Health Promotion Sunday: How Congregations Can Care

How Congregations Can Care for People with Mental Illness and Their Families

From Pathways to Promise

“This is my commandment, that you love one another as I have loved you.”
— John 15:12

Jesus asked us to reach out to all human beings so that the stranger becomes the neighbor. People with mental illness and their families often are treated as strangers, even when they are our neighbors. We are called to be inclusive of them and share the resources and community of our congregation with them.

When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving much advice, solutions or cures, have chosen rather to share our pain and touch our wounds with a gentle and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares.

— Henri Nouwen

The following are some suggestions on how to reach out to people with mental illness and their families in a caring way. These suggestions are generally what you would do in reaching out to anyone with any serious illness and their families.

Be a friend;
Let the person who is ill and the family know that they are not alone;
Avoid expecting that all peculiar behaviors and habits can be corrected;
Avoid being judgmental;
Offer help;
Offer prayers;
Refrain from offering simplistic solutions to complex problems;
Realize another breakdown or a relapse is often temporary;
Be supportive of the entire family, including those members who infrequently come to services, as they may feel the most isolated;
Encourage the person who is ill and the family to continue as a part of congregational life;
Offer opportunities to integrate the person who is recovering into the church community;
Designate individuals within the congregation to be there when help is needed;
Educate yourself and others about mental illness;
Be an information and referral source;
Sponsor support groups;
Challenge false and stigmatizing statements about mental illness;
Be willing to work with other congregations to improve the quality of life for people with mental illness and their families.

— © Pathways to Promise, 5400 Arsenal St., St. Louis, MO 63139; pathways2promise.org; pathways@mimh.edu, (314) 877-6489 Used with permission.

Called to Care Within the Wider Community

By Rev. Rose Ann Briotte

Suggestions for Clergy Working With Mentally Ill Individuals

Always be respectful of confidentiality issues. Confidentiality is not only necessary, in the case of mental illness, it is the law!
Have a plan for what to do if ever faced with a crisis situation.
Know how to reach the local Mental Health Crisis Response Teams in your area.
Remember that police, sheriff and fire departments are referral services also.
When someone appears to be a danger to themselves or others, do not hesitate to call 911.
Don’t assume that all persons with a mental illness have the skills or mental capacity necessary to get the services they need.
Educate yourself about various symptoms of mental illness so you know when a referral is advised.
Clergy may not recognize at first that some requests for support from persons who have a mental illness are not appropriate. As with other members of your congregation, experience teaches how to provide appropriate support while at the same time setting limits and boundaries when requests become inappropriate.
Educated clergy have the ability to recognize when religious practice is not theologically or mentally healthy so that they can respond to “religious ideation” in persons with certain mental illness diagnoses.
Be prepared to work with mental health professionals and community agencies to ensure that persons get the help they need.
When a person with a mental illness comes to you for help, ask them about other services that they may be receiving to avoid duplication of services.

Suggestions for Clergy Helping Families of Persons with Mental Illness

Confidentiality rules apply with families as well as consumers of mental illness. Clergy should never assume it is OK to talk to family members or consumers about other conversations shared in confidence.
Clergy should pray openly from the pulpit to comfort persons who suffer with a mental illness and their families in their congregations only when they have their permission to do so.
Clergy should acquire the ability to use and model non-stigmatizing language with the congregation so that it can become welcoming and supportive.
Be aware that there are sometimes “competing narratives” between persons with a mental illness diagnosis and their families. Careful listening to both without judgment may reveal that families will not always have the same goals for their loved ones that the consumer of mental health services has for themselves.
When there is a mental illness in the parsonage, congregations who love and support their pastor and his or her family frequently want help from the church and will turn to pastoral supervisors to learn what they can do to help their pastor and his or her family. They too should know how to help.

Suggestions for Referral and Working with Agencies

Keep an up-to-date list of agencies frequently used. Cultivate a working relationship with key persons in these agencies.
If you are planning to visit an agency just to get to know them, remember to call ahead, and if you arrive and the place seems particularly busy, be sensitive to their case-loads and talk to someone about coming back at another time.
When dealing with agency personnel, try to put yourself in their shoes. Use courtesy and good human relations skills.
Remember that you may be asked at times to handle confidential or guarded information. Learn what it means to respect the wishes of those you relate to in other organizations.
When professionals are particularly supportive to you, persons you refer for aid, or to members of your church, write “Thank You” messages.
Give agencies feedback and be courageous enough to ask for feedback … to help build a working relationship for problems that might arise in the future.

