on their diagnosis.

That sense of accomplishment is not always shared by insurance companies. Months of intensive residential care that can carry a price tag of hundreds of thousands of dollars is not cost effective in their eyes.

Limited or even non-existent reimbursements have kept the number of people who can benefit from Hopewell’s program well below its capacity.

Residential treatment in general costs between $10,000 and $60,000 per month. Hopewell officials say costs there are on the lower end of that scale and most residents rely on their own resources along with limited insurance benefits. And the farm does work with some families to help subsidize some costs.

“The impact that places like ours are going to be able to make is going to be constrained unless and until insurers and government funding start to realize that if you want to help people be independent and recover from mental illness, you cannot do it through short stays in institutions,” said Bennett.