We have all been aware of the national debate on gun control and mental health in light of the Newtown, CT, tragedy. As I write this column on April 8, 2013, the political news continues to expose the deeply conflicted stances on gun control. However, the public discussion on mental health related to gun control seems to have waned a bit. Part of the reason for this was the clear and decisive information about the minimal relationship of mental health to gun violence. One helpful article was written by Richard Friedman, M.D, “In Gun Debate, a Misguided Focus on Mental Illness,” in the New York Times, published Dec. 17, 2012. Mr. Friedman stated that “there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness. However, a general public understanding of and care about the pervasive presence of mental illness is still lacking.
When visiting the National Association on Mental Illness (NAMI) website (www.nami.org/Template.cfm?Section=By_Illness), we learn that one in 17 people can be living with a serious mental illness, such as major depression, bipolar disorder, or schizophrenia. Roughly one in 10 children lives with a serious emotional or mental disorder. However, it is also the case that nearly half of Americans in their lifetime will experience some sort of mental illness or substance abuse. The NAMI site notes that unfortunately many people struggling with mental illness also experience ongoing substance abuse issues and, in turn, many who abuse alcohol and drugs experience mental illness.
When the then-U.S. Surgeon General David Satcher published in 1999 the first ever surgeon general’s report on mental health, the study highlighted mental illness as a critical health concern, as it was the second leading cause of disability and premature mortality. “One in five Americans experiences a mental disorder over the course of a year. While 15 percent of the adult population uses some form of mental health service each year, nearly half of all Americans with severe mental illness do not seek treatment.”
The report further noted that “in the United States, mental disorders collectively account for more than 15 percent of the overall burden of disease from all causes and slightly more than the burden associated with all forms of cancer (Murray & Lopez, 1996). These data underscore the importance and urgency of treating and preventing mental disorders and of promoting mental health in our society.” profiles.nlm.nih.gov/ps/access/NNBBHS.pdf
As important and pervasive as mental illness is, within the NACC few of our members have identified themselves over the years as working in a mental health facility. It has rivaled correctional chaplaincy as the ministry employing the fewest of our members. In 2006, we had 43 members who identified themselves with this ministry; today there are 16! In 2006, 30 identified themselves with correctional chaplaincy and today 17. I have no explanation at this time for this decline, and it might take some research to come to valid conclusions about this. Perhaps those in the ministry might help us to understand this trend.
Even if we do not have many members whose ministry is predominantly with people with mental illness, all of us realize, given the holistic nature of our health, that mental health is intimately and inextricably tied to our physical and spiritual well-being. Much research has been pursued in this area as well. The most recent issue of Crossroads: Exploring Research on Religion, Spirituality, and Health (April 2013, Volume 2, Issue 10), the publication of Duke University’s Center for Spirituality, Theology & Health, notes the latest systematic review of research on religion, spirituality, and mental health by Raphael M. Bonelli and Harold G. Koenig. It quotes their conclusions based on various levels of criteria: “There is good evidence that religious involvement is correlated with better mental health in the areas of depression, substance abuse, and suicide; some evidence in stress-related disorders and dementia; insufficient evidence in bipolar disorder and schizophrenia, and no data in many other mental disorders.” www.spiritualityandhealth.duke.edu/resources/pdfs/CSTH%20Newsletter%20Apr%202013.pdf
We are grateful in this issue of Vision for renewing this dialogue on mental health and illness and its relationship to our spiritual and religious health! We did not coordinate our themes with Catholic Health Association’s Health Progress, however, it was a blessed coincidence that their March-April 2013 issue was dedicated to this same topic, “Mental Health: Breaking Down Barriers” www.chausa.org/HP/. It is an excellent issue, and I encourage you to take advantage of the articles’ online accessibility and read them along with these Vision articles.
I don’t think we can do enough to inform ourselves in this field. Thus, I am all the more grateful to the Vision Editorial Advisory Panel for dedicating this May-June 2013 issue to this topic, and to those writers who contributed articles. We appreciate their lead as we need to be better prepared to understand mental health care as part of holistic care, and the role of the chaplain to help achieve better care for patients and families.
David A. Lichter