The Church and mental health.

Carl Emerson · Feb 25, 2020

Below is an article that was posted in the Catholic forum...

Church can do more to help with mental health, expert says

This article raises some important issues.

In my country Psychiatrists are not permitted to pray for their patients. They must stay within defined 'professional' boundaries.

For this reason I was called upon by a psychiatrist to pray for a patient who was considered to have 'spiritual' issues.

I note that some Christian Psychiatrists are leaving the profession as they recognise the limitations imposed on them mean they cannot deal with patients that present with spiritual issues, and are training to be Christian counsellors instead.

I was called upon to support a Psychiatrist who wrote a paper on Psychiatry from a Christian world view and was de-registered. The case was fought and she eventually won the right to practice again, but it was a battle.

This raises the issue of how can the church be more involved in assisting the mentally unwell given that this responsibility has been largely abdicated to secular medical science which at times lacks the tools to bring wellness.

Your comments most welcome.

Anthony2019 · Feb 25, 2020

Most healthcare professionals are registered with a regulatory body which governs their education, training, conduct and fitness for practice. For instance, I am regulated by the Nursing and Midwifery Council and have to meet certain requirements to remain on the register. One of the requirements is that I treat patients as individuals, respect their choices and respect diversity. I have to work within the framework of the Mental Capacity Act that supports people to make their own informed choices, whether or not I personally agree with those choices. I have to update my clinical skills and knowledge regularly to ensure that care provided continues to meet people's needs as well as statutory and legal requirements.

Another requirement is that all care that I provide for a patient has to be based on evidence-based practice. EBP is not based on my personal intuition, traditions, or beliefs (even religious beliefs), it is based on scientifically validated methods that have been proven to work. This inevitably means that boundaries need to be set to ensure that the treatment that we give our patients is based on robust documentary evidence and not our own personal beliefs and opinions.

Patients will naturally expect that we will treat them with respect, as well as kindness and compassion. However the relationship between the healthcare provider and the patient is based on mutual trust. They trust us to carry out our jobs safely and effectively, to make critical decisions based not on opinion or conjecture, but on solid evidence and facts. Above all, patients are seeking to improve their health outcomes and they are trusting us to use our skills, knowledge, capability and judgement. They expect us to use methods that have been proven to work based on emperical evidence.

When some offers to pray for a patient, then the boundaries of the professional relationship become blurred. We have to respect their cultural and religious beliefs and allow them to make their own choices. We are not pastors or spiritual advisors. We are healthcare professionals doing our jobs.

Let's consider, for example, a patient visiting a psychiatrist complaining of symptoms of obsessive compulsive disorder, such as intrusive and distressing thoughts. A psychiatrist who is a Christian may feel inclined to offer spiritual guidance and support, however they have a duty of care to ensure that any advice or treatment is based on medically and scientifically proven methods. That is not to say that a faith based approach would not work for the patient, but this method is not based on empirical evidence which is the fundamental basis of providing any medical treatment or intervention, since it follows a framework that meets the legal and professional requirements of the practitioner.

seeking.IAM · Feb 25, 2020

Carl Emerson said:
...

In my country Psychiatrists are not permitted to pray for their patients. They must stay within defined 'professional' boundaries...

I am curious if you really mean what you wrote, "not permitted to pray for their patients." Or do you mean they are not permitted to pray with their patients.

I practice psychotherapy. No regulating body would ever know if I prayed for my patients.

Carl Emerson · Feb 25, 2020

seeking.IAM said:
I am curious if you really mean what you wrote, "not permitted to pray for their patients." Or do you mean they are not permitted to pray with their patients.

I practice psychotherapy. No regulating body would ever know if I prayed for my patients.

Yes, of course, you are correct, poor choice of wording on my part.

Thanks for the correction.

The Righterzpen · Feb 25, 2020

My son was in a public school special education program (ITP = intense therapeutic); which was not really appropriate for his needs. He has Autism and no amount of counseling was going to change neuro-developmental behavioral issues.

Despite that though; he had a teacher, aide and social worker who were all Christians. This was a 6 students to the class, one teacher and one aide. There was one other kid in the class who's family also went to church. That class was a very interesting and unique circumstance.

