A ministry of human fragility: Why I established a mental health office in the Diocese of Phoenix
I am a bishop, but before anything else, I am a human being who understands the severe toll of mental illness, especially when it is left untreated. As a survivor of suicide loss, I have experienced firsthand the pains of mental illness in my own family. Having lost my brother, Tom, my sisters, Mary and Therese, and my brother-in-law, Joe, all through suicide, I understand the importance of finding some comfort in our church and the gift it brings to so many people within our parishes and families.
The truth is, when I had to survive some of these losses early in my life, the church was the only place of comfort for me. I relied heavily on the prayers and spiritual outreach of priests, women religious and deacons. I was blessed by their pastoral care. But there was a gap between the help they could provide as spiritual leaders and the deeper accompaniment I needed. This personal experience led me to establish the Office of Mental Health Ministry in the Diocese of Phoenix in 2022. With a focus on education, accompaniment and advocacy, the ministry aims to fill the gaps in our pastoral care and address in an intentional way mental health challenges in the modern world.
Through our program, volunteer facilitators, many of whom are deacons, are trained in the church’s understanding of mental health and are educated on basic mental health first aid and literacy through a state-run program. They are supported by the director of the mental health ministry as they tend to the parishes in their designated areas. Our goal is to have at least one facilitator in each deanery. As facilitators of accompaniment in parishes, these trainees lead gatherings for those struggling with mental illness, survivors of suicide loss and those grieving the death of a loved one. Facilitators lead group discussions on growing through grief, help people find benchmarks of hope along the journey and ultimately help those suffering see that they are welcome within the family of the church.
The diocesan Office of Mental Health Ministry, which does not diagnose, prescribe or treat mental illness, ensures counselors and psychologists are state-licensed in order to refer people in need to professional treatment and guidance. The office also provides training for our clergy members, religious, deacons, parish ministers, school leaders and laypeople on the most current understanding of mental illness, preparing us as church to accompany those suffering from mental illness with confidence, understanding and pastoral care.
Our diocese’s mental health ministry is based in individual or clustered parishes to help make sure the weight of this responsibility does not rest solely on the shoulders of the pastor. The ministry is motivated by the Gospel mandate to love through accompaniment. Certainly, those who struggle with depression, anxiety, post-traumatic stress, scrupulosity and obsessive-compulsive disorder (just to name a few challenges) need continuous love and care from not only the priests, women religious and deacons but also from the wider parish community.
In his general audience on Jan. 4, 2023, Pope Francis addressed one of his favorite themes: spiritual accompaniment. Preferring the term “spiritual accompanier” to “spiritual director,” Francis encouraged those who seek to accompany others to embrace their own human fragility. “Woe to those people who do not feel fragile. They are harsh, dictatorial,” he said.
God chose to become one with us in our fragility. And through his own human fragility as Jesus Christ, he accompanies us. Sharing in Jesus’ divine mission, we accompany others with the knowledge that we are set apart but never above, because we are all fragile.
As a survivor of suicide loss, I have come face to face with this reality. As a bishop, I am not above anyone. Before anything else, I am a fragile accompanier; and by God’s grace, I am ministering to those who, like me, suffer.
Before anything else, I am a fragile accompanier.
Mental Illness in the Modern World
Imagine a mother of three struggling with depression and feeling guilty that she cannot do more for her children. Our mental health ministry’s method of accompaniment would involve inviting this mother to a parish gathering facilitated by a trained volunteer. Not only would the mother have a place to express her struggles and receive a referral to a professional, but, depending on the parish, she could also find accompaniment in the form of wraparound services: parish members bringing her meals, homework help for her children and additional community support to help lighten her burden in practical ways. This ministry is about the body of Christ coming together to support each of its beloved members.
When we ourselves have not personally suffered from mental illness, it can be difficult to understand how someone could struggle so significantly or even consider taking their life, let alone go through with this act. Thus, our natural reaction is often one of misunderstanding and judgment. But I would like to propose another response, one that seeks to accompany, to understand and to uphold our brothers and sisters who are struggling with mental illness.
This proposal relies on current studies in the field of psychiatry. Thanks to advances in medical technology, including functional magnetic resonance imaging and other imaging techniques, we have been able to gain a greater understanding of the role the brain plays in mental illness. In many cases, the brain scans of those experiencing mental illness show frontal lobes that are not fully developed, holes in the brain that impede blood and oxygen flow to the organ, or some other physical impairment that directly or indirectly results in a mental disorder.
