1. Mental Health 101: Mental Health Ministry
Pathways to Promise A National Mental Health Ministry Resource Developing the capacity of congregations to support recovery and wellness
The goal of this training is to increase our understanding of mental health issues faced by individuals in our congregations and community, and grow our capacity to support recovery and wellness. All of us are vulnerable to stress and experience worry, fears, anxiety and other challenges to our mental health. In this training we will focus on five particular areas of concern.

2. Five Areas of Concern Children’s mental health Trauma
Serious mental illness
Substance use
Issues of aging
Families come to us for help and support caring for a child with special needs – delays in learning and in growth, emotional struggles, difficulties in behavior or relationships. We witness the effects of trauma – violence, abuse and neglect on a person’s life. We see the impact of a serious mental illness – depression, bipolar disorder, schizophrenia – on individuals and their families. We know that substance use – alcohol, street drugs the abuse of prescription medication – takes a tremendous toll on our communities. We know seniors and their families coping with issues of memory loss and failing minds.

3. Our Life Journey
Our path does not always move steadily forward, unfolding neatly step by step. A child may come into the world with limited capacities, develop late, be hyperactive or struggle to relate. At any point on our journey, violence, abuse or neglect can profoundly alter our path. We can slide into a deep depression. Alcohol and drugs can hijack our brain. Our brains don’t fully come on line until our late teens and early twenties. The good news is that new brain cells grow over the years. We can rebalance the chemistry of the brain, repair and restore function. We can make new connections, continue to learn and mature. Like other parts of our body, in later years our brains too may lose strength and capacity.

4. At any point in our life we may suffer a mental disorder.

5. Our journey’s go off track or come to a halt
Our journey’s go off track or come to a halt. We are physically or emotionally attacked. Our brain chemistry shuts down or becomes deeply unbalanced, leading to unusual and extraordinary moods and states of mind. We use, become dependent, addicted. We become confused, stuck, lost.

6. Most of us need some extra help and support in our lives and that includes those if us who face mental health issues. Mental health ministry is part of our care and concern for the whole person. As people of faith we respond to suffering and human struggle. We are sensitive to hurt and pain. We feel sympathy, empathy and compassion. We have concern for the wellness and welfare of sisters, brothers and neighbors.

7. Some signs of suffering are highly visible – cuts and wounds, bleeding, bruises, vomiting, a high fever, open sores, muscle pain, swelling, spasms, numbness, coughing, sneezing, slurred speech, loss of consciousness, paralysis. What are he signs someone may be struggling with a mental health issue, or suffering from a mental disorder?

8. Signs of Brain-related Suffering
Extraordinary changes in mood
Unusual sensations
Irrational or nonsensical thoughts and ideas
Bizarre behavior
Impaired intellectual abilities
Withdrawal, loneliness, isolation
We experience loss, grief and sadness. We have occasions of great delight, wonder and awe. We enter into unique and special moments of faith as individuals and communities. But like other parts of our body, our brains can become ill. Our thoughts and emotions can become deeply disturbed.
What are the signs that a person may be facing a mental health issue?
We see something, or hear something that makes us uneasy. We feel the hurt, the struggle, the pain. We have a concern about where a person is emotionally. An individual is seeing things, hearing voices. The person doesn’t make sense, or is talking about things that don’t seem to have any reality. The way the person dresses, what they collect or carry, little rituals, movements or postures strike us as odd. The individual may be very forgetful, unable to concentrate or do basic activities of thinking and deciding. The person may be increasingly irritable, wary, protective, hidden away, alone. If we are concerned about a person’s emotions, thoughts or behavior, we may be picking up signs of a mental health issue in an individual’s life.

9. Possible Spiritual Impacts of Depression
The brain is slowed in its functioning
Capacities important to spiritual well being may be “off line;” hope is inaccessible
The flow of spiritual energy may be reduced or blocked
Feelings of failure, worthlessness and guilt are amplified; despair predominates
Isolation prevails; God may be perceived as absent, distant or punishing.
A person may present signs of suffering that trigger concern for both the individual’s spiritual well being and their mental health. In the midst of depression a person may present to us as having lost their faith or feeling absolutely hopeless or cut off from God. It may be the brain, not the soul or a relationship with God that is broken or impaired.