The social worker asked me if it was OK if she could pray with my son. He'd asked her to pray for him at one point. And they did talk about God frequently. The aide was Roman Catholic and my son did ask her a few times some questions about what the Roman Catholic church taught. And since these conversations were student directed, the staff could engage with him. They had to be really careful though because it was a "public school". And it got "sticky" at times.

There were other kids in the class. One kid's parents were atheists and another kid's parents were Wiccans. And the atheist was the one kid who asked my son the most questions about God. One of the things they did in the class was talk about "coping skills" and of course, one of my son's coping skills was praying. And he'd talk about even though some really bad things had happened; he knew God was going to take care of him.

Well, LOL. The teacher at one point said that each student could bring in a movie from home that they wanted the class to see. Only it had to be PG or G rated and could not have guns or violence in it. Well, my son wanted to bring in God's not Dead. And even if all the other students agreed that they wanted to watch this movie; they could not show it. And it took a lot of having to explain to my son why. (How would you feel about someone who brought in a movie about satanism?)

It was a hard lesson to learn about public discourse in secular spaces.

So "professional environment" has some appropriate limitations; and yet of course, I also believe in individual freedom of speech.

So yeah, what can "the church" do to help people suffering from psychiatric issues? That can be a hard road to walk, even though there are quite a few believers in that field. I've been in and out of counseling the majority of my life and had some clinicians who had no issues with the spiritual aspect of my life. Other's were very supportive and a few "couldn't go there" and I think that had more to do with where they were spiritually as opposed to "violating" any professional ethic.

Carl Emerson · Feb 25, 2020

Anthony2019 said:
Most healthcare professionals are registered with a regulatory body which governs their education, training, conduct and fitness for practice. For instance, I am regulated by the Nursing and Midwifery Council and have to meet certain requirements to remain on the register. One of the requirements is that I treat patients as individuals, respect their choices and respect diversity. I have to work within the framework of the Mental Capacity Act that supports people to make their own informed choices, whether or not I personally agree with those choices. I have to update my clinical skills and knowledge regularly to ensure that care provided continues to meet people's needs as well as statutory and legal requirements.

Another requirement is that all care that I provide for a patient has to be based on evidence-based practice. EBP is not based on my personal intuition, traditions, or beliefs (even religious beliefs), it is based on scientifically validated methods that have been proven to work. This inevitably means that boundaries need to be set to ensure that the treatment that we give our patients is based on robust documentary evidence and not our own personal beliefs and opinions.

Patients will naturally expect that we will treat them with respect, as well as kindness and compassion. However the relationship between the healthcare provider and the patient is based on mutual trust. They trust us to carry out our jobs safely and effectively, to make critical decisions based not on opinion or conjecture, but on solid evidence and facts. Above all, patients are seeking to improve their health outcomes and they are trusting us to use our skills, knowledge, capability and judgement. They expect us to use methods that have been proven to work based on emperical evidence.

When some offers to pray for a patient, then the boundaries of the professional relationship become blurred. We have to respect their cultural and religious beliefs and allow them to make their own choices. We are not pastors or spiritual advisors. We are healthcare professionals doing our jobs.

Let's consider, for example, a patient visiting a psychiatrist complaining of symptoms of obsessive compulsive disorder, such as intrusive and distressing thoughts. A psychiatrist who is a Christian may feel inclined to offer spiritual guidance and support, however they have a duty of care to ensure that any advice or treatment is based on medically and scientifically proven methods. That is not to say that a faith based approach would not work for the patient, but this method is not based on empirical evidence which is the fundamental basis of providing any medical treatment or intervention, since it follows a framework that meets the legal and professional requirements of the practitioner.

Yes, my wife has a degree including Health Law and Policy so I am well familiar with the requirements.

My issue is that folks in the church struggling with mental health issues invariably end up committed for treatment when the matter may well be spiritual and respond to prayer.

Sadly it is not only that the profession is ill equipped to set such a one free, but the church also mostly has zero faith to deal with the issue, believing that such matters are outside their domain of responsibility.

