Mental health: the importance of challenging stigma and misconceptions
From Dr Tom Selmes
Sir, — It is commendable that the Church Times marked Mental Health Awareness Week with two articles (Features, 13 May). In particular, your interview with Pauline and the Revd David Stocker highlights the devastating impact of their violent attack, and raises questions about why the perpetrator did not receive support much earlier. The Revd Vic Van Den Bergh’s article is clearly the result of much important pastoral work in this field.
I must raise a concern, however, about the balance of the articles. Your feature risks increasing the stigma of people with mental-health problems by only using pieces that focus on violence and treatment under the Mental Health Act.
Time to Change is a coalition of mental-health charities that are campaigning to reduce the stigmatisation of people with mental-health problems by the media. They report that a third of mental-health stories in national newspapers feature violence to others; and yet people with mental-health problems are far more likely to be the victim of crime.
The rates of serious violence associated with mental illness are relatively low, and are not increasing. The vast majority of mental-health treatment takes place in the community at the request of the person concerned. No one would deny that risk-management and coercive treatment are a feature of mental-health care, or that the interview was powerful and important, but newspapers also have a responsibility to commission articles that reflect the broader experience of people with mental-health problems and the support that is available to them.
Unfortunately, Mr Van Den Bergh made several basic errors in his description of the Mental Health Act, which will affect your readers’ understanding of the part that it plays, and the safeguards that are in place.
First, a “voluntary section . . . under the Mental Health Act” does not exist. Mr Van Den Bergh is instead describing an “informal” in-patient who is not subject to the Act at all, and who has the right to either accept or refuse treatment in the same manner as anyone else.
Second, the process for admitting someone under the Act is much more rigorous than two doctors’ simply agreeing “on the diagnosis”. There must also be evidence of significant risk to the person’s health or safety or the safety of others; it must be impossible to deliver the care needed in the community, and an admission without using the Act must be impossible for some reason (usually a refusal by the person concerned).
Admission must also be agreed by an “Approved Mental Health Professional” who has received extensive training in the use of the Act and who is of a different profession (often a social worker).
He is also incorrect in stating that people are discharged only if a medical professional agrees. There are very robust processes for appealing against detention under the Act: both to the managers of the hospital and to a tribunal (a completely independent panel chaired by a judge). These can (and do) discharge people.
The Act has a new Code of Practice that has increased the focus on the person’s autonomy and human rights; and there is a new right to an independent advocate.
Mr Van Den Bergh rightly highlights, however, the funding crisis that is affecting mental-health services. Although recent legislation gives mental and physical health “parity of esteem”, funding for mental-health trusts in England fell by two per cent last year, while funding for physical healthcare in hospital rose by a similar proportion.
Much of our mental-health care is led by GPs, who are facing a recruitment crisis while managing a marked increase in demand. In my experience, many people with mental-health problems receive excellent care, but his description of struggling to gain access to support for someone is sobering. Urgent action is needed to ensure that services are adequately resourced.
TOM SELMES
Consultant Psychiatrist
Flatts Lane Centre, Flatts Lane
Normanby
Middlesbrough TS6 0SZ
From Mr Jamie Summers
Sir, — It was disappointing to read the twin articles on mental illness from the Revd Vic Van Den Bergh and Sarah Meyrick.
The former spent most of his article explaining how to get someone sectioned, with a tiny paragraph saying the best advice was to treat people with care, kindness, and understanding. The second article concerned itself with an unfortunate stabbing in a random situation by a 30-year-old with drug issues in which fortunately no one died.
For the past 24 years, I have been working on and off in this field, trying to help people in spiritual distress, and to help the Church to engage with compassion with such people. These are those that Jesus called, “the least of my brothers and sisters. . . what you do for them you do for me.”
Jean Vanier is wise when he tells us that, “if we come close rather than back off, if we meet rather than retreat. When we come close we will realise that our fears may be unfounded.” Absolutely, Jean: it is my contention that “mental illness” can also be understood as a trauma-induced tussle with the Lord which can be better addressed by the Church than current psychiatric services. Indeed, outcomes are often better for people who avoid contact with psychiatric services entirely. The drugs don’t always work. Love always does.
