wholeness not perfection: an interfaith framework for mental health
TRANSCRIPT
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7/29/2019 Wholeness Not Perfection: An Interfaith Framework For Mental Health.
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Wholeness
An Interfaith Framework forMental Health
Texas Interfaith Center for Public PolicyJanuary 2013
Not
Perfection
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Mentaldisordershavebeenrecordedthroughouthumanhistory.Oneoftheworldsearliestmedicaldocuments,theEbersPapyrus(Egypt,circa1550B.C.E.)describesobservedbehaviorsandsymptomssimilartomoderndaydepressionordementia.Overthemillennia,peoplehavecraftedvarioustreatmentsformentalhealthconditionsfromdrillingholesinpatientsheads,tocastingoutevilspirits,totalktherapy.Whileknowledgeaboutmentalhealthandtreatmentmethodsfordisordershasexpandedsignicantly,thestigmasurroundingthemremains. Faithcommunitiesweresomeoftherstgroupstoprovidesystematiccaretothosewithmentaldisorders,andtheyarestillinvolvedwithmentalhealthcaretoday.Clergyareoftentherstsourceofhelpsoughtbysomeonewithamentalhealthdisorder.Assuch,religiouscommunitieshaveanimportantanduniqueroletoplayinmentalhealthcare. Inthispublication,weexplorethecalltoreligiouscommunitiestocarefortheneedsofindividualsandfamiliesaffectedbymentalillness,
takealookatthecurrentstateofmentalhealthcare,andofferideasaboutwhatyouandyourcongregationcandotohelp.Wehopetoinspireyoutoreectonwhatitmeanstobehealthyandwhole,andtoencourageyoutoexaminewhypeoplewithmentaldisordersoftenfeelunwelcomeinourcommunities.
Created in Relationship
It is not good that man should be alone; I will make him ahelper as his partner. Genesis 2:18
AccordingtotheHebrewScriptures,allpeoplewerecreatedbtzelemElohim,intheimageandlikenessofGod,andarethereforeworthyofdignityandrespect.CatholicsocialteachingsafrmthatpeoplewithmentalillnessalwaysbearGodsimageandlikeness;Godsimageisneither
Know all human beings to be repositories of Divine Light; Do not to inquire
about their caste; In the hereafter there are no castes.
Sikhism, Abi Grnth, Asa, M.1, p. 349
Let us bless the Source o lie in its infnite variety that creates all o us whole, none o us perect.
Judith Glass, Aterbirth
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conditionalnorcircumstantial. TheQuransaysthatallpeoplewerecreatedfromthesamemotherandfatherandbelongtoonehumanfamily.BuddhistsandHindusalsoviewtheentireuniverseascomprisingonesinglefamily.Thissharedlineageconfersdignity
andrelationshipuponallhumanbeings. ThebookofGenesisdescribestherstpersonasbeingcreatedfromdustandbecomingalivingbeinguponreceivingthebreathoflifefromGod(2:7).ThenGodlooksathimandsays:Itisnotgoodthatthepersonshouldbealone;Iwill
Illness and CultureTheformthatillnesstakescanvarybetweenculturesorhistoricperiods.Culturecanbeillustratedasthebehaviorsandbeliefscharacteristicofaparticularsocial,ethnic,oragegroup.
Forexample,thereisanillness,amok,particulartoSoutheastAsiawhereamanhasanepisodeofmurderousragefollowedbyamnesiaandanillnesscalledzarintheMiddleEastexpressedindissociativeepisodesoflaughing,shouting,andsinging.InEuropeduringthelate1800s,doctorsdocumentedanillnesscharacterizedbymenwalkingforhundredsofmilesinastateofamnesia.Theseillnesseswererecognizedonlybytheirparticularcultureortimeperiod. Certainconstellationsofsymptoms
maybesharedbetweencultures,butmanifestthemselvesindierentways.TheWorldHealthOrganizationestimatesthat121millionpeopleworldwidehavedepressionandlistitasoneoftheleadingcausesofdisability.Symptomsofdepressiontypicallyincludesadness,hopelessness,andlackofenergy.InAsiancultures,however,depressionisoftenexpressedasaphysicalacheorpainthathasnoidentiablesource. TheWorldHealthOrganizationestimatesthat24millionpeopleworldwide
haveschizophrenia.Commonsymptomsincludeauditory,visualorsomatichallucinations,
delusions,atemotionality,andsignicantimpairmentsincognitivefunctioning Interestingly,thetypeofhallucinationandthecontentsofdelusionsthatindividualsreportseemtoberelatedtotheirculture.xxiForinstance,inJapan,acountrythatprizeshonorandsocialconformity,delusionsoftenrevolve
aroundslanderorthefearofbeinghumiliatedpublicly.InNigeria,wherementalillnessisbelievedtobecausedbyevilspirits,delusionsmaytaketheformofwitchesorancestralghosts. Sometimes,symptomstypicallyassociatedwithmentalillnessareinsteadassociatedwithreligiousexperience.PeoplefromvariousreligiousbackgroundsreporthearingthevoiceofGod,seeingvisions,andfeelingtouchedbysomeoneorsomethingtheycannotsee.Whilealloftheseexperiencesqualifyashallucinations,theyarenottypicallyinterpretedasevidence
ofillnessunlessaccompaniedbyseriousimpairmentstofunctioning. Cultureaectsnotonlythewaypeoplemanifestsymptomsofmentalillnessandwhattheyconsidertobeillness,butalsoaectstheirstyleofcoping,theirsupportsystem,[and]theirwillingnesstoseektreatment.ResearchhasshownthatAfricanAmericansareoftenreluctanttoseektreatmentformentalillnessforthemselvesorfamilymembers.Reasonsgivenincludeahistoryofoppressionandmistrustofthoseinpower,heightenedstigmaaboutmental
illnesswithinthecommunity,andalackofAfricanAmericanmentalhealthproviders.
