1. Sending the message, intentional or not, that Christians don’t have serious problems–some churches embrace this idea as part of their core teaching; others suggest it without meaning to.

2. Perpetuating misunderstanding and mistrust of psychology–many people have outdated notions of what psychology is and believe it leads people away from God because it’s based in science rather than purely in biblical teaching; so is every other field of medicine, but that doesn’t stop us from seeking treatment for cancer or a ruptured appendix.

3. Focusing on numbers and branding–as we try to attract more people and build a brand as the coolest church in town, we naturally look for the beautiful and popular, and discourage people with problems, who might not fit in and might ask us to take our ministry deeper instead of broader.

4. Emphasizing polite behavior and exaggerated piety–people who function well in most contexts might have more trouble at church if it’s an environment that expects people to conform to rigid standards of behavior; this emphasizes the sense that people with problems don’t belong in the church.

5. Referring and forgetting–while it’s appropriate for churches to refer people to mental health professionals, abandoning them to the system sends the message that the church has nothing to offer people in times of real darkness.

6. Staying silent–when we fail to address mental illness as reality, we reinforce loneliness and marginalization and, again, send the message that the church–and therefore God–has no help or hope to offer.

7. Assuming all mental illness is caused by demons–this faulty belief undermines medical treatment and marginalizes people who need help.

8. Suggesting mental illness is God’s punishment–this idea directly contradicts Jesus’ teaching and paints God as a cruel and capricious master who plays favorites.

9. Claiming mental illness is evidence of weak faith or flagrant sin–we blame people for their suffering, suggest that they are more sinful than the rest of us, and withhold

the grace and hope Christ gives freely.

10. Proposing purely spiritual solutions to medical problems–we discourage people from seeking medical help and instead suggest that religious activity is the solution–burdening people rather than sending them to Jesus, whose yoke is easy to bear and whose burden is light.

Do you recognize your church–or yourself–on this list? The good news is, we can change our attitudes toward mental illness. Our nation is engaged in a redemptive discussion about mental health and how to respond to problems effectively and compassionately. Let’s make sure the church is not only in this conversation, but leading the way, in keeping with our mission in this life.

1. Laughing at mental illness–we regularly watch TV shows and movies that treat mental illness, and people who have such illnesses, as one big joke.

2. Indulging our fears–scary movies, TV shows, haunted houses, amusement park rides, and the evening news all capitalize on our fear of fear itself, and our stereotypes about people with mental illness, and we eat it up.

3. Romanticizing mental illness–sometimes, in a misguided attempt to respect people with mental illness, we suggest their symptoms make them more brilliant, creative, or insightful than the rest of us–thus discouraging people from seeking treatment.

4. Acting as if people with mental illness are mythical creatures–we speak of people with mental illness as if they don’t live among us, sort of like leprechauns and unicorns.

5. Using symptoms as insults–when we really don’t like someone or their personal choices, we flippantly call them “psychotic,” “maniacs,” or “OCD.”

6. Avoiding people–we tend to keep our distance from people we know or suspect have had mental health problems, when we can easily do something as simple as make eye contact and say hello.

7. Making assumptions–we accuse people with mental illness of being weak, lazy, or selfish because they don’t engage in life and relationships in a healthy manner.

8. Keeping silent–we refuse to talk about our own struggles with mental health or stand up for others when people say hurtful or ignorant things.

9. Speaking in hushed tones–when we do speak about mental illness, we tend to do so very quietly, suggesting it’s the kind of thing polite people should never acknowledge.

10. Dismissing symptoms–rather than encourage people to get help or take good care of themselves, we sometimes tell them to “snap out of it” or “get over it,” something many people with mental illness simply can’t do without help.

Watch for my next post, listing 10 ways mental illness is stigmatized specifically in the church.

I wish this conference would have featured people from churches and other faith communities, adding to the conversation and learning more about how we can help. I hope that in the future, when such an event takes place, the church will be front and center because so many of us will be doing effective and sacrificial ministry to people with mental illness–loving and life-changing care that will be impossible to overlook.

In his remarks, the president referred to the terrible and unjustifiable sense of shame and stigma associated with mental illness: “We’ve got to get rid of that embarrassment. We’ve got to get rid of that stigma. Too many Americans who struggle with mental health illnesses are still suffering in silence rather than seeking help. We need to see it that men and women who would never hesitate to go see a doctor if they had a broken arm or came down with the flu.”

He’s right. And it’s up to all of us to recognize and refuse to reinforce stigma in our own language, attitudes, and treatment toward people with mental illnesses. Sometimes that means fighting our own sense of shame when we or members of our families are personally affected.

In Troubled Minds: Mental Illness and the Church’s Mission, I spent a whole chapter discussing stigma. Here’s an excerpt that introduces the topic of stigma within our culture.

Throughout history, mental illness has met with confusion, misunderstanding, and mistreatment. Even horror, persecution, and torture. We have made progress in fits and starts, and people with mental illness have never had more hope for productive life than they have now. But despite the progress, we live in a society that is still deeply confused about mental illness.

