As religious leader leaves New Hampshire Hospital, plans for her position unclear

Last modified: 1/5/2015 12:50:57 AM
For the last six years, Rachael Keefe has been there for patients – and staff – at New Hampshire Hospital in Concord with prayers, with answers to questions about spirituality, with a simple reassurance that they were not alone and there was a reason not to lose hope. As the institution’s chaplain, its lone religious staff member for the last several years, she was able to offer her own kind of therapy to those seeking recovery from serious mental illness.

“Spiritual care is essential to anyone’s well-being,” Keefe said. “When you’re in an acute psychiatric crisis, having someone who can offer hope – at its core, that’s what we do – is essential.”

Last month, Keefe accepted a new position with the United Church of Christ in Minneapolis, where she started work this week. Hospital officials have not yet decided how, or whether, they will replace her. Chief Executive Officer Robert MacLeod said the hospital is using Keefe’s departure as an opportunity to reassess whether it will take a different approach to religious offerings moving forward. In the past, the hospital has partnered with some local clergy to fill in leading its weekly Sunday services as needed, and MacLeod said that will likely be the interim solution until other plans are finalized.

“It’s important to the individuals who want it, and so we’re going to be mindful of that as we move forward and try to plan how we do it here,” MacLeod said. “Her leaving here certainly is something that requires us to figure out how to move forward, and that doesn’t minimize the importance of what she did here.”

Keefe, for her part, feels strongly that her position should be filled. Her role as an on-site chaplain – working five days a week, full time – went beyond leading weekly Sunday services in the hospital’s small chapel. She sometimes dealt with as many as 15 patients a day, by request, providing prayer, comfort and counseling to those of all faiths. In those conversations, Keefe witnessed firsthand how significant a simple affirmation can be to patients with severe depression, schizophrenia and other mental illnesses.

“When you can say, authentically, to someone who feels like their life has no value . . . ‘Your life has value – simply because you are,’ it can be a gift to that person,” Keefe said.

At other times, Keefe acted as a resource for hospital staff, helping them make sense of a patient’s religiosity. When someone is experiencing a mental health crisis, Keefe said, his or her sense of absolute moral authority – “the lines between right and wrong” – can sometimes become very rigid. Keefe has helped clinicians differentiate, for example, between instances in which a person is simply practicing a heightened devotion to religion or exhibiting a symptom of mental illness.

Keefe has also found herself working to counteract sometimes harmful assumptions about religion and mental health – the idea, for example, that someone might be mentally ill because he or she sinned.

“To have a conversation with people to help to remove some of that,” Keefe said, “it can really give people a sense that recovery is possible.”

If the hospital decides to replace Keefe, it may be a challenge to find someone who brings the specific blend of expertise in both religion and counseling. Before coming to New Hampshire Hospital, Keefe worked as a parish pastor and a pastoral psychotherapist. The job at the hospital, she said, offered an environment where she could blend both of those roles together.

In recent years, Keefe’s work to bridge the divide between mental health and spirituality has extended beyond the hospital. She has conducted workshops and offered assistance to local clergy around issues of mental illness.

Keefe is not the only one who would like to see her role live on at the hospital. Ken Norton, executive director of the National Alliance on Mental Illness New Hampshire, said he also hopes the hospital retains someone as an “embedded” religious resource. Such a presence is not only valuable for patients, he pointed out, but also for hospital staff. Working at the hospital, he said, is “extremely demanding” for many reasons – the pressure around admitting and discharging patients, and the presence of occasional tragedies such as suicides or deaths due to medical conditions, to name a few.

“Having a pastoral counselor or spiritual leader allows for those needs to be met and more easily accessed than if it were folks coming in from the community,” Norton said.

And while the mental health community has occasionally underestimated the importance of spirituality, Norton said he has since realized the power of integrating religion as needed into someone’s treatment for mental illness.

“What I’ve come to learn, on many different levels, is that there’s many different paths to recovery,” Norton said. “There’s the traditional medical model, medications, paying attention to physical health, exercise, diet, nutrition – and certainly spirituality is one of those key components for people.”

(Casey McDermott can be reached at 369-3306 or or on Twitter @caseymcdermott.)

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