How Civilian Public Service changed mental health care in the U.S.
On December 27, 1944, the MCC executive committee met to discuss how people of faith might respond to shocking reports of the conditions inside U.S. mental hospitals.
World War II was still raging on, and thousands of conscientious objectors exempted from military combat were engaged in alternative service. Among them were 3,000 youth who had been assigned to serve where most people hoped never to go: U.S. mental facilities.
The young men and women – mostly from Mennonite, Brethren in Christ, Church of the Brethren, Mennonite Brethren and Quaker backgrounds – were some of the first outsiders to enter these buildings. They came out with terrible accounts of the filthy, inhumane and violent conditions within the hospitals. Their stories laid the foundation for national change in the years to come.
A rocky start
Alternative service in mental hospitals almost didn’t happen due to protests from citizen groups opposed to conscientious objectors. Civilian Public Service (CPS) was provided under the U.S. Selective Service and Training Act of 1940 for conscientious objectors who were unwilling to perform any kind of military service. It allowed young men of draft age to perform non-combative work of “national importance” in fields like forestry, agriculture and social services.
For the first year, CPS work consisted almost entirely of manual labour through the U.S. Soil Conservation Service, the U.S. Forestry Service and the National Parks Service. Some young men were energized by the prospect of serving in mental hospitals where they could be of greater service to society, in their estimation.
“The prospect of possible work in state mental hospitals offered the first ray of hope to men in base camps that they might be allowed to serve more usefully.”
- P.R.N., a publication of CPS Unit 63 serving at New Jersey State Hospital, Marlboro, New Jersey
“The prospect of possible work in state mental hospitals offered the first ray of hope to men in base camps that they might be allowed to serve more usefully,” reported P.R.N., a publication of CPS Unit 63 serving at New Jersey State Hospital, Marlboro, New Jersey.
But many U.S. citizens were upset by the pacifist stance; young men who chose alternative service would sometimes hear people around them muttering epithets like “yellowbelly” or “slacker.”
The first two attempts to start CPS work in mental hospitals were halted by American Legion veterans’ groups and local labour groups. Men assigned to a mental hospital in Elgin, Illinois, were already on the train when their assignment was cancelled due to protests.
Finally, a CPS mental hospital unit was established when the superintendent of Eastern State Hospital in Williamsburg, Virginia, proposed that conscientious objectors help with the manpower shortage there. More and more CPS units subsequently opened in mental hospitals. In the end, CPS participants served in 45 mental hospitals from coast to coast. Twenty-six of these CPS units were operated by MCC.
Life in the hospitals
Many CPS participants working in mental hospitals served as attendants. Participants in the MCC-run CPS Unit 63 described their various attendant duties at New Jersey State Hospital in Marlboro: helping patients dress, recording ward events, supervising patients during chores, helping them with personal care and hygiene, assisting them at meals and putting them to bed at the end of the day.
“The attendant has a great obligation and opportunity. He is among the patients a day for every hour the other members of the staff spend on the wards. He determines the way of life there.”
- P.R.N., a publication of CPS Unit 63 serving at New Jersey State Hospital, Marlboro, New Jersey
“The attendant has a great obligation and opportunity. He is among the patients a day for every hour the other members of the staff spend on the wards. He determines the way of life there,” an article in P.R.N., a unit publication stated.
As CPS participants assimilated into patient life and the day-to-day functioning of hospitals, glaring problems immediately became obvious. Conditions in hospitals were often unlivable, with surfaces caked in dirt and human waste. Many patients had nothing to do and simply sat on the dirty floor all day or lay restrained in their beds.
In a daily log kept by one young woman who served with MCC during a summer at Cleveland State Hospital in Ohio, she wrote:
“I definitely feel that a more normal type of life is necessary in order to give the mental patients at least a little happiness. Just a little dog that came near their benches pleased them immensely. Who would like to be herded down to a dinner of greasy soup, black coffee, and bread out of greasy trays, and tin dishes and a spoon, rushed through the meal in several minutes, and then herded upstairs? . . . No consideration is given to individual wishes and desires. They are all part of a group and never worth anything as a person unique in himself!”
The employees who worked at the hospitals posed another major problem. Their positions tended to be low-wage jobs with little training or oversight. Some resorted to violence to restrain the patients. Others suffered from substance abuse issues.
“This work is interesting and one must and easily can become attached to the patients. Attendants work here on the whole for an easy job to slip over, just something to do. Many of the workers … don’t treat the patients with care.”
- Letter written by Norman Bauman, CPS Unit 44, Western State Hospital, Staunton, Virginia
“This work is interesting and one must and easily can become attached to the patients. Attendants work here on the whole for an easy job to slip over, just something to do,” noted Norman Bauman, who was serving in CPS Unit 44, Western State Hospital in Staunton, Virginia. “Many of the workers . . . don’t treat the patients with care.”
