Mental health is one of the great social issues of our time. It is estimated that as many as one in four British adults will be diagnosed with a mental illness during their lifetime. That’s aside from the scale of mental health issues that are not simply medical. Loneliness, for example, is not a medical condition, but is undoubtedly a serious societal problem.
The scale of the issue is being recognised by the Church. There is a lead bishop on the issue, Bishop Richard Moth, and a mental health project run under the auspices of the Catholic Bishops’ Conference. At a grassroots level there are dozens of projects run by Catholic churches and charities, from work by Children’s Societies identifying early signs of mental illness in schools, to chaplains in mental health trusts and parish visits to the lonely.
This is all important work. However, there is a serious question to be asked about theology. Do we, as a Church have a sufficiently robust theological approach to the challenges raised by mental health?
Providing services and pastoral care is valuable, but to really engage with mental health there are hard questions to answer. For example, a necessary tenet of Christianity is the need for repentance. That rests on our ability to discern our own sins and take responsibility for them. Mental health provides a complicating factor here. An increasing body of research suggests that particular mental illnesses warp our perception of reality in such a way that that discernment can be impaired.
Psychosis impairs thoughts and emotions such that the sufferer experiences a loss of connection with their external reality. Can such people be held responsible for what would otherwise be considered sinful behaviour? Depression causes feelings of guilt and a distortion of reality such that some sufferers are incapable of believing that they can repent and be helped.
Some (by no means all) mental health conditions are the result of proven physical problems within the brain itself (either present from birth or developing later – often in adolescence). This might challenge a whole notion of what sinfulness looks like.
The medical understanding of these issues is developing quickly. How the Church ministers to sufferers needs to take account of these developments. Integral to that is the need to be able to develop a distinctive Christian language for mental health. One of the findings from our new report at the Christian think tank Theos (Christianity and Mental Health: Theology, Activities and Potential) was that Christian sufferers of mental illness have a particular issue in finding a register to discuss their experience in a Church context. This is a notoriously difficult process for mental health sufferers generally, as it is incredibly difficult to describe the experience of mental illness to those who have never shared the same experience.
There is material to build on for this. Although it is difficult to read today’s medical language back into the Bible there are passages which can speak to the experience of mental illness. For example, Psalm 88 is sometimes taken as a passage that speaks very closely to the experience of depression:
You have put me in the lowest pit, in the darkest depths. Your wrath lies heavily on me; you have overwhelmed me with all your waves. You have taken from me my closest friends and have made me repulsive to them. I am confined and cannot escape; my eyes are dim with grief. (Psalm 88:6-9)
The psalm goes on to include the line that “darkness is my closest friend” (Ps88:18). There is nothing triumphant in those passages, but there is that expression of pain and abandonment that speaks closely to the experiences of many suffering with mental illness.
Hearing the voices of those who have actually experience mental illness is an important step in developing a theology. That will be much needed in the coming years. The evidence suggests that mental health is becoming a more prevalent issue in British and there is little hope that medical services will be increased sufficiently to meet all these needs. The Church will inevitably find itself more and more on the frontlines of dealing with an issue which is becoming a national crisis. To be the best it can be in providing care we need to open up the theological debate.