10. Possible Spiritual impacts of Trauma, Neglect and Abuse
The alert system may be constantly reactivated, blocking access to love and care
Capacity for relationship may be reduced by fear and protective patterns
Trust, a component of faith may be diminished
High degrees of both need and negativity may make participation in religious life difficult
The power of evil may be an ever present, overpowering and immediate issue for the soul and self
Trauma, abuse and neglect can profoundly alter the functioning of the brain and affect a person’s spiritual capacity. The capacity to trust and accept love and care may be deeply impaired. To be tender and open may be risky and frightening. Feelings of terror, flashbacks, nightmares may continuously overwhelm healthier emotions. The forces of evil and the power of the perpetrator may present a constant danger. Even those coming with genuine love and care may be suspect. The need for care, reassurance and healing support, and negativity can both be high, exhausting clergy and congregation.

11. Possible Spiritual Impacts of Substance Use
Substances may flood channels usually available for spiritual experience
Intoxicants may alter or limit abilities underlying personal freedom, honesty, love and mutuality, authentic joy, good judgment and responsible action
As drugs and alcohol take hold in a person’s life, faith capacity may substantially atrophy; spiritual humility may be lost and religious life may die
Use, dependency and addiction can drive behavior destructive of relationships in family, work, congregation and the wider community
It is perhaps no accident that the field of chemical dependency treatment often includes a clear spiritual component. The effects of alcohol and drug use on a person’s spirituality, faith and soul are often quite visible, if not to the person, to family and community around the person. Daily individuals in 12 step programs witness to the importance of spiritual support in their recovery.

12. Spirituality and Mental Health
Disorders and imbalance in the brain, trauma, serious mental illness, intoxication, the effects of aging can affect our spirituality.
Spiritual resources, a healing faithfulness, soul care, and congregational support can encourage mental health, recovery and wellness.
Brain disorders, biochemical imbalances, stress, anxiety, substances, psychological struggles, and issues of aging all can have an impact on our faith life. Just as importantly, when an individual and their family face a mental health issue, spiritual care and support of the faith community can be very much part of recovery and maintaining health.

13. The Whole Person PSYCHOLOGICAL a BIOLOGICAL SOCIAL approach SPIRITUAL
We pick up the signs of suffering. Our task as clergy, as congregations and people of faith is to come along side the person in their struggle for well being. Our particular concern is for the individual’s spiritual health, but we have care within that framework for the whole person – their biology, their mental health, their social welfare and for each person’s spiritual life, faith and soul. We can work as a team, “hands around the table.”

14. Community Care Providers
Pastoral Counselors
Chaplains
Therapists, Chemical Dependency Counselors and Psychologists
Nurses and Psychiatrists
Peer Specialists
Social Workers
Primary Care Providers
School Systems
Youth and Family Services
Community Mental Health Centers, Clinics
Hospitals and ERs
Social Service Agencies
Housing Groups
There are a range of individuals who provide mental health care, diagnosis and treatment. Pastoral Counselors are cross trained in ministry and mental health. Chaplains are generally found in hospital settings. Therapists provide counseling for a wide range of mental health issues, including drug and alcohol use. Psychologists generally do testing and evaluation as well as providing therapy. Nurses and Psychiatrists have training and focus on the brain and biology, and prescribe and follow medications in the treatment of behavioral health issues. Peer (persons with experience and engaged in recovery) specialists are providing front line outreach and support in a variety of community settings. Social Workers and case managers work with the full range of a person’s needs, including housing, benefits, health care coordination, education and social concerns. Primary care providers, like clergy are often “first responders” with an individual and family in need, and can follow medication treatment, as well as making referrals for specialized care.