Have you ever paid attention to the way people with mental illness are portrayed in popular media? While some, especially more recent, works treat mental illness with honesty and sensitivity, most of popular media treats the mentally ill as either frightening or funny or both. Most people don’t seem to give it a second thought, but for people with loved ones who suffer from ongoing serious mental illness, such portrayals are hard to ignore. Try watching movies like Psycho, Strange Brew, Crazy People, The Shining, Misery, and Fatal Attraction through the eyes of someone who struggles with mental illness. Or turn on the TV this week and watch with a new perspective. On any given evening, you should be able to find at least one show that either reinforces terror of the mentally ill or makes light of their illness for a cheap laugh. News media often mention undefined “history of mental health treatment” in sensational crime stories. Even amusement parks use mental illness to entertain and terrify, with rides like “Psycho Mouse,” “Psycho House,” “Psycho Drome,” “Dr. D. Mented’s Asylum for the Criminally Insane,” “The Edge of Madness: Still Crazy,” and “Psycho Path.”

The Chicago-area Robert Morris University dance team was criticized for a performance in which they dressed in straitjackets, teased their hair, and surrounded their eyes with heavy black makeup. In a Vs. magazine photo spread meant to evoke impressions of a psychiatric hospital stay, actress Eva Mendes posed next to the headline “We Are All Crazy for Eva.” Burger King received national media attention (and stopped running the commercial) for its TV commercial depicting an “insane” version of their king mascot, running from men in white coats and being restrained. A California donut shop, Psycho Donuts, removed their “Massive Head Trauma” donut from their menu after complaints that veterans returning from war would be offended by the donut decorated to look like a man with jelly oozing out of the side of his head. But the shop still features staff in hospital uniforms and a “Psycho Padded Cell” where customers can have their picture taken. Examples abound in popular culture–and they keep on coming.

In everyday conversation, we stigmatize mental illness by casually calling people “crazy” and “psycho.” The mentally ill are widely believed to be more violent than the general population, even though studies have shown that this is not true. As with the general population, substance abuse does increase tendencies toward violence, but mental illness itself does not make people significantly more prone to violence than the rest of us. In fact, according to the U. S. Surgeon General’s office, “there is very little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder–the overall contribution of mental disorders to the total level of violence in society is exceptionally small.”

Such misinformation, as well as entertainment that pokes fun at people with mental illness–and in some cases encourages laughter at the idea of their mistreatment–accomplishes three things. It further marginalizes and dehumanizes people with mental illness by treating them as caricatures; it’s easy to laugh if we forget that we’re laughing at real people suffering from real illnesses. It encourages persecution and mistreatment. And it discourages people from seeking help for mental illness. In an environment that vacillates between mockery and horror, who wants to be the one to raise a hand and say, “Yeah, that’s me. I need to go to the doctor to get my medication adjusted.”

Kathryn Greene-McCreight, in her book Darkness Is My Only Companion: A Christian Response to Mental Illness, addressed stigma: “The worst thing about mental illness, besides the pain, is this very stigma. The taking pleasure from others’ pain. The jokes. Stigma creates a fear on the part of the mentally ill and cycles the fear of those who are healthy against those who are ill. I was so ill that at times I couldn’t move and yet didn’t want to tell my boss why I couldn’t come in to work. I had supervisors and colleagues, then, whom I never told. I realize now that I should have done so, but at the time I didn’t trust them with the news that I had a mental illness–one that would plague me for life. How could I go back to work after revealing that news?…One friend, a professor of theology, actually said about another friend who had been through electro-convulsive therapy (ECT), “His career is finished.” Obviously I never told her about my own problems.”

The U.S. Surgeon General’s office called stigma “the most formidable obstacle to future progress in the arena of mental illness and health.” When people avoid seeking treatment for mental illness, they may unnecessarily suffer debilitation. And society pays the price: estimated at more than 100 billion dollars a year in the U.S. This despite the highly effective treatments available today, some with up to 90-percent effectiveness. As NAMI says, “Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.”

Serious mental illness has mythological status in our culture. No wonder so many people in the church–just like those outside the church–have no idea how to relate to a real person who acknowledges or displays a mental illness.

This general societal misunderstanding of mental illness affects all of us. In fact, in some ways the stigma within the church may be stronger–with additional layers–than it is outside.

Most of this post was excerpted from Chapter 7 of Troubled Minds: Mental Illness and the Church’s Mission. If you want to read more about how mental illness is stigmatized in the church and how we can all help, you can find the book here.

Taken from Troubled Minds by Amy Simpson. Copyright(c) 2013 by Amy Simpson. Used by permission from InterVarsity Press, PO Box 1400, Downers Grove, IL 60515. www.ivpress.com.

My friend had his ups and downs.

The former were almost euphoric times when he’d grab my hand and insist that I blow off that German test or English paper and go have some fun! We ran and played like happy children, fleeing campus for ice cream cones or to walk, tightrope-style, along the ledge at the fountain at the park in the middle of town. We’d read poetry (often our own), shouting our words to the geese, the flowers, and the trees. On parting, he’d pull me close, hug me hard, and then spin himself out of my arms.

“See you when I see you!” he’d call.

A few years earlier, I’d seen the film A Room with a View, and although he was my friend, not my lover, he was a kind of unconventional George Emerson to my dutiful Lucy, extolling the virtues of love and freedom, making me take risks, and–a few years older than I was–helping to nudge me into adulthood.

But then there were the downs. He’d “crash” sometimes and stay in bed for days. He’d miss class and work shifts, sometimes for as long as a week. I’d call his apartment, stop by and try to rouse him, but he was in a deep, different kind of place and sometimes hardly stirred. I remember wondering if he were sick. Or maybe he’d taken something on one of his solo trips into the city that had left him groggy and out of sorts.

