Tag Archives: education

No Casseroles for Schizophrenics: The Church and Mental Illness

by The Rev. Kathryn Greene-McCreight

Imagine your worst nightmare. The kind where you wake up in a cold sweat, panting, glad that you are awake, that it was all a dream. Then imagine that worst nightmare, but you are already awake, in a cold sweat, panting. And it is not all a dream. It is a waking nightmare.

Imagine the death of your dearest lifelong friend. You are absolutely inconsolable. Your grief is too deep for words, your sobs too loud to contain, your body too heavy even to move. Then imagine that this same friend is alive and well, visiting with you. Yet you experience equally unbearable grief. Pain too deep for words, sobs too loud to contain, body too heavy to move.

Now imagine yourself in a cafeteria carrying a lunch tray. You accidentally trip and drop it, dishes shattering on the floor, glasses splintering, food splattering. The feeling of shame and embarrassment is overwhelming. Everyone is watching.

Then imagine yourself in the same crowd, at the same moment, but you have not dropped anything. Nevertheless, you have the same overwhelming shame and embarrassment, the sense that everyone is watching you, laughing, pointing. You hear their heckling voices telling you that you are worthless.

You have now imagined just some of the devastating symptoms of life-derailing major mental illnesses: bipolar disorder, major depression, and schizophrenia.

Stigma and Shame

The external signs of mental illnesses, if they are discernible at all, can be easily misinterpreted. Because symptoms of mental illnesses are sometimes manifested in odd behaviors, sufferers are often ostracized, avoided, and stigmatized. Approximately one out of every four people at some point in their life will suffer from a mental illness. The mental health care community urges us to understand mental illnesses as biological disorders rather than character flaws.

However, the stigma and shame of mental illnesses remain strong, both for sufferers and for their families. There are a few factors which have begun to relieve the stigma over the past few decades: The appearance of new psychiatric treatments and medications and their acceptance by the general public, as well as the “coming out” of celebrities and people of note who live with mental illnesses. These include author William Styron, legal scholar and professor Elyn Saks, comedian Stephen Fry, and writer Andrew Solomon, to name just a few.

And yet the stigma is dug deeper with every public act of violence attributed to someone suffering from mental illness. The tragedies are too numerous even to take in. The perpetrators are often accused of being mentally ill, even though there may not be an actual diagnosis. Social stigma is only fueled by the fear and revulsion such acts bring. One can understand how the public would have even greater fear of people with mental illnesses. However, according to the National Institutes of Health, people living with mental illnesses are in fact less violent than the general population, and are more likely to be the victims of violence rather than perpetrators of it.

Stigma in the Church

The social isolation faced by people with mental illnesses and their families deepens the wound inflicted by the illnesses themselves. And it is compounded when our faith communities turn away from those who suffer. This happens especially when mental illness is perceived as a sign of spiritual weakness or result of lack of faith.

A clinical study published in the Journal of Religion and Health fueled this false perception when it claimed to “prove” that religious people are happier than non-religious people. (My own experience as a person of faith and Christian priest who lives with mental illness does not confirm this. Christians may be as miserable as the general population.) Studies such as this would implicitly suggest that God is a form of therapy, a tool to help us feel better. The Christian faith does not teach that God is a tool to be used, but Creator and Redeemer to be thanked, adored, and worshiped.

I have noticed, though, a general perception that if religious people are not “happier” than non-religious people, they should be. When Christians living with mental illnesses are in psychological agony, the message given is sometimes that there is something deficient in the person’s soul. Christians who suffer from mental illnesses may even be told that they are not praying hard enough, not attending church often enough, or not reading the Bible carefully enough.

When people of faith slog through the deep grief of depression, or soar on the erratic joy of hypomania, or get sucked into the cognitive mud of schizophrenia, and the problem is credited to a spiritual defect, we should all be ashamed of ourselves. Here we find a cruel irony: the very community that’s supposed to support mentally ill members ends up perpetuating their isolation and stigma.