It is sad that fear of the stranger persists in church circles. In medieval times, monasteries were the default mental asylums. Oh that the modern Church would take a more enlightened view of how to come alongside those with troubled minds.
JAMIE SUMMERS
38b Wandsworth Common Westside
London SW18 2EF
From the Revd John Foskett
Sir, — It was good to be reminded of Mental Health Awareness Week by your contributors. What I missed was the voices and experience of people in mental-health crisis themselves. How do they look upon their crisis? What helps and what harms them in the care and treatment they receive from the mental-health service and from religious organisations?
In the past ten years, their voices and experience have contributed much to their own and one another’s mental well-being. Two examples:
Patients in Somerset organised their own research in mental health and spirituality, for the Mental Health Foundation and the NHS Foundation Trust: Taken Seriously: the Somerset Spirituality Project.
They included questions about what helped and what hindered them in the treatment and care received from religious organisations and the clergy. “The clergy lean you on the side of their beliefs rather than look at yours. . . you always got to be preached to, rather than you are a person and you have the right to have your own beliefs.”
“What would help would be somebody from the church rang me up and left a message or something. Not necessarily the same person. . . There could be real danger if I am left on my own.”
The Association for Pastoral Care in Mental Health (Being Alongside) is a voluntary Christian-based organisation for individuals and groups who recognise the importance of spiritual values and support in mental health, and promotes and encourages people experiencing mental and emotional distress by coming alongside them.
The Association’s newsletter is the channel for their voices. “Having anxiety and depression is like being scared and tired at the same time. It’s fear of failure but no urge to be productive. It’s wanting friends but hating socialising. It’s wanting to be alone but not wanting to be lonely. It’s caring about everything at once, then feeling paralysingly numb.”
JOHN FOSKETT
(Patient of and former parish priest and chaplain to NHS mental-health services)
Flat 1, 8 Cornwall Road
Dorchester TD1 1RT
From Rachael Twomey
Sir, — I was interested to read last week’s mental-health feature, which gave useful information on how to respond to a mental-health crisis. I was, however, disappointed that the feature focused so heavily on compulsory treatment (sectioning under the Mental Health Act) and the depiction of those with mental illness as a danger to themselves or others.
While these are important issues, they apply to a very small proportion of people with mental-health problems (NHS Federation, 2014, “Key facts and trends in mental health”). A disproportionate emphasis on compulsion and dangerousness can perpetuate those feelings of fear and shame that prevent people from seeking help, for themselves or others.
Perhaps a future issue of the Church Times could offer a more comprehensive response to the question asked towards the end of the main article, “How do we deal with the mentally ill among us?” Here are some suggested discussion points for churches:
Are there any expectations around self-presentation or behaviour which make participation in church life unnecessarily difficult for some people who are mentally ill?
Does the church promote positive attitudes to human diversity more widely, so that the “different” or “unusual” are not assumed to be “threatening” or “wrong”?
Does the church provide accessible, free, or low-cost opportunities for social contact outside Sunday services? If this is not practical, does the church maintain awareness of such opportunities across their local community and promote them?
If a regular member of the congregation ceases contact, without explanation, how (if at all) is this followed up?
Are mental-health issues named and held before God in prayer, as are physical illnesses?
How comfortable are different people (clergy, lay leaders, long-standing members of the church) about acknowledging their own mental-health problems, and the impact these may have on their life and work? Is there a difference from the way physical illnesses are addressed?
Has the church explored the option of mental-health-awareness training, which can challenge misconceptions and stigma and show us practical ways of promoting good mental health?
RACHAEL TWOMEY
6 Turnstone Close
London E13 0HN
Courage and compassion of Christian Concern
From Mr Mohammed Fyaz
Sir, — I was disappointed to see the letter last week from various clergy and others criticising a Christian Concern article about Sadiq Khan.
Like Sadiq Khan, I am the son of a Pakistani immigrant. My father worked in the textile mills. I am a convert from Islam in this country, and, since conversion, have feared for my life here. Christian Concern has shown not just me, but others like me, nothing but kindness, care, compassion, and a safe place. They have had the courage to look after us when we feared that no one else would.