Take OCD as you mentioned. We have a dear friend who was suffering severe OCD and came to my wife and i for prayer. Her release was so dramatic that folks are asking 'what happened to you' because her whole countenance has changed and she now radiates confidence and peace.

I also speak from first hand experience having been diagnosed 45 years ago with 'mental epilepsy' and committed by my ex wife for treatment which included ECT. Thankfully folks prayed for me and I was released early. I knew deep down that my issues were spiritual so I sought out prayer over an extended period. I attended the meetings of the Order of St. Luke weekly and found healing from a deep wound in the Spirit.

I also learned to deal with spiritual oppression over the years and have a strong confidence to assist others in their journey to freedom and restoration.

I truely believe that Jesus demonstrated authority in this arena and the church has a neglected role to minister to those similarly inflicted.

It is a relief to see some Christian professionals abandoning their Psychiatric practice and moving to Christian counselling knowing that folks presenting with spiritual issues need spiritual help.

Anthony2019 · Feb 26, 2020

Carl Emerson said:
Yes, my wife has a degree including Health Law and Policy so I am well familiar with the requirements.

My issue is that folks in the church struggling with mental health issues invariably end up committed for treatment when the matter may well be spiritual and respond to prayer.

Sadly it is not only that the profession is ill equipped to set such a one free, but the church also mostly has zero faith to deal with the issue, believing that such matters are outside their domain of responsibility.

Take OCD as you mentioned. We have a dear friend who was suffering severe OCD and came to my wife and i for prayer. Her release was so dramatic that folks are asking 'what happened to you' because her whole countenance has changed and she now radiates confidence and peace.

I also speak from first hand experience having been diagnosed 45 years ago with 'mental epilepsy' and committed by my ex wife for treatment which included ECT. Thankfully folks prayed for me and I was released early. I knew deep down that my issues were spiritual so I sought out prayer over an extended period. I attended the meetings of the Order of St. Luke weekly and found healing from a deep wound in the Spirit.

I also learned to deal with spiritual oppression over the years and have a strong confidence to assist others in their journey to freedom and restoration.

I truely believe that Jesus demonstrated authority in this arena and the church has a neglected role to minister to those similarly inflicted.

It is a relief to see some Christian professionals abandoning their Psychiatric practice and moving to Christian counselling knowing that folks presenting with spiritual issues need spiritual help.

Hi Carl and thanks for responding.

I'm of the opinion that spiritual and medical issues should be dealt with separately, otherwise it results in the blurring of professional and legal boundaries. Many Christian counsellors, however experienced and mature they are in their faith, will often not have the medical and clinical training to assist someone suffering with a psychiatric problem.

I could have a sincerely held belief that a person suffering from psychosis could benefit from prayer and stop taking their medications. But if I misjudged that person's situation and their health deteriorated, possibly even ending in tragedy, then I am accountable. My sincerely held beliefs may matter to me, my church and even to God. But my personal beliefs would not matter in the slightest to a Coroner who would be scrutinising all my acts and omissions and the litmus test would not be whether I had acted in good conscience, but whether I had adhered to evidence based practice and agreed guidelines.

When it comes to following guidelines, whether the services we offer are spiritual or secular, we are still human beings and even the most experienced practitioner is susceptible to making errors of judgement. I am in nursing management, but even with my years of clinical experience, I still have to take great caution and care as I recognise that I am just as at risk of making a mistake as anyone else. Since even the smallest of errors can have major ramnifications on a patient's welfare, the guidelines are there to protect the patient and ourselves.

There are many good Christian books and literature available, written by highly reputable and experienced authors, and many patients reading these have found them to be extremely helpful. I have even read and benefited from many of these books myself. But these books are very often presenting opinions and facts that have not been validated by the medical and scientific community. Whether or not we agree with the outcome of peer reviewed studies and controlled clinical trials, that is the level of scrutiny which the public has come to expect.

If you were to ask me whether Christians should seek support from prayer counsellors in their churches and other organisations, then my answer would be yes, providing the individual has given their consent, and that the person providing the counselling works within their scope of their competence and experience. The counsellor should make it very clear to the counsellee that their service is not a replacement for any treatment plan prescribed by their own medical practitioner.

