The Retreat

{{Other uses}} {{Use British English|date=October 2013}} {{Use dmy dates|date=January 2024}} {{Infobox hospital | name = The Retreat York | org_group =  | logo =  | logo_size =  | image = The Retreat York 02.jpg | image_size = 300 | alt =  | caption = The Retreat in 2023 | pushpin_map = North Yorkshire | pushpin_map_caption = Showing site of York Retreat in North Yorkshire | region = Lamel Hill, York | state = | country = England | coordinates = {{coord|53.950972|-1.063125|display=inline,title}} | address = Heslington Road | healthcare =  | funding = Non-profit | type = Specialist | speciality = Psychiatry | standards =  | emergency =  | helipad =  | affiliation =  | patron =  | network =  | beds = | founded = 1796 | closed = | website = {{URL|theretreatyork.org.uk/}} }}

'''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 behaviour model for asylums around the world with mental health issues. Founded by William Tuke, it was originally only for Quakers but gradually became open to everyone.<ref name = "history">{{cite web|url=http://www.theretreatyork.org.uk/history/|title=Our History|publisher=The Retreat website|accessdate=8 July 2017}}</ref> It inspired other progressive facilities such as the US Brattleboro Retreat, Hartford Retreat<ref>{{cite book|last=Shorter|first= Edward |title=A history of psychiatry: from the era of the asylum to the age of Prozac |url=https://archive.org/details/historyofpsychia0000shor|url-access=registration|accessdate=18 December 2010 |year=1997 |publisher=Wiley |isbn=978-0-471-24531-5 |page=[https://archive.org/details/historyofpsychia0000shor/page/44 44] |quote=The Hartford Retreat was founded in 1824.}}</ref> and Friends Hospital.<ref>Kim Van Atta, David Roby, Ross Roby (1980) [http://www.friendshospitalonline.org/eventsaccount.htm An Account of the Events Surrounding the Origin of Friends Hospital & A Brief Description of The Early Years of Friends Asylum 1817–1820]. Reprinted 1988 by The Winchell Company. Retrieved 8 July 2008</ref> The present day The Retreat seeks to retain the essence of early "moral treatment", while applying the principles to a modern healthcare setting.<ref name ="history"/> The Retreat withdrew from the delivery of inpatient services after 222 years on 31 December 2018.<ref name="Retreatclosure">{{cite news |last1=Laycock |first1=Mike |title=The Retreat hospital in York to close services with 45 job losses |url=https://www.yorkpress.co.uk/news/17303816.the-retreat-hospital-in-york-to-close-services-with-45-job-losses/ |accessdate=4 January 2019 |agency=The Press |date=18 December 2018}}</ref>

==History==

===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.<ref>Stanley, J. (2010). Inner night and inner light: A Quaker model of pastoral care for the mentally ill. Journal of Religion and Health, 49(4), 547–59. doi:10.1007/s10943-009-9312-4</ref> 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.<ref name="Charland2007">{{cite journal |last=Charland|first= L. |title=Benevolent theory: moral treatment at the York Retreat |journal=History of Psychiatry |volume=18 |issue=1 |pages=61–80 |year=2007 |pmid=17580754 |doi=10.1177/0957154X07070320 |s2cid= 28459632 }}</ref> A trigger was the death in 1790 of a Quaker, Hannah Mills, a few weeks after she had been admitted to the York Asylum<ref name ="history"/> (now known as Bootham Park Hospital). The asylum had not let her friends or family visit her.<ref>{{cite web |url=http://borthwickinstitute.blogspot.com/2014/10/the-york-lunatic-asylum-scandal.html |title=The York Lunatic Asylum Scandal |date=10 October 2014 |website=Borthwick Institute Blog}}</ref> This situation brought several concerns about the condition of Hannah's death. Therefore, this led William Tuke to think about The Retreat as a place where people should be treated equally. However, visiting afterwards to investigate the conditions, the Quakers found that the patients were treated worse than animals.<ref name="Samuel">Samuel, B. [http://www.quakerinfo.com/qt_retr.shtml Quaker Tour of England: The Retreat Mental Hospital] QuakerInfo.com Retrieved 8 July 2017</ref>