Such impairments can sometimes result from traumatic life experiences, environmental and genetic factors, and long-term infections or other illnesses in the body. Science is showing that impairment to the brain can cause depression, anxiety, post-traumatic stress disorder and personality changes, among other ailments. In other words, modern technology has helped us to understand that mental illness is truly that, an illness. Yet acknowledging struggles and dealing with mental illness has long been taboo within religious groups, including our own.
Many in our church have yet to embrace the immense benefits that medical and psychological treatments can bring in the lives of those who are suffering.
Many in our church have yet to embrace the immense benefits that medical and psychological treatments can bring in the lives of those who are suffering. Medication, therapy and other forms of treatment provided by trained professionals are gifts from the Holy Spirit, who is continually guiding both faith and science to the same end—God himself, who makes all things new. As church, we need to embody aggiornamento, or “bringing up to date,” when considering mental illness in the modern world. The church has made efforts to deepen its understanding of mental illness. We saw this in 2018, when the California Catholic Conference of Bishops produced a document on caring for people with mental illness, called “Hope and Healing.” We see it in the Catechism of the Catholic Church, particularly Paragraphs 2282 and 2283, which remind us of three things: “grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide”; “we should not despair of the eternal salvation of persons who have taken their own lives”; and “the Church prays for persons who have taken their own lives.” We also see this in the change of church law, which now permits those who have died by suicide to have a Christian burial.
Relying on our theological and moral constructs of concupiscence and levels of culpability, accompaniment should begin with the premise that we are all disordered to some degree: theologically, psychologically, socially, physically, sexually, etc. No one is exempt from disorder. Each of us is morally disordered due to sin, but not everyone has a diagnosable mental health condition that requires medical treatment. And having such a disorder is not sinful. We all belong to the church, healthy or not. And each must attend to our own mental health, too.
While we may be called to a certain ministry, we must remember that we undertake it from that place of shared fragility. Mental health ministry, for example, is not primarily about “helping” others. Most importantly, it is about loving others and ultimately abiding in love, as Christ commands. When we focus only on healing others who struggle with mental illness, there may be a tendency to treat the other as a patient. In doing so, we fail to recognize the other as a valued member of the body of Christ, a true brother or sister in Christ.
Our diocese’s Catholic mental health ministry does not treat the person with a mental disorder with the same methods a psychiatrist or psychologist could or would use. As ministers, we neither make a diagnosis nor prescribe a treatment for our family members or parishioners. Nor, after discovering the diagnosis and treatment, do we provide therapy. These are often good and necessary interventions, and we encourage people to seek these treatments. However, for legal reasons, our ministry must leave those forms of intervention to the professionals. Our ministry is meant to complement that treatment. For spiritual reasons, we walk with and accompany our brothers and sisters in Christ and, as far as possible, celebrate in prayer certain benchmarks of hope and gladness that our brothers and sisters have found in the church with our spirit of accompaniment.
Who Are We to Judge?
Our mental health ministry does not judge. Mental disorders come in various forms. Those who accompany others through this ministry should not assume that people with disorders can simply take a “mind over matter” approach to dealing with daily routines or facing life’s issues. Thinking, “If I can get this person to think rationally, willfully or even morally, then I will have done my job” is the wrong way to approach this important ministry. Judging a person based on one’s own reasoning or moral behavior puts the minister outside of the spirit of prayerful accompaniment.
Judging a person based on one’s own reasoning or moral behavior puts the minister outside of the spirit of prayerful accompaniment.
For over 2,000 years, from Jesus to Pope Francis, the Gospel has called us to seek out the lost sheep and, as Pope Francis says, even acquire the smell of the sheep. We are all sheep. Reaching out to the peripheries and allowing those on the peripheries to touch us is the Gospel way, the communal way. It is a journey where those who abide in the heart, the bosom and the extremities walk together as one body of Christ. It is a journey of communion.
Made in God’s image and likeness, we all have a certain unity and communion with God. Gabriel Marcel, a French Christian existentialist who passed away 50 years ago this October, often pointed to the Gospel of John, insisting that there is a certain “withness” embedded in our human essence. If, in the beginning, there was the Word and the Word was with God and the Word was God, we must conclude that to be made in God’s image means, as Marcel says, “To be is to be with.” Anything less is a sin, which in Greek means “missing the mark.”
