Comfort My People

The 218th General Assembly of the Presbyterian Church (USA) adopted a policy statement on serious mental illness in June, 2008 meeting in San Jose, CA for churchwide study and use. The result was the publishing of“Comfort My People: A Policy Statement on Serious Mental Illness”with appendixes and a related study/action guide distributed to the middle governing bodies and their resource centers, to sessions, and to libraries of the Presbyterian theological seminaries; and additional copies are available for sale or download. The Rev. Dr. Bob Butziger, Presbytery of San Jose, served on the Task Force which spent three years developing this study. It was staffed by the Advisory Committee on Social Witness Policy.

The following are the approved definitions of (a) mental illness and (b) serious mental illness:

a. Mental Illness is a medical disorder characterized by disturbance in thought, mood, or behavior that

causes distress or impairment of spiritual, interpersonal, behavioral, and emotional functioning. If left untreated, all mental illnesses are impairing.

b. Serious Mental Illnesses are severe and persistent medical disorders characterized by impairment in

mood or behavior that cause distress and/or impairment in spiritual, interpersonal, and behavioral functioning. Salient examples are the disorders known as schizophrenia, bi-polar disorder, and major depression. Characteristic symptoms of serious mental illness include hallucinations, delusions, disorganized thinking, extreme mood changes, overwhelming hopelessness and sadness, severely impaired perception, judgment, or insight, and problems with concentration and attention. Serious mental illness is an enduring condition that affects one’s ability to cope with everyday challenges. If left untreated all mental illnesses may impair one’s ability to establish and maintain interpersonal relationships, practice one’s faith, worship God, attend school, go to work, or live independently. All mental illnesses can be impairing.

1. The Assembly urges the presbyteries to do the following:

a. Provide educational opportunities for members to learn about treatment, counseling, ministry with people with serious mental illnesses, and how to address the stigma of serious mental illness in their congregations, particularly in regard to the experiences of children and youth, women and men, the elderly, and racial ethnic groups.

b. Provide training for pastors, staff, and lay care providers to help them develop appropriate identification and intervention strategies for persons at risk for suicide, especially teenagers, young adults, and the elderly.

c. Provide continuing education for pastors, staff, and lay care providers to train them to recognize and intervene when a person with a serious mental illness also abuses drugs, including alcohol.

d. Provide continuing education opportunities for pastors to help them learn how to support and advocate for families in crisis and to make appropriate treatment referrals.

e. Require mandatory continuing education credits for pastors on issues of pastoral care such as serious mental illness, addiction, domestic violence, child abuse, and other pertinent health-care issues.

f. Encourage pastors to become aware of the quality of services provided at local treatment facilities by consulting with administrators and care providers of those facilities, touring those facilities, and talking with people who receive such services.

g. Encourage pastors to preach sermons and provide Bible studies about serious mental illness.

h. Support the ministry and witness of the Presbyterian Serious Mental Illness Network (PSMIN), Presbyterians for Addiction and Action (PAA), and the Presbyterian Association of Specialized Pastoral Ministries (PASPM) of the Presbyterian Health, Education, and Welfare Association (PHEWA), and Pathways to Promise, and encourage pastors and local sessions to do the same.

i. Encourage pastors to learn about the resources of the Veterans Administration (VA), as well as educating them to the needs of veterans of all ages, genders, and ethnicity.

2. It urges committees on preparation for ministry (CPMs), in consultation with the Office of Vocation of the General Assembly Council (GAC) and the Office of the General Assembly (OGA), to do the following:

a. Educate themselves about serious mental illness in order to help discern the call of individuals under care with understanding and compassion. This discernment should include consideration as to whether this person can be effective in the ministry of Word and Sacrament.

b. Assist individuals under care to find resources and support for any serious mental health concerns.

c. [If an inquirer or candidate does not pass ordination exams, explore alternative means for administering ordination exams among the range of tools for assessing readiness for ministry.] [Explore alternative means for administering ordination exams among the range of tools for assessing readiness for ministry, if an inquirer or candidate does not pass ordination exams.]

d. Encourage uniform standards and a uniform process for the psychological evaluation of candidates for ministry.

e. Require candidates for ministry and commissioned lay pastors (CLPs) to have successfully completed at least one unit of accredited clinical pastoral education (CPE).

