A special thanks to Jesse Zook Mann for support and guidance in preparing this work.
This afternoon I am offering a session on inclusive spiritual community and caring for our community members living with mental illness. I have served on the NAMI Washington Board of Directors for the past three years and have grown in my advocacy each year. And I have also grown in my compassion for those who are living with mental illness and their families. These are some of the most neglected and stigmatized people in our society. And we all have people in our lives with illnesses: mental and/or physical. And everyone, every one of them, deserves equal care and love. And care from the community. And opportunities to show care and share their wisdom with the community too.
This is the resource sheet! I will post a video of the session at a later date.
Healing in Inclusive Spiritual Community: A New Paradigm in Mental Illness Recovery
The Connection Between Loneliness and Mental Illness
Loneliness is defined as a distressing feeling that accompanies the perception that one's social needs are not being met by the quantity or especially the quality of one's social relationships.
61% of young adults are seriously lonely.
People who are lonely are at a 4x risk of death
People with serious mental illness experience higher rates of loneliness than the general population (approximately 2.3 times higher)
(research by Jesse Zook Mann)
Loneliness is an important public health issue (Groarke et al. 2020).
Loneliness refers to an unpleasant feeling that occurs when one losses the quality and quantity of social or intimate relationships (Peplau and Perlman 1982). Experience of loneliness during the current health crisis can be prevalent due to imposed COVID-19 social and physical restrictions. According to one study, the prevalence of loneliness in UK public was 27% during lockdown, with one in four (24%) reported they had feelings of loneliness in the “previous two weeks” (Groarke et al. 2020).
Greater level of loneliness has potential to stimulate the prevalence of mood disorders, suicide and self-harm, and increase pre-existing mental health illnesses (Holmes et al. 2020).
Researchers have highlighted the importance of identifying the predictors of loneliness in the face of adversity (Groarke et al. 2020).
Various risk and protective factors were identified which increase loneliness (Kızılgeçit 2015).
For example, in the study of Hoffart et al.’s (2020), rumination, health anxiety, and worry as well as being single and having a pre-existing psychiatric condition were significantly associated with more loneliness and loneliness was found to significantly positively predicted depression and anxiety over and above the all potential cofounders (e.g. age, gender, education level) and pre-existing psychiatric conditions.
Another study (Groarke et al. 2020) found that younger age groups, being divorced or separated, greater emotion regulation difficulties, poor quality sleep because of the COVID-19 pandemic, and those who are meeting clinical criteria for depression, are at greater risk of loneliness and social isolation, while higher levels of perceived social support, being married, and living with a greater number of adults serve as protective factors for loneliness in times of health crisis.
How Spiritual/Religious Community Can Partner in Healing
Congregations play a vital role in supporting positive mental and emotional health. One study estimates that as many as 40% of people in the U.S. approach clergy as the first point of contact when seeking guidancwith mental health issues. The way clergy handle these interactions will either reduce or increase the stigma associated with psychological well-being. It’s not enough to send vulnerable congregants home with an encouraging hug, a verse of Scripture and a prayer. If someone is courageous enough to seek out their minister when they are struggling or considering suicide, that’s a real cry for help.
Clergy Motivation and Occupational Well-being: Exploring a Quadripolar Model and Its Role in Predicting Burnout and Engagement Philip D. Parker & Andrew J. Martin
People heal in relationship to other people, and acceptance in a community where their presence is honored and where they can be honest about the mental health challenges they face is central to recovery and to living with their situation.
Meyers, Barbara F.; Meyers, Barbara F. . Held: Showing Up for Each Other's Mental Health (p. 27)
John Schumaker explains that religion can benefit mental health by
• offering order and structure in a sometimes chaotic world, reducing anxiety,
• offering hope, meaning, and purpose, and thus a sense of emotional well-being,
• providing reassurance, enabling one to withstand suffering and pain,
• offering afterlife beliefs, helping to solve the problem of mortality,
• offering moral guidelines for life to serve self and others,
• offering a social identity, acceptance, and belonging, and
• providing cathartic release through participation in ritual.
Meyers, Barbara F.; Meyers, Barbara F. . Held: Showing Up for Each Other's Mental Health (p. 30).
Mental illness is a spiritual problem as well as a medical and psychiatric one. People living with it can experience existential doubts about selfhood, truth, meaning, love, and agency with particular intensity. But even when their need for spiritual care is recognized, it is often left entirely to the minister and congregational leaders to provide it. It’s common for people to believe that only doctors and religious professionals can offer meaningful help to people with mental health problems, and that the best thing others can do is either to just treat them like everyone else or to ignore their difficulties. Indeed, while most people with mental health difficulties don’t act or talk in an unusual way, at times some do, and people who find their behaviors off-putting or even frightening may avoid engaging with them. But they and their loved ones need the surrounding, enfolding care of an entire community, not just the attention of a few designated leaders.
Meyers, Barbara F.; Meyers, Barbara F. . Held: Showing Up for Each Other's Mental Health (p. 15).
