Episode #17 To the Leaders

Mental illness is more common among church members than most leadership would think and the leadership of a ward is most likely to encounter it on a regular basis.  Sometimes everything about the illness is relegated to the LDS services black box.  There are many good things that a leader can accomplish to aid the individual in their treatment and management of the illness.  This podcast covers many of those things most important to leadership looking to better counsel with those who suffer.

Transcript

A podcast about how leaders can help.

I have found throughout many wards and differing leaderships that mental illness is perhaps one of the most difficult issues to address for one who is counseling in spiritual matters.  If you have experienced it yourself you probably have a leg up on someone who has not but I have found even those who have experienced it still have a difficult time counseling someone through else through it.  Most leaders simply hand over the number of LDS services and hope for the best.  While it is wise to leave the diagnosis and treatment to the professionals and handing over the number for LDS services is certainly a good call, there is still much good a leader in the Church of Jesus Christ can do to help those suffering with the illness.

I have mentioned previously that I have served in several leadership callings including bishop where mental illness was a topic of discussion on many occasions.  There are so many individuals looking for spiritual support for their illness and just as many who do not have someone with whom they can discuss spiritual matters in their lives.  I know that statistics show about 10-15% of the normal population will have clinical depression sometime in their lives.  So one might think that about every tenth person through the bishop’s door would be a possible candidate.  The answer in my experience is probably closer to 50% or greater depending upon the ward, culture, environment, social pressures and so forth.  My experience tells me that leadership deals with about 20% of the ward at any given time and that is if they are actively working.  That 20% are often the most vulnerable to mental illness and the surrounding difficulties and are those most often to not have a stable support network.  The leadership of any given ward and that includes those wards that are financially well-off, because depression does not discriminate, are likely to see depression and mental illness on a regular basis.

More often than not because leadership tends to be older and mental illness tends to be more accepted in the younger generations, it is not recognized and discussed as it should be.  Leadership is more likely to partially treat symptoms or ignore the underlying problem and simply act only when asked by the individual for help with issues.  I admit that it is difficult for someone who has not dealt with the disease to even understand it much less pick up on the subtle clues that would lead to a diagnosis.  Even if it is suspected often the leader pushes mental illness to the realm of the Church loony bin, LDS services.  I am sorry if that offends anyone at LDS services and I don’t think that way.  I have just found many who do.  Oh they don’t call it that but to them it is a black box where you send someone dealing with emotional issues so they can get fixed and come back into activity.  They do so with love, kindness and every good intention but still to the black box and let me know when you get it fixed.  

Now before anyone gets too fired up about what I said.  I understand that the bishop, Relief society president, or elder’s quorum president, ministering brother or sister is not professionally trained to deal with mental illness.  It is certainly not their job to treat and fix the underlying issue and yes LDS services is the right call.  But there are many things leadership can do to help someone who is suffering without relegating to the black box and hoping that LDS services can fix everything.  I hope to express some of those things that might be of help to those serving in leadership callings.  This includes anyone responsible for another member of the church in almost any capacity but I will be directing the remarks specifically to those individuals who do the most counseling.  Now I do so out of my own opinion and while I might make mention of the church of Jesus Christ of Latter-day Saints in my remarks, it in no way implies that I speak for the church in any capacity other than a member expressing his opinion on a topic that is dear to my heart.

So if you are leading a flock of members and you know that you are likely to come in contact with membership on a regular basis that is dealing with some level of mental illness what can you do to help the person?  Is there a list that I can check or a manual I can use?  Well I wish there was a manual but no such luck.  If you have listened to any of the podcasts before this episode you will find that mental illness is a complex issue causing changes in reality, ability, capacity, activity, and spirituality.  I do recommend listening to at least a few of them.  So what can you feasibly do?  There are actually many good things you can do on a regular basis within what you are already doing that can be of great benefit and might only require just a few adjustments.  So here we go.

First, recognize that leadership is the most likely to come in contact on a regular basis with individuals suffering from some sort of mental illness.  Many of the things we see in the church such as inactivity, lack of capacity, lack of desire, even sometimes simply walking away from the path are not a set of bad choices someone just decided to make.  Many times individuals are dealing with issues both internal and external causing such a pressure on the mind and soul that depression or other mental concerns such as anxiety takes over.  Often they cannot even tell you that is the problem but the symptoms do show up.  My daughter takes an assessment every time she goes to the counselor and it goes something like this. I am going to walk through a few of the items she gets to answer on a scale of 1-4.

