National Alliance on Mental Illness
page printed from FaithNet NAMI

Steps For A Congregation

Ministry With Those With A Mental Illness

Presented at NAMI Oregon Convention – May 2003

By:  Gunnar E. Christiansen, M.D.

For those of you that are part of congregation that already has an active ministry with those with mental illness, I hope you will bear with me in a discussion of steps that can be considered in initiating or expanding this ministry in a place of worship.

The first and most important step is to gain the approval of the senior clergy person. It is highly unlikely that a congregation will have a successful program develop without it. He or she is the gatekeeper to the congregation.

The best way to get the attention of a senior clergy person is for him or her to hear a personal story concerning the trials and tribulations of having a mental illness, being the caretaker of a loved one who is ill or having a friend with one of these disorders.

There is no better method of education for a clergy person than having personal involvement. When a clergy person hears a testimony from someone that they know and respect, that clergy person becomes personally involved. The value of one person talking from the heart to another listening with his or her heart is immense.

In the testimony, it is extremely important that one include the importance that his or her faith has played in recovery or in the ability to cope with being a caretaker and/or friend. It is extremely important to stress the value of faith, because nurturing of one's faith by the clergy and congregation is the most important part of its role in the mental health of its members. The clergy and congregations need to hear how valuable their ministry is in one's recovery from mental illness.

The perception that you are sincere in your desire to work with your clergy person in developing a program is indispensable. No member of the clergy wants to start or expand a program if it appears that all the responsibility for its success falls solely on his or her shoulders. In short, if you want something done, don't expect your clergy to do it all for you.

If a letter is necessary to obtain an interview, don't hesitate to write one. But, whether writing a letter or having a personal interview, be organized, dwell on the positive aspects of having an outreach program and, as always, speak from your heart.

I emphasize the word "step." One should take care that a large sack of frustrations and demands for immediate restitution are not suddenly dumped on the desk of the clergy person or lay leader. Make certain you don't just give her or him a large packet of material and then leave without giving your testimony. In fact, don't give a large packet of material unless it is requested. Just a couple pamphlets will be more effective. Remember the clergy are inundated with mail and have very little time to read it.

The second step is to establish a "Task Force." The longevity of your program is dependent on this committee, so choose carefully. A "One Man Show" is likely to fail, whereas the encouragement of each other in a hard working group can result in significant accomplishments.

In addition to seeking those with a mental illness. family members and health professionals, ask one or two members who are leaders in the congregation who have had no previous involvement with mental illness to be on your task force. I have found that it is often those with no experience that are the key to your involvement of the entire congregation in an outreach program.

As in any committee there will be a variance of opinions, but don't be distracted. Follow the advice of Thoreau: "Be as the sailor who keeps the polestar in his eye. By so doing we may not arrive at our port within a calculable period, but we will maintain a true course."

Listen to the desires and utilize the talents of each member of your committee rather than concentrating on getting them to do something that you feel is most important.

Before a congregation can respond to a need effectively, it must understand the scope of the problem. This requires the third step, education. Talk to anyone or any group that will listen to you. For those of you in a Christian congregation, if you have a Stephen Minister's group and/or deacons, you will find these groups to be particularly receptive.

Remember those who will listen to you will undoubtedly already be prone to giving love and compassion to those with a mental illness. They are in attendance because they are looking to you for understanding.

It is not necessary for a congregation to have knowledge of all the latest scientific information on the subject. An attempt should be made to convince the members, however, that serious mental illness is the result of an abnormality of the brain and in almost all cases amenable to medical treatment. Equally important is to stress that mental illness is not caused by a lack of character by the person with the illness or by poor parenting. It is amazing and disheartening that so many in our society still have this antiquated opinion.

Despite the glaring need for housing, improved treatment facilities and etc. by many with a mental illness, I advise against making requests for one's congregation to become involved in these issues until the members have been educated concerning mental illness.

When a congregation is able, emotionally and intellectually, to get into the shoes of those with a mental illness, it will be ready to take the fourth step of providing a support group for family members and the fifth step of providing ministry with those who have a mental illness.

It is important not to forget the family members. Having a loved one struck by a mental illness is devastating for the family. Particularly in the early stages, family members will likely have multiple concerns about daily living and the future as well as have distress about the past. Guilt, anger, fear, confusion and exhaustion are commonly experienced emotions.

Siblings may worry about developing a mental illness themselves or their children becoming mentally ill. They are prone to blaming their parents for the illness of their sister or brother. A spouse may be deeply concerned about the family's economic situation and the long- term viability of the marriage. Children are almost always confused about the illness of a parent. They are likely to be embarrassed and sometimes even frightened.

It is usually extremely helpful for a family member individually or together with other members of the family to express these feelings to someone who is willing to listen not only with their ears, but with their heart. Family members need healing as well as the ill loved one. It is unlikely that this healing process will begin without the opportunity to vent these powerful emotions.

It is important that the support groups are faith based. If it is sponsored by a Christian church, it should be conducted from a Christian perspective. If it is sponsored by a Jewish tabernacle, it should be conducted from a Jewish perspective and etc.