But then, as suddenly as it came on, his shadowy mood would pass and before I knew it, we’d be driving around town in his beater of a yellow car, blaring XTC: “I was lucky to remain beguiled/Grown to child since mermaid smiled.”

I knew very little about mental illness as a college student.

My compatriots–including my friend “George”–were intense, creative types, prone to emotional highs and lows. When I had a rough day, I loved to refer to the scene from Crimes of the Heart (another favorite movie of mine from the 1980s) when Sissy Spacek’s character, Babe, explains to her concerned sisters why–all in about an hour–she’d attempted to hang herself, among other things:

Margaret “Meg” Magrath: Why’d you do it, Babe? Why’d you put your head in the oven?
Babe: I don’t know . . . I’m having a bad day.

“Bad days” sent my friends and I retreating under the covers in our dorm rooms. Bad days were good enough excuses for saying we weren’t sure we wanted to live. We tossed off those words casually after being misunderstood by a parent or getting a (in my case, deserved) poor grade on a German test or when we were disappointed romantically.

The bad days always passed and made way for good ones. So when, on a sunny spring morning, I learned that my friend George had taken his life, I was stunned. He hadn’t even been in one of his darker places; only the afternoon before, we’d been together, goofing around in his apartment. “See you when I see you,” he’d said–as merrily as ever–as I left.

When we were in college, 25 years ago, George and I would sometimes talk about what it would be like to be adults and visit each other’s homes. We fantasized over what our lives would look like. I remember once saying I would keep fresh flowers in my house and a bowl of fruit centered on the kitchen table. These things would be welcoming, I said. People would enter my house and feel at home.

“Yes!” George agreed. “And you’ll have to say the very best words a person can say: ‘You can stay as long as you want!’ “

Losing George propelled me into learning more about the myriad forms mental illness can take, and the nightmares and depression I experienced after his death catapulted me into counseling and medication–therapies that helped me through a dark time of grief, anger, and confusion.

I’ve long since stopped beating myself up for the knowledge I didn’t have as a 20-year-old, knowledge that in my best daydreams could have prodded my friend toward help, toward the kind of health that would have permitted us to know each other now in middle age.

What joy it would be if I were able to open my front door, guide my old friend into the room, seat him at my table, and tell him that he could stay just as long as he wanted.

Jennifer Grant is the author of Love You More: The Divine Surprise of Adopting My Daughter and MOMumental: Adventures in the Messy Art of Raising a Family. With Cathleen Falsani, she is co-editor of Disquiet Time, to be released in autumn 2014 by Jericho Books. Find her online at jennifergrant.com.

Most people are surprised to learn that mental illness is incredibly common. In fact, mental disorders are the number-one cause of disability in North America. According to the National Institute of Mental Health and other experts, about one in four adults–a little more than 25 percent of Americans ages 18 and older–suffer from a diagnosable mental disorder in a given year. Yes, one in four. That equates to around 50 million people in the United States. And that’s only in a given year. Because many mental illnesses (like depressive episodes) are short-term and not chronic, a higher percentage of people are affected by a mental illness at some point in their lives.

Serious and chronic mental illness is less common, but still present among 6 percent of the population, or 1 in 17 adults. That’s almost 12 million people in the U.S. Those mental illnesses considered “serious” are major depression, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and borderline personality disorder.

Other mental illnesses, while not as serious as those called clinically “serious” by psychiatrists, still must be taken seriously. The National Alliance on Mental Illness defines mental illnesses as “medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning” and “often result in a diminished capacity for coping with the ordinary demands of life.” All mental illness, by definition, impairs a person’s basic functioning and disrupts the kind of social connections God created us to enjoy (Genesis 2:18-23; Colossians 3:12-15; 1 John 4:7-12).

Antipsychotics are now the top-selling class of drugs in the U.S. This is because of their growing use not only to treat serious psychotic disorders but also to address a broader array of problems. These drugs have powerful side effects, which contribute to the reluctance of people who need them to take them consistently. And these side effects themselves can impair a person’s functioning as powerfully as an illness can.

What about those under the age of 18? Many people think of mental illness as an adult problem because such illnesses in children are not as well-documented and well-known as they are for adults. People hesitate to diagnose, and therefore label, children, who are still forming and who may develop out of a mental illness. Perhaps another reason is that because our bodies begin to break down as we age, we tend to associate illness in general with adulthood. And we find it especially tragic when people in the “prime of life” go through serious suffering.

The nature of much mental illness, though, makes it different from most other disabling disease. The National Institute of Mental Health calls mental disorders “the chronic diseases of the young.” Many of these disorders begin early in life. “Half of all lifetime cases begin by age 14; three quarters have begun by age 24 . . . For example, anxiety disorders often begin in late childhood, mood disorders in late adolescence, and substance abuse in the early 20′s. Unlike heart disease or most cancers, young people with mental disorders suffer disability when they are in the prime of life, when they would normally be the most productive.”

According to the U.S. Surgeon General, every year an estimated 20 percent of children in the U.S. are at least mildly impaired by some type of diagnosable mental illness. And about 5 to 9 percent of children ages 9 to 17 have “serious emotional disturbance.” That’s between 3 and 7 million children in serious trouble–and millions of families in crisis.

