More threads by David Baxter PhD

David Baxter PhD

Late Founder
Home on the Farm: Working therapeutic farm communities
By Michelle Roberts
Reprinted from Schizophrenia Digest, Fall 2007

There were many days when Carmela Kudyba, groggy and listless from her medications, didn?t think she could rise from bed. But the horses waited to be fed, and she couldn?t ignore them. With the help of staff members at Rose Hill Center, a working therapeutic farm in Holly, Michigan, she put one foot on the floor, and then the other.

With each passing day, the once-daunting task of getting up got easier. Before long, Kudyba found herself looking forward to the sounds of morning: doves cooing in the woods outside her window, the shrill beep of her alarm clock.

Eventually she began anticipating her daily walk to the barn, which left dew on her tennis shoes and fresh country air in her lungs.

?There were days I was so tired from my medications I didn?t think I could get up,? says Kudyba, 30, who was in her early 20s when she was diagnosed with schizoaffective disorder. ?But I knew the animals were depending on me. I knew they needed me, and at that point in my life, I needed to be needed.?

It was in the daily routine of farm life that Kudyba found healing from a mental illness that had spun her in and out of psychiatric hospitals for years.

Kudyba spent nearly three years at Rose Hill Center, a private nonprofit psychiatric rehabilitation facility for people diagnosed with schizophrenia, schizoaffective disorder, clinical depression, bipolar disorder, or other major mental illness. Located on 372 rolling, wooded acres not far from Detroit, Rose Hill?s program helps adults who?ve struggled with mental illness to achieve independence.

The driving philosophy behind Rose Hill?one of numerous working therapeutic farm communities in the world (or ?care farms,? as they?re known in Europe)?is as basic as rural life itself: Every person has something valuable to contribute, regardless of the mental or emotional limitations they may face.

Since it opened in 1992, more than 700 people have passed through Rose Hill?s three-stage program, which combines ongoing behavioral therapy and rehabilitation with aggressive medication management. Residents are required to live together, eat together, and contribute by caring for their rooms and performing chores in a low-stress setting. Rose Hill also offers its residents a working farm, gardening and horticulture, cooking, and other work therapy programs to help them on their way.

In this environment of hard work and peaceful serenity, healing happens.

?There?s hope at Rose Hill,? says Daniel Kelly, who along with his wife, Rosemary, founded Rose Hill after their son, John, was diagnosed with paranoid schizophrenia. ?Many of the people who havecome here to live have taken what they learned here and gone on to be very successful. Many of our former residents will tell you it totally gave them back their lives.?

According to a 2002 survey of 100 Rose Hill graduates conducted by Wayne State University, more than 60 percent were living independently in the community; nearly 65 percent were working for pay, volunteering, or attending school.

Kudyba, who graduated from Rose Hill more than six years ago, is one of its many success stories. Today, she rents her own house, works part time as a courthouse file clerk, and rides horses for enjoyment. She funds her passion by mucking out stalls (a skill she acquired at Rose Hill) in exchange for riding time.

And the proper medications have brought back Kudyba?s mental health, but pills couldn?t give her what she needed most: a reason to get up each day.

Rose Hill, she says, helped her reclaim a life worth living.

?I credit Rose Hill for everything in my life,? she says. ?Before I went there, I was doing nothing but going to the hospital. Rose Hill got me on the right medicine and showed me that I wasn?t alone and that I could have a life just as good as anybody else?s.?

A legacy of love
Rose Hill remains today what it started as: a legacy of love.

Daniel Kelly, now a retired national vice chairman and group managing partner of the Deloitte & Touche accounting firm, and Rosemary, a homemaker and energetic mother of four, enjoyed a successful and privileged life.

But all the money in the world could not cushion them from the fear and confusion they felt when their only son was diagnosed with paranoid schizophrenia at age 25.

?One day, John came home and said the cars were talking to him,? Rosemary recalls. ?I was frightened inside, but I still dismissed it.?

A few days later, John told his mother their house was bugged.

?Dan came home that night from traveling,? Rosemary says. ?I said, ?John is sick.? Dan asked me if I?d called the doctor and I said, ?No, there?s something wrong with John.? Dan went upstairs to talk to him and came downstairs a few minutes later. His face was pale.?

The Kellys didn?t know what to do. After John spent three months in the psychiatric ward of a local hospital, they were told that their son should ?go to the state hospital,? Rosemary says. ?We didn?t even consider it.?

Although expense was not an issue for the Kellys, they couldn?t find a treatment center they felt good about. ?We started looking for a rehabilitation facility,? Rosemary says.

?Then we looked at group homes. We were sick at what we saw, absolutely sick.?

The couple finally placed John in an upscale private mental health facility in Connecticut, which cost $500 to $700 a day. But the Kellys still weren?t convinced that John was leading the fullest life possible.

