a review of Amy Simpson's book Troubled Minds: Mental Illness and the Church's Mission

"I think we can do better. I think we can be more like the church we were made to be. ... / / ... Ours is supposed to be a community where the hurting, broken and sin-scarred find rest and redemption. Where everyone present owns up to being a hurting, broken and sin-scarred individual, rescued from the ultimate death, the ultimate suffering--which we deserve--by the grace of God. Where that same grace / causes us to reach outside ourselves and, through the Holy Spirit's power, love one another" (29-32). 

Mental illness is one very real evidence of our living in a broken world. The stats are staggering. "About one in four adults--a little more than 25 percent of Americans ages eighteen and older--suffers from a diagnosable mental disorder in a given year. Yes, one in four. That equates to around fifty million people in the United States" (33). Not only that, but "every year an estimated 20 percent of children in the United States are at least mildly impaired by some type of diagnosable mental illness" (35). 

And when one suffers, all of us suffer. Mental illness never affects only the person diagnosed (or undiagnosed but suffering). It affects a family, a community. 

This is not an easy topic. It hits too close to home. To each of our homes. It's hard. And yet one of the biggest lies out there is that if you or someone you love is suffering with mental illness, you're all alone. You're not! You are not alone. 

Amy Simpson writes with compassion and understanding. Her own mother struggles with schizophrenia, diagnosed when Amy was a teen. Amy graciously but openly shares their story (chapter 1). But she's also done her homework. And while acknowledging "that each person's experiences and perspectives are unique" Amy has "attempted to capture a general sense of many people's reality, along with sharing [her own] family's experiences, to offer some insight into the challenge of ministry to people with mental illness." As I look back and see Amy's words "I hope you'll find that the pages of this book are filled with honestly and yet overflow with grace for both those directly affected by mental illness and those called to help suffering people in the context of the church" (19), I reply, "Yes, Amy, Yes! That's exactly what I've found! Thank you!"

If you're looking for one book to read to help you understand what mental illness is and to initiate some ideas of ways you can practically encourage and be a help to the individuals and families in your community (and especially in your church) who are wading through the deep river that is mental illness -- this is the book! 

Amy goes well beyond defining the categories and giving prevalence, though she includes that in chapter 2. She fleshes out the story, lets us in on personal situations, shares the crisis moments and the day-to-day challenges. Throughout the book, Amy gives "a heavy dose of hope ... based in the power and grace of Christ, who is always with us and who will not allow anything to separate us from his love (Rom. 8:38) ... based in the comfort of God's constant presence with us (2 Cor. 4:8-10) ... [and] rooted in our knowledge that something much better is on its way (1 Cor. 15:43)" (20).

Chapter 3 paints the familial picture, sharing the ways we suffer when mental illness affects our families. She talks about the special rules that are established to maintain peace, the resource monopoly (emotionally, physically, and financially) to manage, confusion, anxiety, guilt, maladjustment of children as they grow up, role reversal when children find themselves being the caregivers for parents, instability, the difficulty of determining appropriate medications, grief and loss, shame, and spiritual crisis. "Wrestling with these ... in the context of a supportive church -- where faith is deep and honest enough to acknowledge that life in a sinful world is painful and twisted and that some questions don't have answers this side of heaven -- could make a huge difference in determining whether the questions destroy or develop faith" (80). This chapter was especially helpful. 

One of the things I admire about Amy's perspective is how balanced it is. As she walks us through Coping, in chapter 4, she advocates for an appropriate respect toward the field of psychology and what we can learn there, while at the same time pleading with pastors to not merely refer individuals for outside help -- but to continue to walk through and counsel the sheep entrusted to their care throughout the journey. For some, the journey will be shorter. For others, it will be ongoing. But to have not just a knowledgeable professional psychologist but also a compassionate shepherd is critical to the long-term success of any believer walking this path. It is important to remember that the individual must give consent for the mental health professional to be able to communicate with the pastor.

Chapters 5 and 6 deal specifically with church life and ministry. 

A few key quotes: 

" When the church is silent to a person in crisis, it can sound remarkably like silence from God" (100). 

"People in mental health crisis, as with any other crisis, need friends. They need connection with loving people--especially those who will point them to Christ. And this kind of loving connection is impossible in an environment that asks people to make the rest of us more comfortable by pretending to be healthy, happy and impervious to trouble" (103).