Nearly everyone is touched by mental illness–directly or indirectly–at some point. From the millions of people with diagnosable mental illness, the suffering extends to parents, children, grandparents, siblings, aunts, uncles, friends, coworkers, neighbors, and church members. If your church is typical of the U.S. population, on any given Sunday on in four adults and 1 in 5 children sitting around you are suffering from a mental illness. Many of them are under the influence of those powerful antipsychotic drugs and their side effects.

This post was excerpted from Chapter 2 of Troubled Minds: Mental Illness and the Church’s Mission. If you want to read more about mental illness and how we can all help, you can find the book here.

Taken from Troubled Minds by Amy Simpson. Copyright(c) 2013 by Amy Simpson. Used by permission from InterVarsity Press, PO Box 1400, Downers Grove, IL 60515. www.ivpress.com.

NBA fans were not shocked to hear that a young star–even a rookie–would place demands on his team. But White was not simply being difficult or demanding. He was taking care of his health. White suffers from generalized anxiety disorder, a potentially paralyzing mental disorder that affects about 6.8 million adults in the United States. One symptom of his illness: fear of flying. Because the Rockets wanted White in top form for their games, they agreed to allow him to travel on the ground whenever possible.

That exception itself grabbed at least as much attention as White’s refusal to fly. Some fans wondered why he should receive special treatment. This is why: “The Rockets are being accommodating toward White because they believe he is one of the top big men prospects to come along in some time. So they’re meeting him halfway by letting him get on a bus and drive away.”

White’s college-career accomplishments and his potential as a player earned him the opportunity to use his gifts in the public eye and try to take care of himself at the same time. Not everyone is afforded the same latitude. Our society tends to assume people with mental illnesses are by nature unproductive and irrelevant. We’re so wrong.

Recall his most famous painting, “The Scream,” and it only makes sense. Read his description of the emotional moment he captured in the painting, and it seems likely: Edvard Munch may have been plagued by panic attacks.

In September 2012, The Atlantic featured Munch and 10 other profoundly influential historical figures who may have suffered from mental illness. Abraham Lincoln suffered from severe depression, the article claims. Beethoven from bipolar disorder. And Isaac Newton . . . well, everything.

Given their posthumous delivery, we can’t take these “diagnoses” as official, but they aren’t offered without evidence. And the list of profoundly influential people should give us pause.

All experienced their productive years and brilliant achievements before the most modern developments in brain science, psychotherapy, and pharmaceuticals. And yet, despite their suffering–or perhaps, at least in some cases, because of their ability to make some sense of their suffering–they were able to make outstanding contributions to society.

Do we grant the same potential to people with mental illness in our midst?

Mental illness is plagued by stigma, as almost nothing else in our society is. This despite the fact that most mental illness is now highly treatable, especially with early and consistent intervention. The main opponent of early and consistent intervention? Stigma. This stigma has many faces, one being the assumption that all hope of productive life ends with a diagnosis, a hospital stay, or that first dose of anti-psychotic medication. Sometimes that belief becomes a self-fulfilling prophecy, when people are discouraged from seeking treatment.

Considering the way our culture views, portrays, and reacts to mental illness, who wants to admit to hearing voices? desperately wanting to die? feeling like running screaming from the room, heart pounding, for no apparent reason? Many people will delay or resist treatment for months, years, or lifetimes just to avoid the shame and marginalization attached to a mental health diagnosis.

Based on my experience, this marginalization is alive and well in the Christian community. When was the last time someone in your church acknowledged struggling with mental health as openly as they might discuss a serious physical injury or illness? Does your church help people with mental disorders find their place in its ministry, or subtly (or not so subtly) suggest they need to find community somewhere else? tell people to “go get help” and come back when they’re ready to be normal? What if they can’t find normal?

It’s a terrible thing to do to someone: to suggest that hope for abundant life in Christ goes only so far, and they’re permanently on the other side of the fence.

Many people with mental illness may not seamlessly fit into church life the way most of us experience it on Sunday morning. But let’s be honest–how many of us really do?

My mother, who has schizophrenia, has been on anti-psychotics and other medications for decades, has spent time in prison, and once temporarily rejected her faith in favor of occult practices while off her medication. Last year, she sent us a package in the mail. Inside were lovely outfits she had custom-made for my daughters. There have been times in my life when I would have said she would never do such a thing again, and she may have agreed. But we were both wrong. Even when I had given up on her, God hadn’t.

As one popular worship song reminds us, Jesus’ love never fails and never gives up on us. The church, then, should be the crowd best known for never giving up on one another. As we close this Mental Health Awareness Month, let’s reflect on our attitude toward afflicted people. A change in our attitude, refusing to consider our brothers and sisters outside the reach of hope in Christ, will do much to help people heal and bring their gifts to the body of Christ.

This article originally appeared here, on Christianity Today’s Her.meneutics.

I grew up in the Midwest, one of four kids in a loving family. Dad was a pastor for ten years, serving two small rural churches. Mom was a homemaker. Our family loved to go camping, and all of my best memories of family life have the six of us crammed into a pop-up camper, swimming in a lake somewhere, or sweating together with the wind thrashing our hair, three in the front and three in the back of our sedan.