===Beginnings=== alt=Illustration of the original building circa 1796|thumb|York Retreat original building {{circa|1796}} Quaker William Tuke was enlisted and took charge of a project to develop a new form of asylum. His family enjoyed the tea and coffee merchant business.<ref>William Tuke. (2017). Columbia Electronic Encyclopedia, 6th Edition, 1.</ref> He appealed to Quakers, personal acquaintances and physicians for funds.<ref name="Samuel"/> 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.<ref name="Edginton">{{cite journal |last=Edginton |first=B. |year=2003 |title=The design of moral architecture at the York Retreat |journal=Journal of Design History |volume=16 |issue=2 |pages=103–117 |jstor=1316269 |doi=10.1093/jdh/16.2.103}}</ref>

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.<ref>{{cite book |last=Tuke|first=Samuel |orig-date=1813 |title=Description of the Retreat|publisher=Process Press|year =1996|location=London|isbn= 1-899209-04-2}}</ref>

====The Design====

There was some minimal use of restraint. The design for the facility was to accommodate the patient by gender in separate bedrooms in a way specific to that patient treatment.<ref name="Edginton" /> 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.<ref>{{cite journal |last=Laffey |first=P. |title=Psychiatric therapy in Georgian Britain |journal=Psychological Medicine |volume=33 |issue=7 |pages=1285–97 |year=2003 |pmid=14580082 |doi=10.1017/S0033291703008109 |s2cid=13162025 }}</ref> 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 in spite of his 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.<ref name="Charland2007"/>

====The Moral Treatment====

The approach of The Retreat was widely derided at first. William Tuke noted that "All men seem to desert me."<ref name="Samuel"/> 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 which convince physicians to adopt it in his 1813, book ''Description of The Retreat near York''. His book explained in detail about the approach to use the moral treatment method for restoring the self-esteem, and self-control in individual with mental issues.<ref>{{cite web|title=The Retreat, York, England|url=http://www.quakersintheworld.org/quakers-in-action/92/The-Retreat-York-England|publisher=Quakers in the World|accessdate=30 October 2018}}</ref> 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).<ref name = "history"/> 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.<ref>{{cite journal | last1 = Borthwick | first1 = Annie| last2 = Holman| first2 = Chris| last3 = Kennard| first3 = David| last4 = McFetridge| first4 = Mark| last5 = Messruther| first5 = Karen| last6 = Wilkes| first6 = Jenny| title = The relevance of moral treatment to contemporary mental health care| journal = Journal of Mental Health| volume = 10| issue = 4| pages = 427–439| publisher = Routledge| year = 2001| doi = 10.1080/09638230124277| s2cid = 218906106}}</ref>

The Retreat states that it provides mental healthcare that is unique to the person and values highly its original ethos.<ref name="CoreValues">{{cite web|url=http://www.theretreatyork.org.uk/values.html|title=Core Values|publisher=The Retreat website|accessdate=8 July 2017}}</ref> 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<ref name="Samuel"/> and has a Quaker Chaplain.<ref>{{cite web|url=https://www.theretreatyork.org.uk/spirituality.html|title=Spirituality|publisher=The Retreat|accessdate=30 October 2018}}</ref> The Yorkshire General Meeting of Friends suggests names for half of the Board of Trustee Directors.<ref name="directors">{{cite web|url=http://www.theretreatyork.org.uk/board-of-directors.html|title=Board of Trustee Directors|publisher=The Retreat website|accessdate=8 July 2017}}</ref> The burial ground of the York Friends Meeting House is in the grounds of the hospital.<ref name="Samuel"/>

===Growth and change=== Quaker as Friends Asylum in 1813, 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. During that time it was difficult to treat and impossible to cure mental health problems. In addition, Samuel's book with his explanation about the moral treatment gained trust from the community, and helped to raise money for the hospital.<ref>{{cite web|url=http://www.quakersintheworld.org/quakers-in-action/136/Friends-Hospital-Philadelphia|title=Friends Hospital, Philadelphia|publisher=Quakers in the World|accessdate=2 September 2018}}</ref>

The abolitionist, John Candler, was appointed Superintendent in 1841. However the Lunacy Act 1845 necessitated the appointment of a medically qualified superintendent and in 1846 the John Thurnam was appointed.<ref name="Boromé, Visit to America">{{cite journal |last1=Boromé |first1=Joseph A. |title=John Candler's Visit to America, 1850 |journal=Bulletin of Friends Historical Association |date=1959 |volume=48 |issue=1 |pages=21–62 |jstor=41944688 |issn=0361-1957}}</ref> 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.<ref>{{cite journal |doi=10.1017/S003329170001970X |last=Digby |first=A. |title=The changing profile of a nineteenth-century asylum: the York Retreat |journal=Psychological Medicine |volume=14 |issue=4 |pages=739–48 |date=November 1984 |pmid=6400132 |s2cid=7055324 }}</ref>

