My mother has seen multiple psychiatrists, counselors, and other mental-health professionals. She has seen the inside of more than one mental-health hospital, one jail, and one prison. Her history with serious mental illness goes back more than 20 years. But if she were to go to a hospital today, in urgent need of psychiatric intervention, she would most likely start from scratch with a team of professionals who have no idea what medications she takes, what she suffers from, or what she needs.
She might be medicated, stabilized, and after a few days, discharged into the care of a family barely able to care for her, even after decades of practice.
Every time her insurance company has made a change, a doctor moved, or the person she last saw wasn’t available, she has had to meet with someone new and start over.
She needs to take medications every day, but until recently, no professional had explained—in a way she understood—that she had a chronic illness and must take meds for the rest of her life, for the sake of herself and others.
Under intensive treatment, she usually has been paranoid and unwilling or unable to consent for caregivers to consult with family. So we have written letters explaining her history and behavior and mailed them to these professionals, hoping she would get better care—even though the recipients could never acknowledge receiving any communication from us.
When she went missing and lived in homeless shelters, we couldn’t find her. No one would answer our inquiries.
When she went to prison, I couldn’t visit because she was required to initiate a multi-step process of obtaining approval for each visitor—and it was much too difficult for her.
Although we suspected for a long time that she suffered from schizophrenia, it took 20 years for us to receive professional confirmation of her diagnosis, from a medical field that is reluctant to “label” people.
We’re Talking about Mental Illness
In the wake of the recent murders at an elementary school in Newtown, Connecticut, many people are talking about mental illness. As they typically do in their coverage of shocking violent crime, the media quickly made reference to an undefined history of mental health needs for Adam Lanza. And almost immediately, speculation began: What kind of illness would cause someone to massacre young children?
The downside of this public conversation is reinforcement of stereotypes and stigma. Our society believes people with mental illness are more violent than the rest of us, although studies have disproven this. In fact, according to the U.S. Surgeon General’s office, “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.”
But there is an upside to this conversation: we’re finally talking about mental illness.
Regardless of Lanza’s state of mind, his act has struck a nerve with people who care for loved ones with mental illness. Notably, many have responded to The Blue Review post “I am Adam Lanza’s Mother,” which speaks with a voice we almost never hear, about a system most assume works—but which in reality, is very broken.
This system, of course, is the mental-health-care system in the U.S., which regularly fails people and allows families to suffer at their wits’ end until, sometimes, a loved one with mental illness commits an act of violence that leaves society scarred.
From the 1950s through the 1970s, the system underwent a massive deinstitutionalization, designed to move people out of hospitals and into communities, where they would receive services with more flexibility, a more personal touch, and the freedom to engage in society. Unfortunately, local communities largely failed to provide the services necessary for all the people sent their way. They also failed to address the stigma and prejudice regularly aimed at those affected by mental illness.
At the same time, stringent privacy laws, strict standards for committing a loved one to care, and insurance limitations have left many families in way over their heads, trying to care for people who desperately need professional help or residential care and won’t seek it on their own. Under current laws, family members—even spouses and parents of adult children—cannot gain access to medical information without the written consent of the person under treatment. In some states, parents must obtain written consent from children starting at age 12.
The natural result of such a system is that jails and prisons become our default care centers. Our largest inpatient psychiatric facility is the Los Angeles County Jail. Second is Rikers Island. According to the Department of Justice, more than half of inmates have symptoms of serious mental illness—ranging from 45 percent in federal prisons to 56 percent in state prison and 64 percent in local jails. Sadly, commission of a crime is the only way for some people to get the care they need.
The Church Can Help
I wrote about my family’s and others’ experiences in my upcoming book, Troubled Minds: Mental Illness and the Church’s Mission. These are stories every Christian should know because the people affected by this system failure need our help. The church is equipped to advocate for and walk alongside people with mental illness. Our shame and abandonment are the last things people affected by such illness need.
In general, the church tends to handle mental illness in one of three ways: ignore it, treat it exclusively as a spiritual problem, or refer people to professionals and wash our hands of their trouble.
When we ignore it, we acquiesce our responsibility to be the church, who “must clothe yourselves with tenderhearted mercy, kindness, humility, gentleness, and patience” (Colossians 3:12). We send the message that our faith isn’t big enough to handle problems we don’t understand. Mental illness does raise challenging questions, but such questions do not threaten God. And they are not inconsistent with Christian theology—all creation is groaning under the weight of our sin. Our minds are no less cursed than the rest of us.
When we treat mental illness as a spiritual problem, prescribing more faith or prayer, we suggest suffering people aren’t eligible for God’s grace. We behave like the Pharisees, whom Jesus said “don’t practice what they teach. They crush people with unbearable religious demands and never lift a finger to ease the burden” (Matthew 23:3-4).
Our bodies, minds, and spirits are interconnected in ways too mysterious for us to unravel. And technically, all sicknesses are ultimately spiritual in origin—they entered our world as a result of humanity’s rebellion against God. But to assume that disorders and diseases which attack the brain have direct spiritual causes and solutions is to misunderstand the way we are made. Mental illnesses are real, treatable, and manageable conditions caused by genetic, biological, or environmental factors, or some combination of the three. To withhold or discourage medical and psychological intervention is as cruel as to deny treatment for a broken arm or a case of diabetes. I find it baffling that people who believe other physical ailments should be treated only with faith and prayer are considered cultists or heretics—but such a perspective on mental illness is accepted within mainstream Christianity.
Yes, mental illness can be fostered, or exacerbated, by people’s choices. But such people are no less deserving of compassion and help than those with other lifestyle-related diseases like HIV, diabetes, and heart disease. And just as most pastors do not claim they can heal broken bones and cancer through their seminary training, church leaders should know when they’re in over their heads with psychological issues—and they usually are.
At the same time, when we refer people to professionals without walking alongside them with love and acceptance, we abandon them to a system that doesn’t give people what we might hope it will. Churches must refer people to professional help—but they must also confer with those professionals and provide friendship and love to suffering people.
Churches can help in many ways, several of which you can find described in my book. A few of the simplest ideas are these:
1.) Talk about it. Every year, more than 25 percent of the U.S. adult population suffers from a diagnosable mental illness—mostly quietly and in shame.
2.) Assemble a network. Before a crisis, find professionals with a variety of specialties. Build relationships with them, ask for advice, and be ready to partner when someone needs care.
3.) Foster friendships. People affected by mental illness need friends who will not abandon them when they’re symptomatic.
4.) Walk through treatment. Visit the hospital. Bring casseroles. Help with the cost of medications. Ask how treatments are going. Minister to people with mental illness in the ways you minister to people recovering from surgery or enduring cancer treatments.
My family has always been in the church. Dad was a pastor for 10 years. When schizophrenia came knocking, we were steeped in church life, yet the church was mostly silent on the reality of mental illness—and we got the message that we should be silent as well. This silence was isolating and cruel.
Yet our greatest moments of hope have come through encounters with individuals in the church who have made eye contact, visited Mom in prison, answered late-night phone calls to help her sort through her thoughts, showed up for small group when Dad cried every week. These are simple acts of love that reflect the heart of our creator, who knows far more than we do about how wretched we all are.
Like it or not, the church is the first place many turn in crisis. And fair or not, the church’s silence or rejection feels like rejection from God. We cannot keep turning away from the most vulnerable among us. It’s time to be part of the solution.