MENTAL HEALTH THE CHURCH AND SOCIETY,  GLOBAL AND NATIONAL MENTAL HEALTH TRAJECTORY!   

BY LEMUEL BAKER, PHD

If you are a leader or professional at any level or discipline the information below is of time sensitive importance to you.

Mental Health and the Church

Every time we come together in a House of Worship, this time set aside for the purpose of worship and hearing the messages within scripture, is most important. It is a time of interventions whereby many mental health disorders are dealt with by the word of God and by the Spirit of God. Many individuals would go over the edge if the Church would not intervene by its psycho-spiritual functions provided by the teaching of the scriptures and the messages within scriptures. The weekly Church services are preventative, proactive and restorative in their implementation. The Church is integral to society and if this institution is removed there would be an immediate decay of every aspect of society.

We attempt to abolish the institution of the Church or to make the institution irrelevant to the fabric of society because we lack understanding of its function as a vehicle used to intervene in the lives of desperate individuals. If we understood the Church and its function we would see the vast number of suicides, murders, abuses, thefts and all manner of deviant behaviors prevented just by a Sunday morning service by the preaching of the scriptures. Each time a Church meets this is a sacred time of psychological and spiritual intervention. The Church is the glue that holds society together. Mental Health regarding parishioners can be mitigated through several models already being used by many local Churches.

For example your Sunday night Testimony time where parishioners share their feelings both hurts and triumphs, your special Prayer time at the end of each service where a leader has the opportunity to connect with a parishioner one-on-one for that moment, home visitation where we can build strong bonds, form community and pray specifically regarding confidential situations, men's and women's gatherings, specialized cell groups, personal prophecy lead by the Holy Spirit that edifies, and most importantly the ministry of the preventive-therapeutic word of God that prevents disasters and heals from the trauma of disasters. Interestingly, your greeting program is also a part of mitigating mental health as greeters provide genuine warmth to parishioners some who may be on the verge of mental, emotional, spiritual, financial breakdown. Each of these eight models if already in place should be augmented, elevated among the many Church objectives and fueled by fervent prayer sometime during each session or event always given priority by the senior leadership.

Mental Health and the Church may seem counter-intuitive because why should any group dedicated to worshiping God be concerned with mental health? The reasons both society and religious institutions hesitate to discuss and to mitigate mental health issues are the stigma, the shame and the embarrassment associated with the topic and pathology. As a result mental health has become a standing crisis surpassing major physical diseases certainly in years to come. According to the World Health Organization (WHO), a specialized agency of the United Nations that coordinates international public health, depression is the leading contributor to the global burden of disease. More importantly according to the W.H.O depression was projected to reach second place ranking in their top 10 list of global burden of diseases by the year 2020 and reach the number one global disease burden by 2030.

Currently 5 of the entries on the top 20 list of global burden of diseases are mental health diseases. The W.H.O has identified depression, psychosis, somatoform and self harm as 4 categories seen globally that require mitigation. A key contributor to bad mental health is "factional fighting" countries such as Israel, Nigeria and South Africa who experience prolonged fighting. As the US increases inter-party fighting, aggression due to opposing ideologies, partisan fighting in the form of violence, mental health disorders will increase adding to the already upward trajectory of mental health disorders. Other major contributors to bad mental health are unemployment, poverty, any economic down-turn, lack of education, and homelessness.
 

The legalization of cannabis is an additional force that may plummet even more people into depression. This point of view is heavily challenged and must be carefully researched. The British Medical Journal 2002, The American Journal of Psychiatry 2001, Australian and UK studies show a direct link between cannabis and mental health disorders specifically depression, anxiety disorders, schizophrenia, mood disorders, psychosis in the form of delusions and hallucinations. These particular research studies that focused on long-term affects of cannabis across all generational cohorts concludes cannabis has a negative impact on mental and physiological health, and causes mental health disorders instead of being a result of mental health disorders due to the high levels of the predominant cannabis chemical THC.

A more recent study lead by Perelman School of Medicine at the University of Pennsylvania and published by the Journal of the American Medical Association JAMA in 2018 looked at the affects of cannabis among young adults and adolescents and reported heavy users scored lower than non users in cognitive domains especially when learning new information, speed of processing, delayed memory, inhibition and attention. This research also reported the negative effects associated with heavy cannabis usage among adolescents were no longer apparent after 72 hours. So there is hope to recover from the negative effects of cannabis but there still remains long-term residual and withdrawal effects associated with mental health and personality disorders even more so while cannabis is still in our system.