Enrichment for participants
In the midst of the distressing conditions CPS participants observed each day, they found joy in forming friendships with each other. The men held prayer groups, played sports like softball and basketball and worked on hobbies such as leathercraft and woodworking. They also threw parties and went on picnics (sometimes lamenting the lack of young women at these gatherings).
Some participants wanted to learn more about the field of mental health. CPS worked with Selective Service, the government agency responsible for the draft and conscientious objectors, to establish a “Psychiatry and Christian Service School” at New Jersey State Hospital. Participants serving at the hospital and other nearby hospitals were able to take night classes from professionals. They studied topics like psychiatry, human anatomy and physiology, social work and a course titled “The Bible and Modern Thought.”
Since the primary purpose of CPS was to provide an alternative service channel for young men of draft age, women were unfortunately not included in CPS records. However, many women made important contributions in the mental hospitals working as nurses or attendants. Some wives and girlfriends served in hospitals alongside their conscientious objector husbands or boyfriends. Others served as Summer Service interns at mental hospitals.
With their compassion and diligence, Anabaptist youth noticeably raised the standard of care for patients in mental hospitals. Hospital officials remarked on the empathetic quality of CPS participants’ service.
“Before this unit came into this hospital, Mennonites and the nature of their faith and beliefs were not well known in this community. ... It was soon noted that the more helpless and difficult the patient, the greater was their sympathy and aid. In their work there was no difference between the Jew, the Gentile, the Catholic, the atheist, or the agnostic.”
- Dr. O. R. Yoder, superintendent of Ypsilanti State Hospital
“Before this unit came into this hospital, Mennonites and the nature of their faith and beliefs were not well known in this community," reported Dr. O. R. Yoder, superintendent of Ypsilanti State Hospital. “It was soon noted that the more helpless and difficult the patient, the greater was their sympathy and aid. In their work there was no difference between the Jew, the Gentile, the Catholic, the atheist or the agnostic.”
But CPS participants wanted more for patients. They wanted mental health care reform with scientifically proven, humane approaches to treatment. And CPS participants from Mennonite backgrounds thought perhaps Mennonites should take matters into their own hands.
When the MCC executive committee met in 1944 to discuss the Mennonite response to inadequate care in mental hospitals, the idea of "establishing a Mennonite mental hospital under MCC administration" was presented for consideration.
Three years later, MCC began remodelling a former CPS camp in Leitersburg, Maryland, to transform the property into the first Mennonite-run mental health facility in the U.S. This became Brook Lane Farm, a 25-bed mental hospital. Shortly thereafter, Kings View Homes in Reedley, California, and Prairie View Hospital in Newton, Kansas, were built through cooperation and sponsorship from Mennonite Brethren and MCC, along with significant support from other U.S. Anabaptist churches.
MCC also established the Committee on Homes for the Mentally ill, which included representatives from MCC’s constituent groups. This committee held the titles to the hospitals and provided guidance and consultation in their operation. The committee would later become Mennonite Mental Health Services (MMHS), which served broader mental health interests in churches as well as operating the hospitals. (MMHS developed into Mennonite Health Services, which today provides resources and consulting for Anabaptist health and human services providers.)
The first hospitals built through MCC and constituent groups were markedly different from the facilities that had horrified young conscientious objectors. They provided compassionate, cutting-edge care. Prairie View and Kings View both received the Gold Award from the American Psychiatric Association to acknowledge its leadership in progressive treatment for people with mental illness.
Several other mental health centers were later created by MCC and other Anabaptist groups. MCC began to relinquish control of the hospitals in 1957, when local boards were established to operate each facility. All the centers now run independently of MCC. The original three facilities still exist today in greatly expanded form.
Beyond this, CPS participants helped reform U.S. mental health care as a whole.
Their reports of the horrors within U.S. mental institutions brought public awareness to the crisis and encouraged the establishment of the National Mental Health Foundation. Without young conscientious objectors who believed everyone deserved to be treated well, mental health treatment in the U.S. might look very different today.
Read more about other areas of CPS work, including fighting forest fires.
“Conscientious Objectors and the Transformation of Mental Healthcare” by Harold Lehman. Mennonite Health Journal, Vol. 15, No. 2, April 2013.
“Excerpts from the Daily Logs as recorded by Members of the Cleveland Women’s Summer Service Unit.” MCC archives.
“Howard’s Nursery Views.” CPS Camp No. 40 (Howard, Pennsylvania).
In the Name of Christ, by John D. Unruh, Herald Press, 1952.
“Mennonite Health Services Alliance.” Global Anabaptist Mennonite Encyclopedia Online. 2006. https://gameo.org/index.php?title=Mennonite_Health_Services_Alliance&old...
“P.R.N.” CPS Camp No. 63 (Marlboro, New Jersey).
“The Civilian Public Service Story.” Mennonite Central Committee. 2015. http://civilianpublicservice.org/
“WWII Pacifists Exposed Mental Ward Horrors.” National Public Radio. 2009. https://www.npr.org/templates/story/story.php?storyId=122017757
“Ypsi.” CPS Camp No. 90 (Ypsilanti, Michigan).