?They diagnosed John with paranoid schizophrenia and told us he would have to stay there for the rest of his life,? Rosemary says. ?But John was not hard to care for, and we thought there was way more for John in life than to stay in a hospital.?

The Kellys pressed for alternatives. ?He can do better than this, I know it,? Dan remembers telling anyone who would listen.

Finally, a doctor remembered a place called Gould Farm. It was literally a farm, located in the Berkshire mountains of Massachusetts, about an hour?s drive from Hartford.

Gould Farm often accepted severely mentally ill people whose symptoms had been stabilized by medication?as John?s had?to live and work on the farm.

There wasn?t treatment of patients in the usual sense, the doctor explained; the idea was to rehabilitate people with mental illnesses in a low-stress setting for a return to normal life, or as close to normal as possible.

The Kellys moved John to Gould Farm the next month. There, with new medications, work therapy, and lots of family visits, he improved dramatically.

But Dan and Rosemary, who also have three daughters, wanted their son home in Michigan so he could be part of family events like birthdays and barbecues. So they started looking for a mental health group setting closer to their home in Bloomfield Hills. But even the most expensive places offered care-taking only.

In December 1988, Dan had an idea: ?Rosemary, why don?t we build a place like Gould Farm here in Michigan??

?I?m with you,? she remembers telling her husband.

The Kellys went to work telling their story, explaining the need and obtaining funding. Dan?s mantra was simple but powerful: ?We rehabilitate people with broken legs. Why don?t we do the same for people with broken minds??

With the support of individuals, corporations, and foundations, along with the participation of leading educational and health care professionals, Rose Hill opened in 1992.

Today, the campus includes residential housing, a director?s home, several greenhouses, a barn and other farm buildings, and a 10,000-square-foot education and therapy center with classrooms, a library, an exercise room, a computer room, and a gymnasium.

But Rose Hill?s best features may have come with the land: still blue ponds, a lake, chirping crickets, and deer that gather in the clearing at dusk.

Over the past 15 years, the Kellys have raised millions to operate what many psychiatric professionals call one of the finest mental health facilities in the United States, if not the world. In 2003, Rose Hill was awarded the prestigious Arnold L. van Ameringen Award for Psychiatric Rehabilitation.

But for John Kelly, now 46, who spends his days gardening and caring for the animals at Rose Hill, it is simply home.

?Welcome,? he will often say to new residents who come to live and work alongside him for a time. ?Did you know that they built this whole place for me??

Learning to live life
Rose Hill residents must be at least 18 years old and diagnosed with a major mental illness, such as schizophrenia, schizoaffective disorder, or bipolar disorder. They must not be actively suicidal or harmful to others, or verbally or physically aggressive.

But the most important criterion, says Janice Snyder, Rose Hill?s director of admissions, is that a person wants to get better.

?If we think we can help a person or improve his or her abilities, we will accept them,? Snyder says. ?But people Shave to be willing?that means taking their medications and ?buying in,? if you will. If you?re not willing to work on your rehabilitation and give it everything you?ve got, you?re probably not going to be successful.?

Those who come to Rose Hill are ?having a difficult time functioning at their highest level,? Snyder says. Some may have just been released from the hospital. Others may be living at home but not doing well. Others come from foster or group homes where ?it just isn?t working out.?

Snyder says Rose Hill offers something very unique: a highly skilled professional staff that interacts with residents in their everyday lives.

?Usually when you have a professional staff, it?s in more of a hospital setting,? Snyder says. ?At Rose Hill, you can interact with and receive help from staff in your regular life.?

Shortly after arriving at Rose Hill, residents are evaluated by a team that includes a psychiatrist, a nurse, a social worker, and a job-training specialist. Based on the evaluation, an individualized treatment plan is developed with the resident, which includes goals and a proposed time frame for meeting those goals. Residents stay an average of nine months to a year.

?This is not a place to bide your time and wait for life to pass you by,? says Ben Y. Robinson, president of Rose Hill. ?It?s a place to prepare for moving on to something else that?s important in your life, whether that?s work, school, or volunteerism.?

Rose Hill?s philosophy is that people learn to live life by living it. And life at Rose Hill begins promptly at 7:30 a.m., when residents gather in the community dining room for breakfast and a morning meeting.

?It?s an opportunity for the staff to eyeball everybody and see how they?re starting the day,? Snyder says.

Everyone is expected to work up to six hours a day, depending on their ability, in one of five work programs: farming, groundskeeping, housekeeping, kitchen, or horticulture.

One of Rose Hill?s guiding principles is that challenging and supportive work can help rebuild the self esteem necessary to recover and reintegrate into society.

