An Open Letter to Pastors Regarding Mental Health Hospitalization

Pastors & Church Leaders,

You probably don't know me, so I appreciate you reading this letter.  What I'm writing to you about is the result of a few years of processing this subject. Yes, sometimes it takes me awhile to come to conclusions about things.  I'm pretty sure one could come to a quick conclusion about the church's role in walking along someone dealing with mental health issues, but the processing that I'm talking about is coming from seeing first hand the presence and absence of the community of Christ in a person's life.  Jesus saw then had compassion, right?  To some, it may be surprising that the presence of mental health struggles is more prevalent on a Sunday morning than you think.  Therefore, there has been a lot to see, feel, and take in.  My name is Kristin, and I'm a Christian and former mental health therapist.  I say "former," because I currently spend my working hours caring for my two little girls as home as a stay-at-home mom.  I am still a Licensed Professional Counselor in the state of NC with an M.A. in counseling psychology, and find that my previous experiences have given me a a window into ministering to those who struggle.  And we all struggle, right? My husband is a pastor of a church we planted five years ago in downtown Raleigh.  As someone in full time ministry now, I would encourage you church leaders to hear me out as a peer and someone else fighting the good fight with you.

There is much to say about mental health in the church and many different opinions on its origins and treatment.  This is NOT what this letter is about.  What this letter is about is an exhortation to do the sometimes hard thing of being the Biblical church to those struggling.  What do I mean by that?

Well, let me back up a bit.  Unless you've personally been through major mental health struggles or been close to someone who has, the idea of mental health may just be a picture of what you've seen in a movie. One Flew Over the Cuckoo's Nest or A Beautiful Mind, perhaps?  Let me give you a general idea of mental health hospitalization, at least from my experiences in three states and in various roles as a mental health professional.   I know that there are various camps out there with opinions on medication and different types of therapy, but hear me out, please!  This is not a dialogue about that...I just want you to know from where someone that walks into your door might be coming.

1. Someone is hospitalized because they are either a threat to themselves or someone else.  In other words, they may be suicidal, not able to make safe decisions that will keep them physically safe, or threatening to harm someone else.  This individual may have just attempted to take their own life, overdosed due to an addiction, or had a psychotic break.  To put it simply, they are broken people (like we all are) at a very low point. 

2. Most hospitalizations last 5-10 days.  The main goal of hospitalization is stabilization, so treatment (medication, therapy, etc.) is focused on getting the person to a place where they are no longer a threat to themselves or someone else.  Working towards this goal, medication is often administered/tweaked, therapy (individual, group, & family) occurs, and the individual is discharged with a plan for continuing outpatient treatment.  It is majorly intense both for the individual and their families.  Trust me, emotions run high. 

3. An individual's discharge plan usually includes a follow-up appointment with a psychiatrist, an appointment with an outpatient therapist, and hopefully a toolbox of things learned regarding coping skills, insight, and support.

And that's where you come in, church.  I've been a counselor in both inpatient and outpatient settings, and I cannot tell you how important the bride of Christ is at this juncture for an individual being discharged.  The role of the therapist or case worker creating the discharge plan is one of great responsibility as he/she helps the individual transition back into the world with services in place to hopefully prevent a future hospitalization. So, with that in mind, I cannot begin to tell you what a tremendous blessing it is to have solid churches in the community that offer services and support.  I believe that God is the great healer and that only through His Spirit can we grow and really change.  Therefore, I am comforted when someone is discharged from an inpatient setting and into the care of an outpatient Christian counselor and the community of believers that helps to meet real needs, prays for them, points them to the cross, and accepts responsibility to Biblically love them.

I humbly urge you to consider the following steps that you, as a leader in the church, can take to extend the love of Christ to those struggling with mental health issues:

• Seize the evangelistic opportunity. The church oftentimes has the evangelistic opportunity to demonstrate and proclaim the Gospel to a hurting person for the first time.  The individual may have had a bad experience in the past with the church or Christians, so love them well by being faithful to articulate and demonstrate fully the Gospel that saves!  Many times, questions surrounding death, hope, and faith often arise after the initial reason for the individual's hospitalization.  They are broken, or close to it, so it can be the perfect juncture to ask about these things, and an individual may be open to talking about such topics.

• Step up to the plate on issues such as Biblical community and discipleship.  Don't be afraid of being a healthy church that cares for the individual by exhorting, discipling, and Biblically disciplining them when needed.  Some individuals with chronic mental health issues can honestly be hard to work with.  They are oftentimes ignored or allowed to create havoc because of the difficulty in working with them.  Please, be the church and do what God calls us to do in terms of extending grace and calling out sin in a loving way.  We do this in love and with the hope of restoration, so this may be the only place the individual hears this type of truth in the context of love.

• Implement Biblical church membership.  First, understand what Biblical church membership is and is not. One of the benefits of healthy church membership is knowing who is under your care as a pastor.  Our church recently had a sermon on Biblical church membership called Making Membership Meaningful (click here to listen to the podcast) and one of the points was that since pastors are held accountable for the souls of those they shepherd (Hebrews 13:17), they need to know who is in their flock.  There are a million things a pastor has on his plate, trust me, I know!  So, enjoy the benefit of knowing where to most wisely spend your time and energy.

• Refer with intentionality and care. Pastors, know the Biblically solid counselors in your community to whom you can refer.  You may not have the specific training to deal with specific situations, but as the individual's shepherd, you have the responsibility to care for their soul, so guide them to someone you trust can walk with them through life's struggles while pointing them to the Gospel.

Please note that I'm not necessarily suggesting the creation of programs or hosting community AA meetings. As the previous suggestions are lived out, your church may end up implementing a host of different programs or creating your own from scratch.  However, I do not believe that programs can effectively drive the church. Biblical conviction does.  If the things God calls the church to be aren't convictions, no program or community outreach can really have the impact that will last.  In other words, strive towards Biblical health for your church and these things will naturally follow.

Pastors and church leaders, thank you for giving your life to glorifying God by serve the body of believers. Thank you for loving your flock.  I sincerely appreciate what you do.