If you treat a Plain community person, you’re treating a community. This phrase resonated with Dennis Keim after he heard it during a cultural competency training on treating Plain people, which include Christian groups such as Amish or conservative Mennonites, at SpringHaven Counseling Center in Dundee, Ohio. Plain people are characterized by separation from the world and simple living, including plain dressing and limited technology.
Keim is Amish. He works at the mental health facility as an Amish liaison — someone who connects Plain people to mental health services.
“I will get calls where people are in a psychotic episode, and they have no idea what to do next," Keim said. "So, I will give them direction on is it severe enough that they need to go to the ER right away? Can they come in and see our nurse practitioner Dr. Snavely for medication? Do they want to set up a counseling session? Do they want to consider coming in in our in-house program?”
Woodside Rest is an in-house program that’s part of SpringHaven where people from the Plain community can live for an average of seven weeks. While there, they receive counseling at SpringHaven’s intensive outpatient program.
The house is staffed by Plain people. Pennsylvania Dutch is the primary language. Christian devotionals are shared in the evening.
Jon Bohley, clinical director of SpringHaven, said Woodside Rest has created a culturally sensitive environment for Plain people since it opened in 2011.
“When you have mental illness and you’re leaving your home and you’re around strangers, it is all disorienting,” Bohley said. “So anything that any treatment center can do to make their program culturally sensitive to the people getting the service, the more it’s gonna help those individuals be successful in that program.”
He said counselors attend cultural competency training during the onboarding process to learn about cultural differences within the Plain community. He said scrupulosity, a type of obsessive-compulsive disorder involving religious or moral obsessions, shows up more often with Plain people and others who are part of religious groups with cultural differences.
Each morning, the residents spend two hours at SpringHaven where the men and women are separated into gender-specific groups to practice communication skills, such as talking through feelings and navigating relationship dynamics.
The residents also participate in a two-hour afternoon session to learn about topics such as understanding self, family origin and grief.
Bohley said the hesitation around seeking mental health services in the Plain community decreases after someone starts treatment.
“They learn that we’re not leading them away from their church, we’re not persuading them. We’re not turning them away from their community. But we’re just helping with the mental health issue, and then they’re going back home," Bohley said. "Then that community as a whole will embrace mental health services. They’ll learn, ‘Oh, mental health services are safe.’ And then, a lot of people from that community will all start coming.”
Carolyn Buck, a psychotherapist from Aultman Behavioral Health in Canton, has counseled Jewish people, Jehovah’s Witnesses and others where belief systems have a major influence on counseling sessions.
“I would ask the patient how they think it might affect it,” Buck said. “Giving them a little bit of power there to say this is either unusual for me or this is uncomfortable for me.”
At Woodside Rest, 15 people can stay at the house at a time. There’s a waitlist, and it can take several weeks to get in.
After a few weeks of staying at the house, a patient receives a weekend pass to go back to their community and practice the tools they've learned through counseling. Bohley said this helps determine how ready someone is to return home.
It's goal-based program where once a patient reaches the goals set by them and their therapist, they can return home. Bohley said that about 10% of those who leave Woodside Rest end up coming back for another stay.
There are only two other places in the country similar to Woodside Rest: RestHaven in Indiana and Green Pastures in Pennsylvania.
The National Alliance on Mental Health, also known as NAMI, provides support across the U.S. to people with mental illness. The local office for Wayne and Holmes counties offers Shop Talk — a mental health education program for the Plain community. Executive Director Jen Grim said the program is held on property owned by someone in the Plain community.
“The men kinda gather in a circle and discuss what we talked about in the presentation. The women gather in a separate circle and discuss and start to apply it to their people in their life, and those conversations after the program is usually where more of the help is given,” Grim said.
Keim said he has seen in the last 10 years that the Plain community is much more willing to seek help for mental conditions than they have in the past.
He receives more than 100 calls a week from new patients, existing clients, family members or hospitals.
