Yoshiba Hiroaki (Jesuit Brother)
This article is a continuation of the series on "mental problems" offered in this bulletin. Mr. Yoshiba reports on the Bethel Home, located in Hokkaido, an organization for the self-support of mentally disabled people he visited last September. People tend to regard such organizations places where one should work seriously hard, but the Bethel Home offers a different image. "The mentally disable have a right to suffer hardships," "Illness will not heal attempting the impossible" "Better than work and medical treatment try to hold meetings together" ··· Such life style infuses fresh living values into our present system that suffocates us so much. I hope you enjoy reading in this report how the disable form their groups, their normal ways to live together without the need of remaining isolated in institutions, and how they offer an antithesis to competitive societies. (Shibata Yukinori, Jesuit Social Center, Tokyo)
Visiting the Bethel Home:
My Interest in Mental Issues
I visited last September the "House of Bethel" located in Urakawa-cho, South of Hokkaido. Time ago a Protestant seminarian that attended a meeting on "mental issues," organized by a church, exposed her experiences working with the mentally disabled and that provoked my interest. I remember that she explained how she saw persons with mental problems that were living and coexisting vigorously with their local communities
Although we accustom to say "persons with mental problems," in fact the definition is very broad. Some people can live painfully going everyday to work or to school, while others remain home with much daily suffering they hide even to their own family members. I heard that among them there are those who make smiling faces to their husbands coming back home.
But when suffering reaches a definite level medical treatment is needed. Thinking that depression reaches maybe 5% of the population and realizing that most people do not receive medical treatment, one can imagine how spread psychological suffering is. And as a result, many are obliged to live mentally disabled.
How have these people been treated and did we do anything for them? Nothing can be said in general, but most probably we treated them as "persons different from us" or maybe we mocked at them and put them aside. Normally speaking, will patients going to a psychiatrist or those interned or leaving psychopathic wards claim openly their disease?  If in our neighborhoods an institution for mentally disabled people is going to be built, people, nowadays, will not oppose it publicly as before, on the grounds that it will become troublesome for everybody if an assassination occurs, but instead people will say: "the environment here is not fit for such an institution." The truth is that we do not want to live nearby with "people who are not normal" and with people we don’t know.
We do not feel comfortable hearing of a person with psychological problems. Groups of supporters are increasing steadily but, in spite that they are not doing anything bad, the mentally disable usually experience people looking at them in strange ways. To avoid to be taken as "spoilt children," many make great efforts to look as the others, but they fail and their psychological wounds become more serious.
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When it comes to that, the only way available will be to assume a defiant attitude, to scream loudly or to continue enduring the suffering. Nevertheless, when they meet persons that understand them they can walk by themselves, no matter the problems facing them.
I want to deal with people who are living with mental disabilities so I went to Urakawa, a town where the mentally disable can live without shrinking their lives, thinking that I could find there hints to know and reflect on ways how people with psychological and/or mental disabilities could live developing their own selves.

