Category Archives: educators

Creating a Culture of Openness: Ways your church can help the mentally ill. Colossian 3:12–14

If you want your church to be more faithful and effective in ministering to those with mental illness, what can you do besides referring people to the professionals? Here are nine suggestions.

De-stigmatize. Make a determined effort to rid your church of the stigma and shame associated with mental illness. Talk about it. Acknowledge the struggles of people you’ve known, and your own struggle if applicable. Contact some local organizations to see how churches can better support the mentally ill. And if necessary, repent privately or even publicly for the way your church has handled mental illness.
Talk publicly about mental illness. When was the last time you mentioned mental illness in a sermon or class? Have you discussed the tough theological questions that mental illness can raise? Is your church a community of imperfect people growing in relationship with a God who is not confused or threatened by our imperfection? Or does your church inadvertently send the message that it’s a place only for the mentally healthy? You can make your church a relevant, accepting place for those who struggle with their mental health by talking openly about it. One note of caution: no “crazy” or “psycho” jokes. Making light of mental illness alienates those who suffer and reinforces the stigma and shame associated with mental illness.
Encourage relationships and ask questions. I asked my parents, who have had to deal with my mother’s mental illness, what the church has done right in ministering to them. They both focused on the open and genuine relationships they have had. Small groups have been lifelines for them, especially when they have been able to talk openly about their struggles, mention their therapeutic work, and relate their experiences to the Bible.

My parents also mentioned how helpful it is when curious people ask questions, learning about their experiences and seeking common ground. Questions like “what it’s like to be on medication?” or “what’s it like to attend group therapy?” might seem intrusive, but for my mom, they open the door to genuine conversation and provide relief from feelings of isolation. Because these are her everyday experiences, they are easy for her to talk about if someone shows interest.

Genuine and mutual relationships are irreplaceable. Encourage the ministry of honest relationships in your church so that when mental health struggles and crises arise, those who are suffering have friends to walk through the suffering with them.

Ask what you can do to help. You must be willing to actually help if the individual or family expresses a specific need. People in crisis don’t always know what they need, but sometimes they do and they feel as if no one is available or willing. You may not be a mental health professional, but you can help—organize meal delivery, visit someone in a psychiatric hospital, provide a ride or childcare. Be especially attentive to the people who are caring for or living with a mentally ill person. They may be better able to communicate what’s really going on and what they need, and like anyone who loves and cares for the suffering, they are suffering themselves.
be present. This sounds simple, but it’s powerful. When an individual is struggling with mental illness, and when the person’s family is in crisis, the earth can feel as if it has come loose from its proper orbit. They need something stable in order to help them keep their faith. A pastor who refuses to abandon a family in crisis powerfully demonstrates that God has not abandoned them either. Make yourself consistently available, even if it’s not clear what else you can do to help.
Radiate acceptance. Refuse to reject the person or family in crisis. Be the person who represents Christ’s tenacious and bold love, refusing to be driven away by what you don’t understand. Don’t ignore them because you’ve given them a referral to a mental health professional. Like others in crisis, people affected by mental illness need to know you care.

Try to treat them as you would a person who suffers from arthritis or diabetes. Ask questions: Are you managing your illness? Caring for yourself? Is the family healthy? A diagnosis or hospitalization doesn’t change who a person is; it just changes your understanding of what someone needs.

Draw boundaries and stick to them. Just because someone is mentally ill, you do not need to suspend standards of morality, biblical theology, or respectful behavior in your church community. Overlooking inappropriate behavior or beliefs is destructive to your congregation, and it does no favors for the mentally ill.

Regardless of how they respond to social expectations, mentally ill people do need structure and boundaries to grow in independence, understanding, and management of their illness. They need healthy people around them to give them objective feedback and an example of mental health. Help them pursue and maintain health by insisting on a healthy community around them. Communicate agreed-upon expectations openly and lovingly, and hold to them consistently.

Know when you are in over your head. Sometimes you need to call in a professional to either handle an immediate crisis or provide long-term care. If you suspect a person in your congregation is struggling with mental illness, refer him or her to a professional counselor or psychiatrist.

Compile and keep a list of trusted professionals and their specialties: from depression to eating disorders to bipolar to schizophrenia. You’ll have a relevant referral at your fingertips when someone in your church needs it.

And obviously if someone in your church is in danger or is endangering another person, call 911. This is not a situation for you or your congregation to handle; it’s a situation for the police. Once everyone is safe, you can move to referrals and pastoral care as appropriate.

Get help if you’re struggling. If you or a member of your family is struggling with your mental health, seek professional help. You cannot effectively minister to a congregation without addressing your own needs. And your first ministry is to the family God has entrusted to your care.

Discuss

In what ways do you see people in your church engaging those with mental illness? How could you encourage healthier relationships that acknowledge the struggles of sufferers without stigmatizing them?
What would it look like for your church to “radiate acceptance”? That is, what are the characteristics of a church that demonstrates love and acceptance toward the mentally ill?
Does your church tend to set boundaries that are too strict or too loose on the mentally ill? Why are boundaries important for the mentally ill? How can they be communicated in a loving way?

De-stigmatizing Mental Illness How does your church think about and minister to those suffering from mental illness? 2 Corinthians 12:9–10

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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.

Persistent Stigma

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.

Redemption

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.

Discuss

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?