This is the first in a series of articles on the intersections of mental health and religious practice.

 

For the past year, I have been conducting research for my masters thesis on mental health care delivery at Mt. Horeb Prayer Camp in Aburi, Ghana. Mt. Horeb is an evangelical Christian organization whose mission is to “set free those held captive by Satan through a ministry of fasting and prayer.” On June 23rd, 1993, amid a rural portion of what Gallup calls the most religious country on the globe, self-proclaimed Prophet Paul Nii Okai first arrived in the bush and reportedly camped out for several weeks with nothing but a small bag, machete, and a few pieces of clothing in accordance with a divine vision.

Today, the camp serves as the headquarters of a global ministry named “Mt. Horeb Victorious Church International,” with branches in Accra and London and a busy Facebook page offering links to sermons and other publications. Despite its global reach, the original camp in Aburi continues to function as a place of spiritual refuge for a diverse set of people from across the Ghanaian socio-economic spectrum. They gather at the camp on an ongoing basis to seek God’s divine guidance, retreat from the challenges of daily life, and be in the presence of the spiritually-gifted founder. In particular, challenges with family, fertility, or finances are commonly cited motivations for visiting the camp. Horebians are encouraged to take on a quasi-monastic regimen of limited sleep, prolonged fasting, and near constant-prayer. Special focus is placed on confessing past sins, confirming faith in the power of the Holy Spirit, and enunciating future goals. In the words of one Pastor, “The work is prayer and prayer is the work.”

 

This is what it looks like to ‘wait on God’ for divine healing.

 

The camp also serves as one of the main providers of mental health care in Ghana. The on-site sanatorium is home to roughly 150 Ghanaians suffering at the hands of schizophrenia, depression, and bipolar and substance abuse disorders. This institution is run by four male caretakers, whose patients call them “Master.” These men provide food, bathe, clean, discipline, and counsel residents. The patients are divided by sex and assigned to one-room buildings where most lie on the floor, in various states of undress, for the majority of most days. Buildings range in size and may provide shelter for between a half-dozen and two dozen people at a time. Bare foam mattresses and mats are lined up next to one another around the perimeter, and a bucket in the corner serves as a toilet. There is no electricity, no running water, and no furniture. Many rooms are filled with the smell of urine and the buzz of flies. Dirt and rubble paths run between the buildings and connect the men’s and women’s “wards.” Over the course of my research, one Ghanaian psychiatrist who visited the camp noted: “I was horrified at the conditions in which patients were kept… if you ask me, I think that the man [referring to Paul Nii Okai] should be arrested. ”

As of July, 2014, a substantial proportion of the sanitarium’s population is shackled to the floor by a 1 meter, padlock chain around their ankles. The practice has drawn sharp criticism from a variety of international human rights advocates including the activist organization Human Rights Watch. Ostensibly, the chains keep violent patients from injuring themselves or others and substance abusers from fleeing the premises in search of a fix. As a result of such a safety measure, there is little to do throughout much of the day but chat with roommates, attend formal services between 10am and 2:30pm, and pray. Those who are un-chained may gather in the shade of one of the buildings to anticipate or review services, eat sugar cane, listen to the radio, or get their hair cut by one of the caretakers. This is what it looks like to “wait on God” for divine healing. Most patients I met had been at the camp for several months, but I was told of at least one who had stayed for nearly ten years.

This camp, and other institutions like it, represent a primary place for mental health care for many Ghanaians. Ghanaian policymakers I spoke with surmise that several hundred prayer camps like Mt. Horeb might exist with patient populations ranging in size from a few dozen patients to several hundred. No one at at Mt. Horeb believes the situation to be ideal, but the enduring condition of resource scarcity is tacitly accepted. And regardless of how Mt. Horeb may appear to the international press, families from across the country continue to stream in the front gates and offer their loved ones to the Prophet and his staff in the hopes they can be permanently healed.

 

Life in the camp and particularly in the sanatorium is structured so as to practice and demonstrate one’s devotion to God continually.

 

The alternatives to seeking care at Horeb are limited. Psychiatric hospitals exist but they are often too distant or too expensive to be practically accessible. And stories of ill-treatment, short-staffs, and irregular supply chains have further marred the reputation of the hospitals, which also face chronic funding shortfalls. What’s more, to travel to a psychiatric hospital is to explicitly take on the label of a “mental patient” or at least the family of a mental patient. Alternatively, traveling to a prayer camp could be understood to mean any number of things. No one on the outside would be able to forge a distinction between a woman praying for pregnancy and a woman being admitted to the sanatorium because she’s hearing voices. Even inside the camp, for those who are not chained, the distinction might be difficult to make. And there is the added element that many well-educated and medically well-informed Ghanaians see spiritual ailments as the core of most mental problems. While the hospitals can only offer treatment in the form of medication and therapy, the camp offers a total cure. In the views of many Ghanaians I spoke with, once God heals you, you are better forever.

