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= The Retreat = From Wikipedia, the free encyclopedia

For other uses, see The Retreat (disambiguation).

The Retreat, commonly known as the York Retreat, is a place in England for the treatment of people with mental health needs. Located in Lamel Hill in York, it operates as a not for profit charitable organisation.

Opened in 1796, it is famous for having pioneered the so-called "moral treatment" that became a model for asylums around the world. Founded by William Tuke, it was originally run by and for Quakers but gradually became open to everyone. It inspired other progressive facilities such as the US Brattleboro Retreat, Hartford Retreat and Friends Hospital. The present day retreat seeks to retain the essence of early "moral treatment", while applying the principles to a modern healthcare setting.

York Retreat original building c. 1796

Background
The York Retreat developed from the English Quaker community both as a reaction against the harsh, inhumane treatment common to other asylums of that era, and as a model of Quaker therapeutic beliefs. A common belief at the time was that the mad were wild beasts. The recommended medical practices included debilitating purges, painful blistering, long-term immobilisation by manacles, and sudden immersion in cold baths – all administered in regimes of fear, terror and brutality. But the Quakers maintained that the humanity and inner light of a person could never be extinguished. A trigger was the death in 1790 of a Quaker, Hannah Mills, a few weeks after she had been admitted to the York Asylum (now known as Bootham Park Hospital). The asylum had not let her friends or family visit her, and they became suspicious. Visiting afterwards to investigate the conditions, the Quakers found that the patients were treated worse than animals.

Beginnings
Quaker William Tuke was enlisted and took charge of a project to develop a new form of asylum. He appealed to Quakers, personal acquaintances and physicians for funds. He spent two years in discussion with, and issuing explanatory statements to, the local Quaker group (York Monthly Meeting), working out the fundamental principles of the proposed institution. Tuke and his personal physician, Timothy Maud, educated themselves about the current views on "madness" and its treatment. Tuke's conviction, however, was in the importance of benevolence and a comfortable living environment encouraging reflection. Tuke also worked with architect John Bevans to design the new building.

The retreat opened in 1796 in the countryside outside York. It was planned to take in about 30 people but started with just three, then eight. Unlike mental institutions of the time, there were no chains or manacles, and physical punishment was banned. Treatment was based on personalised attention and benevolence, restoring the self-esteem and self-control of residents. An early example of occupational therapy was introduced, including walks and farm labouring in pleasant and quiet surroundings. There was a social environment where residents were seen as part of a large family-like unit, built on kindness, moderation, order and trust. There was a religious dimension, including prayer. Inmates were accepted as potentially rational beings who could recover proper social conduct through self-restraint and moral strength. They were permitted to wear their own clothing, and encouraged to engage in handicrafts, to write, and to read books. They were allowed to wander freely around The Retreat's courtyards and gardens, which were stocked with various small domestic animals.

There was some minimised use of restraint. Door locks were encased in leather, the bars on windows made to look like window frames, and the extensive gardens included a sunken wall that was impassable yet barely visible. Straitjackets were sometimes used, at least initially, as a threat or a last resort. There was little formal medical involvement and an apothecary, Thomas Fowler, served as physician. He gave the standard medical treatments "ample trial" but reluctantly and "courageously" abandoned them as failures. Fowler worked with George Jepson, the first superintendent of The Retreat, and the two gradually concluded that the use of usual fear tactics actually made patients worse, and allaying patient's fears helped them. Jepson was said to have been authoritative yet patient, attentive, observant, kind, and open to new ideas due to limited formal medical training. He arrived at the same time as a talented Quaker nurse Katherine Allen, and the two married in 1806, thus heading The Retreat together.

The approach of The Retreat was widely derided at first. William Tuke noted that "All men seem to desert me." However, it became a model around the world for more humane and psychologically-based approaches. The work was taken on by other Quakers, including Tuke's son Henry Tuke who co-founded The Retreat, and Samuel Tuke who helped popularise the approach and convince physicians to adopt it in his 1813 book Description of the Retreat near York. In doing so, Samuel Tuke popularised his use of the term moral treatment that he had borrowed from the French "traitement moral" being used to describe the work of Pussin and Pinel in France (and in the original French referring to morale in the sense of the emotions and self-esteem, rather than rights and wrongs). The term came to refer to a number of moves towards more humane approaches that occurred toward the end of the 18th century in the context of Enlightenment thinking, including also the work of Vincenzo Chiarugi in Italy. Ideas of "moral" management were incorporated, and used for various therapeutic and custodial purposes, in asylums and therapeutic communities around the world.

Growth and change
In 1847 the first formal "medical" superintendent was appointed. Moral therapy was gradually replaced by medication, special diets and hydrotherapy. The size of the institution grew and the formerly close-knit community ethos was left behind. In addition, both Quaker influence and the number of Quaker patients decreased through the century. After the initial period for which it is best known, therefore, there were marked changes in management, therapy and client groups.

