The summer flurry probably caused the recent announcement of the Croatian Ministry of Health’s Mental Health Empowerment Program to go largely unnoticed by the public. For mental health difficulties – which, according to estimates, are responsible for about 5 percent of the total burden of diseases in Croatia – do not usually only permeate media headings but also the intimate conversations of the faithful. Although rarely tackled at the pulpit, the mental health crisis does not bypass the Church: and depression and anxiety are just the most prominent reasons why an increasing number of the faithful seek the help of psychiatrists, psychotherapists, and psychologists. This phenomenon doubtlessly raises many questions: How is the mental health crisis related to faith? And what is the Church called to do in such a crisis? The answers to them we found on another continent. About half a year ago, the Diocese of Phoenix in Arizona launched the first diocesan mental health service. And this would not have happened had not the local bishop, John Dolan, lost four family members to suicide caused by mental health issues. In a sincere conversation, the bishop revealed how the pain of a single person can still grow into the healing of the entire community.
It is a three-pronged process, the first prong being advocacy. We encourage people in the political and financial sphere to further the cause of the institutions and professionals studying mental health. Even more important is the educational component. For instance, complementing spiritual guidance with scientific evidence helps priests and deacons avoid over-spiritualizing mental health issues. But the crucial part is accompaniment: gathering with people that struggle with mental health issues and letting them know that the Church is there for them and that they are loved.
Over the last six months, we have been preparing our facilitators to enter the world of accompaniment. They are not meant to be counselors or psychiatrists; they ought to fill the gaps counseling or therapy does not fill. Sometimes this means giving people a safe space to reflect on the Scripture without focusing on their mental health. Other times it means walking them through the grieving process or celebrating the benchmarks of their recovery.
Numerous people have gone through preliminary training on how to be a facilitator, while also participating in the state-run Mental Health First Aid program. This will allow them to assess mental health-related behavior in their parishes and react accordingly, offering help themselves or referring people further. In the future, we expect those facilitators will run »wells« – mental health venues in each of the fifteen of our deaneries.
A part of it may be. But we mostly trained people who already have leadership experience in their parishes. Along with priests and religious sisters, we rely on about 200 permanent deacons facilitating a lot of remote parishes of our diocese, which covers 44 000 square miles. The laity is also interested, especially those already involved in the outreach of their parishes. For instance, many of them serve in a diocesan bereavement ministry that assists people during and after the funeral of their loved ones.
I would call it a soft-landing space, or attending people by being with them. Many people struggling with mental health already go to counseling but are left without a broader support system afterward. The Church can offer them a place to gather and let them know that they are normal: that mental health issues do not prohibit us from being human.
After having lost three siblings and a brother-in-law by suicide, I feel as though the Church had offered me love and compassion, but never beyond the time of the funeral. When my sister died of suicide last year, I sought a counselor myself. But as a child or college student, I should have had someone steer me in the right direction from outside, to invite me and check on my mental pulse. That is how the Church should help – by surrounding people with care until they return to a sense of wellness.
Part of that change came through counseling and spiritual direction, but part of it required me to accept the reality myself. In seminary, I lost my sister and her husband by suicide on the same day. After some time of grieving, I was up for a vote to become the seminary president, but I lost. The reason was that some of my fellow seminarians thought I was not grieving enough. That was when I realized I must not allow myself to be stigmatized or placed in a box. I belong to the Church, I am a child of God, and I will not let people define me otherwise.
We do not define people with broken arms by their arms. Likewise, we must not let mental disorders define either the people who have them or their families.
It allowed me to become a part of the people who were struggling. When I first came out with the idea of mass for the survivors of suicide last year, we anticipated there would be about a hundred participants. But there came ten times more. I received thousands of letters of gratitude because people had never heard a bishop speak about this issue.
There seems to be a reluctance in the Church to openly discuss mental health problems, reducing them to a moral decline of society or a lack of valid spirituality. Is there truth in this stance?
I do not think they are inextricably linked to mental health issues. It is true that there has been a generational lack of spirituality, and that a lack of integration in the sacramental and prayer life of the Church brought about global apathy. But that is just one train track. Mental health issues are also aggravated by people dissociating from communal life and getting caught in virtual worlds without genuine relationships. That is certainly another train track. And when those two tracks intertwine with the track of a person’s susceptibility toward mental disorder, they can be more easily triggered, especially when there is a lack of support. But those are only factors, not the sole causes of mental health issues.