My parents have adventurous spirits and great passion for serving Jesus. Before I was born, they decided to become missionaries to Africa and worked their way through the process of approval and fundraising in their pursuit of this plan. When I was a toddler, Mom and Dad packed all our belongings in barrels for shipment overseas and moved the family to Lausanne, Switzerland. We spent a year there while my parents did intensive study of the French language. The plan was to go to Africa after that year was over, joining the missionary work underway in what was then known as Zaire. When the time came, however, political tensions prevented our going. We went back to the United States and Dad decided to pursue pastoral ministry instead. I’ve often wondered what our lives would have been like if I had grown up in Africa, different in so many ways, and what if the life that unfolded from there had instead unfolded in a missionary outpost half the world away.

My mom is a gentle person, creative, funny, resourceful, and very smart. She always encouraged my own creative development, indulged my love for reading, taught me to clean the house like I meant it, sparked my love of a good pun, and showed me how to get organized. Mom is also the person who led me to faith in Christ when I was only four years old.

Yet there’s more to our story. Mom has suffered tremendously, and has been the source of much of my own suffering. Ours is a very complicated relationship–as all of her relationships are–and while I didn’t know enough to question the normalcy of our family life when I was a child, something was wrong. This undefined knowledge nagged at my family as we did our best to ignore it. As it became harder to ignore, we started looking for help–and came up short. Then when I was a teenager, on a day when I waited at school for someone to pick me up and no one came, it became obvious.

My brother, stopping at home on a break between college classes, had found Mom in the kitchen, completely unable to function or care for herself. She went to the hospital. When I called home from a pay phone to find out when someone would pick me up from school, a neighbor answered the phone and said my mom had had “a stroke or something.” I walked the two miles home from school, praying and worrying about what this “stroke or something” would mean for my mom. Was she going to be OK? Was she dying? Would I lose my mom? Would our family be the same? It wouldn’t be–life changed after that. And yes, I did lose my mom–over and over again. But it was no stroke that had indelibly altered Mom and our family. That was the day my mom had her first full-on, debilitating, confusing, terrifying, mind-bending, truth-twisting, hospital-worthy psychotic break. And it was a long time before I really understood what had happened.

My family hiccupped through this episode but kept going, and when we got mom back we did our best to live as if what had happened was no big deal. Mom started seeing a Christian counselor and said she was struggling with depression; meanwhile she moved around the house like a zombie, her functioning almost completely suppressed by the powerful anti-psychotics she got at the hospital. My sister and I picked up the slack and tiptoed around Mom like a sleeping ghost. When she was hospitalized again (and again . . . ) we adopted Unspoken Rules 1, 2, and 3 by consensus: Don’t talk about it. Everything is fine. And no one outside this family will understand.

This post was excerpted from Chapter 1 of Troubled Minds: Mental Illness and the Church’s Mission. If you want to read more, you can find the book here.

Taken from Troubled Minds by Amy Simpson. Copyright(c) 2013 by Amy Simpson. Used by permission from InterVarsity Press, PO Box 1400, Downers Grove, IL 60515. www.ivpress.com.

His new question is this: How do you think that faith communities and society as a whole can better respond to mental illness?

Here’s my response, regarding how churches can help:

“If one group can serve a thousand people, how many people can a thousand groups serve?” This vision-casting question came from Bob Mills, one of the people I wrote about in Troubled Minds: Mental Illness and the Church’s Mission. Bob’s church is First Presbyterian in Winston-Salem, North Carolina, one of four churches I profiled, which have intentional ministries to people affected by mental illness. These churches serve as inspiration and examples of what other churches, and other faith communities, can do.

Bob is lead facilitator of the Bipolar Support Group ministry at First Presbyterian, a group that started in 2001 and has ministered to nearly 1,500 people since then. His interest in starting and perpetuating this ministry grew from his own experience with bipolar disorder and the spiritual crisis that came with it. With support from his pastoral staff, he has channeled his experience into a thriving ministry to help others on the same journey.

As I shared in Troubled Minds, Bob said he wants other churches to “understand that this is the simplest and cheapest of all ministries, because all it takes is broken people who are willing to open up to God and allow him to work through them to heal them and then help them then become healers. It costs the church nothing other than whatever power it takes for us to turn on lights for an extra three hours. And what you get in exchange for that is truly amazing.”

All four of the ministries I profiled were driven by people equally passionate about ministry to individuals and families affected by mental illness. All of them have seen their ministries provide tremendous hope, healing, and life-saving friendship.

But not every church can do what these churches have done. Some don’t feel they have the resources to start another ministry or someone willing to lead it. Some feel too stretched by the ministries they already have. Some simply have a long way to go in overcoming stigma and their visceral fear of mental illness, and the thought of a ministry specifically to reach people with such illness sounds intimidating.

Fortunately, there are many simpler–yet still powerful–things we can do. Here are a few:

• Address fear–So many of our initial reactions to people with mental illness are based in fear, most of it irrational. People who behave differently than we do aren’t necessarily dangerous. Decide whether people present a true threat to themselves or someone else. If yes, call the police. If not, try to lay your fears aside and see people for who they are–with the same needs and longings as the rest of us.
• Get educated–Misconceptions about mental illness abound, yet accurate information is so easy to find. Everyone should seek a basic understanding of mental illness and share information with others in the church or community. We can offer a more compassionate and supportive response to someone with depression, for example, when we understand that depression is a true illness rather than simple stubbornness, laziness, or self-pity.
• Check your theology–Revisit orthodox Christian views on suffering and how it relates to mental illness. Recognize how mental illness fits within Christian teaching on the effects of original sin, the presence of sickness in our world, God’s unconditional love, redemption in this life, and complete healing in the next. We don’t need to (and can’t) have all the answers, but we must face these questions and rest in God’s truth, or our own uncertainty will leave drowning people without a lifeline.
• Talk about it–Discuss mental illness in sermons, studies, and prayer groups. Acknowledge that it’s very common to face mental-health challenges–for people of faith as for others. Speak redemptively and hopefully (yet realistically) about life with mental illness. Seek to make your faith community a safe place to admit to mental health problems.
• Welcome needs–Publicly invite people to come to the church for help. Before doing so, make sure you’re ready and willing to help. And realize that walking alongside someone with mental illness may mean traveling down a long road. Such illness rarely has a quick fix or a sudden healing, and recurring episodes may try your patience.
• Offer help–Consider the ways your church already meets the needs of people affected by illness, injury, or other crises. Offer the same kinds of practical help: meals, rides, financial assistance, hospital visits, phone calls to check up on them. Because of shame and stigma, many people with mental illness typically don’t receive this kind of help.
• Grant dignity–Stigma and fear often make us avoid people who exhibit symptoms of mental illness. This only reinforces their sense of shame and separation from the rest of society and the friendships they need. We can make eye contact, smile, and say hello. Perhaps even extend friendship.

Is there more we can do? Yes! Much more–I devoted an entire chapter of Troubled Minds to this topic. But these simple actions make for a great starting point. We need not feel paralyzed by the possibilities or overwhelmed by the idea that supporting mental health is purely a job for professionals. As I wrote in Troubled Minds, “The church can make a difference. The darkness is deep enough that even a tiny light can help someone find the way out.”

Something is way better than nothing–and we can all do something.

Among the films nominated for Academy Awards this year was the quirky picture Silver Linings Playbook. It’s quirky because it defies traditional categories of film. Part romantic comedy, part intense drama, the movie also provides a bit of education on a topic Hollywood historically covers disastrously: mental illness.

The movie follows Pat, played by best actor nominee Bradley Cooper, as he tries to rebuild his life after eight months in a psychiatric hospital. Overall, the treatment of mental illness is surprisingly good. Especially when compared to the usual fare, it’s more sensitive and accurate. If you’ve seen the film, place it against the visual backdrop of movies like One Flew Over the Cuckoo’s Nest, Fatal Attraction, Misery, and Psycho. Silver Linings Playbook represents a dramatic improvement, portraying the characters who struggle with mental health as human, sympathetic, and in most ways ordinary–and with a lot of living left in the wake of diagnosis and hospitalization.

Although it’s not perfect, Silver Linings Playbook does offer helpful lessons for anyone wanting to better understand mental illness and how it affects people in the real world:

Mental illness is common.

Several characters in this movie have mental health “issues.” This might seem like Hollywood overkill, but it’s fairly realistic, especially since much mental illness has hereditary components and tends to run in families. Most people don’t realize just how common mental illness is: In any given year, just over 25 percent of American adults experience a diagnosable mental disorder. In addition, one in five children experiences a seriously debilitating mental disorder. Next Sunday, statistics say, one of the four people sitting next to you at church will be suffering with a mental illness.

Stigma is everywhere.

Unfortunately, although mental illness is highly treatable, less than 33 percent of people with such illness actually receive treatment. This is partially due to the difficulty many have in obtaining services, but it’s also due to stigma. In the movie, Pat runs into this in several places: His brother and his friend didn’t visit him in the hospital; his brother’s friends mock him at a football game; and the teenager across the street keeps showing up at his house with a camera, mocking him but claiming he wants to interview him for a school project about mental illness. Pat even wrestles with his own stigma, especially when deciding whether to take the medications he needs. In our society, mental illness is ridiculed, dismissed, feared, marginalized, and ignored. It takes great courage for people to admit they need help and healing, let alone to go public with their efforts to manage an ongoing disorder.

Medication is a mixed blessing.

Pat provides a good illustration of the difficulty many people have with taking the medication they need. Especially once an initial crisis of symptoms has passed, many people want to believe they no longer need the medications that helped them reach a point of relative health. And psychiatric drugs can have powerful side effects, which sometimes feel just as bad as the symptoms of illness itself–or even worse.

Life goes on.

Despite their struggles with mental health, the two main characters, Pat and Tiffany, both find themselves out in the real world, interacting with others and thinking about the future. They have not officially and permanently “lost it”; they aren’t what our popular culture would call “deranged” or “lunatics.” Pat, who suffers from bipolar disorder, has a relatively serious and chronic diagnosis, but he is not the mental equivalent of a “vegetable.” Contrary to popular impression, a mental health diagnosis or hospital stay does not mean the end of a person’s hopes for productive life. Most mental disorders are highly treatable, with common success rates up to 80 percent, especially with early intervention. Neither does a struggle with mental health jeopardize a Christian’s position before God. As Romans 8:35-37 assures us, “Can anything ever separate us from Christ’s love? Does it mean he no longer loves us if we have trouble or calamity, or are persecuted, or hungry, or destitute, or in danger, or threatened with death? . . . No, despite all these things, overwhelming victory is ours through Christ, who loved us.”

Though no depiction could possibly portray all the possible symptoms and expressions of mental illness, Silver Linings Playbook does have a few flaws when compared to the real-life experiences of many people. To be fair, some are due to the constraints of the movie format.