Imagination, narrative, and other human meaning making activities have
an inescapable role in constructing the experience of someone who is ill.
--David B. Morris, Illness and Culture in the Postmodern Age
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alone.HumankindwascreatedinrelationshipwithGod,withthewholeofcreation,andwithotherpeople. TheshapethatGodsrelationshiptakeswithhumansintheHebrewScripturesisoneofcovenant.Intherstcovenant,Godinstructshumanstobefruitfulandmultiply,aboundonthe
Some philosophers and psychiatrists have suggested that we are investingour great wealth in researching and treating mental illness, medicalizing ever
larger swaths of human experience, because we have rather suddenly lost older
belief systems that once gave meaning and context to mental suffering.
--Ethan Watters, The Americanization of Mental Illness
Symptoms,thenareinrealitynothingbutthecryfromsufferingorgans.--JeanMartinCharcot,translatedfromFrench
The Medical Model
TheUnitedStatesandmuchoftheWesternworldembracesanunderstandingofmentalhealthbasedonthemedicalmodel.Underthemedicalmodel,adiseaseordisordercanbedenedasadeviationfromnormalbodyfunctionsthatcreatesnegativeconsequencesinanindividual.Ingeneral,themedicalmodelconsidersdiseaseasbeingwithintheconnesoftheindividualsbody,anddoesnothighlighttheinuenceofexternalforcesorconditions.Symptomsofdisease,suchasabnormal
behavior,pointtoanunderlyingphysicalabnormality.Mentalillnessesareviewedasdisordersofthebrainthathavephysiological,biochemical,orgeneticroots. AclassicationsystemhasbeendevelopedformentalhealthdisorderscalledtheDiagnosticandStatisticalManualofMentalDisorders(DSM).Amentaldisorder,asdenedintheDSMIV,doesnotrequireapurelyphysicalcause,butisconsideredamanifestationofabehavioral,psychological,orbiologicaldysfunctionintheindividual.xxvThisdenitionencompassesthemedicalmodelbutincorporatesothertheoriesonabnormalbehavior. Adiagnosabledisorderisconsideredseverewhenitresultsinseriousfunctionalimpairmentthatsubstantiallyinterfereswithanindividualsabilitytofunctioninhisorhercommunity,family,workplace,andothersocialsettings.xxviiDisordersthattendtobesevereandchronicincludeschizophrenia,bipolardisorder,majordepressivedisorder,panicdisorder,obsessive-compulsivedisorder,andpost-traumaticstressdisorder.Eachoftheseillnessesaltersapersonsthoughts,feelings,
and/orbehaviorsindistinctways.xxviiiIncontrast,somementaldisordersareacuteandtemporary,suchasanxietyormilddepression,oftenbroughtaboutbyintensestressinanindividualslife. Underthecurrentmedicalmodel,healthislargelyconsideredtheabsenceofdisease,andattaininghealthisfocusedoncuringdisease.Theprimarytreatmentmethodformentaldisordersismedication,whichtargetstheunderlyingneurologicalandbiochemicalcauses.Aftermedication,ifapersonssymptomsdonotsubsideorifthesymptomsintensify,themedicalmodeloerslittlehopeforareturntohealth. Today,mentalhealthprofessionalsincludingpsychiatrists,psychologists,andsocialworkersprovidetreatmentthatexpandsbeyondwhatthemedicalmodelcanoer.Someprovidersalsoincorporatespiritualityandreligionintotheirtreatment.Infact,theAmericanPsychologicalAssociationrequiresthattrainingprogramsincludeeducationinspiritualandreligiousconcepts.
makehimahelperashispartner,soGodcreatesanimalsandthentherstwoman(2:18).ThiscreationstoryillustratestwofundamentalreligiousbeliefssharedbytheAbrahamicfaithtraditionsofJudaism,Christianity,andIslam:one,thathumanlifeoriginatesfromandissustainedbyGod,andtwo,thatitisnotgoodforhumanbeingstobe
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earthandmultiplyinit,andGodpromisesthattherewillneveragainbeaoodthatdestroystheentireearth(Gen.9:7).Theinstructiontohumanstobefruitfulencompassesmorethanmerereproduction,andsuggeststheideaofhumanourishing.ThisideaisechoedintheChristianNewTestamentwhenJesussays,Icamethattheymayhavelife,andhaveitabundantly(John
10:10).Humanbeingsarenotcreatedmerelytoexist,buttobefruitfulandtoourish.InGenesis,Godafrmsthevalueoftheentirecreationbycallingitverygood(1:31). TheBuddhisttraditionbelievesthathumansarefundamentallygoodandcompassionatebeingsattheircore,andthatalllifeisconnected,suchthatIamyouandyouareme.FromtheBuddhistperspective,awakeningtotherealizationthatalllifeisintimatelyconnectedrevivesonescorenature.TheHindusystemofyogateachesthatoneoftheprimarycausesofsufferingisignoranceof
ourtruenatureandourrelationshipwithDivinity.Infact,thewordyogameansunion.
