Mental Heath in Crisis? No, it's on autopilot!

One of the safety nets for those who suffer from mental health issues is that of the crisis team, a bunch of people who monitor the telephone and await calls from those who know they are in the midst of a brain squall (those storms which come from nowhere and sink many a life) - for many of those who suffer from mental illness this is the equivalent of the lifeboat service; you call and the flare is sent up and help is made theirs.

Of course it's not just the mentally ill who suffer through mental illness - there are also the family and friends who, finding a loved one sinking and unable to cope, need to call the crisis team  in the hope that they might get advice and the help of those who are trained to deal with the squalls and waves of depressions, mania and confusion.

I have a great deal of respect for many of those who work in the support and care of the mentally ill, but of course there are some who challenge my Christian love and there are situations which cause me to mutter and moan (after all, we are all human, aren't we?). This is one of those situations:

One of the people we know and seek to support obviously 'in crisis' and in need of assistance and this, as always, presents itself as a 'walking on eggshells' exercise to avoid adding to the ill person's stress and getting the right person to do the right thing in the right way around them!

It wasn't that long ago that we found ourselves in a similar situation which went really wrong and eventually saw the Police enforcing a section 136 (a Police section which permits them to take the ill person into custody at a mental health unit and detain them, without any right to leave so full assessment can be made, for up to 72 hours.) on them.

But here comes the problem.

Imaging you're on an aircraft flying along at 10,000 feet when you notice the pilots come out of the cabin, don parachutes and leave by the nearest exit (OK, we'll forget about decompression and the closing of the door afterwards, it's an analogy not an accurate account of flying at FL100 and the effects of pressure). What would you do?

Imagine you ring the attendant call and ask the steward what's going on, only to be told that the pilot and copilot have started their holidays and since they were flying over their chosen destinations thought it would be handy to parachute in rather than get a flight back after they'd landed the aircraft you are in.

How would you fell - especially when invited to have a peek at the flight deck to reassure you and saw this:

Would you be reassured?

Not even if the steward told you that everything was pre-programmed  for the aircraft to land at your destination automatically and that, "Nothing can go wrong! - all will be well by the time the end arrives."

Well that's the situation my ill person has found themselves in - they've rung their CPN and their support worker, their case worker and, having had no response, called the crisis team to be told, "Your team are all away on holiday but will be back soon and will be able to help you!"

Now imaging you had a fire and heard the message that the firefighters were all on holiday but will get back to you as soon as they return. What do you do? You have the equivalent of a blaze inside someone's head and there's no help on the horizon?

Looking at the situation I find that a combination of reduced provision, holiday season and the usual (yes, it even happens in mental health care) 'jobsworth' attitudes (brought on by too much workload and perhaps not enough training) are all at play here. Were the ill person just up the road I could get involved and 'do stuff' but this usually results in us becoming the carer and support person (and workload means that once in that frame those 'carers' are more than happy to step back and leave us to it) - not always an easy task.

So a plea to those who have people in crisis: MAKE A NOISE - BE BLOODY MINDED!

I am not rabble rousing here but unless the MPs, the local and County government departments, the NHS trusts and the like are challenged and niggled, nothing is going to change and the tide, with regard to mental health care, has already gone out too far - it cannot go out any further without tragedy becoming a daily reality for our communities.

If you read this and are in mental health care, please realise that this is not a knock at you (unless you're the person who told me that those around you were, "Too busy at the moment!") but an acknowledgement that you are part of an underfunded and overstretched occupation and call to draw a line and reverse the trends and to get you some able (and present) coworkers).

In the area I inhabit there are only two mental health units running now and the danger is that soon the stewards will be leaving the aircraft too. Think about the aircraft analogy and ask yourself why, when no one would tolerate such a thing happening, we are willing as a society to let the same scenario be the daily experience of our mentally ill?

Find out the facts - talk to the mentally ill you know - make noise.

And of course, Christian or not, come alongside (and if you're Christian then pray too).

Pax

Clerical integrity and clocking off

Strange how some people complain about taking their work home with them when in my line of business what I do is do my work from home - perhaps this is why when, at eleven minutes into a new day I'm lying here thinking about someone who is lost.

Lost - an odd word when you're not at sea
Or in a jungle
Or a desert
In a wilderness or a crowded in place

The sort of lost you aren't talking about
When you're not talking in Christian terms
Or referring to moral compasses

When there's no game in sight 
Everything is where it is supposed to be (not like that missing watch!)

Except that one person you have somehow misplaced.
Worse still - who seems to have managed to have lost themselves
And you know you are the one to stand in the gap
A gap that no longer exists.

Because you can't have a gap without a person to make the gap appear.

And so I pray and wait and hope and pray(have I mentioned prayer?) and hope that somewhere the focus of my prayer is safe and surrounded by God''s love and tempered by a mind that works, and seeks safe harbour rather than the brainsqualls and tempests of mental illness.

May God touch and His Church act with integrity, love and sure engagement and gentle wisdom all those who are broken, confused and confounded.

May all who others have cruelly labelled as 'mad' find a harbour in the sanity of Christ's people.

Please pray for those with mental illness.

