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The growing need for mental health ministries


Breaking the stigma now

By Rich Copley | Presbyterians Today

Since 1949, May has been known as “Mental Health Awareness Month.” As Presbyterians work to break the stigma in congregations, the simple act of wearing a lime green ribbon — the international symbol for mental health awareness — can be a start to getting much-needed conversations going. Encourage church members to wear a green ribbon to show others they care about their mental well-being. Getty Images

The Rev. Tami Seidel noticed something when people shared prayer requests at First Presbyterian Church of Yorktown, New York. “People get engaged with the joys and concerns during our worship service and have no problem telling us about their loved ones’ physical ailments and diseases,” said Seidel. “Yet very few people would get up and say, ‘Someone I care about is struggling with depression.’ ”

First Presbyterian Yorktown is not unique. In Decatur, Georgia, the Rev. Amantha Barbee of Oakhurst Presbyterian Church noticed a reticence to discuss mental health struggles in her congregation, though she noted, “It’s no different if you fall and break your arm. You’re going to go get a cast. And our mind is part of our body. There’s nothing wrong with reaching out for help there, too.”

First Presbyterian Church Yorktown and Oakhurst Presbyterian are two of numerous churches across the country that have been working recently to address the mental health of people in their congregations and help people find resources to achieve better mental health. It is an effort that has been recognized at the national level of the Presbyterian Church (U.S.A.), which at the 2018 General Assembly called for the updating of the church’s policy on mental health called “Comfort My People” and designated funds for mental health resources, including establishing a staff position and grant program, and supporting the development of a grassroots Presbyterian Mental Health Network.

Last year, the early stages of many of these efforts ran right into some of the most pervasive mental health challenges of modern times: the COVID-19 pandemic and a national reckoning with systemic racism. The situation created a variety of stressors for all people. There were older church members dealing with isolation and fear of the deadly virus; people experiencing the economic fallout, including job loss and hunger; and parents overwhelmed with virtual schooling demands — and internet glitches — while working from home in sometimes cramped quarters.

And then there were ministers (and laity without settled pastors) overwhelmed with holding churches and their own lives together amid the often polarizing stresses of the pandemic, fielding questions such as “When can we worship together?” “When can we sing?” and “Don’t all lives matter?” On top of all this, the the heaviness of staggering losses, without a venue to grieve together, was added.

“You get these layers of disaster, loss and trauma within this bigger crisis, and I think many of our institutions haven’t functioned the way that we might have predicted or expected, such as the health care  system and its capacity to develop testing and vaccinate equitably and efficiently,” said Donna Miller, coordinator of the Presbyterian Mental Health Ministry. “This has been a huge wake-up call for people, and depending on where we’re located socially, culturally, politically and geographically, it is a very different experience.”

“It’s a hard time mentally and emotionally for everybody, and the COVID-19 pandemic is on top of everything that was already there,” said the Rev. Dr. Barbara Wilson, director of Collaboration and Community Partnerships for the Presbytery of Chicago.

Wilson has been working to launch three training programs in the Chicago Presbytery around companionship, mental health first aid and building self-healing communities. It is one of several programs that have been funded in part by grants from the Presbyterian Mental Health Ministry.

“I went out to events where people from the community were coming who are living with mental health challenges, and the need to access quality resources just became more and more evident,” she said.

Time to speak up

Co-pastors the Revs. Tami Seidel and Chip Low of First Presbyterian Church of Yorktown, New York, missed their congregants during the height of the pandemic, filling the pews with their pictures. The pandemic’s isolation is just one of the many reasons the church is pursuing a mental health ministry. Courtesy of First Presbyterian Church of Yorktown

Mental health efforts around the country have roots in numerous causes and have taken many forms. Some churches were hit with the trauma of suicide in their memberships and questions about what the community could have done differently. Others were the result of more sustained challenges and the growing awareness that, even before the pandemic, mental health problems were much more numerous than people were willing to speak about. According to the National Institute of Mental Health, in 2019, nearly one in five U.S. adults lived with a mental illness.

To Seidel, one of the most important things was speaking about it. At a service marking the launch of a companionship program, she quoted Fred Rogers, the Presbyterian minister and longtime PBS children’s show host, who said: “If it is mentionable, it is manageable.”

The Rev. Chip Low, who co-pastors with Seidel, said, “We began to see how Mr. Rogers and his emphasis on neighbors gave us some language to really take people as they are and not assume that everybody’s in the same place on mental health. And then people need to know that there’s a space where they can feel OK to talk about it. That line really spoke to us about mental health, especially.”

According to the church’s website, the companionship program is rooted in the idea that “companionship is a way that is open to us all and a foundation for an authentic life together. It is equally as important as a supportive response to those suffering with mental health challenges.”

First Presbyterian Yorktown has put together a mental health team that has been working with Pathways to Promise, a nonprofit organization with a mission to help congregations build a mental health ministry. Together they have developed five practices to walk alongside those facing mental health concerns. They are:

  • Hospitality — Helping people across the threshold by offering a safe place that honors each person as worthy.
  • Neighboring — Beginning a discussion of common interests where a relationship built on dignity and respect can evolve.
  • Sharing the journey side by side — Developing an understanding of each other.
  • Listening — Hearing the spirit through a language that embraces faith, hope and love.
  • Accompaniment — Connecting with appropriate resources.

