| |
The Church and Serious Mental Illness
Report and Resolution Approved by the 200th General Assembly
(1988)
The following is a report and resolution from the 200th
General Assembly (1988) (Minutes, Part I, 37.113-37.141). It addresses
the important issue of the call of the church to ministry and
mission with those affected with serious mental illness and
their family and friends.
Scope of the Problem
The need to address chronic mental illness
is urgent. Mental and emotional disorders afflict more Americans
than any other category of disabling illnesses. The category
includes a group of disorders which cause severe disturbances
in thinking, feeling and relating, and result in substantially
diminished capacity for coping with ordinary demands of life.
Serious mental illnesses, such as schizophrenia and the affective
disorders (mood disorders, bi-polar swings, depression), afflict
7 percent of our U.S. population. The affective disorders,
which occur at the rate of six persons per hundred, are a major
cause of suicide. Over two million people in this country have
schizophrenia, the most intractable of the mental illnesses;
moreover, this year—and each succeeding year—another
hundred thousand will be diagnosed with it for the first
time.
Ours is an era of growing need to address the issues because
of demographic increases in those populations most vulnerable
to mental disorders (young adults and aging), the recent trend
to "deinstitutionalization" and a corresponding
reduction of institutional treatment space available to people
with chronic mental illness. A large percentage of the widespread
and increasing number of homeless or street persons suffer
the social isolation and stigmatization of severe, chronic,
disabling mental illness. For them, life on the streets may
be the final stage in a series of crises, the end of many missed
opportunities, and a gradual disengagement from supportive
relationships, leaving them totally disaffiliated. Such persons
are rarely homeless by personal choice; their circumstance
is most often the consequence of social policy and helplessness.
Mental illness is a real scientific and biological entity
as clearly as cancer, multiple sclerosis and diabetes are scientific
and biological entities. However, science has not found a sophisticated,
high-technology, curative answer. Despite progress in identifying
genetic and biochemical roots of mental disorders and devising
therapies, severe, persistent mental illness often defies the
medical, technological and rehabilitative know-how which has
enabled physically handicapped persons to become functioning,
contributing members of society.
Disease which ravages the mind, disintegrating the personality,
is as difficult for those who are ill and their families and
friends as is any disease which destroys the body. Yet, stigma
and lack of knowledge about these disabling diseases work toward
separation and isolation of the mentally ill and their families.
The misunderstanding of the general public, and of the Christian
community within the general public, can be almost as devastating
as the actual illness. The church is called to an awareness
of the scope of mental illness, to a strategy for opening doors
of understanding, and to a uniquely significant ministry of
health and healing. It has powerful resources of faith and
presence in that calling.
Theological Base
Laws of social responsibility and hospitality
are clearly stated in the Old Testament and relate to those
whose illnesses have made them strangers within our gates.
Our Judaeo-Christian understanding sees that "God's holy
purpose is for humankind to be of worth and be well; to be
in health and nurturing health for one another." ("Toward
a National Public Policy for the Organization of Health Services," Minutes,
UPCUSA, 1971, Part I, p. 585). The witness of the Christian
faith is that through Jesus Christ, God heals and makes whole
a hurting and broken world. All stand in need of healing.
During his life, Jesus not only proclaimed the good news of
God's favor to all but also demonstrated God's love through
his ministry and obedience. His ministry of healing very often
touched those seriously troubled in mind and spirit. We are
called into communion with our Creator as members of the body
of Christ. By God's grace, this community of believers heals,
nourishes, and enables wholeness just as by God's grace each
of us helps to heal, nourish and make whole the community of
believers. We deny the healing God when we overlook or turn
away from persons suffering from mental illness and their families,
failing to recognize the fullness of their grace, to acknowledge
them as ones for whom God also wills abundant life
.