To that end, the kitchen workers prepare the center?s meals, do the dishes, and keep the dining room clean. The housekeepers clean all of the center?s common areas and wash everyone?s sheets and bedding. The groundskeepers mow and weed. The horticulturists tend to more than 1,000 bare-root roses, nurturing them to blooming size for shipment to three English Gardens stores in suburban Detroit. The farmers feed the animals, including horses, steers, alpacas, goats, sheep, chickens, peacocks, rabbits, cats, and a sassy set of emu.

Though some residents may not have worked much previously, others have high school and college degrees and careers that were interrupted by their illnesses.

?Our work programs are not designed to be vocational, but to help people with pre-employment job skills,? Snyder says. ?We teach them how to work with people, get an assignment, arrive at work on time, be properly groomed, and manage their illness in the workplace.?

For example, many people with mental illness have fixed delusions. ?We would help that person understand that that is their mental illness and they should not be verbalizing it with their coworkers,? Snyder says.

While at Rose Hill, residents also may participate in the school program, which includes General Education Development (GED) classes and individualized instruction in reading and math. Someresidents attend regular high school during the school year.

But Rose Hill is not only about work. Residents can also enjoy computers, music, art, and a therapeutic horseback-riding program during their free time. Lifelong friendships are formed.

It costs $230 a day ($245 for a single room), not including medication, to stay at Rose Hill, which is licensed by the state as a mental health group home. Insurance rarely covers the cost, but Rose Hill does provide limited grants.

Those who successfully complete the residential program may move directly back to the community, or they may participate in the Rose Hill Transitional Living Program, which assists those who do not need such close supervision but are not yet ready to live independently.

The Helen L. DeRoy Townhouses at Rose Hill offer independent living in a supportive environment for up to 20 people. A case manager helps residents transition to semi-independent living and, eventually, to the community. Residents are expected to keep their days structured with meaningful activities like paid employment, off-site school attendance, or volunteer work.

When a client is ready to return to the community, case managers will assist in that move. Clients also may choose to participate in the center?s Community Support Program, which provides case management to those living independently in a community near Rose Hill.

The majority of successful graduates were employed or in school, according to a 2001 study of Rose Hill residents by Cynthia Arfken, PhD, an associate professor at Wayne State?s Department of Psychiatry and Behavioral Neurosciences.

Behind the positive statistics lives a more meaningful truth: Rose Hill residents do well because they finally know they?re not alone.

?There?s a wonderful milieu that includes long-time residents watching over new ones,? Robinson says. ?They help each other, and sometimes they even correct each other. When someone is expressing some delusional ideology, another resident will say, ?Get off it!?

?It?s a very human environment that acknowledges that we?re all in this together.?

Hard, hard work?and lifelong friends
John Kelly lives in his own house at Rose Hill, where he is on staff. Every day, he rotates as needed through the work crews and continues being a part of the Rose Hill community.

But even those who move away from Rose Hill always carry a piece of it with them.

Like Barry C., who had a drinking problem and was diagnosed with paranoid schizophrenia; he graduated from Rose Hill in 2000. He?s been sober for eight years now and lives with a roommate, another program graduate. ?They changed my life 100 percent,? he says.

Rob, a 38-year-old man diagnosed with schizoaffective disorder, graduated from Rose Hill in 2000 and is now in the center?s community support program. With continued support, he works 20 hours a week for Goodwill Industries of Detroit and has become a consumer advocate. He credits his time at Rose Hill with giving him the discipline he needed to survive.

?I was scared when I got there,? he says. ?But it soon became a new family. I?m not saying it was easy. It was hard, hard work. You have to make sure your bed is made and your room is clean. But I am so grateful for a place like Rose Hill.?

And there?s Carmela Kudyba, who drives an hour every Sunday to attend church with her best friend, whom she met at Rose Hill.

?I still go back to the friends I met there,? she says, ?because they are such a big part of my heart.?

Still, there are times when life with a mental illness, despite Rose Hill?s best efforts, can feel small.

?I think down deep it is still hard for John,? Rosemary says. ?He?s seen his sisters get married and have families. I know there was a period of his life where he wanted a family of his own.?

But she takes comfort in her belief that her son?s life held a higher purpose: to inspire a place that helps so many. ?I think God gave him this cross because he was meant to be an instrument to start Rose Hill.?

John, who recently recovered from a relapse of his illness, spends weekends at his parents? home, surrounded by his sisters and nieces and nephews. Every Sunday night, after a hearty family dinner, his mother drives him back to Rose Hill.

Each time she turns down the dark country road, she looks at her son and smiles.

?Well, you?re back home again, John,? she says. ?You?re home.??

Michelle Roberts, a freelance writer based in Portland, Oregon, specializes in mental health and family issues. To discuss this and other articles, visit the Schizophrenia Digest web site. Click on the Speak Up! tab to enter the Discussion Forum.


Account Closed
Fantastic idea - hope it catches on and insurance will cover at least some of the cost of staying at the farm.
Replying is not possible. This forum is only available as an archive.