Recommended Reading: Church Trauma Program Spreads Across Countries and Cultures

United Methodist News Service reported this week on the spread of a church-related program to help trauma survivors. The program has its roots in work carried out collaboratively by Congolese women and Harper Hill Global, a US-based non-profit led by Rev. Neelley Hicks. Hicks and Congolese women have been collaborating through the Mama Lynn Center to bring healing to Congolese women affected by rape.

From her awareness that work, Nigerian United Methodist leader Doris Adamu Jenis requested Hicks expand her work to Nigeria. Hicks collaborated with Joan Gillece, director of the Center for Innovation in Health Policy and Practice, to develop an online course that Jenis led in Nigeria and Uganda.

The program was so successful that Gillece asked Hicks to bring it to the United States. Hicks agreed, and developed several different versions of the curriculum, including a Native American one written by United Methodist clergy Rev. Carol Lakota Eastin “Morning Skyhawk” and the Rev. Michelle Oberwise Lacock “Morning Star Spirit.”

Thus, this curriculum spread from the Congo to Nigeria to Uganda to the United States and to Native communities within the United States. At every step of that way, women led the work.

This story is important because it shows a model of mission that spread from Africa to the United States and is not just about exporting "spiritual vitality" from Africa. There is a trope that reciprocal mission between the United States and Africa should involve Americans sharing financial resources and Africans sharing their spiritual resources. This example is significant because it points to other possibilities.

African leaders and African societies (and other leaders and societies around the world) are innovating missional approaches to problems including mental health, public health, climate change, poverty relief, and more. Missional efforts in the United States can and should look to countries around the world for best practices in mission and not just for spiritual vitality.

Recommended Reading: Mental Health Ministries

A couple of weeks ago, I published a piece entitled, "New Mission Area: Mental Health." The piece argued that the church should consider addressing mental health issues as a form of mission, just as it has long addressed physical health issues as a form of mission.

Since that time, I have been informed of the existence of Mental Health Ministries, a site for online resources for addressing mental illness. Mental Health Ministries is an outgrowth of the DisAbility Ministries Committee of The United Methodist Church. Those who are interested in learning more about the potential for conducting ministry with those with mental illness as a form of mission are encouraged to peruse the resources available on Mental Health Ministries' site.

New Mission Area: Mental Health

Today's post is by UM & Global blogmaster Dr. David W. Scott, Director of Mission Theology at the General Board of Global Ministries. The opinions and analysis expressed here are Dr. Scott's own and do not reflect in any way the official position of Global Ministries.

Three weeks ago, I raised the question of what features of the world and its various contexts in the 21st century might constitute new areas of mission, in the same way that features of the world 50, 100, or 150 years ago led to areas of mission work that we now consider central: education, poverty relief, healthcare, etc.

This week, I suggest a third new area of mission work: mental health.

The church has long been involved in health and healing work as a form of mission. In various times and places, this sort of mission work has ranged from faith healing to patient nursing of the sick to the spread of Western medicine. But it has usually focused on physical aliments: sickness, disability, injury.

Mental health has only relatively recently (within the past century or so) been understood as a category of human ailment. And there has often been a good deal of disbelief or shame involved in using the framework of mental health to describe human ailing.

Yet mental health problems are quite common, more so than many diseases. Estimates of the overall incidence of mental health disorders is about 15% globally, and 4% each for depression and anxiety. Overall incidence of cancer, by comparison, is about .2%. Women and people living in Western countries are more likely to experience mental health disorders. In the US, overall prevalence is just over 18%.

Despite the prevalence of mental health disorders, churches have often struggled to know how to respond to mental health, perhaps because of discomfort or difficulty in discerning the line between the cognitive/emotional and the spiritual.

Yet the church has a great potential to treat mental health in holistic ways that include cognitive, emotional, and spiritual components without reducing any of these elements to the others. Indeed, we don't see prayer and medication as mutually exclusive approaches to treating physical disease. Why should we see prayer and counseling (and perhaps medication) as mutually exclusive approaches to mental health?