3. It encourages committees on ministry (COMs) to do the following:

a. Educate themselves for early identification of pastors who may have a serious mentalillness.

b. Develop more effective early intervention strategies and follow-up in dealing with pastors, sessions, and congregations when serious mental illness may be involved.

4. It urges sessions and congregations to do the following:

a. Prominently display educational material regarding serious mental illness, such as location and times for local meeting of the National Alliance on Mental Illness (NAMI)— support groups/family-to-family training).

b. Display pamphlets from national advocacy groups such as Pathways to Promise, Substance Abuse and Mental Health Services Administration (SAMHSA), Presbyterian Health, Education and Welfare Association (PHEWA), and the National Alliance on Mental Illness (NAMI).

c. Subscribe to newsletters or web-based information updates from agencies listed above and post in newsletter/bulletin boards.

d. Provide support and advocate for individuals and families affected by serious mental illness.

e. Provide meeting room space for support groups and guidance for prayer-based support programs.

f. Consider forming a relationship with a local chapter of the National Alliance on Mental Illness (NAMI) for the purpose of fostering relationships between members of the congregations, their families, and people with serious mental illness.

g. Advocate for establishment of funding of not-for-profit agencies, counseling centers, and treatment programs for persons who struggle with mental illness, including those with dual diagnoses of alcohol and drug abuse.

h. Work to end the stigma of serious mental illness within the congregation and in the surrounding community.

i. Invite local mental health professionals to address serious mental illness in small groups and in worship services, and encourage family members with serious mental illness to attend them.

j. Create a church environment open to the transforming work of God where people know confidences will be kept and they will be accepted and supported when they ask for help.

k. In under-served areas, advocate for greater availability of mental health resources.

l. Encourage all members to prepare a Psychiatric Advance Directive (PAD), which specifies plans for their treatment in case of a mental health emergency. (Refer to Appendix D for an example of a PAD.)

m. Gain a deeper awareness of our own perceptions and attitudes regarding mental illness by making use of the recommendations here as well as the information provided in the background or rationale section of this report.

n. Encourage greater awareness regarding race, ethnicity, gender, class, age, and language as these relate to persons with a serious mental illness.

o. Advocate for housing for people living with a serious mental illness.

p. Encourage local sessions to adopt specific psychiatric units for prayer support, visits (when permitted), and material donations.

q. Conduct acts of worship recognizing Serious Mental Illness Awareness when designated in the Presbyterian Planning Calendar, Mental Health Awareness Month (May), and Serious Mental Illness Awareness Week (the first week in October).

r. Support the ministry and witness of the Presbyterian Serious Mental Illness Network (PSMIN), Presbyterians for Addiction and Action (PAA), and the Presbyterian Association of Specialized Health, Education, and Welfare Association (PHEWA), and Pathways to Promise, and encourage pastors and local sessions to do the same.

s. Encourage local hospitals to design comprehensive discharge plans for all psychiatric patients and to collaborate in and monitor the full implementation of these plans with available social service agencies post discharge.

t. Support church-based counseling services staffed by mental health professionals.

u. Support and advocate for resources to assist veterans such as: the Veterans of Foreign Wars (VFW), Disabled American Veterans (DAV), and The American Legion.

v. Inform and encourage veterans within the congregation to seek available resources to help them such as: the Veterans of Foreign Wars (VFW), Disabled American Veterans (DAV), and The American Legion.

w. Become active in helping members of the congregation prepare a Wellness Recovery Action Plan

(WRAP).