There Is a Balm in Memphis

IN SEPTEMBER 1987, ordained Methodist minister and practicing physician G. Scott Morris opened Church Health, a faith-based health care center in Memphis, Tenn. The first clinic tended to 12 people. Over 35 years later, more than 80,000 different individuals have come through Church Health’s doors. When they started, Memphis was the poorest city in the country, but Morris and companions didn’t open Church Health center as an act of charity. Church Health’s mission has always been about demanding justice. His book Care: How People of Faith Can Respond to Our Broken Health System tells the story of clinics across the U.S. where people practice Jesus’ command to heal. — The Editors

I FIRST CAME to Memphis in 1986. Having completed my theological and medical education, I was determined to begin a health care ministry for uninsured people working in low-wage jobs. I had dreamed of this for years as I slogged my way through the training that would make it possible. When the time came, I chose Memphis because historically it is one of the poorest major cities in the U.S. Today we see patients in clinics for primary care, urgent care, dental work, and optometry services. Behavioral health, life coaching, and physical rehabilitation are integrated into our clinics, and we have a teaching kitchen offering classes on culinary medicine for patients and the community. The Church Health model is used in more than 90 clinics around the country. There are about 1,500 free and charitable clinics in the U.S., many of which have faith-based connections.

God calls the church to healing work. Jesus’ life was about healing the whole person, and Jesus is the church in the world. Tradition suggests that Helena, the mother of the emperor Constantine, was the first to open a hospital specifically to care for the poor. The ancient world never had a system to care for the sick who were poor until Christians offered hospitals. Even Julian the Apostate, a fourth-century Roman emperor who did not have much use for Christians, wrote, “Now we can see what it is that makes these Christians such powerful enemies of our gods, it is the brotherly love which they manifest toward strangers and toward the sick and poor, the thoughtful manner in which they care for the dead, and the purity of their own lives.” We are still Jesus’ disciples, the body of Christ running after God’s priorities in the world together. What does it look like to have a healing ministry in today’s world?

What’s on your mind is in your body

HALF OF THE people who come to primary care doctors like me have no physical medical problem. They are there because of their mental and emotional health needs. These days, people come to the doctor for reasons they used to take to the priest or pastor. Why is that? It is partly because people have decreased trust in the clergy and partly because clergy are less well trained or available to deal with matters of the heart. Unfortunately, physicians are equally ill-equipped to care for matters of the spirit. We are so focused on physical ailments that we can’t see the spiritual dis-ease people have. We are so dependent on technology that we assume our diagnostic testing will reveal the cause of all human suffering. But I could MRI a patient’s heart all day long and never uncover the slow bleeding of their damaged soul.

The church is not always well prepared to care for mental illness or emotional distress. Often we don’t realize the prevalence of mental health concerns in the church — the same as in the general population — or the urgency to minister to them.

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The late Bishop William Young told the story of one woman: “She came looking for help on a Sunday morning.” Twenty years after the fact, he still felt the remorse of wishing he and others in the church had better understood the crisis level of the woman’s grief. Instead, he told her to come back the next morning, and he would try and help. Many pastors just want to get through Sunday.

She did return the next morning — at 6:30.

“She went and stood under the cross at the altar and pulled out a pistol and shot herself,” Bishop Young said. It was devastating for him and the congregation.

The experience led to a 20-year mission to address suicide in the Black church. Bishop William Young had been a chaplain at Western State Mental Health Institute in Bolivar, Tenn., and a chaplain at Methodist Health Systems in Memphis. He was well qualified to lead such a charge. Together with his wife, Rev. Dianne P. Young, they hosted the first National Suicide and the Black Church Conference in Memphis in 2003 and continued to speak around the country. Tragedy can be galvanizing, and ultimately it may open awareness and opportunity for the church to take a leading role.

The church for people who hate church

MATT RUSSELL'S PERSONAL experience was also galvanizing. Matt grew up in an evangelical Christian family in Dallas. When he was 12, his mother became sick. In the church, people accused her of unconfessed sin and being an “unsubmissive” wife. It turned out she had a brain tumor.

Matt felt that he was part of the problem. He managed by reaching out for “substances and processes.” He used anything that would numb him physically and allow him to cope with his overwhelming experiences. He developed a process that would never leave a trail. No one knew, and as a result, he felt constant shame.

Despite all his struggles, Matt sought to become a pastor, and went to seminary. He was in endless conflict over the God he had been taught growing up — judgmental, harsh, demanding — and the God he had come to know — loving, kind, accepting. The disconnect led to a crisis of faith.

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At 27, in his first appointment as a United Methodist minister, Matt met an Alcoholics Anonymous “old-timer.” It was a burning bush experience where he felt God was truly present. This led him to go to treatment, where he experienced confession not as shame but as joy. It was liberating. He saw God — YHWH — as one where “something is happening here.”

When Matt returned to the church after treatment, he asked the senior pastor, Jim Jackson, to let him interview people who had left the church and ask them why. His goal was to start a congregation for people who hate church. What he found was a recurring theme of people who had found their spirits touched through AA and the recovery community, just as he had. Through recovery, people had experienced a vital spirituality.

