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The discussion last week after my post about the Tucson shooting brought home to me all the more clearly that mental illnesses do not affect “those people” over there, but they affect us. Pejorative labels like “crazy” and “whacko” only reinforce this separation or stigma which hovers over people with mental illnesses. But the people who live with mental illness are not just those with the disease itself, but also their family members, friends, fellow church members, and society as a whole.

We’re in this together, and the more we try to separate the “us” (whoever that may be) from the “them” (people with mental illnesses) the more troublesome the mental illnesses will be. Just as with other disabilities, we have a collective responsibility as a church and as a society to do to others as we would have them do to us.

Harriet Brown was forced to think carefully about stigma after he daughter Kitty was diagnosed with anorexia several years ago. Harriet wrote an insightful memoir published last year about her family’s experiences. Reflecting on stigma she wrote, “Back in the 1600’s, people thought you could catch a mental illness by touching someone who had one. We haven’t come very far from that idea. We treat people with mental illnesses like lepers, stepping over them in the street when their disorders lead to homelessness, poverty, drug addiction; we shun them when they turn out to be people we know. A few psychiatric disorders have lost a little of that stigma—for example, people talk more openly now about depression and bipolar disorder. But with few exceptions we still don’t want to hear about the most severe cases of depression, or about the inner lives of people with schizophrenia or personality disorders. Once the label is slapped on, you enter a world made nightmarish not just by whatever disorder you’ve got but by the stress of being marginalized in a society that fears and loathes any hint of mental differences” (Brave Girl Eating, New York: HarperCollins, 2010, pp. 61).

Our collective responsibility means that we need to understand not only compassion and reflective listening and where to get resources but also how to set appropriate boundaries and even when to make decisions for someone who is not competent to make decisions for herself. Brown describes the “refeeding” program that they did with Kitty to restore her from severe malnutrition that put her into a hospital ICU to good health. And Kitty wasn’t offered much choice about what she would eat or how much.

Brown said that to expect Kitty to be able to decide for herself, when her anorexia was at its worst, what she would eat and when and how much would have been cruel. The voice of “the demon,” as Brown calls Kitty’s anorexia, was much too overpowering in Kitty’s life for Kitty to overcome that voice herself. Brown and her husband Jamie had to make diet and portion decisions for Kitty or she would have died.

But as hard as it was for the Browns, making nutrition decisions for their eighth grade child is still much less difficult than helping a severely mentally ill parishioner get the help that he needs (as Pastor Randy described in his comments last week). The Browns never held Kitty and forced food into her mouth. But they were still Kitty’s legal guardians. She still lived in their home. They had a lot of say over what she could be allowed to do and what they would not allow her to do. But trying to get help for an adult, who is not a family member, can feel overwhelming as Pastor Randy describes.
What do we do? Here are a few thoughts, and I would love to hear yours as well.

  • Pray for people with mental illnesses, their families, for churches, courts, mental health workers, and lawmakers.
  • Develop relationships. Let us who are part of the church especially not run away from people living with mental illnesses, but love as Christ first loved us.
  • Get informed about mental illness and basic steps to help. A fine new training, Mental Health First Aid, has become available in the US and in Canada in the past few years. Disability Concerns has a some resources as well.
  • Get involved in the mental health and political systems. Not everyone’s calling is the same, but I’m am thankful for Christians who serve as counselors, psychologists, psychiatrists, researchers, social workers, case workers, judges, lawmakers and others who seek to live out their Christian commitment in whole or in part in ministering with people with mental illnesses. Some of us may feel called to lobby decision makers for broader and better services for people with mental illnesses and their families.

For far too long people with mental illnesses and their families have stood alone. Has your church found a way to minister well with people living with mental illnesses? What have they done? Do you have other ideas? Please share them.

Comments

Mark Stephenson on January 26, 2011

In reply to by anonymous_stub (not verified)

Ken,

I appreciate so much that you stay involved with discussions even though sometimes they are difficult for you.

As to your final question, I think that the right time to be honest is always. But this medium of a public discussion forum on a social network has some severe limitations as you acknowledge. In interacting with others, we can read words, but we don't hear the voice, see the eyes, or experience the personal connection that can come with a face to face discussion. So it is very difficult to guess what someone's intent is simply from what they say or do not say.

It seems to me that as different people post our comments, we are writing out of our own experiences and telling our own stories for others to "hear." (Clearly a lot of people are listening since this already has had 88 page views as of the time I write this.) We're engaging together to get a better understanding of how each of us sees life and experiences the world. So once again, thank you for telling how you see life from your experience. This is helpful to all who read.

God's blessings, Mark

Hi Mark

On "Mental Illness", I have been an experienced consumer as the wife of a doctor with severe Bipolar Disorder/Manic Depression for 27 years. At the time of diagnosis, shock horror, we already had 4 children aged 1, 3, 5,& 7. There was a history of the illness but it was kept under wraps by my church going mother-in-law. She still wouldn't disclose any details after the diagnosis and remained in denial till her sons suicide in 2009. She also lost her mother to suicide when she was 16. Her son was 55.

