Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.
Reaching the Mentally Ill Millions
By Melissa Steffan
May 16, 2014
A version of this article originally appeared on SharedJustice.org, an online journal of the Center for Public Justice dedicated to engaging young Christian thinkers in a conversation on what it means to do public justice.
More than sixty million people suffer from some kind of mental illness, from mild depression to debilitating neuroses that, left untreated, manifest in dangerous ways. Fortunately, modern treatments for many mental conditions are as effective as antibiotics or vaccines are for physical conditions. Yet nearly two-thirds of people don’t seek mental health care, even when they desperately need it.
Our society has not acknowledged mental illness as a policy priority, leaving us with no comprehensive system of mental health services. Instead of recognizing mental illness as a policy matter in and of itself, policymakers prefer to address corollary issues, evidenced most recently by the rhetoric that emerged in the wake of mass shootings. Gun control reform erupted as a huge policy issue, but mental health policy received comparatively little attention. The World Health Organization has been calling for reform in this arena for nearly twenty years, noting even in 1996 that “everyone in need should have access to basic mental health care” that is not only affordable and equitable, but also preserves “the dignity of the patient.” Such language implies a call for justice, for both legislation and services that combat the stigma of being mentally ill.
The government attempted to combat that stigma when it de-institutionalized mental health care and moved to a community-based care model in the mid-twentieth century. “Unfortunately, local communities largely failed to provide the services necessary for all the people sent their way,” says author Amy Simpson, whose mother has schizophrenia. “At the same time, stringent privacy laws, strict standards for committing a loved one to care, and insurance limitations have left many families in way over their heads, trying to care for people who desperately need professional help or residential care and won't seek it on their own.” Further complicating the matter is that most private insurance companies still fail to offer adequate coverage for mental illness—not at all comparable to the coverage available for physical illnesses. All of this results in a system where “jails and prisons become our default care centers (for extreme cases of mental illness),” Simpson states. “Sadly, commission of a crime is the only way for some people to get the care they need.”
But simply offering greater access to those clinical services is not enough; almost two in three adults who suffer from mental illness do not seek help, or even know when it is available, in earlier stages of illness. Unlike physical ailments, mental illnesses come with a huge degree of shame, the burden of which might be greater than the burden of the illness itself in some cases. Unfortunately, this shame is especially prevalent in the church. Even the most well-meaning Christians can inadvertently minimize mental illness by attributing it only to fallen human nature, treating it as if it were just a spiritual problem that can be alleviated through greater faith or more diligent prayer.
In doing so, the church fails to see mental illness as a marginalizing factor that violates one’s inherent dignity. Extreme cases of mental illness violate dignity in visible ways, manifesting alongside other societal ills—including homelessness, poverty, broken families, crime, among others—or occurring as a result of them. It should come as no surprise that the list of conditions associated with mental illness encompasses many of the marginalized groups, such as the homeless and underprivileged youth, to whom Christians minister.
But part of our calling as Christians is to advocate care for the mentally ill because millions who suffer from mental illnesses may never fall into these other categories. We must acknowledge the mentally ill as their own population and do more than simply pray for individuals’ mental disorders to be resolved. We must advocate better care for the mentally ill with policies that provide adequate support and accommodation for mental illnesses across the spectrum, as well as support for families whose mentally ill members refuse treatment.
Moreover, a comprehensive system of mental health services would require many institutions working together to provide funding and access to treatments, ranging from medicine to counseling. Local churches can lead the way among those institutions, not only by advocating increased funding but also by providing low- and no-cost access to counseling as a ministry, either through licensed members of the congregation or through partnerships with local Christian counselors who volunteer their time and services. Esperanza Health Center in Philadelphia, Pa. for example, provides holistic care, including psychological services, regardless of individuals’ abilities to pay. Across the country in California, Rick Warren’s Saddleback Church offers emotional health resources for congregants who struggle. A third option for a counseling ministry would be to offer mentorships with other Christians who may not be licensed professionals but who have faced—and overcome—similar struggles.
Even though the most extreme cases are those in which we see the external symptoms, millions of Americans exhibit less visible signs of their internal struggles. The majority of those who suffer from mental illness battle for their dignity not against society, but against themselves. Mental illness makes you believe that you are unworthy of love—and if you’re not worthy of love, you certainly don’t deserve help. And with forty million Americans who never seek help for their mental illness, that’s one of the most dangerous lies in society today.
- Melissa Steffan is the assistant editor for 1776 in Washington, D.C. She previously interned at the Washington Post and the Center for Public Justice, and was the 2012-13 Editorial Resident for Christianity Today magazine.
“To respond to the author of this Commentary please email: firstname.lastname@example.org
Capital Commentary is a weekly current-affairs publication of the Center for Public Justice. Published since 1996, it is written to encourage the pursuit of justice. Commentaries do not necessarily represent an official position of the Center for Public Justice but are intended to help advance discussion. Articles, with attribution, may be republished according to our publishing guidelines.”