Exiled by Madness

Recently, I’ve seen several articles or blogs about how the church (Christ’s Body) either does or does not minister to the mentally ill. I think at least one of these was in Christianity Today. These articles appeared to be focused on the clinically depressed—a subject about which I have written a book.

My book on how Christians can better cope with that condition was the result of me teaching a class at my church. I began writing “The Unwelcome Blessing” in 1999, and it was published in 2005. It looked at clinical depression from three perspectives: clinical, biblical and personal. One of the points I made at the time was that the depressed were not well served in the church. They were often either ignored or given cheap, inappropriate advice.

It seems like things have changed since then, though I don’t have any data to confirm that observation. It seems like, in general, attitudes in the church are more open to having the seriously depressed amongst us, and that clergy are ministering to them more and more. The depressed usually don’t create any problems. They are easy enough to like, if not to recognize. They usually just sit and suffer in silence. They only made a splash when like the Richard Cory of Edward Arlington Robinson’s poem they go home one night and inexplicably put a bullet in their head.

The people I worry about now are the mentally ill who are difficult, noisy and disruptive: paranoid schizophrenics, bipolars in the midst of mania, the autistic, borderline personality disorders and the actively psychotic in general. Some of these folks have “voices” telling them to do odd things; sometimes they think they are Jesus. They may believe that people are plotting against them, or perhaps that they are constantly being filmed, as though they are the star of their own reality show. They often do not suffer in silence. I know a few people like that and over the years have had clients who were shunned by churches because of their behavior. My mother was one of “those people’ but fortunately her psychotic breaks were brief. After a few weeks of hospitalization she would return to her normal sunny dispositioned self.

I’ve worked in the field of mental health for over 40 years. Things have changed a lot in terms of how our society deals with the persistently and seriously mentally ill. Way back in the 1960s and 70s we had state hospitals. Florida used to have four. They’ve closed several and I think now just have two. The one which serves our area NE Fla State Hospital at Macclenny used to have 3,000 residents. The last I heard they had about 300. There was a big move back in the 70s called “deinstitutionalization.” All of the seriously deranged folks who lived in state hospitals did not suddenly get well; they were instead farmed out to group homes in the community.

Some of the motivation for this movement was humanitarian, but mostly it was just more cost-effective. State hospitals were typically rather ugly, seriously understaffed environments, but for some folks they were home. They might seem to us like the proverbial snake pit, but for many it was their last home—a place from which they would not be extruded.

Today, jail is often the environment where the chronics end up. Living in poorly supervised group homes, and with little follow up by overworked case managers, they stop taking their meds and inevitably begin acting out in various ways. Eventually, they are arrested for a petty crime or vagrancy. In jail they have a roof over their head and three meals, but get little or no treatment, and they are eventually released back into the community and the revolving door of inadequate care. Some go back to living in the woods or sleeping on a park bench. I used to be part of a ministry to the homeless and it was apparent to me that well over half were either addicts or mentally ill.

The federal government is now pushing for changes in how the mentally handicapped are housed by enforcing a 1999 Supreme Court decision relating to the Americans with Disabilities Act. In short, what this means is that thousands of group home residents may be resettled in their own apartments. This may sound good, but unless funding is provided for very close wrap-around support services and case management it will prove disastrous.

At the megachurch I attend there has been a big push of late to hold services in local jails and prisons. They ask for volunteers to go into the jails and be available to the inmates while they watch the service on big screen TVs streaming over the internet. I gather this initiative has been successful in terms of numbers, and I imagine there’s some provisions made for follow-up discipling when they’re paroled. This is a good thing. Folks in jail are often ready to repent and reconsider how they’ve been living. Also, going into jails is a scriptural mandate. But still, I wonder if anyone serves the really estranged people who inhabit group homes or live in the woods. These people are often not easy to like and sometimes they’re scary, and I suppose because of that they’re easy to ignore. We can label them as “uncooperative” and often be pretty accurate. They can be loud and disruptive, and they often have strange beliefs in their theology. But they’re not contagious and they’re not even likely demon-possessed—some are, but most aren’t. Demons don’t cause mental illness, but they most certainly prey on it. The most vulnerable become their targets, and there is no one more vulnerable than someone who hears voices or has wild uncontrollable mood swings. But, like all God’s critters, they eventually respond to love. And so I wonder what Jesus would do today. I don’t think there were mental institutions in his day, but he did minister to a homeless demoniac who lived in a cemetery (Mark 5:1-20).

In all this mea culpa breast-beating about the church’s role in helping the mentally ill I think of the Canadian Roman Catholic priest Henri Nouwen, author of “The Wounded Healer” and other profoundly Christian books. He lived the last decade of his life in L’Arche Daybreak a colony for the severely physically and mentally handicapped founded by Jean Vanier. In the old days the residents of facilities like that were often labeled retarded or schizophrenic; now they’re more likely called autistic. Nouwen was a sad, restless man, who among other things, taught at Harvard, but he eventually found a home ministering to some who Jesus called the “least” of us (Matt. 25:40). We will surely be judged by how we treat the most helpless. What we have done to them, we do to Him.


About diospsytrek

I am a licensed mental health counselor in Florida. I am also the author of four books. The books have to do with coping with depression and other mood disorders, and the nexus of psychological problems and spiritual warfare.
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2 Responses to Exiled by Madness

  1. Jim Wright says:

    In our network of “simple” churches where I live, one has evolved specifically for folks with emotional and cognitive impairments. This didn’t happen by any grand plan. Rather, two brothers who share a townhouse quietly opened their home on Thursday evenings to those who were having a hard time relating, interacting and focusing in some of our other fellowships. For those guys, it has become a ministry of love.

    We also have several indigenous, participatory churches in the jail, but the dynamic there is very different.

  2. diospsytrek says:

    Jim, that’s very encouraging to hear. c

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