mental health
From The Virgin Suicides
THE REMAINING LISBON sister are sprawled in their bedroom when the priest knocks on their door.
“Hello girls, I thought we could talk. Do you feel like talking?”
Their returning stares are vacant and unknowable, and the priest wears only the pretense of concern. Both parties maintain their false decorum, neither fully able to acknowledge their shared grief: the suicide of Cecilia, the youngest Lisbon sister, only 13 years old.
Illustrations by Simone Noronha
IT WAS DARK. Totally dark and empty. Andrea Smith felt a familiar hopelessness. “Of course I’m all alone,” she thought. “It’s my greatest fear.”
Smith, a pastor in the United Methodist Church, was at the Johns Hopkins Center for Psychedelic and Consciousness Research in Baltimore, in the first moments of a psilocybin trip designed for clergy.
“I didn’t know crap about psychedelics leading into it,” Smith told Sojourners. Through work with the center before her 2019 experiment with psilocybin (a psychoactive ingredient found in some mushrooms), she was prepared to possibly meet her greatest fears — some participants even reported seeing their own death. At first, that’s exactly what happened.
Smith’s profound childhood trauma — her mother suffered a fatal aneurysm in front of her at age 9 — had instilled an existential fear of being alone, she realized, which had led her to the brink of self-destruction. Burnt out in ministry, avoiding the truth about her husband’s infidelity, and grieving the death of her father, Smith entered the Johns Hopkins study in a fog of depression. She was considering returning to the antidepressants she’d stopped years before. “I was broken,” Smith said. “I was just exhausted and spent.”
During Smith’s psilocybin treatment, something shifted. She described moving “in and through” increasingly abstract and light-filled imagery that led her on what was ultimately, she said, a journey of redemption and forgiveness. She never got back on antidepressants, because the depressive fog lifted almost immediately after her psilocybin treatments. Smith credits the psilocybin experience with her ability to make major life changes.
The scientists at Johns Hopkins paved the way for contemporary research into the unique pharmacological properties of organic and synthetic compounds known collectively as “psychedelics.” In 2000, the Johns Hopkins team obtained the first regulatory approval in the U.S. to restart research into psychedelic use with healthy voluntary subjects. In 2006, the team published the first wave of results on the “safety and enduring positive effects of a single dose of psilocybin,” which helped catalyze a worldwide resurgence of psychedelics research.
Image: Tero Vesalainen / Alamy
Two years ago, I spoke to one young woman with obsessive-compulsive disorder as part of my research into discipleship and depression. After this woman had received her diagnosis, some well-meaning but ill-informed members of her church instructed her to pray and read the Bible more. Because of their advice, she said, “I was always wrestling with whether it was spiritual warfare.” This spiritualization exacerbated her mental health struggles, adding on a religious component to her symptoms, including compulsive prayers and other spiritual practices to gain God’s favor and find healing. When it comes to accompanying young people through mental health challenges, I know the church can do better.
Photo courtesy of Church Health
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?
yokunen / iStock
HAVE YOU EVER had one of those perfect moments?
My wife and I sat on a bench at the farmers market with a plate of steaming hot tamales before us and a bag of crisp fennel bulbs, Pink Lady apples, and fresh spinach at our feet. The air smelled of salt and cooking oil. A deep yellow and iridescent gold light wrapped around us. Every noise fell away in a holy hush. We met, however fleeting, the “still point of the turning world” described by poet T.S. Eliot. Held and beheld.
To be honest, I usually miss these moments. Though I try (religiously) to keep custody of my mind and attention, the world we live in now beeps, dings, buzzes, and updates 24/7. It’s hard for God to break in. Perhaps this description of digital architecture’s pointed intrusions into our one beautiful life is too minimalist. Most days, I’m holding my breath against the crushing dynamics of digital onrush and knowledge outflow. I miss the still points between the crest and lip of that wave.