Pat engages in several public altercations and outbursts. With the exception of an initial event that got him incarcerated before the movie takes place, his encounters with law enforcement are fairly light-handed. In the real world, he probably would have been arrested at least once, especially as someone with a criminal record and a documented history of violence. In the chaos of domestic disturbances and public displays of rage, most law-enforcement officers are quick to remove a problem person from the scene. Pat’s world was more forgiving of his problems than most people find the real world.

Also, the families in Silver Linings Playbook apparently had enough resources to absorb the costs of helping their loved ones stabilize and pursue health. For example, Tiffany–played by Jennifer Lawrence, who won an Oscar for her role–converted her parents’ garage into a dance studio to help her cope with depression. The cost of psychiatric medications didn’t seem to be an issue. Neither did covering eight months of inpatient treatment. In real life, such expenses can sink a family right into poverty. And even court-appointed hospital stays are not necessary covered by the judicial system; families are on the hook. In some cases, medications can be so expensive, people have to choose between groceries and drugs. Especially considering so many people in the movie are unemployed (which is realistic for many people who struggle with mental illness), their ability to absorb such expenses does not reflect reality.

The movie focuses on high-intensity episodes and displays of symptoms that are apparent to the viewer. This is typical for bipolar manic episodes, which Pat experiences. But for real people with mental illness, including those who suffer with bipolar disorder, many symptoms don’t express themselves in visible intensity. Many people suffer quietly, often through mind-numbing boredom or crushing depression. And most people with mental illness have plenty of days when they don’t experience intense symptoms. Struggling with mental illness doesn’t always mean losing control, usually doesn’t create such exciting interactions between people, and typically doesn’t mean living with the frequency and intensity of symptoms displayed in a two-hour movie.

Throughout the movie, we see Pat keep going because he has hope. He’s looking for that silver lining–and because this is Hollywood, he finds it in romance. In real life, romantic love is not a cure for mental illness–nor is it always easy to find. But such relationships aren’t the only place we can find hope. This is one of the things the church can offer people with mental illness–hope for now and for eternity. The world we live in is marred by sin, and we all feel its effects in our bodies and our minds. But someday that will all change, when we will experience the ultimate in healing, at the hands of the Great Physician. “While we live in these earthly bodies, we groan and sigh, but it’s not that we want to die and get rid of these bodies that clothe us. Rather, we want to put on our new bodies so that these dying bodies will be swallowed up by life” (1 Corinthians 5:4).

It’s part of the mission of the church to reach out and love the downtrodden and forsaken. We don’t have to look far–we are surrounded by suffering people, marginalized by shame and ignorance. If we are to fulfill the mission Christ has given us, we can’t afford to look the other way. Movies like Silver Linings Playbook can help us build a better understanding of mental illness. It’s up to us to pursue greater insight–and to act on what we learn.

Here’s Part 3 (the final installment) . . .

Recommendations

So as a church leader, if you want to help your church be more faithful and effective in ministering to those with mental illness, and overcoming its related stigmas, what do you do? How can churches help, besides refer people to the professionals?

Here are some ideas.

De-stigmatize. Make a determined and intentional effort to rid your church of stigma and shame associated with mental illness. Talk about it. Acknowledge the struggles of people you’ve known, and your own struggle if applicable. Contact some local organizations to see how churches can better support the mentally ill. And if necessary, repent privately or even publicly for the way your church has handled mental illness.

Talk about mental illness. When was the last time you mentioned mental illness in a sermon or class? Have you discussed the tough theological questions that mental illness can raise? Established your church as a community of imperfect people growing in relationship with a God who is not confused or threatened by our imperfection? Or does your church inadvertently send the message that it’s a place only for the mentally healthy? Make your church a relevant, accepting place for those who struggle with their mental health by talking openly about it. One note of caution: no “crazy” or “psycho” jokes. Making light of mental illness is deeply hurtful and alienating and serves to reinforce the stigma and shame associated with mental illness.

Encourage relationships. When I asked my parents what the church has done right in ministering to them, they both focused on the open and genuine relationships they have had with some people in the church. Small groups have been lifelines for them, especially when they have been able to talk openly about their struggles, mention their therapeutic work, and relate their experiences to the Bible. They also mentioned how helpful it is when curious people ask questions, learning about their experiences and seeking common ground. Questions like what it’s like to be on medication or attend group therapy might seem intrusive, but for my mom, they open the door to genuine conversation with people and provide relief from feelings of isolation. Because these are her everyday experiences, they are easy for her to talk about if someone shows interest.

You don’t have to be the only one ministering to the mentally ill in your congregation. My parents’ small groups and church friends have prayed for and with them, visited Mom when she was hospitalized, taken Dad out for lunch after church when Mom was away from home, and shared their own struggles. Genuine and mutual relationships are irreplaceable. Encourage the ministry of genuine relationships in your church so that when mental healthy struggles and crises arise, those who are suffering have friends to walk through the suffering with them.

Ask what you can do to help. Pretty simple stuff, even cliche, but this takes courage. A pastor who asks this question must be willing to actually help if the individual or family expresses a specific need. People in crisis don’t always know what they need, but sometimes they do and they feel as if no one is available or willing. Their needs may not be any different from others in crisis. If you make yourself available to help–organize meal delivery, visit someone in a psychiatric hospital, find a ride to a medical appointment, provide child care, get the kids to school–you may be able to help in some very practical ways.

You may not be a mental health professional, but that doesn’t mean you can’t help. Be especially attentive to the people who are caring for/living with a mentally ill person. They may be better able to communicate what’s really going on and what they need, and like anyone who loves and cares for the suffering, they are suffering themselves.