If you were to give this scale to those with whom you are working and counseling what do you think they would say?  I am not asking you to be a doctor or even diagnose anything, but I am asking you to be observant.  If it looks like depression and feels like depression then it is probably far more difficult on the inside or the person whom you are counseling.  Yes some types of depression come with the pressures and sins of life and adjustments to those pressure and even sinful behaviors should bring a measure of relief and happiness.  Depressions caused by external pressures should ease when the pressures ease.  Depressions caused by internal factors such as trigger events, abuse, accidents, death and by chemical-genetic factors are more likely to need professional help before they can be managed and it is important to note they may only be able to manage it.  There may not be a fixing it.  Sometimes we as leaders go about things as if reading scriptures, going to the temple, serving another is the all encompassing answer.  The be more, do more, serve more is good for situations where it is lacking but it can be more detrimental to someone suffering from clinical depression.  The first thing leaders can do to help is to recognize that depression might be causing some of the issues the person is facing and until they face the depression or other mental illness not much is likely to get better.  

The next thing leaders can do is after a diagnosis.  Mental illness is not leprosy.  And the person is not going to break down every time you talk to them about it.  Support is a key element in managing and recovery from depression.  Support from a leader can make a significant difference.  This doesn’t mean that you are going to have to go over to their house every evening and counsel with them.  What this does mean is that you make sure they have the support they need to keep them on track with the treatments.  This is going to be tough in many cases.  Many individuals are not going to stay on medications and continue to go to counseling and continue to work with other types of treatments.  It is common for individuals to have several start and stop moments with the illness.  What they need is someone who is understanding nonjudgmental and who will gently lead them back to the treatments that are working.  Remember that most individuals who have a mental illness cannot necessarily see the treatments at work and their benefit.  Leaders can be a good resource to remind them how valuable they are.

There is also one particular note for bishop’s and stake presidents in the support process as they are the ones who will have to deal with any repentance issues.  People with mental illness specifically depression will look to all sorts of self-medication to help with the pain and suffering.  They are not intentionally walking away from their covenants or the Lord.  It is simply a natural reaction to emotional fatigue and pain.  Let me tell you that the type of fatigue and pain they are feeling is beyond what I can express.  It is not that the pain is sharp or the exhaustion is always completely debilitating, although it is at times.  It is that it never ends.  The duration and daily torture can be only described as hell.  This doesn’t mean that they will not get addicted to the self-medication but it does mean that during the treatment process they are likely to fall several times before they are able to finally get to a point that they can overcome the addiction.  Depression often takes time to heal to a point of management and recovery and until that happens addictions are likely to slowly subside over the treatment process.  This means that if the addictions include things that would be considered sin such as drugs, alcohol and pornography, that they are likely to continue to fall into the behaviors several times before they are able to claw their way out.  This is not often a function of simple lack of resolve or determination or even a lack of love for the Lord. It is just part of the recovery process.

Depression and all that goes with it feels almost identical to sin.  Not only can you not feel the Spirit or trust your feelings but heavy guilt and difficult worthlessness is almost universal with the mental illness.  So it is no wonder that one might return to self-medications from time to time as one works towards managing the illness.  What I am saying is that it is wise to manage sin with a merciful hand as the individual works through the difficulty of the disease, especially if the individual is young and single but even those who are old and married or divorced or widowed.  I think you get the picture.  Now I am not saying that you give license for sin.  But I can say be wise with removal of church opportunities as it can do far more damage than good and the intent of removal of blessings is to inspire repentance not do further damage to an already wounded soul.  I know that this can be a difficult needle to thread when you are trying to balance the Lord’s requirements of obedience against a mental illness but if you recognize the illness then you can tailor the repentance experience to be loving and helpful not destructive.

Now I agree that sin causes many of the same emotions as depression.  I guess I already might have mentioned that.  So separating those who have the illness and those who do not is incredibly important.  Their paths to becoming whole are likely to be very different.  I have no doubt with the Lord’s help you will be able to do this.

