by Amy Simpson

“I met your mom on Sunday. My best friend’s mom smiled as she dried her hands on a kitchen towel.

“I’ve seen her in church, but I had no idea she was your mom. She always sits so quietly, with her hands folded in her lap. She seems very nice.”

I smiled politely in response, and she went back to her work in the kitchen. It took me only a couple of seconds to push back the wave of pain and panic that always hovered at the edge of my life and threatened to wash over me at moments like these. I was in the habit of keeping those feelings at bay.

Even though my best friend and I went to the same church, there was a reason I had never introduced our mothers. There was a reason I didn’t host get-togethers at my house, invite my parents to school events, or rely on my mom for the kind of support teenage girls need. I was ashamed and terribly afraid of the stigma.

My friend’s mom was right: My mom was, and is, very nice. She also has a serious illness that filled those teenage years with confusion, fear, and grief. Her schizophrenia lived with our family for years, before I was even born, like a quiet but unwanted houseguest. When I was 14, that guest suddenly staged a coup, and before we knew what had happened, we were living in schizophrenia’s house.

Mom was hospitalized multiple times through my high school years, and the decades since have brought a string of run-ins with the harsh effects of her disease: difficult and broken relationships, paranoia, public embarrassment, religious confusion, occult activities, homelessness, danger, arrest, conviction, and prison time.

Periods of stability and hope followed by another slow—or sometimes sudden—loss of the person we know and love. Battles with the shame and stigma that kept us quiet and isolated from each other for decades. Battles for the life and well-being of a woman we cherish, who still has a purpose and a place in this world.

I’m no longer ashamed of my mother’s illness and my family’s experience. I’m proud that we’ve come this far, amazed by God’s grace. And I’m astounded so many people are living right in the middle of stories very much like ours.

Ironically, when I was a teenager, I thought we were pretty much alone. I didn’t fully understand what was happening in my family, and I had never heard anyone else talk about similar experiences.

This is part of what kept me and the rest of my family silent, hiding behind the same smiles everyone else was wearing. We had no idea our own silence made us complicit in our sense of isolation. Because others were silent too, we had no idea how many families were like ours.

Understand the crisis

When the subject of mental illness comes up, many people think first of the most serious, disruptive disorders like schizophrenia, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and major depression. These are the types of illness that tend to be featured (usually inaccurately) in popular media, linked (again, inaccurately) with violence on the evening news, and associated with suicide.

But most people with mental illness do not die by suicide, hear hallucinatory voices, or commit acts of violence. Mental illness is a broad term for a variety of disorders in different categories, affecting thinking, feeling, behavior, mood, social interaction, and self-expression. Mental illness is not a fringe experience best kept in the closet or under the rug.

Every year, 25 percent of the U.S. adult population suffers from a diagnosable mental illness. That’s about equal to the total percentage of people diagnosed with cancer each year, those living with heart disease, people infected with HIV and AIDS, and those afflicted with diabetes—combined!

That equates to around 50 million people in the United States. And that’s only in a given year. Because many mental illnesses (like depressive episodes) are short-term and not chronic, an even higher percentage of people are affected by a mental illness at some point in their lives.

The statistics are staggering, but they don’t tell the whole story. Every case of mental illness represents a family affected in some way by that disease. Mental illness causes financial burdens and hardships. A person with active symptoms may be unable to work.

Psychiatric medications, hospital stays, and residential care can be enormously expensive—when they’re available. Our mental health care system is badly broken and hard to navigate, and it can be difficult to access care. Furthermore, as with other forms of health care, the burden of managing care and treatment is on the person with the illness, who may not be able to manage the condition (and who may not even acknowledge or understand it).

Family members often witness the disintegration of a loved one’s mental health, but lack the tools and legal right to intervene in any effective way. And if the loved one is old enough (age 12 in some states), the family also lacks access to medical diagnoses, records, and other information about treatment—unless permission is specifically granted in writing.

