“When pain is to be born, a little courage helps more than much knowledge, a little human sympathy more than much courage, and the least tincture of the love of God more than all.”
― C.S. Lewis, The Problem of Pain
With about one in five adults struggling with mental illness each year, the intersection between mental health and the church is an important, oft-broken one. If we are to manifest glimpses of God’s kingdom here on earth, we must tend to the fractured parts in pursuit of wholeness.
In recognition of Mental Health Awareness Month, we spoke with Amy Simpson—speaker, leadership coach, and author of Troubled Minds: Mental Illness and the Church’s Mission. She offered galvanizing insight for reforming our perceptions and approaches toward mental illness within faith communities.
What are the gaps between Christianity and mental health care, and how would you encourage the church to fill these gaps?
Historically speaking, when people seek help with a mental health problem, the number one place they go is churches and other faith communities. That is true both for people who see themselves as part of a faith community and for people who don’t. Most churches and most clergy don’t realize this is happening. So helping churches understand how this connects to our sense of mission as the body of Christ. If we are here to represent Christ among our fellow human beings, then we have to respond compassionately to an opportunity like this. That’s a very basic part of what we’re here for and what we’re called to: understanding [people’s] needs and connecting them to our sense of calling.
In most churches there are almost no intentional mental-health-related ministries happening. To do something would be a major improvement over nothing in most places. There are a lot of gaps in our mental health care system that churches can help with. For example:
1. We have a serious shortage of mental health care providers, especially psychiatrists. In 1955 we had one bed in a psychiatric ward for every 300 Americans. And now we have one for every 3,000 Americans. That’s indicative of the whole system: the level of availability of care has gone down dramatically. So when someone actually needs help, if they need to be admitted to a psychiatric hospital, they may not be able to find a bed. If someone needs to see a psychiatrist, they may have to wait six weeks or six months before getting in. That would be a big thing for churches to do, and there are churches that do this: opening clinics. I’d love to see more Christian groups and churches actually making mental health care more available in their communities.
2. Another gap is similar in terms of counseling services. It is easier to find counseling services than it is to find psychiatric care. But finding people who will do therapy and who actually specialize in mental illness is difficult. Most counselors tend to work with a “worried well”—they’re helping people have a better marriage, or work through family issues (which of course are very important). A lot of therapists don’t actually work with people who truly have a disorder. More churches can provide counseling services that are aimed at helping people with mental disorders or mental illness—not just helping them have a better marriage, etc.
3. Another serious gap is in faith-based, Christ-centered care. Depending on where you live you can find peer-support groups. And in some communities there may be one group and in some communities there may be a lot of them, but it can be very hard to find any that are connected to faith. Hosting a peer support group in church, even if you don’t make it faith-based, if you host a NAMI group (National Alliance of Mental Illness with support groups all over the country), host one of those in your church. All you have to do is leave the lights on and have somebody lock up.
4. Another one is just providing spiritual care for people. So often churches tend to fall on different ends of the spectrum. You have some churches who will deny there’s any such thing as mental illness, that it’s all a spiritual issue. On the other end of the extreme are churches who take the opposite approach and and abandon people to the system without recognizing that people need a lot more than just professional mental health care. A mental health crisis is almost always connected to some level of spiritual crisis. When your thoughts and emotions are thrown off, it’s hard to cling to truth. Recognizing those spiritual needs are present and trying to address those needs can be as simple as praying with people, reminding them that God loves them, and listening to their questions.
5. In general, churches are really good [at meeting practical needs] when people are in crisis, like there’s a death in the family, or somebody’s seriously ill. [Churches might] take care of the kids, bring food, provide financial help, visit people in the hospital, and yet when that crisis is related to mental health, it’s very rare to get that sort of help. In fact, mental illness is often called the “no casserole” illness for that reason, because people tend to draw back and think they don’t know how to help. Well, you do know how to help; you do it for everybody else. You can visit people when they’re in a behavioral health hospital, you can bring casseroles to their family, you can give financial help.