Broken Relationship
He was so terrible that he was no longer terrible, only
dehumanized. --F. Scott Fitzgerald, Tender Is the Night
Stigmaisapparentinthewaypeopletalkaboutmentalillnessandinthewaypeopleencounteroravoidthosewithmentaldisorders.Stigmaisacentralbarrierbetweenpeopleandtreatment. Thedictionarydenesstigmaasamarkofdisgraceorinfamy;astainorreproach,asononesreputation.Amedicallyorienteddenitionofstigmaisamentalorphysicalmarkthatischaracteristicofadefectordisease,asinthestigmaofleprosy.ThewordistakenfromtheLatinwhereitmeansatattooorbrandplacedonacriminal. Somestudieshaveshownthatidentifyingmentaldisordersasabnormalitiesofthebrain
hasresultedinincreasedstigmatizationofthosewithsuchdisorders.Symptomsofcertainmentaldisorders,suchasdisorderedthinkingorotherimpairmentsinfunctioning,directlyconfrontWesternnotionsofpersonhoodthatcenteraroundreason,rationality,andself-determination.Labelinganindividualwithadiagnosisofmentaldisordercanoverwhelmtheindividualsidentity
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Mental Health Care: A History Lesson
Overthecenturiesmentalhealthcarehasevolvedfromhidingindividualswithmentaldisordersinbasementsandtreatmentsofstarvationtousageofbehavioralhealthcenterswithpsychologicalcounselingandholistichealthtreatments.
Theearliestculturesunderstoodthecausationofmentaldisorderstobesupernaturalpowers,
metaphysicalentities,orwitchcraft;treatmentcenteredonreligiousrituals,herbsandointments,charmsandprayers,andacupuncture.SomeearlycommunitiesviewedmentaldisordersasadirectresultofaproblemwithanindividualsrelationshipwithGod,whileothersidentiedpositiveaspectsofmentaldisorderssuchasprophesyingandartisticinspiration.
IntheMiddleAges,thegrowthofIslambroughtnewideasandconceptsofmentaldisorders.Islamicteachingconnectedmentaldisorderstoalossofreason,andwritingscoveredlinksbetweenthebrain
anddisorders.Textsfromthisperiodcontaindiscussionsofmentaldisorderssuchasmaniaanddelusionsandproposedtreatments.TherstpsychiatrichospitalwasestablishedinBaghdadin705,andtheconstructionofinsaneasylumsfollowedintheearly8thcentury.Treatmentandprotectionofindividualswithmentaldisorderswas
humaneandfocusedontherapeutictechniquessuchasbaths,drugs,music,andactivities.
InEurope,ChristiantheologydominatedtheviewofmentaldisordersduringtheMiddleAges.Conceptsofmentaldisordersrevolvedaround
thedivine,demonicpossession,andmagic.Mentaldisorderswereviewedasamoralissue,eitherapunishmentforsinoratestoffaith.EarlyEuropeantreatmentsconsistedofpurges,bloodlettingandwhipping;fastingandprayerforthoseestrangedfromGod;andexorcismfordemonicpossession.TheinfamousBethlehemRoyalHospitalapsychiatrichospitalinLondonbetterknownasBedlamopenedduringtheMiddleAges.Bedlamremainsthehistoricalexemplarforinhumaneandbrutaltreatmentofindividualswithmentaldisorders,goingasfarastopromotepublicviewingsandmockeryofpatientsintheircells.
Bytheendofthe18thcenturythewidespreadviewofmadnessshiftedtotheconceptthatamentaldisorderwasanorganicphysicalphenomenon,notinvolvingthesoulormoralresponsibility.Newtreatmentoptionsfordisordersusingphysicalandpsychosocialtechniqueswereprevalent.Sometechniqueswereconsideredhumane,
Many cultures have shown a tendency to depersonalize those who have some formof serious disability, whether of a physical or a psychological kind. A consensus is
created, established in tradition and embedded in social practices, that those affected
are not real persons.
--Tom Kitwood, Dementia Reconsidered: the Person Comes First
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suchashiringsensitiveattendants,butmosttechniqueslikebloodlettingandforcedvomitingwerenot.Duetotheemergingclassicationsystemsofmedicineandbiology,scholarsandexpertsbegantodeviseschemestoclassifymentaldisorders.The19thcenturybroughtashiftinpublicperceptionsofindividualswithmentaldisordersandtheirtreatment,leadingtothementalhygienemovement,aimedatpreventingthediseaseofinsanitythroughpublichealthstrategiesandclinics.Thetermmentalhealtharosefromthisera,andtheprofessionsofpsychiatry,clinicalpsychologyandsocialworkdeveloped.TheSocietyofFriends(Quakers)providedastrongvoiceformorehumanetreatment
ofindividualswithmentaldisorders.TheQuakerspracticedamethodofcareknownasmoraltreatment,anapproachbasedonhumanecareandmoraldisciplinethathelpedtolaythefoundationformodernpsychiatricmedicineintheU.S.xxxvii
CongresspassedtheNationalMentalHealthActin1949,whichprovidedfederalfundingforpsychiatriceducationandresearch.ThisActledtothecreationoftheNationalInstituteofMentalHealth(NIMH)followedbytheCommunityMentalHealthActof1963.FurtheradvancementsintheeldoccurredwiththeenactmentofMedicaidandMedicare,enablinglow-incomeAmericanstoaccessmentalhealthservices.