Though the biblical understanding of life unites body, mind,
and spirit, it is often easier for us to see and accept afflictions
of the body than of the mind and to support, nourish and heal
those whose illness is physical rather than mental. Our thoughts,
language and actions serve to define these persons by their
disability, thus denying their dignity and identity as persons
created and loved by God. Rather than healers of isolation,
we often become part of the barrier experienced by those struggling
to live with mental illness insofar as we continue to accept
their social isolation as inevitable. We often thus miss the
possibilities of being ministered to by the gifts which they
bring to the community.
The Church's Role
The social location and therefore the therapeutic
setting for persons with serious mental illness has undergone
a fundamental change in recent years as a consequence of "deinstitutionalization."
When we think of deinstitutionalization, we must realize
that when a chronically mentally ill person leaves a psychiatric
hospital, the community becomes, in effect,
that person's hospital. That is, the community must then provide, in
some fashion,
all of those aspects of hospital care that are noncustodial in the restrictive
sense:
financial support, low-cost housing, employment or vocational rehabilitation,
socialization, recreation, a degree of protection and supervision, advocacy
and case management, medication, crisis intervention, and
psychotherapy.
Bert Pepper, M.D., and Hilary Rygleqicz, M.S.W.,
in "Testimony
for the
Neglected: The Mentally Ill in the Post-Deinstitutionalized
Age," American
Journal of Orthopsychiaatry, July 1982.
The religious community is in a unique position to be the
bridge between the clinical setting and life in the home community.
Congregations exist in every American county and urban neighborhood.
Together they reach 70 percent of the American population every
month and are involved more intimately in the lives of Americans
than any other institution. Reclaiming health as a central
dimension of the church's faith and life is of particular
importance as the church seeks to meet persons and families
struggling to cope with mental illnesses. The congregation
is the place where the people of faith gather; the place where
wholeness is received, shared and understood. We need community
to overcome fear. Pastors and congregations are urged to develop
ways of inclusion which assure that each person, whether or
not labeled "normal," knows that who he or she is
and who we all are becoming is important ... that we cherish
the presence of all as the community of faith worships, studies,
gives, grows and heals together. Seminaries are called to reexamine
the whole concept of training, to legitimize the role of Christian
community in holistic care, to engage mental health professionals
in the attempt to come together in unified directions consistent
with our theological underpinnings. Theology and mental health
professions should be natural allies, but there are often barriers
of territoriality and adversarial relationships to overcome
before focus on common interest is possible.
Support and Empowerment
The purpose of treatment for the ill
is to provide the restorative and support measures that will
enable the person to be an independent, functioning and productive
human being to the fullest extent possible. The difference
in medical and rehabilitative know-how in dealing with physically
handicapped persons and those suffering serious mental illness
has been noted. The purpose however remains the same: support
and empowerment.
Empowerment for consumers of mental health services, their
families and others means enabling then in their independent
use of talents, skills and abilities. The goal of empowerment
is self-actualization; it is a God-given gift which these individuals
and groups can bring to the service of their church communities
and the community at large.
To the extent that there are proposed or already existing
supportive programs that feature empowerment of consumers,
family members and others, it should be part of the mission
of the religious communities of all faiths to foster and develop
these programs as models. Support by the church and others
and empowerment of consumers and of families are not necessarily
contradictory nor are they quite synonymous. Support involves
consistent participation in one another's lives in order
to nurture each other's growth and development of people
and programs promoting consumers' ability to make choices
for themselves in a realistic setting and to freely express
their human potential.
It is important to recognize, possibly to the surprise of
those considered "normals," that those who are "sorely
afflicted" have special and needed contributions which
cannot be made from any other source. There is a need to move
from a mentality of "charity" to one of mutuality
(or solidarity). Underlying both of these statements is the
understanding that the relationship between those who suffer
from mental illness and those who don't is reciprocity
and that, to empower those who suffer means giving grace—opportunity
for them to make their contributions and to receive these contributions. "The
parts of the body which seem to be weaker are indispensable." (Corinthians
12:22.)