There are cases today when people use a disorder as a crutch, which is a bit paradoxical because not long ago, no one would have wanted to admit to having mental health issues. Counseling should not be taboo, nor should it lead anyone to think they are somehow different. It is much better for people to reach out to a psychologist when they face an issue rather than just moving on. In our seminary system, every seminarian has to go for monthly individual counseling. It is not because they have issues, but because counseling is a normal part of the formation.
When we go to a gym to work out, we do not consider it physical therapy. We do it to improve our physical health. It is the same with counseling: we do it to improve our mental health.
Historically, the confessional surely was a place for emotional support. But people address a wholly different side of their person with counselors.
People go to the confessional to confess their sins, show their remorse, and express their desire to reconcile with God. But they go to counseling to assess and address their emotional and intellectual states. There is a moment of support built into the sacrament, but it is not what we should seek when confessing. Confession is about perfecting the soul’s communion with God; counseling is about improving one’s health. One supports the other, but a worthy counselor and a worthy priest will distinguish them.
Priests should not strive to become counselors, but to gain a knowledge of mental health that will allow them to understand the state of the people they guide. With mental health issues, it is better to refer people further rather than to step into a world we do not understand. Also, many lay people are taking up the flag of counseling. I myself have a lay counselor.
The act of suicide is a grave matter for several reasons. You take the very life God gave you and leave many people in tremendous grief. It truly is a sin – »missing the mark«. But when we say someone »committed suicide«, we impute a rational choice that was not present.
When a person shows signs of suicidal ideation, most of the time there are severe physiological disruptions behind it. We cannot see this sitting across a suicidal person, but it reduces their culpability nonetheless. The Church understands this much better today than in the past. Today we know many ways that a loving family and a loving Church can help these people, yet sometimes there is nothing that can prevent them from suicide.
My sister Mary died by suicide in October. It was not her first attempt. I have never met a person surrounded by so much love and so much professional care and still wanting to die as much as she did. It did not mean she lacked prayer; she had a profound devotion to St. Therese of Lisieux. She loved God, she had wonderful moments when she loved herself, and she certainly loved her children. Yet at the same time, there was something within her that could not be helped. It was not a rational inclination.
For the longest while, the Church has taught that people are morally and canonically obliged to attend church. Then why are people still not attending mass on Sunday, but are going to other churches that do not oblige them?
Because they feel a different obligation. We have to help people rethink the sense of obligation, even the sense of moral precepts.
One of the precepts of the Church is that you have to help the ongoing mission of the Church financially. But if you only tell people they have to give money to the Church, they will tell you that they do not have to do anything. There was a day when the people in the pew did everything their priests told them, but the faithful today want to know why. Half of our congregation consists of highly educated people taught to think outside the box and question everything. That is why I am not as quick to assert that people are solely abandoning morals; I believe they are honestly questioning them. And if we offer them genuine reasons for living in the Church and following its moral compass, the Church can only become more vibrant.
It is vital to know that people who suffer from suicide ideation are mostly already withdrawn on their own or ostracized by others. And teenagers are much more susceptible to withdrawal. They are expected to grow socially, but are also more exposed to different kinds of bullying, increasing the temptation to self-isolate. Social withdrawal is a disaster, and anything we can do to relieve it will help the youth.
Isolation truly is the preeminent trigger for suicide. That is why, when the State of California presented a bill in 2016 called » Physician-Assisted Suicide«, the bishops of California created a program called »Whole Person Care«. It connected hospitals and senior facilities with families and parishes, offering a wrap-around service to alleviate the loneliness many people suffer. When the bill was finally passed, we discovered only a small number of people utilized it. But those who did predominantly were the ones who had no family around them. There is no foolproof system, but whenever we can eliminate stigma or isolation, we are moving in the right direction.
If people with mental health issues are medically stable and regularly tracked, they can become part of any ministry of the Church. But they do not have to become leaders to serve. Their very presence brings value to the Church. Belonging is serving too.