Be present. This sounds simple, and the “ministry of presence” might be cliche, but it’s powerful. When an individual is struggling with mental illness, and when the person’s family is in crisis, the earth can feel as if it has come loose from its proper orbit. People need something stable to help them keep their bearings, and they may need you to help them keep their faith. A pastor who refuses to abandon a family in crisis may be a powerful symbol of the truth that God has not abandoned them either. Make yourself obviously and consistently available, even if it’s not clear what else you can do to help.

Radiate acceptance. Refuse to reject the person or family in crisis. Be the person who represents Christ’s tenacious and bold love, refusing to be driven away by what you don’t understand. Don’t leave just because you can’t answer all the questions. Don’t wash your hands of a family because you’ve given them a referral to a mental health professional. Like others in crisis, people affected by mental illness need to know that you care. Pretending their crisis doesn’t exist is not a way to show care. Try to treat them as you would a person who suffers from arthritis or diabetes. Ask questions: Are you managing your illness? caring for yourself? Is the family healthy? caring for itself? A diagnosis or hospitalization doesn’t change who a person is; it just changes your understanding of what someone needs.

If it’s difficult for you to show acceptance for someone who thinks and behaves in ways you don’t understand, prayerfully confront your fears and prejudices, examine where they come from, ask God to purge you of misconceptions and hatred and replace them with the kind of love he has for the suffering. Educate yourself on mental illness in general, and perhaps a specific illness so you can better understand the struggle and behavior of the person under your spiritual care.

Draw boundaries and stick to them. Just because someone is mentally ill, does not mean you need to suspend standards of morality, biblical theology, or respectful behavior in your church community. Overlooking inappropriate behavior or beliefs is destructive to your congregation, and it does no favors for people with mental illness. Regardless of how they respond to social expectations, people with mental illness do need structure and boundaries to grow in independence, understanding, and management of their illness. They need healthy people around them to give them objective feedback and an example of mental health. Help them pursue and maintain health by insisting on a healthy community around them. Communicate agreed-upon expectations openly and lovingly, and hold to them consistently.

Know when you are in over your head. Sometimes you need to call in a professional to either handle an immediate crisis or provide long-term care. If you suspect a person in your congregation is struggling with mental illness, refer him or her to a professional counselor or psychiatrist. Compile and keep a list of trusted professionals and their specialties, and make sure you’re covering a wide range of specialties on this list, from depression to eating disorders to bipolar and schizophrenia so that you’ll have a relevant referral at your fingertips when someone in your church needs it.

This one is an absolute no-brainer: If someone in your church is in danger or is endangering another person, always call 911. This is not a situation for you or your congregation to handle; it’s a situation for the police. Once everyone is safe, you can move to referrals and pastoral care as appropriate.

As I mentioned earlier, referring someone to a mental health professional does not mean your job is done. Please remember the critical role you play in the lives of the people in your congregation, as representatives of God’s kingdom. Continue to minister to people who are in professional care. You might even extend an offer to talk with the counselor or psychiatrist to discuss ways your church can help support the person’s health. If he or she gives consent, your collaboration with mental health professionals would be an amazing demonstration of acceptance and love.

Get help if you’re struggling. If you or a member of your family is struggling with your mental health, seek professional help. You cannot effectively minister to a congregation without addressing your own needs. And your first ministry is to the family God has entrusted to your care. Overcome your own fears and prejudices; your suffering or your family member’s suffering is not cause for shame. Seek answers to your theological questions. Facing a mental illness doesn’t have to destroy your faith. On the contrary, it’s more evidence of biblical truth: our fallen world and the creation that groans under the weight of our sin.

Redemption

I don’t know exactly where we get all our ideas about people with mental illness or why we tend to simultaneously laugh at them and believe they’re all dangerous criminals. I don’t know why we believe mental illness is so much rarer than it is, or why we have such a hard time accepting the presence of psychosis in a world pervasively poisoned by sin. I do know, though, that mental illness gets a bad rap. And the people who love and care for those with mental illness often feel a shame they can’t explain and a terrible burden to keep secret what they most need to share. This doesn’t stop at the doors of the church.

I’ll be among the first to acknowledge that what an illness like schizophrenia does to a person is not pretty. It’s an ugly and heartbreaking reality, and my mother’s illness has presented the single greatest test to my personal faith. So I’m not trying to minimize the confusion and revulsion we can feel when dealing with someone whose brain is giving them a skewed picture of reality. But like any suffering person, people with mental illness should find solace and acceptance in the church.

By God’s grace (and I’m not using that term flippantly) and for his glory, my siblings and I are all healthy, productive, and living in relationship with Christ. Mom is currently doing well, managing her illness and benefiting from the advances made in the latest generation of anti-psychotic drugs. I’m proud of her determination to enjoy life and pursue health despite her struggles. I’m also proud of her enduring commitment to Christ. And Dad continues to live as a paragon of faithfulness, both to his God and to the woman he committed himself to nearly 50 years ago. I’ve been inspired by his passionate pursuit of ministry in Jesus’ name, whether in or out of the pulpit. God’s redemptive work has used our family’s pain to keep my dad’s heart soft and ready to serve, and God uses him in a loving ministry toward people who cross his path.

May God’s same redemptive work cause the struggles of people in your church to blossom into loving ministry toward the suffering.