Since the church proclaims freedom from our burdens, it would seem that mental health care could be a promising new form of mission work. Indeed, since Christianity proclaims joy and peace as among the fruits of the Spirit, it would seem a failure if the church did not address mental health issues that can rob people of these elements of a healthy, holy life.

Moreover, mental health is an area that the church is already engaged in, at least in places. Drawing on his experience of church work with mental health, Peter Bellini wrote a fine three-part series for UM & Global a few years ago on "Global Mental Health and the Church." For those looking to explore this topic further, I commend it to you:

Global Mental Health and the Church, Part I
Global Mental Health and the Church, Part II
Global Mental Health and the Church, Part III

Peter Bellini: Global Mental Health and the Church, Part III

Today's piece is written by Rev. Dr. Peter J. Bellini, Assistant Professor of Evangelization in the Heisel Chair and President's Associate for Global Partnerships at United Theological Seminary. It is the third in a three-part series.

In the first part of this series, I provided an overview of the global scope of depression and other mental disorders. In the second part, I shared examples of how The United Methodist Church is responding to this problem. In my conclusion to this brief discussion on global mental health and the church, I share 10 insights on healing that can be contexualized and implemented in most settings as more United Methodists seek to minister with those impacted by mental disorders:

1. RESURRECTION - Build your healing ministry on a robust and comprehensive theology of the resurrection. The resurrection is the origin, source, power, authority, and goal of our healing. Thus, God works from and to resurrection. Resurrection is the foundational evidence of the Kingdom of God, and the restoration of all things in heaven and earth, here and now. Restoration includes our health and wholeness. God desires to restore all things to their original purpose including our bodies and our minds. Healing is God’s gift to us both now and for the future. Our healing, and the healing of all things, begins now and culminates with the resurrection and redemption of our bodies, as well as a new heaven and a new earth (the new creation). All healing is a foreshadowing of this ultimate healing and prefigures it.

2. GOD HEALS - Since the resurrection is the complete picture of our healing, our faith and expectations should be based on the power of the resurrection and in the God of the resurrection. Jesus said, “I am the resurrection and the life.” Although repentance, faith, wisdom and proper medical treatment are essential to the process of healing, we rely ultimately on God who raises us from the dead. It does no service to the ministry of healing or the integrity of persons to judge, stigmatize, condemn or blame persons for sin or a lack of faith when we do not see or receive our expectation or  our version of healing.

3. EDUCATION - Educate the community of faith concerning divine healing. Prepare the community by utilizing the teaching ministry. Instruct on healing from the pulpit, Sunday School, small groups, seminars, webinars, health fairs and by other means. People are able to process change and adopt new practices more easily once they are informed about the subject. Education clarifies and diminishes the strangeness and unfamiliarity of a complex subject such as healing or mental health. Work to create a culture of nurturing and healing.

4. COMMON LANGUAGE – Since healing, health, and wholeness can be complex, seek to communicate and operate out of a common language. For example, if you are to officiate a healing service, do it in the liturgical language with which your congregation or participants are familiar. For United Methodists, which is my tradition, I use the healing service in the UM Book of Worship. People are more apt to participate and receive in an ecclesial culture that is familiar, especially something as sensitive and complex as healing.

5. TRAIN & CERTIFY - Train, certify and install (publicly in a service) workers for a healing ministry. For example, if your local church has persons gifted to pray for the sick in the church, the community, or throughout the world, set them apart for proper training, and then recognize and commit their gifts and leadership in a public service. Those asked to pray for healing should feel equipped and confident for the task, and the people should feel confident to receive ministry from such persons. The community of faith needs to affirm and confirm such a ministry and its workers.