If mental illness is not accepted and supported within Christian families, what hope is there? Isolation resulted from all our friends including those from the church. Deliverance was proposed by some, to the total destruction of a marriage, career and ultimately loss of life. The family and my own children blamed me. This was based on lies. Yet church going families chose to believe it over the facts. Isolation? You could call it that. But, my faith in God only grew. I am not alone!

As to "Ministry"; my book is my testament to overcoming impossible odds when God is on side. I am a retired nurse turned author to help others make less mistakes and more informed decisions using my hindsight as foresight. The main thrust is to protect from and prevent emotional damage of children in the marriage/relationship. The well parent is all they have. I have donated my proceeds to "World Visions Rescue Programme", for enslaved, abused, damaged kids.

A Butterfly Landed An Eagle, is my true story, from butterfly to becoming an overcoming eagle and landing another Christian Eagle in my second husband; a miracle in itself. I thank God for His provision, I emerged whole not a gibbering, abused, remnant of humanity. I could have lost my mind or my life if I stayed in my doomed marriage. As it was, I stayed too long. My marriage vows were my un-doing. http://laineatamazon.blogspot.com has links for purchase.

Please leave your comments as they are valued. I can only tell of my experiences and must disclaim any conclusions that may be drawn from or with my book. I found every church attended in Perth to be out of their depth or not properly informed to deal with mental illness. There are side issues such as business, charismatic practices and praying in tongues. Deliverance without medications is dangerous and may result in suicide from untreated depression.

God bless you as you overcome barriers to ministry in mental illness and its isolation.

 Even trying to get help for an adult family member who is psychotic and paranoid and refuses that their psychiatrist inform the family is difficult.  As soon as the patient is 18 or over they are considered able to decide for themselves, even if they obviously aren't.  A cousin of mine who was suffering from paranoid psychosis would not cooperate with her treatment plan as proposed by her doctor, and seeing signs in tree branches that her landlords wanted to kill her, she broke her lease every three months and moved before they'd have time to carry out their somber plans.  Eventually, she killed the one child she'd ever had by drowning the girl in the bathtub after drugging her so the kid would not resist.  And then she tried to kill herself by throwing herself in the nearest river.  (Montreal is an island located between two rivers.  The Rivière des Prairies on the north side and the St.Lawrence on the south.)  When she didn't drown fast enough to her taste, she got out of the water and walked to the nearest house where she was arrested after she'd told the owners her story and they called the police.  After that she fired one lawyer after another as soon as they suggested she get treated for her obvious disorder, because she wasn't aware of being ill.  Psychosis will pull that trick on people. Not all people with psychotic disorders have what is referred to as anosognosia, a term borrowed from neurology to describe the sequels suffered by some stroke victims where they are not aware of having lost abilities, but it is believed that 50% of people with schizophrenia and other forms of psychoses are afflicted in this way.  If it can comfort their close relatives and caregivers, they don't refuse to cooperate just to aggravate you.  In those cases they really don't believe they're ill.

Anyway, at her trial, the Crown prosecutor recommended she be sent to the Philippe Pinel Institute, a prison for the criminally insane, but she refused and ended up in a regular federal penitentiary for women, where she ultimately died by killing herself after three failed attempts.  

Fortunately, not all psychiatric patients suffer such tragic fates.  I am one of the fortunate few who had the symptoms hard enough to know what I'm talking about yet mild enough to be able to talk about the experience.  Some of those who know they're ill are just too severely afflicted to be able to talk about their illness in a cogent manner, or they started being ill at such a young age that it prevented them from getting an education because their symptoms interfered with concentration.  I know from personal experience how ineffective studying for a test can be when you haven't slept a full night in weeks and you're hearing voices.  It doesn't work. I'm writing this so that those who feel frustrated by trying to help mentally ill people and don't get any cooperation from the system will know that they are not the problem.  A system that considers adult people with mental illnesses in a psychotic state as competent to decide whether they need help or not, and entitled to have their privacy respected when they obviously need outside intervention is the problem.  Our system of individual rights was not designed for such patients.

Michèle, thanks for your story and comments. You describe the enormous challenge that public health officials have. On the one hand, we don't want to go back to the era of One Flew Over the Cuckoo's Nest, when people were institutionalized inappropriately. The bar is set very high for involuntary hospitalization. On the other hand, it seems that people usually have to hurt themselves or another before they can be hospitalized against their will. And in the case of your story, even in the tragic instance of the murder of a child, your cousin was still allowed to refuse help. The intrinsic challenge of judging when and when not to hospitalize someone against their will, combined with limited public dollars allocated for mental health and overworked mental health workers results in a lot of suffering that could be abated somewhat. Thinking about these challenges, about the story of your cousin and her child, and about other similar stories in which people refused help even though they could have benefited from it makes me start to feel hopeless. I'm thankful that you are helping me and others at least to be aware of the issues. Perhaps some better way can be found. God, help us! God bless the public health officials and lawmakers with compassion and wisdom. Amen

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