According to the National Institute of Mental Health, “26.2 percent of Americans ages 18 and older—about one in four adults—suffer from a diagnosable mental disorder in a given year.” That means more than 50 million people.
Serious mental illness is less common, but it is present among 6 percent of the population, or 1 in 17 adults. And antipsychotics are now the top-selling class of drugs in the U.S. If your church is typical of the U.S. population, on any given Sunday 25 percent of the adults in your congregation are suffering from some form of mental illness and many are under the influence of antipsychotic drugs.
Leadership Journal recently conducted a survey of 500 churches, using the National Alliance on Mental Illness definition of mental illnesses: “medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning” and “often result in a diminished capacity for coping with the ordinary demands of life.”
In this survey, 98 percent of respondents indicated they’d seen mental illnesses or disorders in their congregations.
The mentally ill might feel as if they are on the margins of society, but they’re actually in the mainstream. And with the drugs available today—and future improvements to come—mental illnesses can be treated and managed effectively for most people. And yet the Leadership Journal survey also found that only 12.5 percent of respondents said that mental illness is discussed openly and in a healthy way in their church. Fifty percent said mental illness is mentioned in their church’s sermons only 1 to 3 times per year; 20 percent said it is never mentioned.
It should be no surprise that people in the church aren’t sure how to respond to the mentally ill. We live in a society that is still deeply confused about mental illness. Have you ever paid attention to the way the mentally ill are portrayed in popular media?
While some, especially more recent, works treat mental illness with honesty and sensitivity, most popular media treat the mentally ill as either frightening or funny or both. For people with loved ones who suffer from ongoing serious mental illness, such portrayals are hard to ignore. Most people don’t give it a second thought, but try watching movies like Psycho, Strange Brew, Crazy People, The Shining, Misery, or Fatal Attraction through the eyes of someone who struggles with mental illness.
Or turn on the TV this week. On any given evening, you should be able to find at least one show that either reinforces terror of the mentally ill, or makes light of their illness for a cheap laugh. Even amusement parks use mental illness to entertain and terrify, with rides like “Psycho Mouse,” “Psycho House,” “Psycho Drome,” “Dr. D. Mented’s Asylum for the Criminally Insane,” “The Edge of Madness: Still Crazy,” and “Psycho Path.”
And in everyday conversation, it’s common to stigmatize the mentally ill by casually calling people “crazy” and “psycho.” The mentally ill are widely believed to be more violent than the general population, even though studies have shown that this is not true. No wonder people in the church—and outside the church—have any idea how to relate to a real person who acknowledges or displays a mental illness.
In addition, other factors contribute to the stigmatization of mental illness in the church.
- Social discomfort—the church is a community drawn together in love by a common Spirit. But made up of imperfect and sinful people, that community often feels fragile and sustains itself by polite behavior and exaggerated piety.
In such an environment, mentally ill people can upset the balance and intimidate the rest of the community because their behavior can be unpredictable and socially unacceptable. And while people might show patience with a short-term difficulty, the prospect of ongoing interaction with someone suffering from a chronic mental illness may be more than most people are willing to endure.
Pastors too can be put off by the ongoing nature of a chronic illness: “Sometimes clergy distance themselves from people with mental illness because they realize the problem can be long term. To become involved with this person may mean a lengthy commitment. Perhaps this person will never be cured. Such a problem is contrary to contemporary Western ideas of being in control of one’s life and destiny. People in modern day America expect to find a rational solution to any problem. And yet, in this case, there may be no solution. It is tempting, if an answer is not apparent, to avoid the person for whom one has no answers” (quoted from http://www.pathways2promise.org/family/pastorandperson.htm).
- Referral for treatment and care—the increased professionalization of psychiatry and counseling reinforces pastors’ feelings of inadequacy to help the mentally ill and their families. Pastors and others often refer those struggling with mental health to professionals inside or outside the church, and then assume that the person’s needs are met. But the need for pastoral care remains, even if professionals are treating ill people.
We’re tempted to see mental illness as something we’re not qualified to deal with, so we ignore it. But when someone is struggling with a different type of physical illness, the church doesn’t ignore the people who are suffering, even though they may be under a doctor’s care. The mentally ill and their families still need pastoral care and the love of a Christian community.
- Theological challenges—seeing people suffer with mental illness brings up troubling theological questions many people would rather avoid …
- Suffering—how can a good God allow people to endure the kind of suffering mental illness can produce? How can his followers suffer psychological terror, anguish, and despair?
- Accountability—can mentally ill people be held accountable for their choices? Are they responsible for their sin if they are delusional or under compulsion? How lucid is lucid enough to be responsible? And how can God hold mentally ill people accountable for their spiritual choices?
- Demonic attack—is mental illness caused by a demon? If so, how should it be handled in the church? If not, what role does the person’s spiritual condition play in his or her mental health? (The difference between mental illness and demonic influence or attack is discussed in our Spiritual Warfare)
- Punishment—is mental illness God’s punishment for sin? Is it a sign that God’s judgment has fallen on the suffering person? And if so, how should the church respond?
Such questions are troubling, especially in the face of illnesses, like schizophrenia, which are at least largely caused by biological conditions/tendencies present at birth. Such realities are not inconsistent with Christian theology—all creation is groaning under the weight of sin—but can present a great test of faith.
Leaders who feel uncomfortable with raising questions they can’t easily answer are unlikely to bring them up. And yet people in every congregation must face these questions—with or without the church’s guidance. Perhaps if our theology is too small to allow us to wrestle with them, we need to repent for our lack of faith.
- Over spiritualization—for some Christians, every problem and every solution is spiritual. In this environment, mental illness is evidence of a lack of faith. Medical and psychiatric interventions are suspect. When “just have faith and pray more” doesn’t work, they turn away, and the mentally ill are shamed and alienated even further.
I don’t know exactly where we get our ideas about the mentally ill or why we tend to simultaneously laugh at them and believe they’re all dangerous criminals. I don’t know why we believe mental illness is so much rarer than it is, or why we have such a hard time accepting the presence of psychosis in a world pervasively poisoned by sin.
I do know, though, that the mentally ill get a bad rap. And the people who love and care for those with mental illness often feel a shame they can’t explain and a terrible burden to keep secret what they most need to share. This doesn’t stop at the doors of the church.
I’m not trying to minimize the confusion and revulsion we can feel when dealing with someone whose brain is giving them a skewed picture of reality. But like any suffering person, the mentally ill should find solace and acceptance, love and redemption, in the church.
May God’s redemptive work cause the struggles of people in your church to blossom into loving ministry toward the suffering.
- How is mental illness talked about in your church? Is it talked about at all?
- Why might the mentally ill in your church be unwilling to admit and/or seek pastoral help for their illness?
- How would you respond to each of the four theological challenges listed here? How have you addressed these challenges in your church? What steps can you take to more intentionally address these challenges?