From this perspective, we must insist that our church, our parishes, our pastors and all who are one in Christ be inclusive. Still, our church continues to miss the mark when it comes to including others. For example, our parish churches have made great strides in addressing the requirements of the Americans With Disabilities Act. But beyond building ramps and retrofitting our restrooms, are we being proactive in using the gifts that people with physical restrictions and disabilities bring to our parishes? Are our holy water fonts and front pews accessible? Do we provide interpreters for those who are deaf and hard of hearing, allowing them to fully participate in the sacrifice of the Mass? Are lector, acolyte, and ministerial opportunities available for all? If “To be is to be with,” are we not erring if we are concerned simply with compliance, attending only to the bare minimum?
In the realm of advocacy and politics, parishes are often charged up to vote no on abortion and physician-assisted suicide. But how effectively are parish communities accompanying those who are contemplating these hard decisions? State and national bishops’ conferences have produced roadmaps toward such levels of accompaniment. While this is a step in the right direction, how many of our parishes are implementing these practices? If “To be is to be with,” aren’t we still missing the mark?
In the same way, when it comes to accompanying our brothers and sisters in Christ who suffer from mental illness, too often we embrace merely the aspects of their stories that we are comfortable with. We avoid the very real parts of their hearts that we do not understand.
We tend to psychoanalyze a person struggling with mental illness, rather than simply tending to their needs. How often are we tempted to look back at a person who has committed suicide and think they must have been “crazy”? Perhaps they were highly intelligent but very depressed. We tend to judge the soul of the one who has taken their life. We over-spiritualize and over-moralize. We assume that the suffering person simply did not pray enough or, again, could have taken a “mind over matter” approach, when in reality they struggled with a brain-related issue.
We tend to psychoanalyze a person struggling with mental illness, rather than simply tending to their needs.
I personally witnessed a pastor chastise a family at the funeral Mass of their child who had died by suicide. He told them if they had been going to Mass as they should have been, this never would have happened. This is missing the mark—egregiously so.
We often stand in judgment, falsely wondering why our brothers and sisters in Christ who struggle with mental illness are not trying harder to keep the course. But there are levels of culpability in our actions and decisions, and—we must recognize—those with severe mental health struggles have a different level of culpability than others. Mental illness is not a sin, and it does not disqualify them from our love, nor does it disqualify them from being held in high esteem by our perfect God.
I find Craig Rennebohm’s book Souls in the Hands of a Tender God helpful. He writes:
Perhaps we need to ask what it means to be perfect as God is perfect. The perfection of God is not achieved by cutting out and throwing away whatever is spoiled or wrong or broken, wounded or damaged. The perfection of God is wholeness, a taking up of all that has happened and is, and including it as part of life, and working with it redemptively, so that even the worst of experiences, the most terrible and destructive events in our history, become part of an ongoing creation, ever renewed. The perfection of God is inclusive. The perfection of God is all about a love that nothing can deny. God’s love and care for our souls is a gift, freely offered, no matter who we are or what we have done. It is the denial of God’s grace to the suffering and struggling that is abhorrent to God.
This call to love and be loved in totality goes to our core and responds perfectly to Jesus’ invitation to “abide in my love, so that you may have joy and your joy may be complete.” This is hitting the mark.
Notice that Jesus does not say to abide in his heart. To abide in his heart is to rest in him, to become part of him. While this is where we begin, resting in Jesus is not enough. We must abide in his love, an active Christian love. We must go beyond abiding in his heart.
A heart, even his Sacred Heart, is meant for pumping. Like blood that is sent from the heart to the extremities, we are sent forth to actively abide in his love, accompanying saints and sinners, the healthy and the sick, and to attend to those who are oppressed. All the while, we must recognize that we ourselves are sometimes holy, sometimes sinful, sometimes healthy and sometimes sick and oppressed. We, too, are in need of the Great Physician.
As a priest, I have been touched and transformed by many people whom I first sought to comfort.
Because of our great need for grace, we always return to rest with the Lord for a while—but only to be sent out again. All along the way, we abide in his love.
As a priest, I have been touched and transformed by many people whom I first sought to comfort. This sense of Gospel journey is a two-way street. The more I give of my time to others in need, the more I am rewarded by love in return. As I am sent forth from the heart of Jesus once again to foster the mental health ministry of the Diocese of Phoenix, I know that in my own fragility and imperfections, I am called to accompany fragile and imperfect people in this imperfect world in an imperfect way. But I also know that as long as we abide in his love, our God who makes all things new will perfect our journey along the way.