Illustration by Blake Cale
EVEN IN MY earliest memories, I was consumed by terrifying worries and did everything in my power to alleviate my deepest fears. When I was 8, I can remember being plagued by guilt following the death of my aunt to cancer, worrying that it was somehow my fault. Intrusive thoughts and images flooded my mind at night, and I called my parents into my room to confess, seeking reassurance that I was not a dangerous monster. As I grew older, my fears began to consume every single area of my life that was important to me. By college, I was afraid to sleep out of fear that I had left the stove on or the door unlocked. And by graduate school, I moved through my day wondering if I had called people derogatory names or written horrific things in birthday cards before blocking the memories out. I repeatedly checked the stove, took pictures of locks, and called friends to make sure I hadn’t somehow caused harm. At the time, I was unaware that these acts, known as “compulsions,” only made my condition worse.
In my early 20s, I learned that I was experiencing the symptoms of a diagnosable mental illness known as obsessive-compulsive disorder (OCD). OCD is often represented in television and movies as something laughable—think Tony Shalhoub’s Monk. In reality, OCD is far more serious: a debilitating disorder defined by unwanted obsessions that terrify the sufferer and compulsions repeated over and over to alleviate overwhelming fear, guilt, or anxiety. Some obsessions might relate to more commonly known themes of contamination or organization, while others might include culturally taboo themes involving violence or sex. But they are all equally painful to those caught in OCD’s grasp.
We all have thoughts—happy, sad, violent, intrusive, and strange. But those with OCD tend to place more value on these thoughts, concerned that they may be true. When time spent experiencing these obsessions and engaging in compulsions impedes functionality, that’s when it becomes a disorder. But even in my struggles, I feared documentation of an official diagnosis would negatively impact my pursuit of ordination. I had always heard that we should turn our worries to God, so I wondered what those approving my psychological evaluations for ministry would think if they viewed me as in need of mental health treatment that could not be solved through prayer.
Illustration by Jackson Joyce
HOW HAS THE pandemic changed you? This question can feel loaded, as though our answers should contain revelatory insights or transformational changes in our mindsets or lifestyles. My answers have varied. Since the pandemic forced my intense travel schedule to come to a screeching halt, I’ve realized just how unsustainable that schedule, with its impact on my family life, had become. I look forward to returning to traveling soon, but I am determined to be much more selective about it. I also often reflect on the ways that my family deepened our love for nature during the pandemic, breathing in the beauty of God’s creation. These are just a few of my answers.
But for some of us, the question elicits anxiety about going back to the broken “normal” of pre-pandemic times. For many, lurking behind the question is a recognition that some of the ways COVID-19 has changed us may not be for the better, and some of our struggles during this time may not simply go away because we are vaccinated and can now resume social activities. Sadly, the pandemic amplified a preexisting mental health crisis in this nation. A New York Times article by organizational psychologist Adam Grant popularized a new term: “languishing,” which describes the state of feeling aimless, joyless, and unfocused. This captures a wide continuum between flourishing and full-scale depression. Languishing can also have a deep spiritual dimension: We feel a sense of spiritual fatigue and emptiness or even feelings of abandonment and anger toward God. They can be compounded by the inability during the pandemic for most of us to experience in-person fellowship and worship.
A recent report by Stop AAPI Hate, Brigham and Women’s Hospital, and the Asian American Psychological Association found that Asian Americans who have experienced racism are more stressed by anti-Asian hate than the pandemic. Further, it found that 1 in 5 Asian Americans who have experienced racism show signs of racial trauma.
Professional tennis player Naomi Osaka in action during her 2018 US Open semi-final match at Billie Jean King National Tennis Center in New York City on September 6, 2018. Leonard Zhukovsky / Shutterstock.
I am no stranger to the ways that sports is often derided in faith and justice circles. But I contend that sports and competition offer valuable insights into what it means to be human.