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, while 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.<ref>{{cite journal |doi=10.1017/S0033291700010990 |last1=Renvoize |first1=E. B. |last2=Beveridge |first2=A. W. |title=Mental illness and the late Victorians: a study of patients admitted to three asylums in York, 1880–1884 |journal=Psychological Medicine |volume=19 |issue=1 |pages=19–28 |date=February 1989 |pmid=2657829 |s2cid=24519607 }}</ref>

As key people in the history of The Retreat, the names of Katherine Allen and George Jepson were given to two units at the hospital.<ref name="services"/>

===1952 air incident=== A Gloster Meteor ''WH342'' from 66 Squadron at RAF Linton-on-Ouse crashed at The Retreat on Friday 29 February 1952.<ref>''Times'' Saturday March 1 1952, page 3</ref><ref name=":0">[https://asn.flightsafety.org/wikibase/20925 1952 Gloster Meteor]</ref> Pilot Officer John Speirs Paterson (1 March 1927 – 29 February 1952), from Waterworks House in Farewell and Chorley in Staffordshire, died in the crash. He attended the King Edward Grammar School in Lichfield, and the University of Cambridge.<ref>''Rugeley Times'' Saturday 8 March 1952, page 5</ref> The tail landed in the cemetery and the body tore the roof off part of the building, but there were no casualties among the patients or staff.<ref name=":0" />

==Current services== The Retreat continued to operate as an independent hospital into the modern era. However, on 31 December 2018, it withdrew from inpatient care with its remaining services for eating disorders and personality disorders now being run by the Schoen Clinic.<ref name="Retreatclosure"/><ref name="services">{{cite web|url=http://www.theretreatyork.org.uk/inpatient-mental-health-services/|title=Inpatient Mental Health Services|publisher=The Retreat website|accessdate=3 January 2019}}</ref> The Retreat continues to run outpatient community psychological assessment, diagnostic and therapy services at the Tuke Centre, including an Autism and ADHD service.<ref>{{cite web |title=The Tuke Centre |url=https://www.theretreatyork.org.uk/the-tuke-centre/ |website=The Retreat |accessdate=4 January 2019}}</ref>

==Notable figures== *Joseph Rowntree and Samuel Tuke (grandson of William Tuke) are buried in the Quaker cemetery found within the grounds.<ref>{{cite web|url=https://www.rowntreesociety.org.uk/history/rowntree-a-z/retreat-the/|title=The Retreat|publisher=The Rowntree Society|accessdate=30 October 2018}}</ref> *Aubrey Hopwood (1863–1917), lyricist and author, died there.<ref name=Probate>[https://www.ancestry.co.uk/imageviewer/collections/1904/images/31874_222923-00223?pId=5239220 England & Wales, National Probate Calendar (Index of Wills and Administrations), 1858–1995 for Henry Aubrey Hopwood, 1918 Ancestry.com {{subscription required}}]</ref>

==References== {{Reflist}}

==Further reading== *{{cite book|last=Digby|first=Anne|title=Madness, Morality and Medicine: A Study of the York Retreat 1796–1914|publisher=Cambridge University Press|year=1985|location=Cambridge|isbn= 0-521-26067-1}} *{{cite book|last=Tuke|first=Samuel |orig-date=1813|title=Description of the Retreat|publisher=Process Press|year =1996|location=London|isbn= 1-899209-04-2}}

==External links== *[http://www.theretreatyork.org.uk/ Official Website of The Retreat] *[http://www.historyofyork.org.uk/timeline/georgian/the-retreat The Retreat on History of York] *{{YouTube|channel=UCZxnyDWXbqNl_M6FOqtiqrw}}

{{DEFAULTSORT:Retreat, The}} Category:Psychiatric hospitals in England Category:1796 establishments in England Category:Quakerism in the United Kingdom Category:History of mental health in the United Kingdom Category:Organisations based in York Category:Quakerism in England Category:Hospitals established in 1796 Category:Private hospitals in the United Kingdom Category:Religion and mental health