Why should a mental and behavioral health issue be causing people to leave the church and find renewal elsewhere? But it was. The church for people who hate church took on the name Mercy Street. It began with about 60 people the first time they met, most of them in recovery. And then it grew. And it grew. No matter how people had been harmed, many found a source of solace in Mercy Street.

The call to heal includes mental and behavioral health. Perhaps one of the most unmentionable realities of mental health care is how it negatively impacts other health care. People with severe mental illness die 15 to 30 years younger than those who do not have these illnesses. People with mental health illness are less likely to get cardiac catheterization when they have chest pain, less likely to get appropriate care to manage diabetes, less likely to get screening and treatment for cancer — the health care most of us expect that could help prevent or manage chronic disease for longer life. We must work harder at removing stigmas, removing obstacles, and believing in the health of the whole person because that is who God created us to be.

The church — the body of Christ — must show the here-and-now nature of the kingdom of God through healing. The call to mercy is not to figure out the reasonable limits of mercy but to embrace its unlimited nature. Jesus tells us to put compassion in action, even if it costs us something.

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‘The Poorest People Get Nothing:’ An interview with G. Scott Morris, founder and CEO of Church Health in Memphis, Tenn.

This interview was conducted over email with Sojourners’ Rose Marie Berger.

Sojourners: What piece of health care legislation would positively impact your patients?

The Affordable Care Act (ACA or “Obamacare”) passed in 2010. Most of the key components went into place in 2014. With this in place, the Supreme Court decided that expansion of Medicaid was left to every state to enact on its own. In Tennessee, along with most states in the South, our legislature has chosen not to expand the Medicaid rolls, which would have included many of the working uninsured. Without the expansion, someone under 65, who might never earn another cent, will not qualify for Medicaid because they don't meet a “categorical criteria,” such as being blind or disabled. Now their only option is the ACA health exchange, which allows people to purchase health insurance from the exchange on the open market with subsidies that the government would provide.

Currently, about 80,000 people depend on Church Health for their health care. Ninety percent of the people we see at Church Health fall below 138 percent of the federal poverty level. Anyone whose income is below 138 percent of the federal poverty level will not qualify to purchase insurance off the exchange. I know you must think I got that wrong—what I just told you is that the poorest people get nothing.

In states such as Tennessee, for most working uninsured patients, the impact of the Affordable Care Act has been very, very little. Jesus said, “The poor will always be with you.” So far, he has been right. I just don’t think he thought there would be so many poor people.

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Most of the legislation that can impact large groups of people is at the state level. In Tennessee that would be accepting the funding to expand Medicaid, but with the Republican supermajority, that is, sadly, unlikely to happen. Which means much of our effort needs to be with smaller endeavors working at a bureaucratic level. For example, finding ways for physician loan repayment programs to apply for free and charitable clinics like Church Health, which exist all over the country, so young doctors can participate in medical school debt forgiveness programs run by the federal government. The same should be true for their malpractice insurance. These types of changes can impact the care for tens of thousands of Americans.

Are you mentoring new doctors into the field?

Someone a lot smarter than me said, “You should always overinvest in the young.” We do that through our gap-year program for recent college graduates who want to go into health professional schools. Students work full time, earn $15 an hour, and get enormous clinical experience with the types of physicians they hope to become. We also want Memphis to be known as the city that trains Black doctors. There are 168 allopathic medical schools in the U.S., but only four historically Black college or university (HBCU) medical schools — one of which is Meharry in Nashville. Of the HBCU medical schools, Meharry is the only one affiliated with the Christian church; it’s a United Methodist institution. We are working with Meharry to create a Memphis campus affiliated with Church Health and other key Memphis institutions.

Does providing services for the “working uninsured” create a theological tension between “deserving” and “undeserving” poor?

I bristle at a suggestion that we focus on the “deserving poor.” We focus where the need is greatest. Today, the overwhelming majority of people without health insurance in America are working — conservatively about 26 million. They wash our dishes, clean our houses, cook our food, care for our children, and will one day dig our graves. When they get sick, they don’t qualify for anything. Their options are very few.

These days more than half of our patients don’t speak English and are undocumented immigrants. In rare situations, a physician may not be willing to donate care for an undocumented patient. We must respect that decision, to have that physician be willing to care for someone born in Memphis who has the same problem. And no one, not even Bernie Sanders, is willing to talk about health care for immigrants. On average, undocumented workers have been in this country working and paying taxes for 15 years or more. Yet, if they fall off the roof and need surgery as a result, they are told to go back from wherever they came. While we work every day to develop Dr. King’s Beloved Community, we aren’t there yet.

The call to discipleship requires three things: preach, teach, and heal. You don’t get to take a pass on the healing piece. If you want to follow Jesus, you must be engaged in a healing ministry. If you are not, then you are ignoring one-third of the Bible.

This article is adapted with permission from the book Care: How People of Faith Can Respond to Our Broken Health System.