15. Diagnosis
Diagnosis literally means “a deep understanding.” A referral can help us deepen our understanding of the person and the issues the individual is facing A good diagnosis guides care and treatment
As clergy, pastoral staff and people of faith, we seek to understand the spiritual issues and concerns of life. It is the role of mental health professionals and providers to diagnose and treat mental disorders. We may pick up signs of a mental health issue or feel that an evaluation may be helpful to a person. A pastor says this: “I will often say to a person, that I’d like to be part of a team helping them. I’d like others in the congregation to be of support, and maybe work with others in the community who could be of assistance. I say I’d like to consult with someone who has experience with the issues the person is facing, and maybe set up an appointment to get some consultation. I make a call, lay out the situation and ask if this is something that my colleague in the community can help with. If not, I ask for their suggestions about where we might turn. I report back to the person and we talk about a referral. I offer to help set up an appointment, write a letter of introduction, or perhaps go with the person. The idea is that the person isn’t going in alone to a stranger, or that somehow I just want to pass them on to someone else. I ask the person to check back with me and tell me how it went. I assure them that I want to stay in touch and be part of the team, and to continue to support them, especially with any spiritual concerns and questions they have.”

16. Spiritual Care Tasks Assisting a person to assess their suffering
Exploring possible explanations for suffering
Introducing appropriate spiritual and mental health care resources
Opening the door to the support of the congregation and wider community
Clergy and pastoral staff can help a person to assess their suffering. “What is of the spirit and what is of illness?” We can help a person look at the biological, psychological and social aspects of their suffering. We can introduce appropriate spiritual and mental health care resources. Prayer and medication. Scriptures and counseling. The resources of the congregation and the clinic. And we can open the door to the support of both the community of faith and the wider community.

17. Caring Congregations Call for aid in an emergency or crisis
Refer for appropriate care and treatment
Organize an ongoing Mental Health Ministry
Do education; build commitment to recovery and wellness; welcome individuals and families facing mental health issues; provide spiritual support and practical service; advocate for effective community mental health care
911 operators are trained to help in an emergency. Most communities also have a 24 hour crisis line. You may also call 211 for information on a wide range of local health and social service resources.
Develop a relationship with one or two nearby community mental health providers; consult; build a referral network. Organize a Mental Health Ministry Team; draw on the experience and expertise in oyur congregation and community.

18. Clergy alone cannot carry the mental health ministry burden
Clergy alone cannot carry the mental health ministry burden. Clergy are on call responding to individuals and families in need, along with a full range of other responsibilities. Clergy support and consultation groups can be helpful. Clergy and pastoral staff can multiply their gifts through a Mental Health Ministry team to help create a caring congregation and connection with resources in the wider community.
PASTORAL SUPPORT

19. Organizing a Mental Health Ministry Team
A children’s mental health guide
A guide experienced with trauma, PTSD
A guide knowledgeable about mental illness
A guide familiar with drug and alcohol recovery
A guide who understands the mental health issues of seniors
In our congregations and community are parents, teachers, and other professionals who know the community resources and services for children and youth. In our congregations and community are veterans, survivors of domestic violence and caregivers who have had experience with trauma and know what treatment is available. In our congregations and community are members of the National Alliance on Mental illness, peers, family members and providers who have a first hand knowledge of the mental health system. In our congregations and community we have individuals who are familiar with drug and alcohol recovery and treatment resources. In our congregations and community we have family members and staff people who have cared for elders. Invite people to an informal meeting and discussion of mental health issues. Ask a handful of people from the congregation and the community to start the conversation by saying a word or two about their particular area of interest and experience. Form a core group of guides to serve as the heart of the Mental Health Ministry Team.

20. The Role of a Guide
A guide knows the lay of the land and where resources can be found. A guide helps others to get started and supports them on the journey. Guides help people move into new territory and learn about what may seem strange, foreign or frightening.

21. A Mental Health Ministry Toolkit
A guidebook for mental health ministry is available from Pathways to Promise
Monthly mental health ministry activities
Suggestions for doing education, building a commitment to recovery and wellness, ways to welcome individuals and families, models of support and service, and becoming advocates
Pathways to Promise a national mental health ministry program has a free Mental Health Ministry Toolkit available on its website. The toolkit offers a calendar of monthly mental health ministry activities, and provides links to resources on children’s mental health, trauma informed care, mental illness, drug and alcohol issues, and elder health. The toolkit offers practical suggestions and assistance for growing mental health ministry in a local congregation.

22. “When I was a Stranger”
“You made a place for me. You treated me as a human being. You sat beside me. You listened. You shared the journey.”
Our focus in mental health ministry is especially on the person who is isolated and estranged, Our calling is to build with this neighbor a relationship supportive of healing and recovery, wellness, spiritual renewal and faithful growth.

