Saturday, April 19, 2014

Can the church provide psychiatric care?

These churches are not trying to supplant traditional mental health care. “When someone asks, Should I take medication or pray?” one speaker remarked, “I say, ‘yes.’ ” But they think that there aren’t enough services available for people who are really sick, and they think that many people don’t turn to them anyway because of the stigma. ...

The public mental health system is a woefully underfunded crazy-quilt of uncoordinated agencies whose missions shift depending on who gives them money and for what. It can be hideously difficult to navigate even for someone who is not hearing hallucinated voices. Many people with serious mental illness use the public mental health system at best intermittently for psychiatric care. ... Many psychiatric clients hate the idea of being forcibly medicated.

But they do often go to church. More than 40 percent of Americans say that they attend church nearly every week. Even people who have nowhere to live often go to church. ...

In my formal sample of nearly 90 women, only one in four said that they liked psychiatric services. But fully half of them said that they had a church and that they went to that church at least twice each month, and over 80 percent of them said that God was their best friend — some, that he was their only friend. ...

[In] fact, Sangath, a program based in Goa, India, has demonstrated that it is indeed possible to train local community members to identify mental illness and deliver care. A study just published in the Lancet demonstrated that this community care even produced modestly better outcomes for patients with schizophrenia than care in the psychiatric facility. ...

Being in church automatically gives someone what the great sociologist Erving Goffman would have called an “unspoiled” identity. In the conference announcing the initiative, person after person said: “I am not defined by my mental illness. I am a person with mental illness, and I am defined by Christ.” In a world in which serious mental illness is like a punishing badge, that is a powerful shift. And the safer identity may make it easier for people to accept care.
--T. M. Luhrmann, NYT, on helping the sick among us