Globally especially in countries with low GDPs there is a large gap between the demand for mental health services and the adequate supply of those services. Poor countries especially and welfare communities do not have access to adequate mental health resources because of the lack of trained psychologists and psychiatrists in their communities and lack of money. In many developing countries there are institutionalized barriers and ethnic exclusion. Poor communities as well as developing countries may have the resources of a social worker who deliver a level of treatment but not the high level treatment a licensed psychologist or psychiatrist can deliver thus many mental illnesses go undiagnosed or not diagnosed properly.

Depression, obsessive compulsive behavior and anxiety disorders that are detected as early as ages 7 - 11 in children lasting through adulthood have been overlooked on the world stage and even more denied by the Church as valid diseases we must combat and apply remedies to as we do regarding any other disease. 1% -3 0 % of the life span of many people depending on the pathology is eroded by some type of disability to varying degrees measured by calculating a persons healthy life years (HLY), disability adjusted life years (DALY) and their disability free life expectancy (DFLE) against their general life span of 120 years some say 70 years. Humans are expected to live 120 years but many do not enjoy the high quality of life without some form of disability.

The Christian Bible addresses the pervasive personality disorder of narcissism which is by definition a grandiose  view of one's own talents or an inordinate inflated view of one's self. Romans 12:3 records "For by the grace given me I say to every one of you: Do not think of yourself more highly than you ought, but rather think of yourself with sober judgment, in accordance with the faith God has distributed to each of you." Narcissism although characteristic in children becomes a personality disorder when pervasive in adults. After the fall of man, our personalities fell or decayed and the Apostle Paul understood this warning against one of the most pervasive personality disorders called narcissism. Romans 12:3 helps us to identify the problem so we can avoid it or seek intervention and treatment if overwhelmed by it. Narcissism will destroy every relationship and ultimately our own lives leaving us without friends.

Instead many lose years on their quality of life due to mental, physical, spiritual diseases to include early death by diseases or suicide. A recent United Nations initiative global survey showed an aggregate 65 million lost years among the 85 thousand respondents surveyed due to some form of disability. Clinically as well as Biblically the goal is to achieve long life expectancy, healthy life years meaning a high quality of life, disability free life expectancy and very low disability adjusted life years where we are robbed by years of a disability that lowers our quality of life or even cuts our life short.
 

Christian leaders, Pastors as well as Political leaders should be aware that those who are part of their ministries and constituency who struggle with long-term mental illnesses have shorter life spans than the general population, with men 14 years shorter and women 9 years shorter. Varying research shows the difference in life span to be higher and some lower but all agree the life span for the mentally ill is shortened.

The reasons for the shorter life spans is to a lesser extent people with mental illnesses engage in more risky behaviors that lead to accidents and also take their own lives. The greater cause of early death to those with mental health illnesses is physical illnesses and medical complications such as strokes, diabetes, heart disease, pneumonia, COPD, flu, liver disease, cancer, infections, poor weight management, over all poor life management, lack of annual health care, their complaints not taken seriously and follow-up not done, poor nutrition, physical inactivity, sugar levels and blood pressure not monitored until in crisis, anti-psychotic medications contra-indications causing weight gain and the grand daddy of them all poverty. The daily grind of poverty and mental health disorders shortens lives, decreases life expectancy. The poverty life expectancy gap between the top 10% richest and the very poor is 11 years for men and 10 years for women. Treat poverty as urgent and arrange quick interventions.

Georgetown University, Harris School of Public Policy Studies, University of Chicago, Chicago Institute for Policy Research, Northwestern University and the OECD Organization for Economic Cooperation and Development continue to lead the studies concerning poverty, economic development and life expectancy.
 

All Pastors and Political leaders need to know this and must make this a priority to get people out of poverty. Pastors need to know that approximately 20% of early deaths of the mentally ill is due to suicide while approximately 80% of early deaths are due to medical issues that are a result of mental illnesses and poverty. Pastors while praying for your congregation who show signs of mental illness as the trajectory continues this population in the Church require additional attention by competent, loving, kind, leaders who can handle confidentiality, to ensure proper life management which will help prevent early deaths.

A soft strategy such as forming genuine friendships called friendships with a purpose consisting of weekly phone calls as well as weekly meals together are critical to keep with an alternate person who can step in if needed. Friendships with a purpose require set objectives to meet during your visit and goes beyond sharing a good meal and good conversation. Some data gathering is required such as updated checklist regarding nutrition, weekly physical activity, general appearance of dwelling, noticeable weight gain, medications, complaints, positive feelings, countenance, mood, physical appearance, pattern of walk or gait and overall mental attitude. Data gathering should only be done after you return home because the visit should be one of genuine friendship that brings healing and that the person looks forward to each week. A Pastor must quantify data.

If we as Christian leaders do not analyze for example why individuals die in our local Church in addition to calculating how many funerals we did this year we will never find out what we could have done to assist the individual extend their life span as well as to extend their quality of life.