Doctors can be reluctant to diagnose disorders because of stigma and discrimination by insurance companies. Insurance companies pressure hospitals to shorten treatment. And short hospitalizations focused on stabilizing patients don’t always set them up for long-term success.

For many families with mental illness, police officers become mental health workers by default in crisis situations. Some lose their loved ones to homelessness, jail, or prison. Many sources report that about 40 percent of homeless people have some kind of mental health problem, and 20 to 25 percent have serious mental illness.

The Department of Justice estimates that more than half of local, state, and federal inmates have symptoms of serious mental illness—ranging from 45 percent at the federal level to 56 percent in state prisons and 64 percent at the local jail.

Many families affected by mental illness live with special “rules” (Don’t let Mom see that newspaper headline; Don’t upset your brother; Don’t talk about your feelings) designed to keep just one person happy or stable. For some, life is unstable, confusing, and full of worry, anxiety, and feelings of helplessness.

Some family members are plagued by guilt-producing questions (What did we do wrong?) and questions that can lead to a spiritual crisis (How could you let this happen, God?). Roles are reversed, families go through repeated cycles of grief and loss, and people feel the awful need to submit to shame and stay silent about their suffering.

Hope in the church

People who live with mental illness, whether their own or someone else’s, need to break the silence. They need to speak and be heard in the church and elsewhere. They need the church to break its own silence as well.

So many have allowed stigma and fear to prevent acknowledgment that mental illness exists within the walls of churches. The silence sends a clear message that God is not interested in their suffering, serious problems have no place in the church, and our faith has no answer for hardships like theirs.

Compounding this tragedy is what research shows: The church is the first place many people go when they’re looking for help with mental illness. Among people who have sought treatment, 25 percent have gone first to a member of the clergy. This is a higher percentage than those who have gone to psychiatrists, general medical doctors, or anyone else.

How should the church respond to this opportunity? Here are a few ideas:

• Acknowledge universal human brokenness. This is Christian doctrine at its most basic, but we sometimes forget to walk in the humility of the knowledge that we are all flawed and scarred and in need.

• Teach about suffering. Contradict the idea that we should expect an easy or pain-free life on this earth.

• Treat people like people. Make eye contact, smile, say hello, and refuse to succumb to irrational fear. (If someone truly is dangerous, call the police. That’s rational fear. But still recognize the very real and suffering person.)

• Offer friendship. We often think we’re not qualified to help, but everyone is qualified to do this.

• Do what you already do—provide meals and rides, visit them in the hospital, take care of their kids, help with expenses, ask how they’re feeling.

• Talk about mental illness. Mention it in sermons, classes, Bible studies, and public prayers.

• Refer to mental health professionals. Build a network of local professionals and make it widely available.

• Be the church. Recognize that professional mental health care is not a substitute for the social support, spiritual care, and loving community you can provide.

• Start a support group ministry. Check out Fresh Hope and Mental Health Grace Alliance for resources.

Ministry to people with mental illness and their families is not easy, quick, or fashionable. It may not even be rewarding. But it is right and fitting for people called to love as Jesus loves, to serve as “the pleasing aroma of Christ” in this world, and to represent His healing grace.

Amy Simpson (@aresimpson) is author of Troubled Minds: Mental Illness and the Church’s Mission and Anxious: Choosing Faith in a World of Worry. She also serves as editor of Gifted for Leadership, senior editor of Leadership Journal, a speaker, and a Co-Active personal and professional coach. You can find her at AmySimpsonOnline.com.

Sources

National Institute of Mental Health, “Statistics,” www.nimh.nih.gov

www.pbs.org/now/shows/526/homeless-facts.html.

Doris J. James and Lauren E. Glaze, “Bureau of Justice Statistics Special Report: Mental Health Problems of Prison and Jail Inmates” (Washington, DC: U.S. Department of Justice, Office of Justice Programs, 2006), www.nami.org

Health Research and Education Trust, “Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States” (2003)