A friend of mine told me how her church’s lay pastoral care team would regularly deliver meals to families of ill parishioners in a gesture of care and support, a common practice in many churches. But when her son was first diagnosed with and hospitalized for schizophrenia, the pastoral care team did not reach out to her at all. There is even today an underlying perception that mental illnesses are somehow “contagious” and shameful. The church’s lack of care in this case seems to have been a symptom of a very deep stigma and shame. “No casseroles for schizophrenics,” responded my friend.

Indeed, we in the church perpetuate stigma and fear in our ignorance of psychiatric symptoms. The biblical stories of Jesus and his disciples casting out demons are sometimes used to explain away mental illnesses as demonic possessions. But these same stories can be understood in another more helpful way. The symptoms of mental illness may indeed be like the demons Jesus encountered insofar as they are not the patient herself. The symptoms, like the demons in the story, need to be cast elsewhere, away from the sufferer.

One important lesson we must all learn, Christian or otherwise, is that the patient is not the illness. Symptoms of the illness are not the patient’s fault nor are they signs of a sick soul. Symptoms are external manifestations of a sickness of the brain. This is the theological analogue of what mental health care professionals encourage us to remember: our illnesses and our symptoms don’t define us.

Educating Clergy about Mental Illness

In order for faith communities to be able to care for their parishioners who suffer from mental illnesses with the same support they would give to those living with cancer, we need to draw back the curtain of fear and reveal the face of the person who suffers. Once we personally know someone who is mentally ill, the fear becomes less overwhelming and the stigma becomes less powerful. This is part of the reason why the celebrities with the courage to write and speak publicly of their experiences with mental illness are so important.

Research shows that within Christian denominations, across racial and class divides, clergy are often the first responders for those suffering mental and emotional distress. This may be the case because parishioners are frightened to seek mental health care at all, much less from secular providers. Clergy seem “safer.” Yet clergy can be, among the caring professions, some of the most ignorant about mental illnesses.

Educating clergy is crucial for the mental health of our faith communities. Clergy need to be familiar with basic symptoms of mental illnesses. We need to teach our congregations how to intervene when mental health crises arise. We need to know how and when to refer suffering parishioners to quality mental health care providers. This will mean accepting that we are not competent enough to handle these crises on our own. We have our own role, and it is separate from the role of a psychiatrist.

We need to know how to treat sufferers with respect at all times, learning to discern that gentle care and listening are not possible without maintaining firm boundaries. We need to mold our communities of faith around learning to support the families as well as the sufferers, and to guide our communities in showing the love of God even amid the deep despair of mental illnesses.

In short, we should not leave these families to suffer in silence. If we bring casseroles to cancer patients, we must also show love and concern to families grieving in seasons of mental illness. As my friend says, we should not neglect to bring “casseroles to schizophrenics.”


The Rev. Kathryn Greene-McCreight, Ph.D., is the author of Darkness is My Only Companion: A Christian Response to Mental Illness (Brazos: 2006) and a Priest Associate at the Episcopal Church at Yale.

The recently released 2015 second edition of Greene-McCreight’s book contains a foreword by the Archbishop of Canterbury, an afterword by the author, a significantly expanded bibliography, and a set of discussion questions for parish use.

Originally published October 20, 2014 in a series of “Online Exclusives” for the Fall 2014 issue of Tikkun, “Disability Justice and Politics.” Reprinted with the permission of the author and Tikkun magazine.

Link

Mental Health: A Guide for Faith Leaders

In June 2015, the American Psychiatric Foundation (the public education division of the American Psychiatric Association) published this 20-page booklet intended “…to help faith leaders better understand mental illness and treatment, and better help individuals and families in their congregations facing mental health challenges.”

