Intersections

What American Mental Health Care Is Missing and How Churches Can Help

by: 
Stephen P. Greggo, PsyD

Ministry along the Mental Health Continuum, Part II

Editor's Note: This Intersections post is part of a series, Ministry along the Mental Health Continuum.  You can view Part I here.

Ministry leaders who foster vital congregational community can constructively address the adverse trends in the growing national crisis regarding the upturn in mental illness. In the previous piece on ministry along the mental health continuum, the charge to ministry leaders was to be part of the solution: faith communities serve a stabilizing function that increase disease resistance by reversing isolation. Here, that challenge will be expanded. Ministry leaders can indeed be part of a larger social movement that promotes mental health and fulfills our Gospel calling. Awareness of trends in mental health care can assist clergy to customize and deepen the support offered to struggling parishioners.

First, the past two decades have seen the formation of an impressive research base beneficial to the treatment of mental illness. The availability of evidence-based findings is wide-ranging and applicable to mild, moderate, and severe manifestations. One implication for ministry leaders is to reconsider our referral policies for counseling services. Given the present hurdles in accessing mental health clinicians, clergy may resort to offering a generic list, lean into divine providence, and experience relief if the hurting member secures an appointment. When a disoriented seeker actually discloses a need for help, best soul care practice will include selective guidance and follow-through. Spiritual leader referral support must exceed that of an internet search engine.

It is prudent to recognize that not only do counselors have specialties, each has a unique style and approach. Clergy can educate congregants on how to recognize and access professional helpers who are proficient in applying evidence-based practice. Such providers hear the request, clearly define the presenting problem within the client’s narrative, and offer a treatment direction that holds because it is tied to sound research. Quality providers are prepared and willing to transparently track the outcomes of the helping endeavor by seeking feedback on the therapeutic alliance and establishing behavioral benchmarks that make gains evident.[1] This can be done by trained Christian counselors in ways that honor Scripture. Pastors may elect to supplement quality secular mental health care with faith discipleship support.

Second, the upturn in demand for mental health services during the pandemic is intensifying a greater dependence on technology in service delivery. This applies not only in the United States but across the globe. In an effort to be medically responsible, pragmatic, and equitable in the distribution of resources, mental health providers are in the throes of change. Experts describe the increase in telepsychiatry, telebehavioral health, and digital options as “meteoric.”[2] Any reference to change at lightning speed is stunning for this branch of the medical establishment that has sought to instill strict quality standards and regulations to reduce stigma and elevate respectability. Clergy can anticipate being called upon to support parishioners as they anticipate services, apply behavioral strategies gleaned via technology, or require up front and personal encouragement to pursue change.

Consider these predictions. Virtual mental health services (telehealth) are likely to remain available and are on track to become the norm. Patients appreciate its ease, providers find it efficient, and systems view this delivery option as a means to increase access across rural and urban areas. Further, alternative and automated digital options are coming online. Clients will be encouraged to participate in online psychoeducational modules or practice experiential mindfulness via apps as a supplement to psychotropic medication and/or psychotherapy. The use of artificial intelligence (AI) can produce robotic chat-style sessions to dispute irrational thoughts or promote grounding. More advancements via technology are on the horizon. Technology-based interventions blend readily into evidence-based outcome evaluation systems. There is less dependency on clinician reports in favor of direct client behavior and satisfaction ratings. Again, the progression towards virtual and automated intervention gives reason for optimism regarding accessibility. On the flip side, such ventures may not reach communities where access to technological resources are limited or when the dysfunction is severe.

Finally, one mental health expert is offering an insightful and informed confrontation for those in the medical community and beyond. Despite the progress in evidence-based care and expanded high-tech delivery, there is an inherit conundrum. Those most acutely in need of care are not amenable to the medical offerings currently available. Virtual services are most effective when the impact of mental illness is in the mild to moderate range. This leaves those with severe manifestations at a disadvantage.