6. COMPREHENSIVE - A healing ministry should be comprehensive, encompassing physical, emotional, mental, spiritual, relational and other types of healing. Local churches and ministries should partner with other persons and institutions that are better trained at ministering healing in a certain area. Partnering with nurses, therapists, nutritionists, clinics, or 12 step groups adds to the bandwidth and effectiveness of the healing ministry. A good holistic health network, in-house training, and a thorough referral system are essential to an effective healing ministry.

7. INTEGRATIVE APPROACH - A healing ministry is most effective when it takes on an integrative approach. Theology and science, at their best, should work hand in hand. Do not be afraid to take an approach that identifies multiple causes and solutions to problems. For example, counseling, medications, intercessory prayer, laying on of hands and anointing with oil can work together effectively to combat mental health issues. Not every problem is an ‘either/or’ issue of faith or science.

8. NETWORK OF MINISTRIES- Contrary to popular opinion or even stereotype, there are many types of healing ministries that one can have in and from the local church: healing services, an altar team, a visitation team, 12 step groups, health fairs, an in-church clinic, a medical missions team, deliverance and exorcism ministries (Yes, I said that), a Zumba class, a weight training room or gym, Stephen ministries or similar grief recovery ministries, various support groups like NAMI, nutrition classes, suicide awareness seminars, classes for Christian forms of yoga and or intentional deep breathing (may not be acceptable to all local churches), confessional and accountability groups (i.e. Wesleyan band meetings), Theophostic, Sozo, and other types of more “charismatic” inner healing prayer ministries, healing prayer teams, food pantries, free community meals, cooking classes, along with a host of other courses, events, ministries and teams. Think of creating an environment or culture of wholeness that nurtures and fosters health rather than merely relying on crisis intervention that addresses the problem after it occurs. Think of creating a healthy environment that fosters wholeness as a lifestyle: prevention as well as intervention.

9. EXPECTATION - Expect healing to come at any time, any place or in any way. If you are a leader, teach the people under your care likewise. Many are disappointed because they do not receive the healing they wanted or in the way or time they wanted it. Resurrection comes in many ways and at different times, and at all times death and resurrection become the greatest healing. Teach people to look for and expect resurrection every day and in every way. Give God the space and time to work God’s will and expect miracles.

10. OUR PART- Educate people to be responsible in terms of doing their part in the process. In Philippians, Paul instructs us that it is God who works within us the desire and the will to carry out his purposes. Healing is in God’s hands, but some things God has providentially given to our care and responsibility. Through prevenient grace, God chooses to use the practice of medicine, proper diet, sleep, exercise, wisdom, repentance, faith and other means of grace to work healing. Teach responsibility and education for our health.

Peter Bellini: Global Mental Health and the Church, Part II

Today's piece is written by Rev. Dr. Peter J. Bellini, Assistant Professor of Evangelization in the Heisel Chair and President's Associate for Global Partnerships at United Theological Seminary. It is the second in a three-part series.

In my previous post, I described the global scope of the problem of depression and other mental disorders. The problem of mental disorders is wide-spread and, especially in developing nations, often untreated. Yet the church can play a role in responding to this problem.

WHO claims the misconception is that many believe that amelioration of such mental health conditions requires sophisticated, highly specialized or expensive responses, which is not the case. The WHO goal is to increase the development of non-specialist healthcare providers through training, support, and supervision. The Mental Health Gap Action Programme (mhGAP) is part of the WHO’s comprehensive plan and strategy, which was adopted by the 66^th World Health Assembly, for each country to develop non-specialist healthcare to supplement any existing specialized health care.[1] The plan seeks to create “more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; the implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.”[2]

The WHO along with other organizations are planning and executing strategies to tackle the global challenge of mental disorders. The church is also in the midst of the fray. The United Methodist Church has clear statements about the nature of the problem and has also strategized through its Boards (i.e. GBGM) and Agencies (i.e UMCOR) to address the crisis. The Book of Resolutions cites a lack of knowledge as a chief contributor to the problem. I would encourage our churches to become familiar with the statements on mental health from The Book of Discipline 2012, The Social Principles, and the Book of Resolutions 2012. These resources provide informed theological responses for the church to minister comprehensive healing to a broken world. These resources draw from the ministry of Jesus Christ, the model of John Wesley and the early Methodists, and the scientific and medical communities to shape a United Methodist theology and practice of healing.[3]