The Righterzpen · Feb 26, 2020

Carl Emerson said:
My issue is that folks in the church struggling with mental health issues invariably end up committed for treatment when the matter may well be spiritual and respond to prayer.

Sadly it is not only that the profession is ill equipped to set such a one free, but the church also mostly has zero faith to deal with the issue, believing that such matters are outside their domain of responsibility.

The other side of this is the opinion of: "You have the issues that you have (be they medical or psychological) because you just don't have enough faith."

To that I say: "Shut up and go away; because first off, you don't even know me and secondly there aint nothing wrong with my faith." How is it that you assume that because I have some physical disability and my son has some medial problem like epilepsy, that those conditions are due to our lack of faith? That's an awful arrogant assumption to make; that you know what the point of our disabilities are, more than God's purpose for them? How many "faith healers" put all the wheelchair bound people in one section in the back of their meetings and remove them before the "service" is over?

Psychiatric issues in general have a poor "cure" rate. I have PTSD both from a war and sexual abuse from family of origin. I'm 50 years old. I've been a Christian for 30 years. My PTSD is managed fairly well; but I will have it for the rest of my life. The nightmares, occasional anxiety attacks and especially the exaggerated startle response has never gone away.

BUT! I don't worry about that any more; because on the other side of eternity, NONE OF IT is going to matter! The sexual abuse won't matter. The war won't matter. The fact that I'm on crutches for the rest of my life due to a car accident isn't going to matter either! My son's epilepsy isn't going to matter. He's not going to have Autism any more. My relationship with God is not about what I can "get" from Him in this life. So we enter the Kingdom blind, mentally retarded and in a wheelchair. That's better than never getting there at all!

And THAT"S the problem with the church. People who THINK they have answers to this stuff - DON"T!

Anthony2019 said:
I have an enormous respect for Christians who support others with prayer and counselling, and would never dissuade anyone from seeking such a service if they feel it would benefit them. But there are many situations where I feel that a clinical approach to counselling would be more appropriate.

I've gotten more success dealing with my PTSD from cognitive behavioral therapy, then from someone who thought they could "pray it away".

Not that I think prayer, (and certainly repentance - there's another word no one likes to talk about - LOL) deals with SIN effectively! But are the physical effects of Desert Storm and a catastrophic car accident on my body and nervous system somehow reflect some sin of not trusting God? No they don't. More "faith" in God is not going to grow the cartilage back in my knees; but to trust that His grace is sufficient; despite the fact that I don't have cartilage in my knees is the difference between disease and sin!

Anthony2019 said:
A Christian worker, however experienced and mature they are in their faith, will normally not have the medical and clinical training to assist someone suffering with a psychiatric problem.

Agreed; because medical and clinical training is a learned skill set. Yet a spiritually mature Christian who has that skill set, can be very effective at helping someone cope with the trials in life. Because more often than not; life is managed, it isn't cured!

Carl Emerson · Feb 26, 2020

Anthony2019 said:
I'm of the opinion that spiritual and medical issues should be dealt with separately, otherwise it results in the blurring of professional and legal boundaries. Many Christian counsellors, however experienced and mature they are in their faith, will often not have the medical and clinical training to assist someone suffering with a psychiatric problem.

This is why it heartens me to see psychiatrists themselves making to move as they have some background knowledge yet are prepared to tackle what is spiritual when it presents.

seeking.IAM · Feb 26, 2020

Carl Emerson said:
This is why it heartens me to see psychiatrists themselves making to move as they have some background knowledge yet are prepared to tackle what is spiritual when it presents.

I can't imagine there will be many psychiatrists making this move, if no other reason the disparity of reimbursement rates from those offered for psychiatry.

Carl Emerson · Feb 26, 2020

Well believe it or not there are still some who have chosen not to bow to mammon. I met one the other day, he is in training at a bible college right now after being a practicing psychiatrist for several years but was frustrated that the profession was turning a blind eye to the spiritual nature of certain conditions.

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The Church and mental health.

Carl Emerson

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Anthony2019

Pax et bonum!

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seeking.IAM

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The Righterzpen

Jesus is my Shield in any Desert or Storm

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Anthony2019

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The Righterzpen

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seeking.IAM

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