Themid20thcenturyalsosawadvancesintreatmentoptions.Treatmentssuchaspsychotropicdrugtherapy,lobotomies,insulinshocktherapy,andelectroconvulsivetherapyhelpedtofacilitatethetransitionofthementalhealthcaresystemfromaninstitution-basedstateandnationalsystemtoalocal,community-basedsystem.Theensuingclosureofmany
statehospitalsresultedinthemovementofmanyseverelymentallyillpeopleintolocalcommunitiesthatoftenwereill-equippedtomeettheirneeds.
Theresultsofdeinstitutionalizationaremixed.Themovementofindividualswithmentaldisordersfromin-
patientfacilitiestocommunitycentersmeantincreaseddemandforcareandcoordinationofservicesthatmanylocalcommunitiescouldnotprovide.Individualswithunmetmentalhealthneedsbecameandremaindisproportionatelylikelytoenterthecriminaljustice
systemorbecomehomeless.Ontheotherhand,community-basedservicesinadditiontobeinglessexpensiveforthepublicallowindividualswithmentaldisorderstoremaininfamiliarsettingsneartheirfamiliesandothersystemsofsupport.
What sort of religion can it be without compassion? You need to showcompassion to all living beings. Compassion is the root of all religious faiths.
Hindu. Basavanna, Vacana 247.
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Healing is impossible in loneliness; it is the opposite of loneliness.
Conviviality is healing. To be healed we must come with all the other
creatures to the feast of Creation.
Wendell Berry, The Art of the Commonplace: The Agrarian Essays
callingthemschizophrenicratherthanaperson
withschizophrenia,forexampleleadingtofeelingsofworthlessorabandonmentbyGodandothers.Manypeoplewithmentaldisorderswrestlewithexcessiveguiltandshame,retreatingintoisolationratherthansharingtheirstrugglewithothers.Stigmahastheeffectofcompoundingthedistressthatpeopleexperience.Infact,shameandisolationmayhaveanevenstrongernegativeeffectonwellbeingthanapersonsunderlyingcondition. Mentalillnesscanbeunderstoodasthe
leprosyofthemodernera.Biblicalscriptures
onleprosyhelpilluminatethatconnection.TheTorahsaysthatthepersonwhohastheleprousdiseaseshallweartornclothesandletthehairofhisheadbedisheveled;andheshallcoverhisupperlipandcryout,Unclean,unclean.Heshallremainuncleanaslongashehasthedisease;heisunclean.Heshalllivealone;hisdwellingshallbeoutsidethecamp(Lev.13:45-46).Thescripturessaythatanyonewhotouchesaleperbecomesunclean(Num.22:4-5).
St. Francis and the Leper
FrancisofAssisiwaswalkingaloneonedayonaroadintotownwhenhesawamanwithleprosywalkingaheadofhim.Hehadalarge,festeringsoreabovehislips. Francis,feelingrepulsed,wantedtoturn
andwalkintheotherdirection,butGodledhimontowardtheman.Atrst,hegavethemanmoney,thinkingthatwouldhelphim.Themantookthemoney. Then,Francisnoticedthatthemanwasshivering,sohegavehimhiscoat.Still,Francisfeltthathehadnotreallymetthemansneed.HeprayedsilentlytoGodforguidance,andGodsanswersurprisedhim:kisstheleperonhislips! Francisembracedthemanforthecustomarygreetingbetweenfriends,and
whenhislipsfelluponthemans,themandisappeared.FrancisfeltinhisheartthathehadjustembracedGod.AsSaintFrancisdid,Christianfaithtraditionscallotherstocrossboundariesinordertoshowlove.s
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Today,manypeoplewithmentaldisordersreportpositiveexperienceswithfaithcommunities.However,therearestillthosewhohavenegativeexperiencessuchasfeelingjudgedorbeingexcluded.Separationfromfaithcommunities,pairedwiththefactthatsomeindividualswithseverementaldisordersbecomeincarceratedorhomeless,revealstousthatmanypeoplewith
mentaldisordersenduplivingoutsidethecamp.Sometimes,religiouscommunitiesgobeyondexcludingindividualswithmentalillnessandcauseharmtothementalhealthoftheircongregants.Justasinanyotherinstitutionorrelationship,thepowerandauthoritythatclergyandotherreligiousleadersholdinpeopleslivescreatesthepotentialforabuse.Religiousabusetakesplacewhena
The Gift of Being Human
Ismentalillnessagift?Somepeoplethinkso,andlinkshavebeendrawnbetweenmentaldisordersandcreativegeniussincethe4thcenturyB.C.E.Platobelievedthatmadness,provideditcomesasthegiftofheaven,isthechannelbywhichwereceivethegreatest
blessings....MadnesscomesfromGod,whereassobersenseismerelyhuman.Famousscientists,theologians,religiousleaders,athletes,writers,actors,politicians,musicians,andartistsallmakethelistofpeoplewithseriousmentaldisorders.Severalresearchstudieshavelinkedcreativityandmentalillnesstosimilar,underlyingstructuresinthebrain.Considerthatonecommonreasonthatpeoplegiveforavoidinguseofpsychotropicmedicationsisthatthesemedicationsalterbrainfunction,dullingcreativityand,thus,
personality.
The wound is the place where the Light enters you.