The Bethel Home
The Bethel Home consists of a workshop with training facilities, a "group home" under a socio-welfare moral corporation supporting community living and a private company selling medical instruments. About 150 community members gather there. The name Bethel comes from the Old Testament and from the name of a German town. Germany’s Bethel is historically known because, during the Second World War when the Nazis tried to massacre all disabled people, citizens of that town without disabilities demanded to be also brought with the disable. Even now the town is known for its solidarity with disabled people.
At Bethel there are people living at the "group home" facilities and people living with their families. Recently there are some that moved from outside Hokkaido to live in nearby apartments alone by themselves or with their families, often single mothers with children. My impression was that Bethel accepts any comer and outdoor hospital patients can easily join any number of programs organized there.
Although most of the disabilities of Bethel's community companions are psychological, other disable and a few mentally retarded persons use also the facilities. The mental cases are mainly patients with schizophrenia and some alcoholic persons. The disable receive pensions and/or socio welfare assistance. The administration posts are in their hands and this I thought is a proper system to assure the continuation of the work. The President of the board is Mr. Sasaki Minoru and the Directors of the institutions are Ms. Shimizu Rika and Mr. Ogino Hitoshi.
Several years back a former patient of the psychiatric department of the Red Cross Hospital of Urakawa organized a group, called "Dongurikai," that became the historical beginning of the Bethel Home. Members of the "Dongurikai" started to live by the church of Japan Christian Association and under the suggestion of the Protestant Minister and his wife started to pack a local product called "Hidaka Konbu (tang)" under contract. Later, on they established their own business for the production and sale of Konbu and, at present, run a company for the manufactory and sales of sea products, Video production and a printing shop, shops called ‘4 chome stroll’, like Internet use, orientation seminars and the organization of events to promote local inter-exchange. Recently they have expanded to new schemes on ecological and agricultural products, besides the existing "group home" with community housing facilities.
Visitors have also increased to the point that about 2,000 people visit Bethel every year. When I was there, people from even Kyushu came for a visit, as well as persons from foundations, socio-welfare specialists, psychiatric social workers, nurses, students in social welfare schools and even economic experts. Members of Bethel perform speaking tours in Sapporo and other cities, including Tokyo, for auditory hallucination and special meditation that have received several rewards. They are also in close contact with the members of the Council of Social Welfare, Japanese Red Cross and other official local committees and conduct routine meetings to examine problems involved.
I have heard that the relationship with the local residents was difficult at the beginning. This is different now that the institution has become a natural part of the town. There was no other business in the locality except fisheries, but because of groups visiting Bethel, the place has developed the concept of common prosperity. Ms. Shimizu, Director of one of the institutions, holds the opinion that, since the mental disable have been obliged to live apart in society, in medical centers, and due to the dosage of medicines that left them weak without their own thinking, they have been deprived of "suffering hardship." That is why, she explains, by conducting business they are trying to bring back the experience of hardship.
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Bethel Characteristics
In order to summarize what Bethel is about, the expression that fits more will be 'a place where nothing is done accurately.' For instance, during the meetings it is natural for the members to come in and out at any moment. Since mental disabilities have unexpected symptoms it is often difficult for people to continue coming and, from time to time, one can hear greetings like this "we haven’t seen you for over a month." Anyhow people do not worry much about it. Of course, this presupposes that close relatives or friends are well aware of the whereabouts. Once somebody visiting the packing of konbu asked, "how many boxes do you usually pack?" Then, Hayasaka Kiyoshi, representative of Bethel and a celebrity with schizophrenia answered, "we don’t care. No matter how good the plan is we can’t accomplish it. We do as much as we can and that’s all." Efficiency is not a priority there. Priorities are impossible and after all nobody cares.
I felt that, no matter somebody disappears for a while others recognize that person, because there is a relationship of trust, people feel at home somehow there.
I had never been in contact before with schizophrenics and thus I kept a selfish image of that disease, without realizing that there is no other disease with so many varieties. Some patients suffer from auditory hallucinations while others, in fact only a few, from soliloquy. Some persons can just perform one type of work due to side effects of medicines, while there are others that hardly show their disability.
The day starts with one-hour morning meeting where everyone makes sure of his/her tasks.
Depending on the work to be done much time is given to group sharing, like social skills training (SST) or self-reliant group for Schizophrenics (SA: Schizophrenics Anonymous). Bethel conducts meetings at the beginning and end of the day. Bethel's characteristic motto is: "to move your lips is more important than to move your hands"

My Experiences at Bethel
Weakness is a joining bond
This is part of Bethel’s ideological statement. It manifests that with confidence in the strength of each moment one should express what he is thinking. For instance, it was interesting to hear the patients in all meetings to talk about their health, about what "went all right" and "what was really hard." There was no talk about "what went wrong." In other words, it shows that "what had been hard was different from mistakes done."
It is clear that they have an original concept with regard to hallucination. Normally, doctors or patients will immediately try to make hallucinations disappear using medicines. Here, instead of saying "hallucination" they will say friendly, "Mr. Hallucination." Once in a meeting a person mentioned that he was quite annoyed by hallucination and then an expert said that, it would be wonderful if you could say: "Mr. Hallucination thank you very much, let’s become friends." Then, a different person said that there are two types of hallucination, "hallucination of light and of darkness." The one of darkness looks good at first sight, but when you follow it, might be troublesome. On the contrary, the one of light is critical of oneself but, after all, makes one reflect. I found this very inspiring.
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Normally a disease is a symbol of some weakness, but there is nothing wrong with being weak. I found out that Bethel is a place that gives recognition to that and has the proper atmosphere for patients to share their existence.

Meetings are more important than meals
Although many meetings are held here, I will only refer to Schizophrenics Anonymous (SA) and the Supporting Conference.
SA consists only of patients with schizophrenia. It is a self-reliant group where people discuss the themes agreed upon by them. The chairman is also a companion patient. The day of my visit I was admitted as an observer sitting down at a corner of the room.
The meeting following the characteristic line of Bethel started with, "How is your health? What was good today? What kind of hardships did you experience?" I must refrain from exposing the content of the discussion, but a patient approached me at the end of the meeting and told me, "I felt much helped by your silent presence listening to my talk regarding my hard experiences, something like a scream, no matter how small it was." To tell the truth, I did not receive the impression that the atmosphere was one of listening attentively to each other. Nevertheless, they seemed to feel a sense of security joining companions that were screaming and I felt that the atmosphere was fit to reassure them of a meaning in their own actual existence.
The "Support Conference" was also quite moving. The patients gathered at the facilities of the Japan Red Cross Hospital to discuss the problem of one person. I was astonished at the experiment of picking up a concrete problem to reach a solution at the conference. Including visitors there were about 30 persons there. Most of the participants were patients from Bethel. A hospital social worker acted as facilitator clarifying the issues involved in the case. She asked the participants for their internal moves and feelings hearing the case, how do they see the person of the case and her situation. What do they think could be done (just cry? be patient?) She, then, invited them to find ways to proceed ahead. I was impressed at how the meeting was held. When the facilitator asked a companion for some reactions the first remark consisted of praising words "his/her smiling face was good."
From the beginning nobody speaks about "bad points or things to be improved." I felt that this fact proves that they live in a community of mutual trust.
As a matter of information I already mentioned about the social skills training (SST). It is difficult for them to express themselves and in the training sessions they make them imagine a concrete situation, like, for instance, one of their companions moves to another place and they want to say a farewell but start crying. The training consists in finding ways to express the feelings they have in occasions like that. Since they are not skillful to express themselves such training sessions are very important.