First Presbyterian Yorktown has a membership willing to take on the project, which includes an extensive survey they have launched in their church and offered to other churches in Hudson Valley Presbytery to “get a sense of the benchmark of how people feel and how many people in the congregation would really want to participate in the companionship training,” said church member Sue Caruso, co-chair of its mental health initiative.

Pastoral pressures mount

Low recalls that as the pandemic took hold, members with the mental health initiative told him and Seidel, “We’ve got this, and we’ll loop you in as we need pastoral leadership,” recognizing the strain the pandemic has put on pastors. “We’re not handling it well at all,” said Barbee, referring to the toll the pandemic has put on pastors. “Church is 80% different than it was a year ago.”

From virtual services to the loss of volunteers because they are in vulnerable populations, to leading people through grief and pain and handling the impact of the pandemic on their own lives, including virtual funerals, the pandemic has upended how pastors were trained to work, particularly the “ministry of presence” that is so vital.

“People know someone is sick and ask how they are, and you can’t tell them because you can’t go sit with them in the hospital,” said Barbee.

The Rev. Dan Milford, moderator of the Presbyterian Health Network and pastor at Covenant Presbyterian Church in San Antonio, talks about the need for mental health awareness. Courtesy of the Presbyterian Mental Health Network

The Rev. Dan Milford, moderator of the Presbyterian Mental Health Network and pastor at Covenant Presbyterian Church in San Antonio, says he has heard numerous variations on the sentiment: “I can’t believe I skipped the course in seminary on how to be a pastor during a pandemic.”

Jinah Yoon, a therapist in Seattle and membership chair of the Presbyterian Mental Health Network, said, “We want to somehow split ourselves up between those who need help, and those who are the helpers. And when you split it up like that, pastors get stuck because they are the ones who are supposed to be the helpers. But then when do they get to cry out for help and not feel any shame about it?”

As the pandemic wore on, pastors had to deal with additional tensions, such as conflicts over if and when churches should reopen and the racial justice issues that took center stage last summer. For some congregations, racial justice is a regular part of their ministries, while other pastors experienced pushback from members when they spoke about systemic racism and white supremacy. Also in a pandemic, most conversations were not as easy as taking someone aside after the service to discuss what they might have disagreed with or been offended by. A breakdown in communication has also led to added stress. “When someone says, ‘We’ve got to talk,’ there’s already a certain amount of tension there,” Milford said.

New concerns will arise

Tensions will not end when COVID-19 wanes, restrictions are lifted and the doors of churches reopen. Most people involved with mental health ministry believe that will bring new concerns. “I think that we’re going to go through another mental shock, if you will, because it’s not going to be normal,” said Barbee.

She cites a variety of factors from the reticence of many people to have contact, like hugging after the pandemic, to many people not wanting to come back to Sunday morning worship regularly, either because they don’t want to be in a room with several hundred people or they have found they enjoy the time-shifting convenience of video ministry.

“I can go to that soccer game at 11 a.m. and watch worship later,” said Barbee. “What we’re going to have to do is regroup and look at purpose-driven ministry, where they will come out if there is something to do. We’re looking at a digital age where people will come if there’s something to do or a project to work on.”

Outside the dynamics of church, there will be the lingering impact of the pandemic on mental health that churches need to prepare to address. “That’s what happens when there’s a national crisis like this, like 9 /11, where people come in with PTSD, depression, anxiety and suicidality years after, because that’s when it hits,” said Yoon. “It’s not during the crisis; it’s after it’s over. It’s during the aftermath when all the symptoms rise up. As hospitals and emergency rooms were triaging patients in 2020, therapists are now getting prepared to do some triage as well. Every [therapist] colleague I know is full right now, and it’s not going to let up until the next five years or more.”

Eric Kreuter, co-chair of First Presbyterian Yorktown’s mental health program, said they are concerned about an overloaded system. “Therein lies the problem: If we’re able to help people identify a need, and somebody says, ‘You know what, I’m admitting I have a problem. And you’re right, I need to get help,’ and then there’s no help — that actually could be very crushing,” said Kreuter. “That would be like somebody calling a suicide hotline and getting a busy signal.”

Pastors are not therapists

As the mental health conversation grows in churches, congregations need to remember that a mental health ministry is not a substitute for professional care.

“Pastors need to be crystal clear: We are not therapists,” said Barbee. “Please do not make your pastor your therapist. It is my job to know enough to know what counselor to get them to.”

The work of churches is an important component of addressing mental health. Most people involved with programs say it was prescient that churches were getting involved before the pandemic hit, and it will be even more important they are involved afterward.

Yoon says going forward it is particularly important that mental health programs remember to center the voices of people who are impacted and others in marginalized communities, particularly considering that, like health care in general, economic disparities are an important factor in the ability of people to get mental health care.

“It may be that mental health ministry is becoming no longer a specialty,” Wilson said, “but integral and foundational to the ministry of Presbyterians, which by that I mean the ministry of congregations. How can a presbytery come alongside congregations and reduce the stigma around mental health?”

Rich Copley is the communications strategist for the Compassion, Peace & Justice ministries of the Presbyterian Mission Agency.

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