The pastoral implication is that those who are most disabled and desperately in need of care may demand extra support to acquire and make use of it. Thomas Insel, former Director of the National Institute of Mental Health and prominent psychiatrist, states that it is going to take a profound social movement to promote mental health, not merely treat mental illness.[3] Insel’s recent book, Healing: Our Path from Mental Illness to Mental Health, lays down a challenge for a broad-based cultural response.[4] His thesis is worthy of pastoral consideration since our ministry strengths are more high-touch than high-tech. Treatment for human conditions now defined as “mental illnesses” are embedded in larger worldview and lifestyle phenomenon. Beyond increasing resources to treat mental illness, there is a necessity to promote human connection and locating one’s significance to amplify mental health.

Insel’s building blocks for a social movement will sound resoundingly familiar to ministers of the Gospel. Writing to the Corinthian church, Paul correctively addresses a wide range of concerns. He builds to the height of his thesis with the image of church community as a healthy functioning human body where each part (eye, hand, foot, etc.) plays a role (1 Cor 12). Recall Paul’s intense emphasis on how “weaker,” “unpresentable,” and “suffering” parts deserve special honor. It is this hurting or unseen segment of the population the apostle brings into sharp focus. This spotlight is the setup for Paul’s profound statement on love as the “most excellent way” (1 Cor 12:31). Might the public health crisis regarding the plague of mental illness be our call to turn attention to members of our community who need profound human kindness in the name of divine redemptive love?

According to Insel, in order for people to experience a full and meaningful life, there is a prerequisite need for the three P’s: people, place, and purpose. This thinking flows along the lines of Maslow’s humanistic hierarchy of needs: physiological, safety, love and belonging, esteem, and self-actualization. Simply put, the people-P asserts that human beings require a network of acquaintances and allies for social support. The place-P refers to an interior longing for a safe sanctuary of living conditions with human-to-human nurture available to foster growth and healing. The purpose-P holds that each individual needs to discover and find value in fulfilling and meaningful activity. As common sense as these prescriptions may sound, Insel offers critical insights as to why these features remain out of reach for those who need them most. The increased incidence and prevalence of mental illness ties to declining cultural conditions that contribute to mental well-being.

Ministry leaders can be encouraged and inspired by this health promotion perspective. These existential priorities may not be identical to our faith moorings but they run consistent with ancient and Scriptural pathways. As mental health care rightly increases intervention precision, giving priority to behavioral and relational techniques via high tech delivery, the warm embrace of empathy and human hospitality is a critical ingredient that is too often diluted. Ministry leaders can stir congregational communities to embrace with love the hurting, traumatized, disoriented, and suffering. Christian ministries can join the movement to cultivate mental health in high-touch ways via nurturing and loving community; offering worship experiences that center on redemption, reconciliation, and recreation; and by guiding the faithful to discover a profound sense of vocation in a world lost in a frenzy to consume.

References


[1] Stephen P. Greggo, Assessment for Counseling in Christian Perspective (Downers Grove, IL: Inter-Varsity Press, 2019).

[2] Muhammad Omair Husain et al., “Mental Illness in the Post-pandemic World: Digital Psychiatry and the Future,” Frontiers in Psychology 12 (2021): https://doi.org/10.3389/fpsyg.2021.567426.

[3] Tom Sullivan, “What Will It Take to Fix the U.S. Mental Health Crisis? ‘A Social Movement,’” Heath Evolution, February 16, 2022, https://www.healthevolution.com/insider/what-will-take-to-fix-the-u-s-mental-health-crisis-a-social-movement/.

[4] Thomas Insel, Healing: Our Path from Mental Illness to Mental Health (New York: Penguin Press, 2022). For a succinct online statement of Insel’s key arguments, check out his own summary provided in The Atlantic: “What American Mental Health Care Is Missing, February 13, 2022, https://www.theatlantic.com/ideas/archive/2022/02/american-mental-health-crisis-healing/622052/.