Rumi
Whilesomeconsidermentalillnessagift,othersfeelthatcallingitagiftminimizesthepainandsueringthatisexperiencedasaresultofsuchillness.Whatfaithcommunitiescanarmisthegiftednessofeachindividual,whethergiftednessisrelatedtomentalillnessornot.AJewishrabbi,theMaggidofZlathcov,saidthatitisthedutyofeverypersontoknowandconsiderthatheisuniqueintheworldinhisparticularcharacterandthattherehasneverbeenanyonelikehimintheworld.TheChristianapostle,Paul,saidtherearevarietiesofgifts,butthesameSpirit,(1Cor.12:4).Faith
communitiescanhelpeverymemberofthecommunityrealizehisorheruniquecharacterandgiftsforthegoodofthewhole.
Being human is difcult. Becoming human is a lifelong
process. To be truly human is a gift.
Rabbi Abraham Heschel
Ratherthancondemningmentalillnessasanaberrationoridealizingitasanacceptablecostofdivineinspiration,faithcommunitiescanoeramorenuancedapproach.WecanarmthatdiversityisapartofGodscreation,thatpeoplehavedierentwaysofexperiencingtheworld,thatthereisnonormal.Bysharingourdierentexperiences,wecancometounderstandthefulldepthandbreadthofwhatitmeanstobehuman.Wecanarmthatnoneofusareperfect,thatweneedoneanothertobewhole.TheologianStanleyHauerwassaid
thatwearecreatedforoneanotherandthatincompletenessmakespossibleourgifts.s
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personorinstitutionclaimstobespeakingfororactingasGodcommands,yetperpetuatesverbal,emotional,physicalorsexualabuseofothers.InBiblicaltimes,illnesseslikeleprosywerecommonlyunderstoodtobetheresultofsin,apunishmentfromGod.ThisisaviewthathasbeenexpressedbyalloftheAbrahamicreligions.TheIslamictraditionhasalsoviewedillnessordisease
asadivinetestofthelevelofpiety,devotion,andloyaltythatafollowerhastohisorherfaith.Today,manyfollowersofthesereligioustraditionsstillsharetheseviews,thoughthereareothersthatholdalternativeviews.SomebasetheirconceptionofillnessonthestoryofJobintheHebrewBible.Jobwasamanafictedwithleprosyandmuchmisfortunethroughnofaultofhisown. Onemoderntheologiandescribessinasprofoundestrangement.JamesB.Nelsonwrites,Itisrelationalbrokenness,separation
fromeverythingmeaningful.Itisalienationfromourselves,fromthosearoundus,andfromourenvironment.Itisseparationfromlifeitself.Fundamentally,itisestrangementfromGod,thesourceandgroundofallthatexists.Whenthefaithcommunitysfearsorpreconceptionsleadtotheexclusionordehumanizationofpeoplewithmentalhealthconditions,thenthiscanintensifya
personsexperienceofprofoundestrangement.Buddhiststeachthataboundarybetweenselfandothersisafalsedistinction,afalseconstructofthemind.TheBuddhistpracticeofmeditationcentersonraisingapersonsawarenessofhisownthoughtpatternofformingjudgmentsandseparatinghimselffromothers.Thefruitofmeditationistorealizethatindividualsmaybethoughtofaswaves,buttheyallpartofoneocean;that,infact,alllifeisinterconnected.
Illness and Religion
Whilemanyreligioustraditionsarmthatmentaldisordershaveabiologicalbasis,mostspeakofthehealthandhealingneededforindividualswhosuerfromsuchdisordersinadierentmanner.JewishandChristianscripturescontainnoexactwordforhealthalthoughtherearehealth-relatedconceptswithintheBiblelikeshalom.OnetheologiandescribesshalomasthewebbingtogetherofGod,humans,andallcreationinjustice,fulllment,anddelight....Wecallitpeacebutitmeansfarmorethanmerepeaceofmindoracease-rebetweenenemies.IntheBible,shalommeansuniversalourishing,whole-nessanddelightarichstateofaairsinwhichnaturalneedsaresatisedandnaturalgiftsfruitfullyemployed.xxixHealthasshalomspeakstothewholenessandourishingoftheentirecreation;itis
focusedonmorethantheindividual. Healing,fromareligiousviewpoint,representsatraditionsdeepesthopesandpromises....Itmaytaketheformofenlightenment,salvation,aplaceinHeaven,lifeinaWorldtoCome,Paradise,Nirvana,freedomfromcyclesofrebirth,immortality,sagehood,veneratedancestralstatus,remainingaliveinhu-manmemory.xxxTheseconceptsprovideindividualsandcommunitieswithanultimateframeofrefer-encewithinwhichtointerpretallotherexperiences,includingthemeaningofhealthinthislifetime.xxxiFromareligiousstandpoint,healingmayinvolvecuring,butitisconcernedmuchmorewiththeultimatemeaningandpurposeoflife. Religiousinterpretationsofillnessarediverse.Thereisparticularlywidevariabilityintheologi-calunderstandingsofmentalillnessbothwithinandbetweenreligioustraditions.Mentalillnessesareviewedasareectionofafallencreation,asaresultofindividualdisobedienceorcollectivesin,aspartofGodsdesign,astheresultofpossessionbyevilspirits,oraspartofthehumanconditionthateveryone
shares.Mentalillnessesareexperiencedasblessings,asameansofgrowth,ascurses,orasthecauseofimmensehumansuering.Attimesthroughouthistory,respectedrabbis,prophets,andtheologianshaveexhibitedbehaviorsmanywouldndsymptomaticofmentalillnesstoday. Peopleoffaithwrestlewithwhyandwhatforquestions.Theseareimportantanddicultquestions;howeveraskingwhowearecalledtobeandhowwearecalledtobeinrelationshipwithpeopleaectedbymentalillnessmayultimatelybemorevaluableandleadustowardgreatercommunityhealthandwholeness.