The letter does not engage with the substance of the Christian Concern article, and instead merely asserts that their views are wrong. The issues raised about Sadiq Khan were also raised by many others in the mayoral debate, and raise legitimate concerns about his track record of relationships with Islamic extremists. It is entirely reasonable to look at someone’s past behaviour when trying to assess how he or she might behave in the future.
Sometimes, engaging with Muslims and Islam will involve asking some hard questions and saying some difficult things. This should not be avoided or shunned by those seeking to win Muslims to our Lord and Saviour Jesus Christ. We all long to see Muslims coming to faith in Jesus, but this will not happen without some exposition of the truth about Islam and Muhammad. Radicalisation and segregation of Muslims in London, and beyond, is a significant problem, and I hope and pray that with Sadiq Khan the direction will change.
MOHAMMED FYAZ
c/o Christian Concern
70 Wimpole Street
London W1G 8AX
Expectations and the hand of God in the Church’s ministry of healing
From the Revd Dr Philip Goggin
Sir, — Simon Jones’s article “Healing by consensus” (Features, 6 May) inevitably must be selective in what it presents. But a very big part of any Christian healing ministry, particularly that associated with hospital chaplaincy, gets no direct mention: prayer that God will work through conventional medicine — an aspect of what Bishop John Saxbee would call the “weak” case for God’s intervention (Comment, same issue).
Jesus himself on occasion used the medical means of his day as part of a healing process, as presumably did Luke, Paul’s beloved physician. Nearly all Christians accept the logic of using a range of means to treat illness.
There are very many agencies that work to achieve healing of mind and body. If these, including the NHS, are regarded as God’s hands and feet, then our prayers for their effective working become part of a Christian healing ministry. We might say that God needs us to use the spiritual power of prayer, however that might be understood, to support the work of these agencies, just as he needs us to do his work in many other ways. In that sense, he uses our prayers.
Despite referring to well-regarded sources that challenge a simple identification between “healing” and “cure”, it is still “cure” that this article explicitly or implicitly takes as the gold standard. Indeed, we have the tell-tale admission: “I have been looking for some piece of magic that might make me believe that Christians can act like Jesus, healing hundreds at a touch.”
Dream on! Rather, God heals by attending to a person’s needs in a holistic way. We pray that he will work through medical science and human agency. We pray for better relationships, acceptance of forgiveness, and peace, and that these will contribute to physical health. Often a physical ailment may remain, but a person may experience healing in the sense of accepting his or her condition without anger or frustration. Being at peace on a death-bed is a form of being healed.
PHILIP GOGGIN
The Vicarage, Middlewich Road
Minshull Vernon
Crewe CW1 4RD
From the Revd John Ryeland
Sir, — I was disappointed by the tone of your recent feature article on the ministry of healing. It is all too easy to remember the worst practitioners of this ministry, and create an impression that everyone is like this. There are bad examples in every profession, but we would be unwise to judge the whole body by negative memories or stories.
I have been an Anglican priest for 35 years, 19 of these working as the Director of The Christian Healing Mission, and I have the privilege of chairing Christian Healing UK: a network of many leaders in the healing ministry across our country. I know them to be people of outstanding integrity, humility and honesty, who work sacrificially and with a stunning commitment and gentleness to those who turn to them. The occasions when we get together are quality times for sharing experiences, prompted by a mutual desire to offer the very best that we can in this ministry. Incidentally, none of us would ever call ourselves “faith healers”.
For some people, research and academic studies add weight to their belief that there is insufficient evidence to prove or disprove that divine healing happens. There have always been those who will demand more proof for what appears to be miraculous, as well as those for whom every petal of a flower is a miraculous wonder.
I was interested that Professor Brown, referred to in the feature, argued that prayer “significantly improved the hearing and vision of a number of prayer recipients”. Although the case was not made for “some magic finger of God reaching down from the heavens”, maybe this was God at work.
Perhaps it is we who make healing so complicated by putting it in the domain of professionals and trying to define it? It may be that the very differentiation that is often made between healing and curing is not something that the Gospel-writers would have understood.