"We do have victory in Christ. As forgiven people, we are no longer slaves to sin and its ultimate consequence. ... But while we are not slaves, we still live in the slaves' quarters. Our world is poisoned by sin, our bodies are cursed, and all of our endeavors are flawed. God has promised to remove us from this world someday and to replace these imperfect bodies with new bodies ... suited for life in a perfect world without decay. We can walk in the light of that future hope, even though we live in a shadowy world. When churches embrace this dual reality, they help bring lifesaving hope to suffering people" (107-108). 

"I believe our minds, bodies and spirits are more interrelated than we can understand. And we know that each of these elements of who we are can have a powerful effect on the others. I won't deny that spiritual problems can lead to problems in our brains and bodies, just as physical suffering can affect our spirits. But this does not justify the assumption that all mental illness is spiritual at its root and can be cured through more spiritual work on our part--any more than we should expect to cure cancer by simply confessing sin and praying more. Spiritualizing mental illness translates to blaming sick people for their illnesses. ... It traps people into working harder. ... This is not the gospel message, and it is very effective in discouraging people from acknowledging their struggles and seeking help" (108).

"[Caring for individuals and families affected by long-term mental illness] is a daunting task, and it doesn't fall to an individual eventually--it has to fall to the whole body of Christ because it's only the body that can handle something like that for a lifetime" (113). 

"People with mental illness need to work hard to manage their illnesses as effectively as possible. But they might still [struggle] over the long term, even after working hard and taking required medications" (114). 

"For people with any kind of brain disorder, accurately understanding the world can be difficult at times. Accurately understanding deep spiritual truths can be, on occasion, impossible" (117). 

"The good news: God is not intimidated or limited by our lack of wits or resources. He will (and does) minister to people with mental illness through the bumbling efforts of church leaders, through the presence of silent companions who keep quiet only because they have no idea what to say, through the efforts of caring people who don't know Christ..." (119).   

"The church matters because it is the first place many people go when they need help of all kinds, including help with symptoms of mental illness. And it matters because it represents God and is equipped by the Holy Spirit to pour out Jesus' love on this world. And when someone is rejected, ignored or marginalized by the church--representatives of God--they feel rejected by God. It also matters because it is a powerful instrument against darkness in the hands of a God who loves the light. The church can and does make a difference" (132-33).

Chapter 7 is entitled "Persistent Stigma" and provides both a brief history of how people have responded to mental illness as well as a handful of reasons that have historically magnified the stigma within the Church. We need to face these honestly and pray for God to open our eyes to ways we've given into cultural stigmas instead of reflecting Christ's love and opening our arms to welcome these fellow human beings into our family. We don't like to believe that these kinds of pains are so prevalent and can affect the people we love. But pretending doesn't prevent pain from affecting us. In fact, it can set us up for false expectations and leave us not knowing how to cope when our stigma-glazed reality is shattered. I can't even choose which portions of the second half of this chapter to quote. I read the whole thing out loud and discussed it with Alan on a recent road trip. Such important things for church leaders to work through. Please -- read this chapter!! 

Chapter 8 gives some great examples of communities who have done well to include and help individuals and families who are touched by mental illness. Can I just say, it's not as complicated as you might think. And in a big way, what we're doing in our church with Life Groups is a really practical starting point to be knowing one another, living life together, opening up about our struggles, and sharing the load together. Living like this is beautiful. This is what church is all about. 

I will quote this, because our church has been focuses on prayer recently and because it's a take-away that can quickly change the atmosphere: "The hush-hush approach actually reinforces and lends credibility to the stigma by suggesting that mental illness is something to be ashamed of. Besides sermons, public prayers are a good place to mention mental illness. As you're praying for those facing other illnesses and obstacles, why not mention (in general unless you have permission) people struggling with depression, anxiety disorders and other mental illnesses?" (183). 

The final chapter rejoices in what God does throughout the journey. God is working for our good and for His glory. Amy shares some really precious testimonies as she closes her book. 

I can't even begin to tell you how thankful I am to have a book like this. Amy, you made yourself raw and you really worked hard to be thorough and intensely practical. Well done! May God richly reward you for your labor of love for His body. 

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