By Elaine Chan, MSW, MDiv, BCC
On Good Friday I got a referral to see a Roman Catholic patient whose adult son had died recently. The woman was lying in bed and spoke very softly, almost inaudibly. As I listened carefully I learned that she was upset about her son’s death and that the staff would not give her medication to dull her emotional pain. She said she did not really want to talk, just to get her medication. A few days later I saw her again but she repeated her request for medication. The doctor had requested “spiritual care” because he did not see the need for more psychotropic drugs. But unfortunately the woman was adamant about receiving medication and was not receptive to spiritual care.
When I first started doing pastoral care a priest told me that while individuals come to the hospital for a physical illness, many may have underlying personal issues that adversely affect their well-being. Sometimes it may be the death of a close family or friend or some other personal issue. My sense is that the woman whose son had died had other issues besides his death. As chaplain, I am not trained to assess her mental state but rather to be present to her, listening and witnessing her pain and offering spiritual or religious support, as needed.
While I am not a mental health professional, I am familiar with mental illness, having experienced this with two of my siblings. My siblings from time to time have had to be hospitalized. I am happy to say that the pastoral care provided to them has been meaningful. One sibling, who had already been diagnosed with an illness, lived near the World Trade Center and was deeply affected by the events of 9/11. She was admitted to the hospital and felt better after receiving medication and care. In the hospital she also received regular visits and Holy Communion from a priest which gave her much comfort.
Another sibling needed surgery a few months ago due to the damaging effects of some medication which she had been on for years, and from which she has since been removed. She did not fully understand her medical condition and was quite upset. At the time I worked in another part of the city and was concerned about her during the day. The chaplain I asked to visit her assured me that my sister was getting a lot of attention and good care from the staff. This put my mind at ease until I got to see my sister in the evening.
This same sister used to attend services with a foster family she lived with. At these services she learned to pray out loud, asking God for help with various needs. When our father died, she offered a prayer, and my pastor was impressed with how well she spoke.
Spiritual care can be offered to an individual with mental illness. It is difficult to generalize about what spiritual care can be offered. Each individual is different, and each one is a person with feelings, needs, dreams and hopes. People with mental illness need to be encouraged and supported to reach their potential. Similarly, their families and caregivers need support as they deal with the stress, worry and emotional overload of their responsibilities. Individuals with mental illness need chaplains to be present, to listen and assure them that they are safe. Individuals who are psychotic may not be receptive to a chaplain but this may change once they are treated with medication. Schizophrenics may hear voices from God or Satan, telling them to do one thing or another. While chaplains can speak to some of this, the individuals will need more than pastoral care to deal with the voices.
Individuals with mental illness want the same things the rest of us want and are frustrated that their mental illness may prevent them from fulfilling their dreams and hopes. My siblings live in supervised settings and miss not being with family. They crave attention and love from family. Sometimes they call multiple times in the same period just to be reassured that someone is there for them. What my sister says does not always make sense, but it is not so much what she says but that she wants attention.
Thank God there are many resources to help individuals with mental illness as well as their caregivers. In the past I have been a member of The National Alliance on Mental Illness (NAMI) and have taught their Family-to-Family Course for family caregivers of individuals with serious mental illness. This is an excellent 12-week course which is taught by trained volunteers who have experienced mental illness in their own families. It covers a variety of topics including current information about different mental illness diagnoses, e.g. schizophrenia, major depression; up-to-date information about medications and their side effects; current research on brain disorder; how to understand and relate to the person with the mental illness; strategies for dealing with crises and relapses as well as self-care for the caregivers. NAMI is a national organization with offices throughout the United States. Catholic Charities may also offer resources for individuals and their families.
On Good Friday I gave a reflection on the Seven Last Words, noting that we cannot appreciate Easter and the Resurrection if we do not contemplate what happened on Good Friday. Individuals with mental illness as well as their families and caregivers daily walk the road to Calvary. We celebrate moments of grace when we see our loved ones do well and thrive. We also weep with them when they falter. Chaplains can walk alongside them, letting them know that they do not walk alone. As much as possible, we can try to include individuals with mental illness, their families and caregivers in various activities such as spirituality groups, worship services etc. Resurrections are possible as we help individuals reach their full potential and be the people God meant them to be.
Elaine Chan is staff chaplain at New York Hospital in Queens, New York, and is a member of the NACC’s Editorial Advisory Panel.