23. The Healing Process The Healthy Self The Illness Self
In the midst of illness the disorder dominates the person. What we see is the “illness self, “ the pattern of symptoms, the signs of imbalance and disturbance in the brain and mind.

24. Treatment healthy self illness self
With treatment and care, the impact of the illness is diminished. Symptoms are reduced or eliminated. The healthy self is strengthened and grows.

25. Wholeness healthy self Illness self
Healing and recovery move toward new wholeness. We don’t simply “return to normal.” We grow and change. We acknowledge the
impact of the illness on our lives. We recognize our vulnerability and the possibility of relapse or the recurrence of symptoms. We seek to develop and maintain maximum health and well being.

26. An Understanding of Spirituality
The core of a person
An aspect or dimension of our life
Our relationship to the whole - to all, to creation, to God, to the infinite and ultimate
Canda and Furman 1999
Spiritual care supports healing and wholeness by encouraging the faith at the heart of a person’s life, by increasing a persons spiritual resources and strength, and by deepening and developing appropriate support for the person in the congregation and community.

27. Companionship A one to one ministry of presence
A relationship responsive to suffering
A relationship supportive of recovery and wellness
A public relationship
Companions are members of the congregation equipped and available to be present with the stranger and with individuals and families facing a serious mental health issue. Companions share the journey of recovery. Companions minister at the congregation’s front door, during gatherings of the community and congregational fellowship, and in community settings like meals, day drop-in centers and shelters.

28. Five Practices of Companionship
Hospitality
Neighboring
Sharing the journey side by side
Listening
Accompaniment
The way of companionship includes five basic practices. The practice of hospitality begins with creating, in the words of Henry Nouwen, “safe space with the stranger.” Neighboring simply means meeting each other on common ground, as human beings. Rather than pushing or directing a person, or interviewing or confronting a person, we share the journey side by side, looking out at the world together. At the heart of companionship is the practice of listening to a person’s story, listening especially for the words of faith, hope and love, for the person’s spiritual story. Companions may accompany an individual to an appointment or a resource in the community or simply hold the person in thought and prayer.

29. Companionship Care Teams
A group of several companions
Companioning one or more individuals
Accountable to the Congregational Mental Health Team or other leadership
Meeting regularly for prayer, study, sharing and spiritual discernment
Providing each other mutual support
Companions, trained and organized in small care teams, provide front line, person to person support for recovery and maximizing wellness. Each companion may companion one or two persons, or the whole team may work with a single individual or family. Companions are accountable to the Mental Health Ministry team in the congregation or another appropriate leadership group. Companionship care teams meet regularly for learning and mutual support.

30. Clergy Support Groups
Clergy interested in developing mental health ministry in their congregations are invited to form a neighborhood level support group
A pastoral counselor or other mental health professional with background in mental health and ministry can help in facilitating a group of local clergy meeting for mutual support and consultation.

31. Neighborhood Clusters
Mental Health Teams from neighboring congregations are encouraged to learn and serve together
Congregations in a neighborhood or community are encouraged to share in supporting a local mental health ministry coordinator
Congregations are invited to celebrate their mental ministry together with the community each year.
Few congregations have the staff to develop mental health teams and companionship ministries on their own. A cluster of congregations can join together in helping support a local mental health ministry coordinator. Parish nurses, pastoral counselors, chaplains, community ministers, parish social workers and others with a background in ministry and mental health are well suited to this role.

32. A Mental Health Training Cooperative
Members: individuals; local congregations and other faith community organizations; representatives from community mental health providers; representatives from peer, family, education and advocacy groups; community allies Purpose: plan and offer a calendar of mental health education and resources for the faith community in a given region
Pathways to Promise is helping develop mental health training cooperatives at the city and county level in a growing number of sites across the country.

33. An Invitation
View the other two presentations in this series: Organizing a Mental Health Team, and Companionship
Share these presentations with colleagues and laity
Collaborate with neighboring congregations to develop mental health ministry and companionship teams in your community

34. May All Have a Home Rest Safely, And Be Well
Mental Health Ministry reaches out to the isolated and excluded, welcomes the stranger and joins us each in the deep process of healing and recovery. Sharing in he journey toward wellness, we all are made whole.