Local contacts
I mentioned above that the beginnings of Bethel created some tensions in the locality but now the situation looks very friendly. The local residents do not object to the increase of disabled people in their area. According to a patient I talked to, local residents do not make any opposition now at the construction of group-home community housing of Bethel. There are 10 new apartments now.
The relationship with other official organizations in Urakawa town, as I already mentioned, like Urakawa’s Educational Council, Japan Red Cross and others proceed smoothly. There is a Liaison Committee that meets often and mental health issues are regularly on the agenda. Social workers of Japan’s Red Cross Hospital work often in Bethel also. I realized how important it was to involve the local community to cooperate with families of mental patients and to reflect how to build healthy relationships on an equal basis.
For instance, there are cases like this. One member of the community was urgently interned in the hospital without anybody being aware. The owner of a local shop told the people of Bethel that the person had not been feeling well for the last 3 days. This, I felt, was a sign of the natural ways to care of each other. The members of the Group-Home, without interfering in others’ life, knew exactly that one of their companions had been hospitalized and discussed among themselves the health problems concerning the patient at the Home meeting.
During my stay there I could not see many resident visitors at the shop "4 chome Stroll" that sells goods from Bethel and promotes exchange programs in the locality. Most probably they will have to reassess the meaning of it.
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Medical issues
During one of the meetings of the Group Home I sat down by the side of a teacher of a Nurse College and a nurse of a Medical Faculty specialized on mental diseases of a University.
Then a discussion took place out of some odd issues between Mr. Hayasaka and one of the nurses. Mr. Hayasaka asked whether the policy of the hospital was to let patients leave the hospital in case they were willing to do so. A nurse replied, "It is up to the doctor' s judgment."
When Mr. Hayasaka heard that said angrily, "Why does not the doctor allow a patient to leave the hospital, if s/he wants to go home?" Mr. Hayasaka reacted angrily at the tendency of medical institutions for mental patients to keep the patients interned, in spite of the fact that, by establishing communication with mentally disabled people, one can make sure that they are not strange people. When patients get somehow healthier it is better to continue rehabilitation in society.
Certainly, living in Urakawa one meets often members from Bethel that look a little peculiar sometimes but without calling much your attention. This is the result of the acceptance given by the population of disabilities of patients from Bethel that are living shoulder to shoulder with the local residents.
Dr. Kawamura Toshiaki, specialist in schizophrenic diseases at Urakawa' s Red Cross Hospital, writes often in books that medical treatment should rely on the strength hiding behind the disease, not on given drugs.

Living with Mental Problems
in Urban Areas
I had the opportunity of asking people in Bethel for their good experiences. Their answers were: 1) I could meet many people; 2) When I want to remain home I do it and when I want to work I go;
3) People, in similar situations like myself, are able to work; 4) I can naturally show my sickness 5) Before coming to Urakawa if I became sick I had friends visiting me, but here I enjoy the friendship of many.
The fact that Urakawa is located in an isolated region and its streets form a compact small area everybody is easily visible. The experiments done at Bethel cannot all be repeated in urban environments, but some could also be viable in modern cities. For instance, SA self-supported groups are in fact, existing and can develop further in cities.
The building of cities stresses heavily extreme efficiency and seems to be impossible to act with flexibility, but maybe by chance a "crevice" appears and from that the whole system starts crashing down. Because it is not allowed to lose courage one has always to make great efforts while one’s heart screams loudly. As a member of Bethel’s community explained, one of the good characteristics of Bethel is that people move from "doing the impossible to some kind of liberation."
In the final stage and in the process of evangelizing society one has to solve the sense of impossibility. In the cities there is a need for space to share suffering in common within an atmosphere of forgiveness, an attitude like the one practiced at Bethel, getting interested in the difficulties of others and without rejecting persons with mental problems as if they were "strange persons."
Ms. Shimizu has a message for those dealing with "mental problems." "Before getting sick it never came to my mind that I could come to live in this town. Once I came to Urakawa I reflected for the first time on my own identity and relationships with others. If I were a healthy person I would have hardly thought about this. My sickness helped me to reflect deeply about it."
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