According to data submitted by the W.H.O depression is common and affects 14% of the world's population, 121 million people and just under one million people commit suicide each year. Some are ashamed and many deny it. Depression is also the cause of disability worldwide. The W.H.O characterizes depression as a mental disorder having symptoms that include sadness, loss of interest and pleasure, feelings of guilt, low self worth, low energy and poor concentration. In chronic cases depression may lead to suicidal ideations or ultimately suicide. The response should be to seek help just as we do for any organic illness. Even more prudently individuals should take preventive measures as well.

Based on the trajectory of mental illnesses leaders of every discipline at every level of responsibility, both religious and secular must understand and possess a working knowledge of mental health, must have general awareness of the issue and be able to manage mental health in their organizations, departments and teams in the appropriate manner even by seeking advise from professionals and doing referrals. Leaders are now behind the eight-ball and currently do not have a choice regarding mental health because the pathology is already upon us in our work places, houses of worship and in every institution both private and governmental to include government entities, federal, legislative, judicial, state, local municipalities and law enforcement.

Mental health disorders will impact every aspect of society as certain as the four seasons arrive each year thus prudence dictates we become ready to mitigate the issue with full dignity, compassion and competence. The United States will have to look at amending the Health Insurance Portability & Accountability Act (HIPAA) only specific to the mental health discipline so as not to compromise patient privacy. Regarding houses of worship and religious audiences every audience without fail has a representation of the 5 mental health diseases identified on the W.H.O's top 20 list of global burden of diseases.

If we look further at God's plan for mental health we see clearly He addresses the issue diligently. As a preventive measure He gave Adam, Noah, Abraham, Jacob, Moses and the prophets instruction including the Ten Commandments and the 613 mitzvots or commandments located in the Old Testament to keep man's mind out of inner conflicts including guilt in regards to God and mankind.
 

God has a mental health program for His children that is primarily preventive but also therapeutic to bring healing to the mind whenever necessary through wisdom, love, the scriptures and through the relationships with human beings who are whole themselves. Ideally in every effective house of worship there should be leaders who themselves are emotionally effective showing indicators such as creativity, flexibility, being focus, positive and the ability to rebound from negative situations providing emotional leadership to others. Leaders of this caliber are also cognitively prepared in light of the fact those who are well prepared do best when in crisis as do those who get help at the very beginning of a crisis.

Every therapist counts on the drive for recovery deep within a patient. Within all of us is a God given drive to recover placed there especially for situations that seem terminal. The message is do not give up on yourself, loved ones or society. Similarly the church congregation that is whole who has a leader who is whole has within it's structure the ability to heal feelings of isolation and even be a support to orphans, to the elderly, to children of divorced homes and to singles. Religious institutions can indeed engage Tikkun Atzmi and Tikkun Olam which is repair of ones self and repair of the world at large and communities respectively.

A Plug for the local House of Worship

We may not have realized that religious institutions to include effective mission programs and effective local houses of worship are designed to contribute to personality health. God had the health of our personality at heart when He recorded in Hebrews 10:25 "not forsaking the assembling of your selves together with the brethren." Based on the record contained in the historical book of Genesis after the fall of mankind from grace mankind decayed physically, mentally to include our personality and decayed spiritually becoming susceptible to physical, mental and spiritual pathologies.

According to Karl Menninger millions of people in every age would be diminished in their abilities to handle life situations constructively without the stabilizing, under girding, nurturing, value-supporting ministries the churches provide. He further states individuals would have been much more vulnerable to mental, emotional and spiritual illnesses without the psychotherapy programs offered by the Church. This includes the message given to a group from the pulpit by a trained leader. As a society we miss the psycho-spiritual effect of scripture as it is read, spoken, heard and sung weekly during Church services.

As we step back and take a fresh look at houses of worship at large of any belief system, and also at the groups of people we speak with weekly or bi-weekly, within the congregation of the local Church itself based on various research studies it could be estimated there are those who have been hospitalized for major mental illnesses in the past, current alcoholics, severe to moderate neurotic symptoms seen by a physician. Also in the congregation are those who feel they are going to have a nervous breakdown, many who have sought help for a marital problem, some who have been hospitalized for mental illness, and some who will attempt suicide if not helped. There are people in the congregation who will be involved with serious crimes if not reached and others who are married but will admit they are not happy and who need help. As the economy changes there are those who have minor to very severe financial pressures.

It is imperative to be nice to all congregants when interacting with them because you don't know what each of these is going through. It is important to help fellow congregants understand these statistics so they too can be friendly to all who come through the door of the local Church. Religious leaders may also be concealing problems to avoid being embarrassed. COVID-19 has also presented unique opportunities that influences the mental health of all generational cohorts. See https://www.linkedin.com/pulse/corona-virus-how-covid-19-may-influence-local-life-baker-ph-d/ If we project these statistics unto a national stage and more so internationally we will find each category mentioned above will run into hundreds of millions of people for each category.