The leader should have respect for the faith of those in attendance. This proved to be very important in the weekly support group that we started in our church in 1994. Regardless of the fact that our group was advertised in our NAMI Orange County newsletter as being from a Christian perspective, we had people of many different faiths attend our sessions. They came because they wanted a group that was spiritually based and many drove for as far as 35 miles on busy freeways. Our attendance averaged over twenty people with at least two new families represented each week.

Leaders for a family support group must be knowledgeable about the availability of services in the community and about the various serious mental illnesses. It is ideal to have a psychologist, but I have observed leaders that have no degrees do a wonderful job.

One of the most valuable aspect of these groups is the presence of other families who have survived the original trauma of having mental illness strike a family of faith and now want to serve others. For those families going through a crisis stage in the care of loved-one, hearing from others who have "been there and done that" is very helpful. This opportunity to serve others in a support group has been very meaningful for many families. A crisis for one family can be an opportunity for another family.

It seems that for many families, mental illness is a life-long commitment. In those situations supporting such families by a congregation needs to be a long-range commitment as well. If we as congregations are truly sanctuaries, such commitment will be part of our mission.

Whether or not we are mentally ill our basic needs are the same. We need to have the feeling of acceptance in our community, to have responsibility, to have the opportunity to contribute and to experience God's presence in our lives. It is in the suggested fifth step of ministry with those who have a mental illness that these needs can be met. It will happen when those in the congregation accept those with mental illness in the same manner that they accept those without a mental illness and give support to them in the same manner as they support those with a different illness. It is in this step that people "touch" people and that God's presence is best manifested.

It is not every congregation that will have someone who has the experience necessary to conduct a support group for those with a mental illness. If such a person is available and those with a mental illness desire such a group, it can be a great success.

The suggested sixth step of ministry is to those with mental illness living in the community surrounding a congregation. This could involve providing low cost housing, providing or assisting other organizations with a "drop in center," financially supporting non profit organizations that give assistance to the homeless, adopting a board and care facility, sponsoring conferences such as we are having today and/or making facilities available for classes conducted by organizations such as NAMI.

The suggested seventh step of ministry is to provide a model as an employer by offering employment for those with mental illness.

Especially if one is adequately treated early in the course of his or her mental illness and the proper treatment is continued, functioning at a high level with employment in a responsible job is the rule. Unfortunately this is often not the case. For example 50% of those with schizophrenia are not being treated adequately. The longer the illness is allowed to persist either untreated or inadequately treated, the less likely the affected individual will be able to assume a full time and/or stressful job.

Thus in consideration of employing someone with a mental illness, these factors must be considered. But if the job can be tailored to the capability of the person, it can be of tremendous value to the person, the family and society. The rewards from having the opportunity to have employment is particularly significant for those that were once so ill that they and others did not feel they would be able to work again. Sometimes having an easy job to start with will give them the self-confidence necessary to handle a much more demanding and rewarding job in the future.

Although I add an eighth step of advocacy by the congregation to the city council, the county board of supervisors, the state legislators, governor and etc., I am respective of those who feel that we should keep government and religion separated as much as possible.

At the same time, I also respect those who through prayer and study of the Bible are convinced that a congregation should become politically active, particularly in areas that it appears that justice is not being served by our representatives in government.

I feel it is indicated that members of a congregation are made aware of actions by our government and society as a whole, which are or are not consistent with its beliefs. At the same time I feel that whether we, as individuals, direct our political advocacy independently, in concert with others in one of the secular advocacy groups such as NAMI or corporately in our congregation is not what is most important. What is important is that we do something.

In establishing ministry by a congregation it is important to keep in mind that one set of guidelines does not fit every circumstance. One's approach must vary in accordance with the needs and capabilities of those to whom the outreach is directed and of the people desiring to reach out.

Don't be too structured. Just as one of the biggest mistakes in raising children is to try to raise the second child exactly the same as the first, so is trying to have a set procedure in ministering with those with a mental illness.

It always helps of course to do the right thing at the right time. Wisdom is a great help in making good decisions. For this reason there was a group of people that went to great effort to seek a "mighty" guru to ask the question, "How do we become wise?" They finally found him on top of a tall mountain from where he answered, "Make good choices." When the group asked, "How do we make good choices?", he answered, "By getting experience." They of course then asked him, "How do we get experience?" to which he answered with a smile, "By making bad choices."

I'm certainly not recommending that we make bad choices. At the same time we should not refrain from making decisions because of a fear of failure. We need to keep in mind that doing nothing is a major problem that we are trying to rectify.

Also, we must avoid focusing only on outcomes. Instead we should appreciate the importance of our daily efforts. Sometimes what we do will have a significant influence on another, who will take our ideas to completion.

I don't believe God is asking us to be perfect, but he is asking us not to give up.

We, as individuals, and our congregations have been given the choice as to whether or not we accept an active roll. I pray that it will be the choice to make ministry with those with mental illness and all other illnesses central to our mission.

But we are not alone, I believe God is with us. How could we have a better co-worker?