One such example is the United Methodist Mental Illness Network of "Caring Communities” developed by the General Board of Church and Society. According to Mental Health Ministries, #3303, Book of Resolutions 2012, global United Methodists are invited to join the Caring Communities program that unites congregations and communities in covenant relationship with persons with mental illness and their families to educate and help remove the stigma around mental health issues.[4] Caring Communities “Educate congregations and the community in public discussion about mental illness and work to reduce the stigma experienced by those suffering. Covenant to understand and love persons with mental illness & their families. Welcome persons and their families into the faith community. Support persons with mental illness and their families through providing awareness, prayer, and respect. Advocate for better access, funding and support for mental health treatment and speak out on mental health concerns.”[5]

The theological statement on mental illness from the Book of Resolution 2012 stresses education as the key to opening the door to healing and wholeness, and the Caring Communities program models this type of education. The statement also specifically calls our seminaries to train clergy to educate and equip congregations and communities to minister with those impacted by mental disorders.[6] At United Theological Seminary where I teach, I designed a course entitled “Renewal Ministry and Practice” that focuses on a comprehensive theology and practice of healing and wholeness. Students learn to construct theologies of healing and wholeness as modeled in Scripture and the history of the church. Students also engage in “labs” that challenge them to put their theology to practice in situation in their local contexts.

In my final post on this topic, I will offer 10 insights on healing from that course that can be contexualized and implemented in most settings, insights that can help guide United Methodists around the world who are seeking to develop their own responses to the problem of depression and other mental disorders.

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[1] WHO Mental Health Gap Action Programme (mhGAP), http://www.who.int/mental_health/mhgap/en/

[2] WHO Comprehensive Mental Health Action Plan 2013-2020. http://www.who.int/mental_health/action_plan_2013/en/.

[3] http://www.umc.org/what-we-believe/ministries-in-mental-illness The United Methodist Church website offers the entire theological statement of the church on ministries in mental illness from the Book of Resolutions 2012.

[4] http://umc-gbcs.org/resources-websites/creating-caring-congregations
 

[5] Faith and Mental Health Bulletin Insert, 2013. http://umc-gbcs.org/resources-websites/creating-caring-congregations

[6] Book of Resolutions 2012, Theological Statement on Ministries in Mental Illness from United Methodist Church website. Accessed January 20, 2016. http://www.umc.org/what-we-believe/ministries-in-mental-illness

Peter Bellini: Global Mental Health and the Church, Part I

Today's piece is written by Rev. Dr. Peter J. Bellini, Assistant Professor of Evangelization in the Heisel Chair and President's Associate for Global Partnerships at United Theological Seminary. It is the first in a three-part series.

The United Methodist Church has a theological statement in the Book of Resolutions 2012 on ministries in mental health that opens:

We believe that faithful Christians are called to be in ministry to individuals and their families challenged by disorders causing disturbances of thinking, feeling and acting categorized as "mental illness." We acknowledge that throughout history and today, our ministries in this area have been hampered by lack of knowledge, fear and misunderstanding. Even so, we believe that those so challenged, their families and their communities are to be embraced by the church in its ministry of compassion and love.[1]

According to a World Health Organization report in 2012 entitled “Depression: a Global Public Health Concern,” one in four persons suffers from a mental disorder, and among mental disorders, depression is the most prevalent. Depression is the leading cause of disability worldwide in terms of total years lost due to disability.[2] Depression, as well as other mental disorders, adversely impacts the ability of affected persons to perform at work, school, and in the family.

