In the Fellowship of his Suffering: A theological interpretation of mental illness — a focus on "schizophrenia"
Elahe Hessamfer
The Lutterworth Press £25
(978-0-7188-9382-8)

THIS densely written, deeply theological book tackles a difficult subject, that of mental illness in general and schizophrenia in particular, and what the appropriate response of Christian communities might be. It is based on a doctoral thesis, which was supervised by the influential practical theologian John Swinton, who has contributed a foreword.

While the context of this book is that of American psychiatry, it has implications for all Western mental-health settings. Its tone is scholarly, and it bears the hallmarks of rigorous research, while it is shot through with the agonising experience of a loving parent whose daughter suffers from the illness.

Sharply critical of an exclusively medical approach to schizophrenia, with its routine use of psychotropic drugs, Hessamfer draws on a range of sources, explores alternative approaches, and ends with clear recommendations to those wishing to live out New Testament commands today.

There are four main chapters. The first sets up a theological anthropological lens through which to view mental illness. By synthesising the work of past and present theologians, the author offers an original contribution to the anthropological debate. Next, Hessamfer outlines key principles underpinning the medical model of psychiatry, and critically examines the success of this model in serving the needs of those suffering mental distress.

The third chapter identifies the voice of schizophrenia, and reflects theologically on what it might be saying, through the guidance of scripture and the Holy Spirit. The final chapter attempts to formulate practical and theological approaches to care, solutions influenced by alternative approaches already practised in a range of settings.

It is not possible to do justice to this study in a short review, but, if given serious attention, it has the potential to be a game-changer. The author recommends a multi-disciplinary approach in which the best examples of medical and faith-inspired practice are combined.

Those who work in psychiatric settings are rightly concerned about too heavy a dependence on psychotropic drugs, much of whose use is justified by research funded by drug companies. Hessamfer raises disturbing questions for society as a whole about the way in which the status quo is protected by the false notion that most mental-health sufferers are dangerous to others. The equation of sufferers with modern prophets does not sit easily with post-Enlightenment secularism.

I do have concerns about the efficacy of pastoral care, including residential hospitality, which, the author suggests, could be offered by often hard-pressed Christian communities. Hessamfer is right to insist on training and supervision for those involved. As a clarion call to Christians, in particular, for compassionate justice, her case is important and carefully argued, and perhaps visionary. As she says, however, in the context of a moving account of her daughter’s illness and the challenge to those around her to find the solution to their own alienation and madness, "there is no short cut with God."

The Revd Anne Holmes, a former NHS mental-health chaplain, is a psychotherapist and self-supporting minister in the Oxford diocese.