Faith healing is at the center of Mt. Horeb, as it has been with many other Pentecostal ministries in the developing world. Church services, conversations with leadership, and reviews of the Horebian literature leave little doubt that achieving deliverance is the community’s primary theological commitment. Life in the camp and particularly in the sanatorium is structured so as to practice and demonstrate one’s devotion to God continually. In turn, an all-powerful God may bless faithful followers with many kinds of prosperity, including but not limited to health. These blessings are most often bestowed upon Horebians during four hour deliverance services on Thursdays. According to the staff, people have been cured of all sorts of illnesses at these services—including malaria, diabetes, HIV, lower back pain, abdominal pain, and mental illness. In the words of a local pastor, “That’s why we talk about how God is good and God is still in his miracle business.”

This emphasis on faith healing is reflective of Mt. Horeb’s ecclesiastical roots. Today, the camp leadership considers Mt. Horeb to be an African Independent Church (AIC), not formally affiliated with any denomination. However, there are historical connections between Mt. Horeb and the Church of the Pentecost in Ghana, the largest Pentecostal church in Ghana and prior to independence, the Gold Coast Apostolic Church. Both of these Ghanaian churches were at least partially led by British missionary James McKeown, who had been sent to the country from the Apostolic Faith church in Bradford, UK. This lineage can be traced all the way from Mt. Horeb to the beginnings of the Apostolic movement in the early 20th century in Pennsylvania and Oregon. These US-based churches placed high priority on faith healing as a sign, or primary evidence of baptism by the Holy Spirit. And lest we forget, a litany of American churches hold fast to these same theological commitments today.

 

The Horeb caretakers recognize the impact of medication as beneficial, insomuch as it allows for more focused prayers, but it the effects of medication are not to be confused with real healing.

 

The details of just how faith healing works are not widely agreed upon and many of my conversation partners had grown comfortable with the uncertainty. At times, it seems that patients have been cured primarily by developing a deeper and more honest relationship with God, which “straightens out” whatever spiritual affliction was causing their troubles. In other instances, the narrative places more emphasis on the power of God to intervene directly on a person’s body. These narratives come through most clearly when the caretakers describe how God has healed broken bones or remove tumors, but it stands to reason that if mental illness was understood to have a biochemical component, God could also correct serotonin levels. In any event, the pervasiveness of this belief in God’s ability to cure all ailments means patient’s improvement on medication is viewed as a stopgap measure. The Horeb caretakers recognize the impact of medication as beneficial, insomuch as it allows for more focused prayers, but it the effects of medication are not to be confused with real healing. That only comes at God’s will.

Understanding faith healing is a complex enough question here in the United States. It is even more difficult in a context that is geographically and culturally distant from my own. Over the course of a year of research, my sentiments about Mt. Horeb have run the gamut. Seeing the physical and emotional impact of chaining has horrified me—but seeing caretakers purchase food for patients with their own limited funds has moved me. I have told myself that the camp’s insistence on fasting and prayer for mental illness does nothing—but psychiatrists have told me that they refer difficult patients to camps. I have thought the camps should be shut down—and I have thought the camps are Ghana’s most realistic hope at creating a progressive, community based model of mental health service delivery. And in some sense, each of those inclinations probably bears some semblance of truth.


Lauren A. Taylor is a graduating Master of Divinity candidate and Presidential Scholar at Harvard Divinity School. In both domestic and global contexts, she studies how to partnerships between medical and community institutions for the purpose of improving health. In 2013, a book she co-authored with Elizabeth Bradley, The American Health Care Paradox, was published by Public Affairs. Over the past year, she has presented this work on MSNBC, C-SPAN, Sirius Radio, and at the Mayo Clinic and Institute of Medicine. Lauren received a Bachelors in the History of Medicine and a Masters in Public Health from Yale. She is currently a Fellow at both the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School and the Harvard Global Health Institute. Next year she will begin a doctoral program in health management at Harvard.

 

Image of Mt. Horeb Prayer Camp courtesy of author.

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