At The Christian Healing Mission, we rejoice at the many lovely touches of God’s healing we see in all sorts of ways, but trying to analyse and critique the gracious activity of God is to miss the point. Were the recipients of healing at the hands of Jesus ever 100 per cent healed of everything in their lives? The Bible never claims that they were.
The Church’s ministry of healing today is an expression of the touch of Jesus upon the lives of people, churches, and communities. It is a ministry that is expressed across the whole range of churchmanship and tradition, and in the vast majority of cases is practised with love, care, and true pastoral concern. Many of us are not counsellors or qualified health practitioners — and do not feel a calling to be.
Of course, it is important to follow good guidelines, to submit ourselves to training, and to be accountable; but in the end we are ordinary people with a desire to reach out in the name of Jesus because we serve a God who heals.
JOHN RYELAND
8 Cambridge Court
210 Shepherds Bush Road
London W6 7NJ
Publications list denotes an inward-looking C of E
From Mr Mike Plunkett
Sir, — The recent leaflet from Church House Publishing contains no booklets about social, national, or global issues. In the 1980s, there were regular and stimulating booklets in Church House publications.
Today’s C of E appears to be concerned with faith in the Church rather than faith in the city. Jesus did not organise fresh expressions of synagogue life and worship, nor did he advocate synagogue-planting. He showed concern for loving the neighbour that you least expect to be asked to treat as your neighbour.
The Church is not the end: it is the means. Has the C of E forgotten this?
MIKE PLUNKETT
1 The Ridge, Bishop’s Castle
Shropshire SY9 5AB
Labour and criticism of the Israeli government
From the Revd Tony Crowe
Sir, — In your leader comment “This goes beyond criticism of Israel” (6 May), you rightly draw attention to extreme views, expressed by a small minority within the Labour Party.
When I was Vicar of St John’s, Clapham, I became involved in the Israel/Palestine conflict, after a visit to Jordan over Easter 1970 with a Labour Party delegation, led by our MP, Margaret McKay. She was later hounded out of the party, who accused her of anti-Semitism.
I read Theology at Oxford in the 1950s, and knew nothing about Zionism until I read The Decadence of Judaism in our Time by Moshe Menuhin. He quotes these words from Clement Attlee in a press release on 30 July 1958: “The creation of Israel was a mistake, but Britain must not let the young nation of Israel be swept away.”
Attlee’s views were anti-Zionist and in no way anti-Semitic. He died in October 1967, four months after Israel occupied the West Bank.
I have met Israelis who, in the tradition of the Hebrew prophets, are very brave in speaking out against the injustices inflicted upon Palestinians. They are accused of being Jew-haters and Nazis.
Next year will be the centenary of the Balfour Declaration. Britain has still to implement the second part “that nothing shall be done which may prejudice the civil and religious rights of existing non-Jewish communities in Palestine”. If we vote to remain in Europe, we will have more diplomatic clout in pushing for a European initiative to bring about a peaceful solution in the Middle East, giving security for Israel and justice for the Palestinians.
TONY CROWE
4 South Lodge Close
Whitstable, Kent CT5 2AD
From the Revd Jonathan Frais
Sir, — Thank you for facing the issue of anti-Semitism. To write, however, speaking of Palestinians’ “suffering oppression from their Israeli neighbour” without a reference to the frequent mortar attacks by Palestinians on Israel, suggests that you are less than even-handed yourself.
JONATHAN FRAIS
The Rectory, 11 Coverdale Avenue
Bexhill, East Sussex TN39 4TY
It’s a fine thing to be outsped by ecumenism
From the Revd Alexander Faludy
Sir, — I am grateful to the Bishop of Coventry for his gentle correction (Letters, 13 May) to my article (Comment, 29 April). News of the assent given to the Joint Declaration by ACC-16 emerged into public view via an Anglican Communion Office press release only on the afternoon of Tuesday 26 April — several hours after I had supplied final copy to the Church Times.
It is fair to say, however, that I have seldom been happier to be overtaken by events.
ALEXANDER FALUDY
The Vicarage, 381 Station Road
Wallsend NE28 8DT