6. [We must] understand what resources are available in the community. Churches are the number one places people are going for help, and if that’s the case, we need be serious about our role as gatekeepers to mental health care. Who are some professionals who specialize in different kinds of care? Get to know them, then help people find them. You can help serve in that gap because often when people experience a mental health crisis, especially for the first time, they have no idea how to access care. And because the system is fragmented, it can be difficult. The more churches can step in and help move that along, the better.
Why is mental illness stigmatized in ways that many other illnesses aren’t?
We have this robust mythology about mental illness that’s rooted in ancient misunderstanding. Christians often think mental illness is caused by demons. They’ll look at the Bible and say, “Well if someone was acting crazy Jesus would cast a demon out of them, so obviously…” That idea doesn’t originate in the Bible or with Christians; it’s a pagan idea in ancient Greece and ancient Rome—if somebody had a mental illness they were shunned because people were afraid that the evil spirit that was in them would fly out and infect them if they got too close. It’s an idea that’s been around for a long time, and it’s like a lot of other things: when human beings don’t understand something, historically speaking, we look for an explanation based on the information available to us at the time.
[Within the church] we often confuse the brain with the soul. [We] think that if there’s any kind of behavior/feeling/thought that we don’t understand or can’t explain or doesn’t seem true then it’s a problem with the soul. [We] discount the fact that we have brains in our heads that can go dysfunctional. These are physical organs of our bodies. And of course if your brain is not functioning properly, of course it’s going to affect the way you think/feel/behave. We tend to not think of the brain as a physical organ that can be injured/dysfunctional/diseased, just like any other organ in our bodies. So we need to advance our thinking on those things, because a lot of it is really based in mythology and in outdated ideas/superstitions.
[The church can also] over-spiritualize everything; to some people, human beings become very flat and two-dimensional, that there’s the physical and the spiritual and that’s all there is to you. The physical is the stuff we can see and understand, and if we can’t see it or understand it, then it must be spiritual. Human beings are far more complex than that.
How can we transcend the tendency to dismiss mental illness as a spiritual problem that can be addressed through prayer?
If we’re going to be handing out [spiritual] advice as our number one go-to prescription for people with mental illness, why are we not handing it out to people with diabetes and cancer and spines that aren’t straight and all of these other problems? I know there are fringe groups that do hand out that kind of advice for anyone with any kind of illness. Orthodox, mainstream Christianity does not. We accept that people need medical intervention. We accept that our bodies are broken, that we are subject to the forces of decay that entered the world at the fall of humanity. We accept that we will die because of human sin. Why do we have such a hard time accepting that our brains are subject to those same forces and problems?
People think sometimes that they can give this kind of [spiritual] advice to someone with a mental health problem and they’re not taking a huge risk, that it’s not life-threatening. They couldn’t be more wrong. Mental illness is life-threatening. Experts estimate that about 90 percent of people who die by suicide had a mental illness at the time. People with mental illness are much more vulnerable than the general population to things like being victims of violence, to being in situations where they can be hurt, to not caring for themselves. People with untreated mental illness also run a very high risk of substance abuse and addiction because often people will attempt to self-medicate. So there is a lot at stake, including people’s lives. Do we really want to be promising them that God will heal their illness or discouraging them from receiving treatment when we’re not willing to take that risk with any other form of disease?
I would also challenge people to think about the science, what we now know to be true about the human body and how our brains work. The evidence is out there that says these medical interventions do work…when people receive treatment for mental illness, they are up to 90 percent effective. We have some really good interventions. They don’t help everybody, but they help most people. And the problem is that just under 50 percent of people who need treatment for mental illness actually receive it in the United States.
Resources for further reading/exploration:
Grace for the Afflicted by Dr. Matthew Stanford
Mental Health and the Church by Stephen Grcevich, MD
Darkness Is My Only Companion by Kathryn Greene-McCreight
The Recovery-Minded Church by Jonathan Benz with Kristina Robb-Dover
Grieving a Suicide by Albert Hsu
Fresh Hope for Mental Health: http://freshhope.us/
Mental Health Grace Alliance: http://mentalhealthgracealliance.org/
Church Therapy: http://www.churchtherapy.com/
My Quiet Cave: http://myquietcave.com/
Photo by Nevin Ruttanaboonta.