Pax

The Cell: Mental illness

Trapped in a cell, not of walls, but of mind;
Invisible to those outside,
Unbreakable to those within.
The sunny days that only you can see
As trapped within my life, gloom is my reality,
And where you see hope;
I see only more of the same.
You give me anti-psychotics but fail to see - 
The way that psychosis and your, many, diagnoses,
are really anti-me.
But there's a tunnel,
created with despair,
and death.

I'm free!

In memory of a man who proved that mental illness is indeed a terminal disease and on a day that is World Mental Heath day I find his death to be a stark reminder of the tragedies that accompany mental health issues

dona eis requiem

Mental Health - starting to take a look

Following on from my Good Friday experience I have started taking stock of the people and situations around me and have realised that there are so many issues and attitudes which collide. Some show our society off to a bad light and others damage and mar the image of Christ in the Church and the Church in the world.

What has to be said is that the Church is made up of very human, humans, and this sometimes shows. But (always a but somewhere!) the Church is also made up of some truly Christlike people too and it would be wrong to tar the Church because of a few poor experiences (which after all might be their learning experience, albeit a costly one for some at times) and some ignorant (they can hopefully be taught) and costly (in terms of broken and wounded people) errors.

A few of the sadnesses I have discovered thus far:

+ A fair number of people have the attitude that once someone has had a mental health issue they are 'mental' for the rest of their life. This is obviously not always the case.

+ A fair number of people assume that mental illness has nothing to do with physical causes and ascribe the effects (which we call mental illness) to a number of odd causes ranging from abuse to demons! This often gets the 'cheer up' response to depressives and the enforced exorcisms that I have received mail about!

+ Those with mental health issues fluctuate and can be testing at times. I know this from experience and have to struggle to be open and accepting of this, especially at 3:00am! But if we stop and take a look in the mirror, so too can we be testing and a trial to others at times, so what's the difference they have a condition with a name, that's all (what's our excuse?).

+ I am amazed to find that some people don't like to be around those with mental health issue in case the 'catch it' and because people thus afflicted can be embarrassing.

I have started a thread on the Cavedwellers blog about this issue, anyone who wishes to join in is more than welcome (you'll need to join). I thought this was a better option than directing the blog to this issue, which I think is going to take some unravelling.

Thank you for the mail and comments I have received, I hope that from it I might be able to develop a positive way forward at personal, church and wider levels.

Pax

Madness and the believer

I find the issues around the subject of mental illness and Christians rather disturbing. Because of this, here's one of the things that appeared in our parish magazine this month:

Loving as Christ Loved Us
The subject of mental illness has cropped up a lot recently and I am saddened at the response of many to this subject.
People have used words like ‘locked up’ or ‘managed’ I get the feeling that this is an area many of us struggle with. And as we struggle, I get the feeling that a man, somewhere in time, is holding a scroll of the prophet Isaiah, and reading thus:

"The Spirit of the Lord GOD is upon me, because the LORD has anointed me to bring good news to the poor;

He has sent me to bind up the brokenhearted,

To proclaim liberty to the captives,

And the opening of the prison to those who are bound;

To proclaim the year of the LORD’s favour, and the day of vengeance of our God;

To comfort all who mourn; giving them beautiful headdress instead of ashes,

The oil of gladness instead of mourning,

The garment of praise instead of a faint spirit;

that they may be called oaks of righteousness,

The planting of the LORD, that he may be glorified."

If we cannot stand with those who know the Lord and have broken minds;

If we cannot stand with those who know the Lord and have broken lives;

If we cannot weep with those who weep, grieve with those who grieve, love those who are unloveable and yet know the Lord, what hope is there for the lost?

What hope is there for the Church?

Who can be saved?

What reason is there for His rising up today?



I wonder what the response will be?

Pax

Christian churches, depression and mental illness - Gordon's story.

What follows below is a post from Gordon's Blog. It follows on wonderfully (and courageously) from my thoughts regarding mental illness ('Thank You' to Gordon for allowing me to post it here):

The church has a poor record of handling mental health issues and my own experience bears this out in a number of ways which I will outline in this article.

I have probably had some level of depression from about the age of ten when I was referred to a child psychologist because I was a bit withdrawn. Yes, she was a Freudian, and no it had nothing to do with sex. She was not very helpful and the experience probably put me off seeking help later on.

My condition has varied over the years from perfectly functional to totally suicidal with elements of self harm. In spite of this I have been very successful in life by adopting a strategy where I choose work and social activities that suit my abilities at the time. For example, I was at my most successful in business when my condition was at its worst because I did not care about my own well-being and working hard became a substitute for physical self harm. At other times I have chosen to pursue my music through recording rather than performing because I could not face an audience.

I can go several years without any depression at all and often it is not that severe. The severe episodes seem to be about ten years apart. I am very conscious of signs that I might be losing interest in things or taking less care of myself, as these are the early indicators of my depression.

Mental health problems and the church
I was first diagnosed properly with depression while living in Edinburgh. It was only after reading a book by Dorothy Rowe called Depression The way out of your Prison that I realised that I had a real, treatable condition that I could recover from. So I went to see my doctor, who actually uttered that classically unhelpful line “pull yourself together”. I got no help at all, but I persisted and after moving house and changing doctor I did start to get some help in the way of medication and Cognitive Behavioural Therapy.

