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The EditorsNovember 20, 2013

One of the last great stigmas in American society is that attached to mental illness. How often we hear insensitive comments about people with mental illness and even accusatory moral judgments, like “They just need to shape up and get over it.” The dynamics of stigma enable the great majority of the population to say, “He or she is not one of us.” And because of the stigma and our own fear, we tend as a society to provide only self-defeating half-measures to care for people with mental illness.

A major ray of hope shone on Nov. 8, however, when the Obama administration issued long-awaited federal regulations implementing the mental-health parity law signed by President George W. Bush in 2008. The new regulations oblige insurance companies to provide coverage for mental illness and drug problems comparable to what they provide for any other illness. It is a historic breakthrough that was a long time in the making.

This initiative reverses the dramatic decline in public support for mental health between 2009 and 2012, when states lost some $4 billion in mental health care funding, the largest cuts since the de-institutionalization movement of the 1970s, which reduced the number of people in large psychiatric facilities by moving them to local residences. Addressing mental illness as early as possible is critical for helping people to become self-sufficient and live a relatively independent life. We need only to look around us to see the consequences of neglect.

For example, 20 to 25 percent of the homeless population in the United States suffer from some form of severe mental illness. In comparison, only 6 percent of the total U.S. population are severely mentally ill, according to the National Institute of Mental Health in 2009. In far too many states, the second largest “psychiatric” institution is the state prison or a county jail.

To say that the system is broken implies that at one time it was robust and adequate. But progressive care for people affected by mental illness has never been a hallmark of American society. Families with out-of-control, suicidal or aggressive children have no central place to turn to for help, and there is no coordinated action plan they can use to learn about and access services that could provide desperately needed support.

The National Alliance for the Mentally Ill plays a crucial role as a support system for families and as an advocate for mental health resources. Every state has a chapter, and many of these chapters have a faith or spiritual component.

Churches are tremendous social assets, but it is only in the last 25 years that they have begun to harness their resources for the benefit of people with mental illness and their families. Deacon Tom Lambert of the Archdiocese of Chicago underscores the isolation that can occur. He calls mental illness a “no-casserole disease.” When his wife had open-heart surgery 25 years ago, “the doorbell never stopped ringing.” But when his daughter was hospitalized because of mental illness 20 years ago, he said, “No one came to the door.”

Deacon Lambert also found during those dark days two decades ago that Catholic Church leaders knew very little about mental illness and that there was nothing in place to help those with mental illness or their families. So he and his wife established a commission on mental illness in the Archdiocese of Chicago, albeit without any church funding. “I call it an unfunded Gospel mandate,” he said.

Jennifer Shifrin of St. Louis, Mo., worked out of her kitchen to found Pathways to Promise, an interfaith program on ministry and mental illness to support families, which are most often the primary caregivers for people with long-term mental illnesses.

The Rev. Craig Rennebohm of the United Church of Christ has spent a lifetime on the streets of Seattle, greeting people, building trust, sometimes helping them find food or shelter and in some cases paving the way for hospitalization. He will be a keynote speaker at a one-day workshop in Chicago on Jan. 15 on “Creating Hope: the Power of Faith Communities in Mental Health Recovery.”

Pastors and ministers, especially, can help break through the stigma of mental illness by their preaching. One third of the Gospel of Mark depicts the healing ministry of Jesus. And half of all these healings, it appears, were of people afflicted with mental illness. By the religious standards of the day, people with mental illnesses were similar to lepers, prostitutes and others who were considered “unclean” and hence excluded from the community worship. When Jesus healed a person with mental illness, he not only took away their infirmity but also restored them to the community. We too, as people of faith, can engage in this healing ministry, breaking down barriers and welcoming all as children of God.