Kathleen McTigue, the director of the Unitarian Universalist College of Social Justice, explains, Despite their many variations, three essential threads weave through all spiritual practices: intention, attention, and repetition.
Intention is the deliberate engagement of our will, in a practice that nurtures a sense of connection to something bigger than ourselves. Attention means we exist only in the present moment: We practice quieting the incessant chatter of our minds in order to receive one moment at a time with openness, curiosity, and a willingness to be with what is. Repetition allows our centering activity to form part of the rhythm of our day, and … helps us hone qualities like awareness, patience, and compassion.
Meyers, Barbara F.; Meyers, Barbara F. . Held: Showing Up for Each Other's Mental Health (pp. 31-32).
Loving and nurturing communication guidelines
SOME PEOPLE find it difficult to speak with someone who has a mental health problem. Sometimes we can understand them, and sometimes not. They may have a perspective that we don’t agree with. Rather than arguing with them, we can assume that they have their reasons for what they are doing.
Listen to the person and remember that their feelings are real, even if they are not based on reality.
Doing so helps preserve interpersonal, family, and congregational harmony.
Here are some guidelines for communication with people whose mental disorders may make speaking with them difficult, adapted from advice offered by the National Alliance on Mental Illness.
Not all people with mental disorders will have these problems, but when they do, these guidelines will help you connect with them.
WHEN A MENTALLY Ill HUMAN
has trouble with “reality”
be simple and truthful
is fearful
stay calm
is insecure
be accepting
has trouble concentrating
be brief, repeat yourself, clarify what you are hearing
is overstimulated
limit input, not force discussion
is easily agitated
recognize their agitation, allow them to take a break for a while if they need to
has poor judgment
not expect rational discussion
is preoccupied
get their attention first
is withdrawn
initiate relevant conversation
has little empathy for you
recognize this as a symptom
believes delusions
empathize without arguing
has low self-esteem and little motivation
stay positive
is in crisis
speaking loudly and fast match the person’s speaking volume and rate, then slowly reduce your own. This will encourage the other person to do the same.
Make positive requests in a direct, pleasant, and honest way
Express negative feelings in an effective, non-threatening way
1. Look at the person.
2. Say exactly what you would like the person to do.
3. Say how their doing it would make you feel. Example: “I would like you to dry the dishes. That would help me and brighten my day.”
Use praise and warm encouragement to cheer on any progress, no matter how small, while ignoring flaws.
Be specific. These can be in the form of attention, physical affection, expressions of interest, or commendation.
Avoid negative and disheartening remarks.
Research shows that people are at greater risk of relapse when they often hear
• blaming,
• threats,
• highly emotional responses,
• negative stereotypes,
• denigrations of their character,
• minimization of their distress,
• advice to “buck up,” OR
• too many demands on them or arbitrary limits on their behaviors.
These communication guidelines are not something you will resort to just once. People with mental disorders need connection and encouragement all the time, and sometimes they need to be reminded that you love and care for them over and over again. Even when they fail. Especially when they fail.
Meyers, Barbara F. . Held: Showing Up for Each Other's Mental Health (pp. 91-93).
Tips for religious leaders and communities
The Unitarian Universalist Mental Health Network (uumentalhealth.org) offers a Caring Congregation Program (uumentalhealth.org/education/the-caring-congregation-curriculum) that includes nine steps for setting up a mental health ministry, first outlined by Gunnar Christiansen. Here is a modified version of these steps, which should be done in order:
1. Gain support from the minister and lay leadership. It is important that the people in power in the congregation agree that this work is important and should be carried out.
2. Make sure that your congregation has adequate guidelines for appropriate behavior: a covenant of right relations and a disruptive behavior policy. (These are discussed later in this chapter.)
3. Give worship services that focus on mental health.
4. Offer classes and educational programs on mental health. Rev. Susan Gregg-Schroeder’s guide Mental Illness and Families of Faith: How Congregations Can Respond is one possibility. There are numerous other print and media resources on the Mental Health Ministries website (www.mentalhealthministries.net).
5. Ensure that the religious education program provides support for children with mental health problems themselves and for those whose parents or siblings have mental health problems. Congregations must commit to serving all children, weaving them into the fabric of the congregation. The best resource on this topic is Sally Patton’s Welcoming Children with Special Needs (Boston: Unitarian Universalist Association, 2004).
6. Provide support groups for people with mental health problems and their families, or refer them to groups elsewhere. Support groups can be located through local affiliates of the National Alliance on Mental Illness (NAMI) and other mental health organizations and through municipal, state, and community organizations.
7. Create a referral list of therapists, support groups, and community programs, and keep this list up-to-date. The easiest way to compile this list is to ask parishioners about therapists, psychiatrists, and other mental health professionals who have been helpful to them and whom they would be comfortable referring others to.
8. Encourage the congregation to establish a companioning program to care for people who may be struggling in worship services. (These programs are discussed later in this chapter.)
9. Advocate for providing pastoral care, spiritual support, and hospital visits for people with mental health problems who want such attention. This will require the pastoral care team to be educated about mental health; resources for this can be found in appendix C.
Meyers, Barbara F. . Held