Image via REUTERS/Mike Segar
Normally, in moments very unlike our present, I could sit and laugh with extended family without fearing that my presence will expose them to an early death. I could get takeout without having to surgically remove the food from its packaging in a designated clean room like it’s a rupturing spleen. I could even venture to a quiet park where I’m passed too closely by a jogger or family of five without having my existential ire erupt out of me like a sermon, delivered only to my weary family on the way home. Most days I was able to have a tough day at work without having to forage for canned beans and toilet paper in surgical gear at our local Kroger as a nightcap.
Screengrab from ‘I don’t want to be in my body no more: a visual poem’
Writing poetry has helped me face all the fear and uncertainty that surrounds a lifelong diagnosis.
Speaking and preaching will only take a congregation so far. Real and sustained progress requires a change in cultures that demand people hide a part of who they are. “We must become congregations in which people are welcome to be their whole selves,” Snell writes. “When we do the work of making our congregations welcoming to those with mental illness, we can live into a vision of the fullness of the body of Christ, accompanying all and excluding none.”
Our mounting anxieties are confronted in the psalm for the final Sunday of this month. Not the wear and tear of personal difficulties, but stress, fear, and exasperation at the flourishing of injustice, denial, mendacity, and exploitation. All exacerbated by the frenzied input of the media in which we are saturated. The psalmist speaks: Be still before the Lord and wait patiently. Do not fret over those who prosper, who succeed in evil schemes (see Psalm 37). The psalms do not prescribe withdrawal, tranquilizers, or techniques of self-calming, but stillness “before the Lord.”
Those who are emotionally tortured by the enormity of the damage being done to humanity by so many powerful people need a renewed spirituality for activists that derives its strength from a deepened intimacy with God. The psalmist shows the frankest awareness of the howling frustration that wreaks havoc with our physical and mental health and shreds our emotional availability to one another, and yet is certain that the only ultimate antidote is personal exposure to the joy and tenderness of God. “Take delight in the Lord, and you will be given the desires of your heart” (verse 4). Those who listen closely will hear echoes of this in other readings. Very tellingly Jeremiah urges, “Blessed are those who trust in the Lord, whose trust is the Lord” (17:7). Trusting in God, but more than that, experiencing the indwelling of God in our hearts and the pulsing trust from that heart living in us.
It is easy to overuse the word “prophetic” and tread it flat. We need scriptures like these to restore authenticity to our language about prophetic calling and ministry. Jeremiah recounts his experience of God’s call to be a prophet when he was still a youth. He resisted the call because he was still embedded in a culture weighted toward the kind of authority supposedly earned by years of experience. But a prophet must be disembedded from her culture to address that culture with God’s authority. And “experience” is often just a code word for initiation into the values of an unjust order. God challenges the normal requirement of experience, placing the prophet solely under the authority of God’s own promise. No experience necessary! I am reminded of God’s mordant skepticism toward society’s conventional valuation of experience in Charles Péguy’s great poem “The Mystery of the Holy Innocents.” Péguy writes: “As for what you call experience, your experience, I call it waste, diminution, decrease, the loss of hope.”
In Jesus’ confrontation at Nazareth with those who knew him only too well, he quotes a bit of folk wisdom: “No prophet is accepted in the prophet’s hometown.” By definition, a prophet is an outsider: She thinks outside the categories that form the common-sense worldview. And so she is drawn to the stranger and those on the fringe who are more likely to be open to acts of God invisible to conventional eyes. Jesus then scandalizes his former playmates by mentioning that the only successes Elijah and Elisha had at healing were with pagan foreigners. The congregation instantly changes into a lynch mob from which Jesus narrowly escapes.
Paul’s praise of love in 1 Corinthians 13 challenges our prophetic practice: “If I speak in the tongues of mortals and of angels, but do not have love, I am a noisy gong or a clanging symbol.” Prophets take their stand where God’s incandescent holy love meets human resistance. It is a perilous place where prophetic actions can insidiously draw on the dark energy of hostility and self-righteousness, and utterly forfeit their authenticity.