— Rev. Rose Ann Briotte, psychiatric chaplain, Knoxville, Tenn. Used with permission from the Virginia Interfaith Committee on Mental Illness Ministries; www.vaumc.org/gm/micom.htm (800) 768-6040, ext. 153.

Visitation in Mental Health Centers

“From The Deacon Manual for Caring Ministries

All of us suffer mental distress at one time or another, and it is not uncommon to seek counseling and medication to aid with depression and other difficulties. Assessing severe symptoms and assisting those who suffer is difficult for those who are outsiders.

Access to persons in a mental health institution may be restricted, in part because confidentiality laws protect the person who is being treated. It is always best to first call the institution to find out the rules for visitation. The staff may not be able to confirm that a particular patient is actually registered there, but messages will be returned if the person involved gets permission. Even if visitation is approved, institutions prefer that treatment not be interrupted. The institution will be able to tell visitors when it is convenient to visit with individual patients.

Consultation with those working with a patient helps to prepare the visitor for relating to the patient. Sometimes the situation is very complex and it may be difficult to know what to do to help. What deacons can do when they visit is care, listen and pray with or for the patient. Do not judge. Bring the face and love of Christ with you.

Listening

Jan Vanier, founder of L’Arche communities for the mentally handicapped has written:

So it is important to approach people in their brokenness and littleness gently, so gently,
not forcing yourself on them,
by accepting them as they are, with humility
and respect.

Learning to listen is at the heart of empowering and healing.

— The Lafiya Guide: A Congregational Handbook, Association of Brethren Caregivers

Improving Personal Interactions

“From That All May Worship

When a person	Then…
has trouble with reality	be simple, truthful.
is fearful;	stay calm.
is insecure	be accepting.
has trouble concentrating;	be brief, repeat.
is overstimulated;	limit input.
becomes easily agitated;	allow person to change subject or location.
sounds unclear, has poor judgement;	do not expect rational discussion.
is preoccupied;	get attention first.
is withdrawn;	initiate relevant conversation.
keeps changing plans;	keep to one plan.
believes delusions;	ignore, don’t argue.
has little empathy;	recognize as symptom.
has low self-esteem;	stay positive.

— That All May Worship, National Organization on Disability

Connect Individuals and Families with Help

Congregations can offer important help to families dealing with mental health issues by referring them to nonprofit organizations such as the National Alliance on Mental Illness (NAMI), Depression and Related Affective Disorders Association, Obsessive-Compulsive Foundation, etc.

Below are resources for individuals and families offered through NAMI:

Family-to-Family
A free 12-week course for family caregivers of individuals with severe mental illnesses.

NAMI Support Group
The NAMI Support Group model offers a set of key structures and group processes for facilitators to use in common support group scenarios.

Provider Education
Education program for mental health service providers co-taught by consumers, professionals and family members.

Peer-to-Peer
For any person with a mental illness, this course contains individual relapse prevention planning, a debriefing/storytelling week, and an advance directive for psychiatric care.

NAMI-C.A.R.E Mutual Support Program
A program in which people with mental illness learn from each others’ experiences, share coping strategies and offer each other encouragement, understanding and support.

In Our Own Voice: Living with Mental Illness
A one-and-a-half hour interactive, multi-media presentation by consumers for consumers and others about living with mental illness.

To access these resources, visit www.nami.org. A state locator can guide users to the closest NAMI support groups.

Other Support Groups
Other organizations offer support groups for individuals with mental illness and their family members:

The Depression and Bipolar Support Alliance (800) 826 -3632 www.dbsalliance.org/info/findsupport.html

Depression and Related Affective Disorders Association (703) 610-9026 or (888) 288-1104
DRADA offers support groups within the Maryland, Virginia, Washington DC., Delaware or southeastern Pennsylvania areas. To locate a support group in these areas, call (410) 583-2919.

Obsessive-Compulsive Foundation
(203) 401-2070; www.ocfoundation.org

OCF is an international not-for-profit organization composed of people with obsessive compulsive disorder (OCD) and related disorders, their families, friends, professionals and other concerned individuals.

Anxiety Disorders Association of America
www.adaa.org/GettingHelp/SupportGroups.asp
ADAA is a nonprofit organization whose mission is to promote the prevention, treatment and cure of anxiety disorders and to improve the lives of all people who suffer from them.

Church of the Brethren Pastors
Call Brethren Benefit Trust at (800) 746-1505
Members in the Brethren Medical Plan Minister’s Group have access to the Clergy Consultation Service for times when pastoral staff need a confidential and accredited place to turn to deal with professional or personal issues. This confidential service, staffed by licensed pastoral psychotherapists, is available day or night to Plan members at no additional fee.

ABC Home | Health Promotion Sunday Themes | Offering Hope Resources