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Healing Relationship
Createdinandforrelationship,humanbeingsarenotmeanttobealone.ThebookofEcclesiastessays:Twoarebetterthanone,becausetheyhaveagoodrewardfortheirtoil.Foriftheyfall,onewilllifttheother;butwoetoonewhoisaloneandfallsanddoesnothaveanother
tohelp.Again,iftwolietogether,theykeepwarm;buthowcanonekeepwarmalone?(4:9-11).Peoplewithmentaldisorderscannotourishinisolation,alienatedfromothers.Theyneedcommunity,andthecommunityneedsthem.Buddhismdescribesfourkindsofgoodfriends:onewhohelps,onewhoisconstantingoodtimesandbad,onewhopointsoutwhatisgoodforyou,andonewhoissympathetic.ThereisaSikhsayingthatonlythosepersonsaremyfriendswhocanwalkalongwithme. Islamandmanyotherreligioustraditions
recognizethatthehealthofanindividualisrelatedtothehealthofthewholecommunity.InHinduthought,thewell-beingoftheindividualisconsideredfoundationalforthewell-beingofsociety.Karma,orthegoodorbademanationsresultingfromonesactions,iscollectiveaswellasindividual;anindividualsmanifestationofillnessmayreecttheenergiesofthegreatersociety.Jewishtraditionteachesthateachpersonissoimportant,thatsavingonepersonslifeislikesavinganentireworld.IntheNewTestament,theChristianapostle,Paulsays,Ifonemember[ofthe
church]suffers,allsuffertogetherwithit;ifonememberishonored,allrejoicetogetherwithit(1Cor.12:26).Similarly,theBuddhisttraditionsaysthatallpeoplesuffer,andallpeopleareatone.Iftheworldistoourish,thenallwhoareinitmustourish. Compassionandempathy,orlove,formthebasisforhealing,wholeness,andhumanourishinginmanyreligioustraditions.ThereisanIslamicsayingthatyoushallnotenterParadiseuntilyoubelieve;andyoushallnotbelieveuntilyouloveoneanother.BasedontheTorah,ChristiansteachthatGodsultimatecommandmentistolovetheLordyourGodwithallyourheart,
andwithallyoursoul,andwithallyourmind,and
toloveyourneighborasyourself(Matt.22:37-40). Jainismteaches:Havebenevolencetowardsalllivingbeings,joyatthesightofthevirtuous,compassionandsympathyfortheaficted,andtolerancetowardtheindolentandillbehaved.AnearlyChristianapostleinstructedmembersofhischurch:Donothingfromselshambitionorconceit,butinhumilityregardothersasbetterthanyourselves.Leteachofyoulooknottoyourowninterests,buttotheinterestsofothers(Phil.2:3-4).Thiskindofloveisfocusedon
boththeneedsandthevirtuespresentinothers.Itlooksforthebestinothers.Thiskindoflovecanonlytakeplacewhenpeoplespendtimetogetherandknowoneanother.Acommunitygroundedinmutuallovemakeshealingpossible.
What Can Congregations Do?
Faithcommunitiessometimesabdicatetheirroleinhealingtophysicians,psychiatrists,orotherhealthprofessionals.Mentalhealthprofessionalsofferaparticularkindofexpertise,focusingprimarilyonunderstandingandtreatingbiologicalandpsychologicaldisorders.Manynow
The Divine Presence dwells where there is love and peace generated
by friendship. --Rabbi Abraham Weinberg of Slonim
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Connecting the WholeCommunity
Congregationshaveauniqueroleinshapingtheentirecommunityinwhichtheyarelocated.Intherealmofmentalhealth,congregationsnotonlyhavetheopportunitytoeducateandestablishinclusionpracticeswithintheirreligiouscommunities;theyalsohavetheopportunitytobetterthementalhealthsystemasawhole. Faithleadersandcongregationscanbetterthesysteminamultitudeofways.Atthelocallevel,opportunitiesincludebecomingconnectedandworkingwithlocalmentalhealthcenters,participatinginlocalissue-forumsthatexploreboththechallengesandpositiveaspectsofthementalhealthsystem,partneringwithlocalhospitalstoprovideprogramsandsupportformentalhealthcommunitycenters,andjoininglocalboardsandfocusgroups. Alongsideconnectingwithmentalhealthprovidersandnetworks,congregationsandfaithleaderscanconnectwithhealthcaresystemdecision-makerslikelocalgovernmentofcials,stateagencyofcialsandlegislators.Whendiscussingissuesfacingthestate,faithleadersoftenprovideamuch-neededvoice,onewithexperienceandabackgroundthatisdifferentfromthatofthedecisionmakers.Whatfollowsisalistofsomeoftheprinciplesthat
canguidefaithcommunitiesintheareaofworkingwithindividualsandfamilieslivingwithmentalillness:
Learn.Faithleaderscanlearnaboutcommonmentaldisorders,symptoms,treatments,andstrategiestoworkwiththoseaffectedbythem.Theycanraiseawarenessaboutmentaldisordersthroughouttheircommunityduringtimesofprayer,worship,religiouseducation,orothercommunity-widegatheringsandthrough
recognizetheneedforspiritualcare,too.Religioustraditionshavesomethinguniquetocontributetothehealingprocess.Peopleoffaithareparticularlyequippedtohelpindividualsndmeaningandwholenessinthemidstoftheirillness. Religiousleaderscanhelpindividualsandfamiliesreframetheirexperienceinlightofthesacredwisdomofthetradition,encouraging
movementtowardpeace,forgiveness,andwholeness.Theycanhelpindividualsstrugglethroughtheprofoundspiritualquestionsthatmentaldisordersmayraise,theycanafrmthesacredworthofindividualswithmentaldisorders,andtheycanofferteachingsandprayerstohelppeoplemovetowardwholeness. Faithcommunitiescanprovidestoriesandmodelsthatgiveshapetopeoplessuffering.Forexample,thelamentsoftheHebrewBibleofferamodelforrelatingtoGodduringtimesofcrisisorgrief.ForChristians,JesusisGod-with-uswho
understandswhatitistosufferandbeabandonedbyGod.Faithcommunitiescanproviderituals,practice,prayerandmeditationthathelpprovidepeaceandstabilitytosomeonelivingwithamentaldisorder.Mostofall,congregationscanprovidefriendship,community,andacceptance. Therearesymptomsofmentaldisordersthatcan,attimes,bedisruptivetocommunitiesandwhilemostmentaldisordersdonotresultinviolentbehaviors,somedo.Itisappropriateforfaithcommunitiestosetboundariesaroundthekindsofbehaviorsthatareacceptableat
communitygatherings;however,behaviorsrelatedtomentaldisordersshouldnotbeusedasanexcusetoexcludeparticularindividuals.Faithcommunitiesareencouragedtomakeacommitmenttoremainopenandndcreativewaysofkeepingindividualswithmentaldisordersconnectedtothefaithcommunity.
There is no worship, no music, no love, if we take for granted the blessings
and defeats of living.
--Abraham Joshua Heschel
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An Interfaith Framework for Mental Health 13 January 2013
Navigating The System
Thetermmentalhealthcareisusedinvariouscontextstocoverawidevarietyofservices,rangingfromfamilycounselingtotheprescriptionofanti-psychoticdrugsforschizophrenia.Thesystemafragmented
networkofprograms,services,andpaymentsthroughwhichindividualsaccesscare.Thementalhealthcaresystemisseparatedfromphysicalhealthcareandsubstanceabusecaresystems.Thisseparationoftenmakesitdiculttoknowwhereandhowtogetassistance. Therearefourcategoriesofmentalhealthproviders:highlytrainedspecialistssuchaspsychiatrists,psychologists,andpsychiatricnurses;providerswithtrainingingeneralhealthcaresuchasfamily
practitioners,pediatricians,andnursepractitioners;socialserviceproviderssuchasschool-basedcounselorsandcriminaljusticeworkers;andinformalvolunteers,suchaspeercounselors,thatgenerallyhaveneitherformaltrainingnoralicensetotreatmentalorphysicalhealthservices.Manyreligious-orientedprovidersaresocialserviceworkersorvolunteers. Thementalhealthcaresystemisintertwinednotonlywiththephysicalhealthcaresystem,butalsothecriminaljustice,
educational,andhousingservicessystems.Asaresult,mentalhealthprofessionals,individualswithmentaldisorders,andtheirfamiliesoftenrefertothementalhealthcaresystemasaconfusingmaze. Therststepforanindividualaccessingmentalhealthservicesisoftenareferralforamentalhealthassessment.Familymembers,emergencyroomattendees,schoolcounselors,primarycarephysicians,socialworkers,andavarietyofotherprofessionalsinvaryingcapacitiesmake
referralsforassessments.Forexample,ifachildisexperiencingsymptoms,acounseloratschoolmightrecommendanassessmentbyaprofessionalatacommunityhealthcenterorbythechildspediatrician.Apersonenteringthecorrectionalsystemmayhaveamentalhealthassessmentaspartoftheintakeprocess. Initialassessmentsareconductedbyanarrayofprofessionalswhothendiscuss
andanalyzebeforedecidingontreatmentoptionsandproviders.Onceassessedanddiagnosedbyaprofessional,anindividualwithamentaldisorderisquicktodiscoverthathealthinsuranceisaneededresourceforreceivingcare. Healthinsurancecoverageformentalillnessisoftenlesscomprehensivethanforphysicalillness.
