Chances are, you know someone struggling with mental illness. You know their stories of struggling with depression, their battles with addiction, and the losses they and their families and relationships have experienced. Maybe you’ve observed this from a distance – your coworker, neighbor, or friend – or maybe it’s a dearly loved family member. Maybe it’s you.
The brokenness of this world and the fallout of sin has resulted in many hurting, injured people struggling with their mental health. Current national research shows that nearly 1 in 5 adults has struggled with a mental illness in the last year.1 We know that as Christians, we are called to care for and serve those who are sick; Jesus exemplified this regularly during his time on earth by caring for those with physical and mental ailments.
But what does this mean? How do our friends, neighbors, and family members seek and access mental and behavioral health services that will help them in their journey towards health? How do we as Christians and as a society “look after” them, and how can we do better?
First, a little historical perspective. For many years in the state of Iowa, the financial responsibility of caring for the indigent, mentally ill adult population fell to the counties and their respective Boards of Supervisors. With ninety-nine counties in Iowa, what this meant was that you had, quite literally, ninety-nine different mental health systems. If you lived in one county, the amount and types of services you were able to receive to assist you in your recovery may vary significantly from those that your neighbors a few miles away received. In addition, since the counties paid for those mental health services, they could also require you to receive services at a certain provider.
In 2014, that changed. With Medicaid expansion through the Affordable Care Act, far more people now had access to health care coverage, including coverage for mental health services. This would allow people to “vote with their feet” and choose where they would seek care. Additionally, with Mental Health Redesign legislation (SF2315), the state required counties to join together into Mental Health Regions and set specific, required core measures that all regions must now ensure are available to all the residents of their regions, regardless of their financial situations. These two factors significantly changed the landscape of mental and behavioral health services for adults in the state of Iowa, giving people more access and choice than ever before.
Recent years have also brought many significant campaigns in raising awareness of mental illness. These campaigns seek to de-stigmatize mental illness and encourage people to seek help. Many local agencies, including the one I work for (Seasons Center), have worked to bring a knowledge of mental illness to public consciousness and provide people with new and innovative ways to receive services. We work alongside others to educate and remind people of the importance of seeking treatment and prevention. We know that the health of each individual impacts the health of the community as a whole, from education and employment settings, to the local economy and justice systems.
Although in many ways the healthcare system is still fragmented and we are far from a perfect solution, all of this work across the state has improved and expanded services. Individuals seeking help have options across a variety of providers and locations. They may receive these services in outpatient clinics, hospitals, community settings, or in their own homes. Services may be paid for through private insurance such as Blue Cross/Blue Shield, Medicaid, or private pay. Ideally, services are evidence-based, proven to have high success rates with the population the organization is caring for. In the best settings, services caring for an individual’s mental health understand the impact of past trauma and adverse childhood experiences and also take into account and integrate all the other factors that come into play, including spirituality, physical health, and social issues, such as housing, employment, and food security.
These improvements have taken a lot of work by a lot of people. It has taken people who were willing to stand up and acknowledge their personal battle with mental illness. It has taken others – from family members to churches to agencies and legislators – to say enough. The shame and the stigma needs to end. Those struggling with mental illness should not have to hide in the shadows, and they should have a say and choice in their care. It has also taken many dedicated faith groups who have been willing to walk alongside and support individuals in their journey to recovery, saying with their actions, “You have value to Christ and to me.”
As Reformed Christians, we acknowledge that we all have some form of brokenness and hurt. If you were diagnosed with cancer, you aren’t ashamed to go to the doctor. You don’t hide it from your neighbor lest they judge you for being “weak.” If a church member offered to mow your lawn for a few weeks while you went through treatment, you likely wouldn’t struggle with humiliation because you weren’t able to do it on your own. People don’t assume you made some poor choices that led to your current problems. And yet, somehow as a society and even as Christians, we often have these thoughts for those experiencing a mental illness, forgetting that our brokenness manifests itself in different ways.
If you know someone struggling with a mental illness, I encourage you to come alongside them, support them, pray for them, and love on them. Don’t be fearful to ask them how they are really, truly doing. Encourage them to seek help and work to make it possible for them to do so. Offer to drive them to appointments or watch their kids after school so they can go. Bring a meal, send a card. Accept that while you may not fully understand what they are going through, you being there and offering your support really can make an impact. Treat them with the same care and compassion that we are so good at lavishing on those with physical illnesses. Because at the end of the day, agencies, clinics, and legislators can only go so far in improving health. As a community, we can do better.
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (September 4, 2014). The NSDUH Report: Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use and Health: Overview of Findings. Rockville, MD. ↩
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