Action for Mental Health pp. 139-140 states "the churches, as nearly as this study was able to determine, are not devoting much more attention to mental health than society at large." I believe this indictment may be partly a result of lack of information. Leaders of all disciplines at every level must have a working knowledge of mental health in light of the global trajectory established for mental health disorders as it pertains to both the secular and the religious global population. Religious leaders may feel like failures if they have to refer a person to a clinical professional but we have to be realistic acknowledging each professional has limits mandated by their discipline and skill sets. Thus a Pastor who is gifted in spiritual matters to watch over the soul of a parishioner may need to refer a person to a qualified medical professional to include psychiatry to help facilitate a person's healing.
 

Recognizing there are two aspects to mental health disorders is critical to a Pastor’s success and Pastoral approach. Below is a synopsis of the clinical aspect of mental health disorders especially personality disorders that provide a working knowledge of mental health all leaders should possess as a Pastoral leadership competency.

The Diagnostic and Statistical Manual of Mental Health Disorders or DSM - 5th edition published by the American Psychiatric Association, classifies personality disorders for us in clusters with cluster B explaining 4 personality disorders, anti-social personality that disregards the rights and feelings of others, borderline personality that fervently sees issues in only black and white, histrionic personality attention seeking and the narcissistic personality. Ten separate personality mental health disorders are categorized into three clusters premised on similarity of symptom. These clusters are as follows:

Cluster A "the odd, eccentric" personality disorders
Cluster B "the dramatic, emotional, erratic" personality disorders
Cluster C "the anxious, fearful" personality disorder

All of the above clusters have four symptoms in common that are consistent which are as follows:
1) Distorted thinking patterns,
2) Problematic emotional responses,
3) Over- or under-regulated impulse control, and
4) Interpersonal difficulties.

There really is a clinical aspect to mental health not only a spiritual aspect, and both aspects must be addressed together not just one aspect or the other. The clinical aspect to mental health disorders may require the use of stabilizing medications as one would use stabilizing medications to address diabetes or hypertension. Mental health disorders and Personality disorders may be a result of physiological deficits, for example associated with our endocrine system, head trauma, congenital defects associated with our anatomy. In recognition that there may be a need for clinical intervention alongside a Pastor’s spiritual intervention, a Pastor must be ready and willing to make a referral to a medical professional to complete the loop without feeling like a failure.

A good rule to follow is to consider a person's physical health, mental health and spiritual health. All three aspects of our human make-up are interdependent, closely connected and affect each other. A full physical by a medical doctor is recommended to include a complete blood count with differentials because the behavioral problems may be physiologically related even food allergy related. If there are no physiological problems, congenital defects or head trauma identified then a psychologist can help identify any need for behavioral modification due to bad habits causing problems. After this type of comprehensive Pastoral approach, assuring confidentiality, administering the love of God, a Pastor can now be satisfied to successfully address spiritual issues through the ministry of personal one-on-one prayer, counseling by explaining specific benefits in scripture, and addressing even demonic related issues by prayer.

A trained leader who has a personal fellowship with the Holy Spirit can incorporate biblical therapeutic elements into every message, set the tone for each service and provide a full measure of both the Spirit and the therapeutic Word of God at each setting with a crowd. Quotes from scriptures such as "be anxious for nothing.. come unto me all who labor and are heavy laden and I will give you rest.. I will not leave you comfortless.. Do not let your hearts be troubled.. Peace I leave with you; my peace I give to you.. Cast all your anxiety on Him because He cares for you" are designed by the authors to address anxiety disorders and to bring the mind and spirit back into faith and rest when agitated. The presence and gifting inside a leader is released and deposited to a congregation each time there is a sermon thus an expositor of the gospel must walk personally with God and be filled to overflowing with Him.

All leaders must realize that it is ultimately ones uninterrupted relationship with God that yields full well-being or good mental health and proper thinking. Finally using the Tanak, B'Resheit or Genesis seen below as a point of reference God originally intended that mankind be whole in every area of life and He created mankind both men and women in His exact image and likeness.

And God said, Let us make man in our image, after our likeness: and let them have dominion over the fish of the sea, and over the fowl of the air, and over the cattle, and over all the earth, and over every creeping thing that creepeth upon the earth.
27 So God created man in his own image, in the image of God created he him; male and female created he them.
28 And God blessed them, and God said unto them, Be fruitful, and multiply, and replenish the earth, and subdue it: and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth.

Chinese Version

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