Clem Onojeghuo / Unsplash
Everyone is supposed to love Christmas and the holidays. It’s supposed to be a time of family and gratitude. But I dread them. I dread the weeks leading up to Christmas, starting the day before Thanksgiving when Christmas carols begin permeating the radio and stores and build to a crescendo through Christmas Eve. The growing darkness in the absence of daylight saving time doesn’t help.
Undocumented immigrant families walk from a bus depot to a respite center after being released from detention in McAllen, Texas, U.S., July 26, 2018. REUTERS/Loren Elliott
"Imagine your family ripped apart. That’s going to have reverberations across family members for years to come."
Pennsylvania was the first state to institute the practice of confining prisoners alone in single cells. It started when a jail in Philadelphia became Eastern State Penitentiary, the country’s first state prison, in 1790. That was one year before the Eighth Amendment prohibited cruel and unusual punishment, and 223 years before the DOJ found the state’s use of solitary violated that amendment.
Sean Bear/ Shutterstock
IN A GIVEN YEAR, about one in five U.S. adults will experience mental illness of some kind. And though mental illness does not discriminate, African-American adults are more likely to experience serious mental health problems, but less likely to seek treatment, than white folks, due in part to the lasting effects of slavery, segregation, and other forms of race-based exclusion—effects that translate into socioeconomic factors such as poverty, homelessness, and substance abuse which are, in turn, risk factors for mental illness.
According to the National Alliance on Mental Illness (NAMI), the factors that keep African Americans from receiving mental health services include a lack of health insurance, a distrust of the medical community, and conscious or unconscious bias among practitioners resulting in misdiagnoses. But NAMI also named another barrier to African-American mental health: the church. While one’s “spiritual leaders and faith community can provide support and reduce isolation,” explained NAMI, the church can also “be a source of distress and stigma.” The report noted that even when medical care is necessary, African Americans turn to their families, communities, and churches rather than turning to health-care professionals.
None of this comes as a surprise to Monica Coleman, a professor of constructive theology and African-American religions at Claremont School of Theology in Southern California. Throughout her new memoir, Bipolar Faith: A Black Woman’s Journey with Depression and Faith, Coleman navigates the challenges of race, gender, and the church as she heals from rape (committed by her then-boyfriend in seminary) and wrestles with a faith that ebbs and flows like the cycles of severe depression that began as she entered adulthood.
Sojourners assistant editor Betsy Shirley spoke with Coleman about mental health, social justice, and how the church might become a place that more fully fosters both.
LAST SUMMER, THE FUTURE of for-profit prisons seemed bleak. The U.S. Department of Justice announced it would begin phasing out its use of privately run prisons and the U.S. Department of Homeland Security quickly followed suit, declaring that it would reconsider its use of privately run detention centers. Stocks for companies that ran for-profit prisons plunged.
But then Donald Trump was elected president, and private prison stocks immediately soared. The nation’s largest prison company, CoreCivic (formerly Corrections Corporation of America), reported a boost of more than 40 percent in the value of its shares. Given Trump’s promises to “create a new special deportation task force,” investors bet that privately run detention centers will play a key role.
And the investors may be right. Every year, DHS detains about 400,000 undocumented immigrants in 250 centers nationwide, and 62 percent of the beds in these centers are operated by for-profit corporations.
According to Maria-José Soerens, a licensed mental-health counselor serving undocumented immigrants in Seattle, there are two major problems with for-profit detention centers. First, for-profit centers are not held accountable to the standards that govern federally run centers. In her work in these centers, Soerens has heard complaints ranging from a lack of medical attention to inadequate opportunities for parent-child visitation; one young woman who was having suicidal thoughts was kept in solitary confinement until she told guards she was “better.”
But the deepest problem, explains Soerens, is that most detention centers only exist because corporations saw a “business opportunity.” Beginning in the early 2000s, for-profit prison companies successfully lobbied Congress to expand drastically the number of beds in the immigration detention system—a move that doubled the revenue of the two largest for-profit prison companies. In 1998, there were 14,000 beds available for immigrant detention; today, there are 34,000.