Part I of Mental Health: A Guide for Faith Leaders begins with an introduction to the concepts of mental health and mental illness. It goes on to describe common mental disorders and provide an overview of other key mental health concepts including suicide, diagnosis, treatment and recovery. Part II of the guide focus on supporting individuals with mental illness. This section contains guidance related to making referrals, dealing with reluctance to seek treatment, and recognizing the differences between spiritual problems and mental illness.

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Mental Health Ministries

The mission of Mental Health Ministries is to provide educational resources to help erase the stigma of mental illness in our faith communities and help congregations become caring congregations for persons living with a mental illness and their families.

Link

Pathways to Promise

Pathways to Promise is an interfaith cooperative of many faith groups… a resource center which offers liturgical and educational materials, program models, caring ministry with people experiencing a mental illness and their families.

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Mental Health Chaplaincy

A ministry of outreach and care for people with mental illness, especially those who live on the streets. Training programs for clergy and laity to develop mental health ministry within faith congregations. Based in Seattle, Washington.

A Lenten Practice for All Seasons

From a member of St. Michael’s, Little Rock

“Each of you should use whatever gift you have received to serve others, as faithful stewards of God’s grace in its various forms.” 1 Peter 4:10 (NIV)

Many of us use the period during Lent to give something of ourselves to others. After all, every one of us is blessed with our own set of gifts and we answer our calling when we share those gifts with others. This year when Lent arrived, I didn’t come up with a specific commitment at first. Then it occurred to me during one Sunday morning service what I might be able to give of myself. In my career as a psychologist (which I consider one of my key gifts), I’ve pursued a variety of areas of practice. I’m more like a “jack of all trades and a master of none” than anything else, but I spent a number of years working with families and kids, so that was a particular area of interest for me. During the past year, I had put together a few presentations with a fellow member of our congregation on mental health, targeting family issues in particular. So as I thought about what to do that might be helpful to some of the members of our congregation here, I decided to try to share some of my knowledge in that area.

How to share what I knew was not without potential problems. While I wished to be helpful, I already practice locally in a Veterans’ medical center, which provides me with professional liability insurance coverage for my work there. It does not, however, cover any professional services I might provide on my own outside of that setting. Nor did I really want to engage in a separate private practice on the side. For those of you who aren’t healthcare professionals, you may not realize that practitioners must be acutely aware of the potential for personally damaging lawsuits for malpractice, which can arise from even the most seemingly benign advice given to others. Thus, mental health providers have to be extremely cautious about offering direct services or advice to others unless it is part of their job or practice for which they have insurance coverage.

I finally hit on what seemed a reasonable solution. In a church newsletter, I offered to field questions and suggestions from members of our congregation about broad issues of interest to them. I would then write a column on that general topic, offering information and resources that hopefully would be of help to a variety of individuals but might also be helpful to the person who had a specific concern. I would include local resources for follow up if anyone wished to pursue professional services, as well as general information for self-help.

To start off the project, I wrote a brief column in our church newsletter inviting anyone to email questions to me or to express an interest in learning more about issues related to family, kids, or other broader topics. With the help of the local priests and staff, we set up an email account specifically for me and a section in our web pages where these articles could be shared with all. My promise to those contacting me was to provide either a column on the topic to be published in our newsletter or on the website, or to send some resources and information directly to those inquiring. In my career, I’ve accumulated a lot of handouts and reference information on many topics in my field that I can share, so my hope was that I could use existing materials I already had on hand to help fulfill my part of the bargain and simply be able to augment these resources with the occasional column. I also specifically made it clear that what I would be doing was not “treatment” or advice for particular individuals or situations, but rather an attempt to provide information and resources (such as handouts, websites, books, etc) related to their general area of interest to use as they saw fit.

So far, I’ve not been swamped with requests, but it has been enough to keep me occupied. Other congregations may find this model to be helpful, as most will have some healthcare professionals among their members. They may find this a palatable means for sharing their own gifts and knowledge in an appropriate and safe way, while offering a potentially helpful service for others in the congregation. It might even be helpful to create a health committee of several folks with such backgrounds and interests, so that not just one person has the burden of helping with all requests. I’d also suggest considering inclusion of persons who have a lived experience of dealing with their own mental health challenges. These individuals can offer insights into how others might make progress on their own road to recovery. Remember, we all have gifts. Not all of them come with a diploma or legal certificate to officially sanction a person’s abilities, but they may be helpful nevertheless.