Thisdisparityincludescompletenon-coverage,highercopayments,andlowertreatmentlimitsformentaldisorders.Lowerincomeindividualsturntonancingoptions,slidingscalepayments,andMedicaidandMedicareformentalhealthservicesandcoverage. Hospitalsoftenareovercrowdedandlackopenbeds,causinglongwaitinglistsforservices.Hospitalssometimesreferindividualstocommunitycenters,viewedbymanyexpertstobeidealforthetreatmentofmentaldisorders.Unfortunately,notallcommunitieshavetheresourcestoprovidealocal
mentalhealthcarefacility,andiftheydo,thereisfrequentlyalackofqualied,culturallycompetentemployeestostathecenter. Severementaldisordersandlackofavailableserviceshaveledtoanincreaseinpubliccostsrelatedtocrimeandcriminaljustice,homelessness,anduncompensatedhealthcare.Statebudgetcutsformentalhealthprogramshaveincreasedcostsforlocalgovernments.Thecombinationofdeinstitutionalization,inadequatecommunitymentalhealthprograms,andlimitsimposedbyprivateinsuranceplanshaveincreasedthelikelihoodthat
individualswithmentaldisorderswillendupinthecriminaljusticesystemorexperiencehomelessness.oday,thecriminaljusticesystemisthedefactoprovideroflastresortforindividualswithuntreatedmentaldisorders.Thefederalgovernmentestimatesthispopulationtomakeupabout16percentofthejailandprisonpopulation. Correctionalfacilities,mentalhealthprofessionals,hospitals,localprovidersandlawmakersencounterthesamemazeoffrustrationsthatindividualswithamentaldisorderencounter.Statementalhealthprofessionalsnotonlyassist
withtreatmentoptions,butalsoconnectindividualstobasicneedssuchashousingorincomeassistance.Often,mentalhealthprofessionalsatthestatelevelmaintainlongworkinghoursandamultitudeofpatientsorclients.Hospitalchallengescenteronalackofresources,beds,sta,andnances.Legislatorsmustmakedicultdecisionsaboutmentalhealth,fromtheallocationofresources,topoliciesinthecriminaljusticesystem,tomandatesrelatedtohealthinsurance.s
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Wholeness, Not Perfection 14 Texas Interfaith Center for Public Policy
supportfamiliesofpeoplewithmentaldisordersandestablishwellnessprogramsandworshipservicesfocusedonhealing.Therearealotofresourcesavailabletohelpinthisendeavor.Theextenttowhichaparticularfaithcommunitycanofferdirectservicesorprogramswilldependontheirsizeandbudget.
Partner.Mentalhealthprofessionals,stateagencies,communityhealthcenters,andnonprotorganizationscanoffervaluableinsightsinidentifyingsymptomsandworkingwithpeoplewithmentaldisorders.Theyoftenactasreferralsourceswhensomeoneneedshelpbeyondwhatthefaithcommunitycanoffer.Somementalhealthorganizationsarefaith-basedandprovidespiritualcarethatisintegratedwithmentalhealthcare.
Advocate.Faithcommunitiescanadvocateforpoliciesandprogramsthatprovidebetteraccess
toservicesforuninsuredindividualswithmentaldisorders.TheycanadvocateforsystematicimprovementtothesystemofmentalhealthcareinTexasandthenation,improvingthelivesofpeoplewithmentaldisorders.
Inlearningaboutsomeonedifferentthanourselves,wecometounderstandmorewhatit
meanstobehuman.Inchoosinglanguagethatafrms,ratherthanseparates,wemovetowardwholeness.Inconnectingwiththecommunityandmentalhealthsystemasawhole,welearnhowtobestassistthoseinneed.Inshowingcompassiontosomeonelivingwithmentalillness,webringmorepeace,love,andjoyintotheworld.
s
congregationalcommunications.Theycanlearnaboutthementalhealthcaresysteminordertohelppeoplewithdisordersgetassistance.
Afrm.Bysharingtheirtheologicalunderstandingofthesacredworthofallpeople,religiousleaderscandiffusethestigmasurroundingmentaldisordersandhelpindividualsreframetheir
identity.Peopleoffaithcanadoptperson-rstlanguagethatdoesnotidentifyapersonsolelybytheirdisorder.Peoplearenotthesumtotaloftheirmentaldisorder;theyareGod-breathedcreaturesthatGodcallsverygood.
Befriend.Perhapsoneofthemostvaluablethingsthatpeopleoffaithcandoislistenandbeafriendtopeoplestrugglingwithmentaldisorders,ortotheirfamilymembers.Friendshipinvolvesmutualunderstanding,acceptanceandsharedenjoyment.Itlooksforandcallsoutwhatisgoodinanother.
Itrequireseffort,commitment,andopennesstodifferentwaysofexperiencingtheworld.
Support.Faithcommunitiescancreateprogramsto
A believer who participates in human life, exposing himself to its torments
and suffering is worth more than the one who distances himself from its
suffering.
--Islamic Hadith of Ibn Majah
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An Interfaith Framework for Mental Health 15 January 2013
SOURCES
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Justice FrameworksisapublicationseriesoftheTexasInterfaithCenterforPublicPolicy.BeeMoorhead,ExecutiveDirector.ThiseditionofJustice FrameworkswaswrittenbyEricaKniselyandAndreaEarl,andsupportedbytheHoggFoundationforMentalHealth(www.hogg.utexas.edu)andMethodistHealthcareMinistriesofSouthTexas,Inc.(www.mhm.org).TheopinionsexpressedinthisdocumentarethoseoftheInterfaithCenteranddonotnecessarilyreecttheviewsoftheHoggFoundationorMethodistHealthcareMinistries.SpecialthankstoTomFreeman,NelsonBurns,BarrySilverberg,BarbWatson,JackiePeck,andDr.PhilippaStrelitz.
The Texas Interfaith Center for Public Policy is a faith-based, 501(c)(3) non-prot organizationproviding theologically grounded public policy analysis to people of faith and other Texans. TheCenter is the research and education arm of Texas Impact, the states oldest and largest interfaith
legislative network. Texas Impact was established by Texas religious leaders in 1973 to be a voicein the Texas legislative process for the shared religious social concerns of Texas faith communities. Texas Impact is supportedby more than two dozen Christian, Jewish and Muslim denominational bodies, as well as hundreds of local congregations,ministerial alliances and interfaith networks, and thousands of people of faith throughout Texas.
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