Between 1880 and 1884, most patients of The Retreat were under 50, single, and non-Quaker. A majority have been assessed today as having met criteria for a diagnosis of schizophrenia or a mood disorder. The majority experienced delusions, with the most common being of persecution, grandeur and guilt, whilst about a third had religious content. Just under a third of patients were suicidal. Drug therapy was commonly prescribed. Just over a third of patients had a history of assault on other patients or asylum staff. About a tenth of patients were force-fed at some stage during their stay. About a half of patients were discharged within a year of admission, with the prognosis being better for patients with a mood disorder than for schizophrenia, but just under a third remained in the asylum for five or more years.

As key people in the history of The Retreat, the names of Katherine Allen and George Jepson have been given to two units at the hospital.

Services
The Retreat is a registered charity operating as an independent hospital with 100 beds. It offers specialist services, including rehabilitation for psychosis, dementia, eating disorders, and personality disorders.

The Retreat states that it provides mental healthcare that is unique to the person and values highly its original ethos. Although you do not have to have any connection to the Quakers to work at or receive healthcare from the Retreat, it remains a Quaker ministry and has a Quaker Chaplain[citation needed]. The Yorkshire General Meeting of Friends suggests names for half of the Board of Trustee Directors. The burial ground of the York Friends Meeting House is in the grounds of the hospital.

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What I would like to do!

After reading the article called, "The Retreat" which has accurate information and good references, but was not effectively presented in chronological order. The omission of important names involved should make a great enhancement on the article. For "The Retreat" classified as 'C' on Wikipedia, I would include more information about the background history, detailed information from the Quaker family and friends, and people involved in mysterious circumstances. In addition, I hope to add more information about the approach used by the Quakers, "Moral Treatment," which is supposed to be a behavior model to help people with mental health issues.

The six articles:

William Tuke

William Tuke, creator of the "Moral Treatment", was born in York on March 24th, 1732. His family had a tea and coffee merchant business. Tuke had philanthropy and educational skills. However, when his father the leader of the Quaker family passed away, his father was recognized as having revolutionized the treatment of the insane. So, William Tuke was appealed to the Society of Friends and he began to raised funds in order to open the York Retreat for to care for people with mental heath issues.

The York Lunatic Asylum Scandal

This article is about the early history about the scandal which involves The York Lunatic Asylum came from the death of Hannah Mills, who was a Quaker fellow. She was admitted at the facility and, during the six months of treatment she was not allowed to have any visitation.This situation brought several concerns about the condition of Hannahs' death. Therefore, this lead William Tuke to think about The Retreat as a place where people should be treated equal.

The Retreat

This article tell us about the foundation of The Retreat in early 19th century. The Retreat was founded by William Tuke and a Society of Friends(Quaker). His inspiration came after the tragedy involved one of the Quaker fellows, named Hannah Mills, who died at the York Lunatic Asylum, which was the first place open to deal with mental health issues.

The Retreat, York, England

This article tells about the the origins of The Retreat which was founded by William Tuke in 1792, but was only opened to non-Quaker in 1796. The Retreat gained the respect from the York community because it was a psychiatry facility that treated those with mental health problem with respect and dignity. The method used for treatment such as restoring the self-esteem, and self-control of residents was very successful. In addition, religious was involvement enabled patients to feel like a family, so patients had faith and trust. William Tuke's approach of "moral treatment" became a model for the psychiatric community.

Friends Hospital, Philadelphia

Quaker as Friends Asylum gained trust from the United States of America and had the opportunity to open the first private Friends Hospital which was a mental health facility on Philadelphia in 1813. That time was difficult for treating and impossible to curing mental health issues. So, patients were treated in a locked facility, and sometimes wore chains, on the top of other punishments. However, this facility became a paid entertainment for the community on Sunday afternoon. Therefore, Thomas Scattergood, a traveling minister, after he returned to York, UK, he had the feeling that something wrong with the Friend Hospital in Philadelphia. The grandson of William Tuke, Samuel Tuke and Scattergood were engaged to bring back the 'moral treatment' for patient with mental health issues. Samuel Tuke published a book about "The Retreat" to raise money for the hospital and in his book explained the 'moral treatment.'

Influence on Prison Design

There are many reasons that show Quaker had a profound impact on prison design. William Tuke created The Retreat in York, for people who experience mental health issues. The design from the facility was to accommodate patients by genders and to separate bedrooms. Thus, The Retreat in York created several expectations in regardless to best justice and became a strongly concern on how to address the type of offenders to the right sentences if they used as unusually behavior as an excuse for the cause. Inspired by Tuke's facility, prison, like Walnut Street Jail in Philadelphia, and others in the United States and England adopted his design for their inmates. The criminal justice also began to distinguish between criminal and the mentally ill.

Sources:

Raskassa's Peer Review

I would like to say good job on making your draft sound neutral it makes it very easy to read. Very straightforward and clear points made about the article. The only thing that I can say is adding your citations into your draft so I know where you're getting all this info from. Otherwise, this is good work and I look forward to reading more from you.