If anyone is interested in pursuing this idea and would like to contact me for further information or to hear more about this project, you may email me at: resources@stmichaels-church.net.

J. Glen White

What One Congregation is Doing to Create a Caring Community

By the Rev. Bean Murray

St. Michael’s Episcopal Church in Little Rock, Arkansas, is the home of several members of the EMIN steering committee. We are continually trying to show how to create a caring congregation by implementing our own suggestions in the life of our own faith community. We want to recommend activities in EMIN News that are not just ideas, but activities we have put into practice.

Creating an atmosphere where having or talking about a mental illness is not met with stigma or the need for feeling shame is accomplished in incremental steps. Results are often small and low key, but parishioners have come to understand that St. Michael’s is a faith community where mental illness is not ignored, but met with compassion and solid information.

General Awareness Education

Our educational activities include the following:

  • Promoting Mental Illness Awareness Week and the National Day of Prayer for Mental illness recovery and understanding during the first week of October each year
  • Incorporating mental illness concerns in the Sunday sermons during Mental Illness Awareness Week in October or Mental health month in May
  • Making sure that announcements on mental illness related activities and issues are included in the parish newsletter, in the weekly e-mail congregational update, in the service bulletins, and in bulletin inserts
  • Making sure that at least one adult education forum each year addresses an aspect of mental health
  • Including mental illness concerns in the Prayers of the People
  • Including The Episcopal Mental Illness Network in the parish outreach ministries prayed for on a rotation along with other ministries

Mentioning mental health issues frequently:

  • In Ministry Moments
  • As a ministry to sign up for on the annual Time and Talent pledge sheet
  • Advocating for mental health social justice issues such as health care parity and the plight of incarcerated persons with mental illness
  • Making books on mental illness and spirituality and information on mental health resources available in the church’s library

Conducting Book Study Groups

Study groups on books relating to mental illness and spirituality are excellent ways to provide reliable information about mental illness and questions of faith.

In 2007, St. Michael’s hosted two book study groups.

Darkness is My Only Companion: A Christian Response to Mental Illness by the Rev. Kathryn Greene-McCreight was the basis of a group that met weekly on Thursday nights for eight weeks. The steering committee sought the advice of St. Michaelites who are mental health professionals to help in setting up a structure for studying the book. Norms for the study were agreed to by the group participants. The norm of group confidentiality was extremely important.

The book study series ended with a Service of Healing and Eucharist.

In addition to the material in the book, book group members received local resource information so they could follow up with qualified professionals if desired.

Several members of the congregation were interested in the book, but were not able to attend because of other obligations or the current status with their own mental illness. The deacon leading the group made sure anyone who was interested in the book got a copy regardless of their ability to come to the group.

Advent book Study

Advent is a good time for providing emotional support. EMIN distributed a brochure prepared by the Mental Health Ministries to the clergy and deacons of the diocese.

At St. Michael’s, EMIN had an adult formation session on the realities of cultural Christmas pressures versus the “Hallmark” ideal.

This was followed by five Sunday morning sessions of study on depression using In the Shadow of God’s Wings, by the Rev. Susan Greg Schroeder, a personal accounting of depression by a Methodist pastor who now heads a vital mental health ministry. This book has an accompanying study guide.

An encouraging word

As you begin your mental health ministry, many times your events will not draw much of a crowd and you might not get a lot of feedback, but the activities are critical for those who do come. For those who don’t come, you are planting the seed that yours is a faith community where brain disorders are not regarded with stigma or shame, but all are welcomed as beloved children of God. You are planting seeds that if and when a member of your faith community has to face such a challenge, a supportive faith family is ready to assist.