Back to the idea of support.  I know from experience that those most likely to suffer with depression are those who may not have a good support network.  They may come from good homes with loving families but are simply not supported in effective ways.  This is especially true for youth.  Sometimes they need support in different ways to help them through treatment and healing.  They are going to need help with friends, family, quorums, classes, leaders as so forth.  How can you best help?  If you don’t know how best to support them find someone who will.  Often this can be another leader, a good friend, even someone else in the ward who has or is suffering.  You will find that those of us who suffer have a tendency to be kindred spirits who connect.  

This is also true when talking about those dealing with less than ideal situations.  Individuals who are divorced, widowed, young single, older single or who are dealing with issues of same-sex attraction.  These individuals should be watched over with care as they are the most susceptible to depression and other mental illness concerns.  Children of these vulnerable individuals can also be just as susceptible to mental illness.  The illness comes in all varieties and forms and levels.  Individuals who have recently experienced what would be termed as a trigger event are also very vulnerable to variations of the illness.  Trigger events are often events such as death, especially a suicide, abuse in all forms, accidents of a traumatic nature even if it only happened to someone close to them and other types of jarring occurrences in our lives.  Sometimes no one even knows that the event has happened.  Watching for the signs of depression can give you an understanding that something needs to be addressed.  It doesn’t always need to be the leadership and often is might need to be a professional counselor.  The key is to be close enough to recognize the changes and to find out what is happening.  A normal happy youth whom seems to have become reserved, standoffish, absorbed in music, not desiring to come to activities and church, looks depressed, sad, or is sick frequently without really any community illnesses running around is likely having some depression.

Some other notes are probably important but not sure I really have a category for them.  Individuals who suffer often look to someone spiritual they can use as a sounding board.  They have great difficulty feeling the Spirit because of the illness so they will often be unsure of themselves ask for frequent blessings and so forth.  Just a quick thought on the blessings.  I know that there is a prevailing thought in the church that one blessing is sufficient and then you need to somehow claim the promises of the blessing and you don’t’ need another one.  I am not sure where it has come from and I don’t think that there is any doctrine to support it anywhere.  When someone asks for a blessing, it should be given.  Often those suffering from mental illness will ask for blessings of health as many symptoms do show up in the body as ailments.  The reality is that they more often need spiritual guidance they are having great difficulty finding due to the effects of the illness.  I received a blessing every month during my mission and the effects were miraculous in every occasion.  Give blessings and don’t worry about the misconception that blessings somehow need to be regulated.  If they ask for a blessing of health, then give that.  I don’t’ think that the prophet would have any difficulty with me saying that but if he does I can certainly be corrected.

Leaders can do so much for those they serve by simply listening.  I know that it is the nature of men to try and fix the issue and so it might take great restraint for some of you to just listen but sometimes that is all they need.  They need to be heard and their promptings confirmed and then allow the person to work through the treatment and healing process.  It took me more than decade to finally work through my healing process and that was after I had a blessing that removed the illness.  So be kind, loving and understanding when they come to you broken because they have fallen again or the treatments aren’t working quite as quickly as they hoped.

Remember that mental illness has serious impacts to the spiritual abilities of the afflicted person.  The illness doesn’t make them inept or incapable but it will affect their spiritual abilities from time to time and make going to church, activities, the temple, or fulfilling assignments very difficult.  If they don’t show up a simple call with understanding and love will do the job.  Anything more will likely add to an already guilty conscious.

Finally, one of the main reasons that I would hide my illness from my leadership is that I didn’t want to be treated with kid gloves and treated as a patient in a psych ward.  I wanted a calling.  I wanted to contribute.  I wanted to be a full member of the church.  Yes my body and my illness didn’t always agree but I still had the capacity to serve.  Don’t avoid giving callings to someone afflicted and that means even what we term heavy callings.  Allow them to serve just make sure that they have capable counselors, advisers and others who can take over when needed.  Yes they are going to need understanding and help but to avoid giving them callings or relegating them to hymn book rearranger is not going to help them feel and better about themselves.  Depression comes with sufficient guilt and feelings of worthlessness and self-doubt there is no need to add to that battle.  Just make sure they communicate with you and to let you know when things are difficult.

Well that’s enough for today.  I hope that I have helped in some small way.  I hoped that maybe I have provided something that sparked in your mind.  Even a small amount of inspiration can be a match that starts a fire.

And as always the Lord requires the fight and then he can do the rest.  Talk to you next week.