Notes Toward Strategy for the Church
All the people and structures
of the Presbyterian Church (U.S.A.) are called to ministry
and mission with those afflicted with serious mental illness
and their families and friends. This will involve the communal
life of the church in healing fellowship, at study and in worship.
It will involve service and advocacy in the wider life of society
as the church seeks equity, justice and the preservation of
human values in health matters generally and in relation to
mental illness specifically. It will involve the fullest possible
degree of ecumenical and coalitional collaboration with other
religious bodies and with health organizations, consumers,
and social service agencies.
In fulfilling this ministry and mission, the church at all
levels more specifically should:
- Seek heightened awareness and visibility for
the presence and needs of the severely mentally ill, exploring
possibilities for the collaborative effort in consciousness-raising
with other denominations as well as public social service
agencies and secular organizations.
- Develop and
implement innovative approaches and programs for ministry
and mission with the severely mentally ill; identifying local
and regional governing body policies, strategies and programs
already in place and lifting up appropriate models; preparing
or pointing to resources and suggesting study and strategy
for committees, task forces, and other groups in synods,
presbyteries, congregations, and coalitions; intentionally
creating linkages and structure for doing things together with
other denominations and groups, using existing resources; deploying
effective systems for gathering and sharing information and
for communication.
- Support increased understanding and the development
and training of leadership, through ecumenical effort and utilizing
societal programs, through education and training in seminaries,
consultations and network-building at national and regional
levels, through workshops and continuing education events,
and through intentional use of church periodicals and both
regular and special educational resources.
- Provide
a model as an employer, offering employment opportunity to
persons in transition from psychiatric wards to the community,
persons who have recovered from mental illness, or persons
who may continue to be ill and require modified employment.
- Give vigorous and continuing support to public
and private health services that include the mentally ill,
are accessible to all, and recognize the relationships between
deinstitutionalization and homelessness and AIDS and mental
illness.
- Get involved in pubic policy processes, actively
advocating in behalf of the mentally ill at all levels of
government for adequate support for services and for legislation
on housing, nutrition, job training and placement, as well
as for increased funding for research.
Resolution
The 200th General Assembly (1988) of the Presbyterian
Church (U.S.A.) affirms anew the ministry and mission of the
church and all its people and parts with those suffering
from or affected by severe mental illnesses. The General
Assembly further:
- Recognizes and extends prayerful support to the diversity
of persons whose lives are touched and affected by mental
illness: to persons who experience mental illness and to
their families; to professionals who are trained and called
to the healing arts; to clergy whose ministry will inevitably
include people affected by mental illness; to lay persons
who in many diverse ways maintain a community of healing
and support.
- Requests sessions and appropriate governing
body committees to review their current response to the
needs of those with severe mental illness and their families
and consider new or strengthened approaches drawing on suggestions
put forth in the Report of the Consultation
on the Church and Serious Mental Illness.
- Encourages
clergy and lay staff of congregations, governing bodies
and church-related institutions to learn about mental
illness so that programs, policies and pastoral counseling
will be based on up-to-date medical and scientific information;
and encourages seminaries to consider expanding opportunities
for such learning in M.Div, D.Min. and continuing education
programs.
- Directs the appropriate ministry units or committees,
as determined by the General Assembly Council, to:
- Continue taking initiative in the formation
of an ecumenical, interfaith task force, to focus on
ministry with persons who are chronically mentally ill
and their families in cooperation with any existing denominational
or ecumenical efforts;
- Inform sessions and appropriate governing
body committees as to the availability of educational
and program resources, on an ecumenical or interfaith
basis to help Presbyterians and others deal knowledgeably
and constructively with problems of mental illness; provide
resources for families that encounter mental illness;
and give guidance in planning programs of ministry, mission
and advocacy in relation to mental illness;
- Develop patterns of relationship and support
for the Presbyterian chaplains who work with the mentally
ill and their families in either the hospital or community
setting
|
|