As a very keen Christian, attending an independent evangelical church, I felt very guilty about being depressed as it appeared to me as a great spiritual failure. The reason I thought like this about my brain chemistry when I wouldn’t have about an injured leg is probably down to the bible itself where people with symptoms of mental health problems are quite literally demonised, but I digress. As a Christian I thought that the church might be part of my recovery so I went to see my minister, told him that I was being treated for depression and that I really needing to feel involved with other people as part of my recovery. I had become quite distant from things and a bit unwilling to mix with people so I hoped he might be able to help me get more involved again. Instead of this, he told me that I must have no contact with anyone else in the church in case they caught the depression from me. I was permitted to come into the church service and sit at the back, but that was as far as it was to go. I was not to mix with anyone else socially until I was well again.

As it turned out, this sort of attitude is not unique amongst ministers, and undoubtedly this type of treatment has led to me being iller for longer during my lifetime.

After moving house and changing church to a Baptist church the new minister’s preaching was very much of the “you must try harder” variety which made me feel really guilty as I was already running at full capacity just trying to function as a human being. He only had one sermon regardless of the text which was “look at what God has done for you, so how much are you going to do in return”. For a long time I thought I might have misinterpreted what he was saying due to the poor reasoning caused by my depression, but I met someone recently who had attended the same church shortly after I stopped going. He mentioned the same thing with no prompting from me so it seems that my understanding of what the minister was saying was correct.

Sad to say, if I had stayed away from that church I would have got better quicker.

After withdrawing from church my condition did improve a lot and I made a good recovery followed by a few years of very good health when I was not attending any church. Then another bout of depression set in with quite serious self harm. By this stage I had started going back to church and had chosen the nearest church to my house. This was a pentecostal church. Goodness knows why I was going there. I suppose I went because they were very welcoming, but they had a very clear expectation that the normal Christian life was one of very fast transformation within six months or so of attending. Anything else was a sign of something being wrong with your spiritual life or the result of hidden sin. It was a guaranteed recipe for disaster with regards to my mental health. I didn’t spot the signs of depression this time till it was too far advanced, having spent time in prayer rather than seeing a doctor, but finally I forced myself to go to the doctor (and felt a failure in doing so). He was able to get me very good help, including psychological treatment and this has given me the tools to move forward and prevent future recurrences of my condition. I know that I have already prevented one major recurrence since then and my life is much more stable.

If I had not attended that church would I have had a recurrence of depression? Probably, but I doubt it would have been as severe as I definitely would have sought professional help sooner.

Suggestions for ministers
Isolation is not the answer. People with depression are isolated enough and usually feel lonely and vulnerable. When I was depressed I wanted to feel wanted. You should assign someone to check regularly on people with this condition in your congregation and work at maintaining a relationship with them. Don’t consider people to be “backsliders” if they can’t regularly attend services. They may be uneasy being in large groups, which always made me feel very lonely and vulnerable. When I have been depressed I have been very nervous about travelling to be with strangers so home groups were not really an answer either unless someone had picked me up and taken me there. Even then I might not have been that keen. The key is probably one to one contact with someone and encouragement to seek and maintain medical and psychological treatment.

Are people with mental health problems likely to be more religious?
One of the regular suggestions made is that religious belief is a form of mental disorder and it has even been classified as such by some psychiatrists. I think there are correlations, but more like this: people of an artistic or intuitive temperament are more likely to suffer from mental illness. They are also more likely to explore spiritual issues so are more likely to be religious. As a result, I would expect the percentage of mental patients with an interest in religion to be higher than the population average. Its not a significant statistic and not directly elated.

Some thoughts on Cognitive Behavioural Therapy
I won’t go into the details of cognitive behavioural therapy (CBT) here as you can find information in this article, but I found that CBT did not work for me. Principally because it challenged my creative intuition which is one of my most useful senses. My intuition is generally quite good and I have made a large part of my living from being able to discern the best path to achieving something without any supporting analytical evidence for my decision. CBT turned that on its head and made me less functional in business and as a musician because it said that everything has to be reasoned out and based on evidence. This was actually quite damaging and I began to question if the sky was really blue or the grass really green. I found interpersonal therapy with a psychologist to be the answer for me and its been surprisingly long lasting. Probably because it provided me with tools and dealt with underlying issues, rather than being solely a treatment for symptoms.

Useful Books
I found these books very helpful in my own recovery:

Why Do Christians Shoot Their Wounded? (Not Hurting Those With Emotional Difficulties) By Dwight Carlson - explained to me why I was treated the way I was by people in the church and helped me to depersonalise the hurt.

Depression The Way out of your Prison by Dorothy Rowe - helped me to recognise that I needed help.

There are a number of books about depression written specifically for Christians. I would advise against these because their authors' underlying position seems to be that mental illness is not like physical illness and requires spiritual cures rather than medical help. This, in my opinion, is wrong and is likely to deter people from seeking the professional help they need and which will help them to recover more quickly.