The World Health Organization (hereafter referred to as WHO) estimates 350 million people of all ages around the world suffer from depression, contributing significantly to the overall global burden of disease.[3] Lack of treatment compounds the problem. Less than half of the persons afflicted with depression, and in some countries less than 10%, receive any kind of treatment.[4] Lack of treatment is due to a lack of resources, including education, diagnostic tools, psychiatrists, psychologists, therapists, medication and support systems. Lack of resources is directly connected to the poverty and underdevelopment of such countries. Misdiagnosis is also another contributor to improper treatment. Untreated or improper treatment of depression can lead to other more dangerous mental disorders and often to suicide. The WHO cites that over 800,000 persons commit suicide every year, and it is the second leading cause of death globally in 15-29 year olds.[5]

Depression is not the only mental disorder that afflicts persons globally. Anxiety, bipolar disorder, schizophrenia, dementia, autism spectrum disorder and other mental and developmental disorders are on the rise as well, and countries face the similar challenges in treating these disorders. There are many individual and social factors that determine risk: genetics, perinatal infections, nutrition, stress, environment and environmental hazards, individual cognitive-behavioral coping skills, trauma, life crises, national policies, social protection, standards of living, work conditions and community support among others.[6]

Many of these factors are part of the larger systemic issue of poverty and underdevelopment. The WHO has identified a mental health care gap between high-income countries and low- and middle-income countries. In low- and middle-income countries, 76%-85% of persons with mental disorders receive no treatment, while in high-income countries the figure is 35%-50%.[7] When it comes to treatment of mental disorders, substance abuse, and neurological conditions four out of five persons in low-and middle-income countries do not receive them. The resources are often not available, and when some resources are available, many of these countries allocate less than 2% of their overall health budgets for mental health.[8]

For example in Sierra Leone where I have ministered, the WHO cites that there is no mental health policy or national mental health program and thus no allocated funds in the budget beyond taxation as the primary source for funding. There are also no benefits paid for persons with disability due to mental disorders. However, a mental health policy and programming are currently being developed.[9] The Mental Health Atlas put out by the WHO also cites that in Sierra Leone “Regular training of primary care professionals is not carried out in the field of mental health. There are no community care facilities for patients with mental disorders. Some traditional healers and general practitioners provide mental health care in the community setting.”[10] Much of the lack of treatment is due to the poor socio-economic conditions in Sierra Leone. Sierra Leone ranks 181 out of 188 countries in the 2015 Human Development Index.[11] Poverty is clearly a factor in their ability to minister mental health care.

Having detailed the scope of the problem in this post, I will turn to how the church can respond in my next post.

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[1] “Ministries in Mental Health, Theological Statement” from the Book of Resolutions 2012. Accessed January 20, 2016, http://www.umc.org/what-we-believe/ministries-in-mental-illness.

[2] “Depression: a Global Public Health Concern,” World Health Organization, 2012. Accessed January 20, 2016, http://www.who.int/mental_health/management/depression/en.

[3] “Depression, Fact Sheet No. 369,” World Health Organization, October 2015. Accessed January 20, 2016, http://www.who.int/mediacentre/factsheets/fs369/en/

[4] WHO, “Depression, Fact Sheet No. 369.”

[5] WHO, “Depression, Fact Sheet No 369.”

[6] “Mental Disorders, Fact Sheet No. 396,” World Health Organization, October 2015, Accessed January, 20, 2016, http://www.who.int/mediacentre/factsheets/fs396/en/

[7] WHO, “Mental Disorders, Fact Sheet NO. 396.”

[8] WHO, “Mental Disorders, Fact Sheet NO. 396.”

[9] World Mental Health Atlas, 2005, WHO. http://www.who.int/mental_health/evidence/atlas/profiles_countries_s1.pdf?ua=1

[10] World Mental Health Atlas, 2005, WHO.

[11] United Nations Development Program: Human Development Reports, Human Development Index, 2015,  http://hdr.undp.org/en/countries/profiles/SLE