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Christopher Rushlau
10 years 6 months ago
Let's start at the end of your essay and work backwards. How did Jesus cure the mentally ill, as you call them: it took faith, right? No automatic spritzing and--presto!--you're cured. So how does that fit with your denunciation of the 'pull yourselves up by the bootstraps" line? Where does the theory of mental illness fit in with the theory of human freedom? Tom Shaffer, long-time Notre Dame Law School professor, told me in an email a few years ago about diagnosed schizophrenics who'd passed through the legal clinic in the years he assisted there, ran the place, and so on. He said he'd never been able to spot any pattern in their behavior to account for the common diagnosis they all bore. Finally, two quotations from your essay. First, "[f]amilies with out-of-control, suicidal or aggressive children have no central place to turn to ...". Leaving aside the scam/charlatan/quack angle, two of these three symptoms might very well be described as political protests. And "... those dark days two decades ago that Catholic Church leaders knew very little about mental illness ..." What's the latest news on health insurance, something about substance addiction now being approved as a mental illness? If you want to see weird bizarre behavior, look at the US and its Global War On Terror. Look up the definition of terrorism in the Federal statutes. Consider the Jewish state of Israel which denies its racism but if a Jewish state doesn't favor Jews over non-Jews, what is it doing, then? Crooning about tolerance? If mental illness is somehow losing track of reality without at all trying to, we have to ask ourselves if essential elements of our national life together are crazy. Or are we responsible? Is denial something someone chooses to engage in? I note from a bit of Aquinas (ST 1, Q. 84, A. 7) in Rahner's Spirit in the World that the former's idea of insanity was the result of "the operation of the imagination [being] impeded by an injury to a corporeal organ" (Spirit, p. 7). Either mental illness is a choice, in which case the Jesus healing model with its demand for faith is the right one, or there is damage, which would justify confinement, surgery, a lifelong use of medications, etc., including involuntarily by court order, but I would like to see the damage. Show us the damage. Not a region of the brain that is redder on a scan due to increased blood flow, which may...linked to...associated with..assumed to be... You know what that sounds like? It sounds like rationalizations and justifications for "taking out" "terrorists".
John O'Neil
10 years 6 months ago
Bravo. While we still have more questions than answers, the science behind the causes of mental illness has come a long way in the last 30 years. Understanding the chemistry of the brain and it's disorders is many orders of magnitude more difficult than other less compex and more observable parts of the body. It is tragic that as a society our attitudes towards mental illness have not made similar strides. It is easy to understand the ignorance of prior generations towards things they could not understand - belief that illnesses were a curse from God resulting from something the afflicted did wrong. They did not know about bacteria or viruses. It is much harder to understand the continuing ignorance many demonstrate when it comes to mental illness. The voices that say "they're not sick they choose to be that way" or "they are lazy" remind me of the reactions of upper class English to the famine in Ireland. The Irish were starving because they were lazy drunks. The church should not stay on the sidelines here. Jesus did not come to heal the healthy and one of the most valuable contributions we can make is to draw attention to those who suffer. The suffering of the mentally ill and those that love them is too great to continue to be ignored
10 years 5 months ago
Mr.Rushlowd, I have brain damage. I'm not "mentally ill," though other injuries I suffered in the same accident I acquired my brain damage in necessitate PRESCRIPTION medications. (bad liver, now, as well as other antibiotics for orthopedic stuff) My parents are old. They need PRESCRIPTION meds. And other family members need meds for other stuff. Ad yada - yada - yada. (to sound like Dr.Seinfeld) THE PHARM INDUSTRY OWNS CONGRESS. I know this both from watching PBS, which is not told what & what not to report, and from my brother - who works for Eli Lilly pharms. (a big drug company) THE PHARM INDUSTRY CONTROLS A VERY BIG PERCENTAGE OF THE MEDICAL BUDGET. That's wrong but this America. And America has created, with capitalism, the curse of "the golden rule." (whoever has the gold, rules) This can be rectified democratically, as with the new healthcare insurance law, or it can be condoned by sinners (ignorant capitalists) like yourself. edit 1/1/14 - Mr.Rushlowd: Not that it adds anything to my argument that "you must stop blaming the victims" or anything, but if you want to check my creds, your friend at Notre Dame Law might help you. I honestly doubt he could, but it was at Notre Dame in 1985 that I had my terrible car incident (hit-and-run victim > there's nothing ACCIDENTAL about a hit-and-run INCIDENT) which necessitates my taking PRESCRIPTION meds. Your ND Law-prof MIGHT be able to corroborate my story, albeit 28+ years old. Good day.
Lynn Czarniecki
10 years 5 months ago
As V.P. for NAMI NJ Somerset affiliate I want to thank you for your article and to commend you for raising this important issue. Faithnet, NAMI's spiritual arm, works to inform and engage faith based communities about mental illness and the role these groups can play in helping people with mental illness and their families. As a deacon in the Episcopal diocese of Newark NJ, I have started a ministry called "Building Bridges to Hope" which aims to raise awareness about mental illness, decrease stigma and encourage congregations to offer support and love to people with mental illness and their families. Studies have shown that spiritual support can help people with mental illness live lives of recovery. It is time for people of all faiths to become more involved.

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