The Pastoral Care of People with Mental Health Problems

This post is an unashamed advertisement for a good book written by a good friend and colleague. The Pastoral Care of People with Mental Health Problems, by Marion Carson, has just been published by the SPCK Library of Pastoral Care. Marion trained and practised as a psychiatric nurse, is a theological educator at International Christian College where her research and teaching span the bridge between New Testament and pastoral care, she is an active member within her own church community and serves on the Board of Ministry of the Baptist Union of Scotland. This book is therefore a coalescence of professional experience, theological scholarship, pastoral engagement and personal reflection on the nature and impact of mental ill health on the quality of human life, and also on the ambivalence and uncertainty of Christian communities to welcome those with mental health difficulties with 'radical friendship'. (John Swinton)

The book is not intended to provide technical medical information, nor is it an attempt to provide a detailed and conceptually advanced theology of disability. This has been done by people like Hauerwas, Swinton and most recently Thomas Reynolds' courageous and moving book which is a profound theological reflection on disability and hospitality informed by the experience of caring for a son with complex learning difficulties. (I will review and give details of this book later). Marion's book is more specific in its aim; it is an informed and informative book that covers several major human conditions, offering enough information to provide an undergirding awareness of the condition and the issues it raises for the person affected, their carers and the professionals who seek to help. As such it combines clear description of certain conditions, provides suggested practical responses, relates the process of understanding and care to an underlying theology that is pastorally rooted in the expereinces of those of whom she writes. Each chapter is therefore an important resource for pastoral response, theological reflection and better understanding.

The seven core chapters deal with mood disorders; anxiety, phobias and stress; schizophrenia; addictions; dementia; eating disorders and self-harm; personality disorders. Listed like that they are an intimidating list of human conditions which can seem like the extreme end of human difficulty in negotiating the complex world of relationships, perceived reality and self knowing. Marion Carson is well aware that the Church often makes unhelpful responses to the presence of people with mental ill health – either shunning them because of their capacitry to be disruptive, or intervening in ways that can be dangerous or ill informed. The book is therefore intended to help communities and individuals to befriend, support and care for those who suffer and their carers. There are case studies and explanation of the condition; theological reflection on what pastoral care would look like in this situation; and practical suggestions to ensure that care is appropriate and responses constructive.

I've been a pastor for many a year now, and met and walked with people who have suffered from the kind of conditions considered in this book. The treatment here is sensible, compassionate, practical, informed and above all rooted in an expereince both professionally skilled and theologically alert, and therefore pastorally responsible and responsive. At 168 pages, chapters around 23 pages long, a writing style that is never talk down but is nevertheless deliberately practical and at times didactic, this is a book that fills the important space this side of the technical diagnostic or theologically advanced books, which remain important but are less accessible. I wish such a book had been around at some of the times when in the context of church life people in such difficulties found their way to our doors.

I finish by quoting the last two paragraphs which are written in such a way that those of us who know Marion, can hear the ipsissima vox Carson!

It is precisely in recognizing our own vulnerabilities that hope springs. Only thus are we led to build communities in which our collective and individual dependence on the triune God is acknowledged. In such communities we can admit when we get things wrong, support each other as we learn from our mistakes, and forgive one another – all the time looking to God for guidance and wisdom. In such communities, we will be enabled to follow the incarnte Christ and serve those whom society considers 'inclean'. In such safe communities, radical friendship can flourish.

In the process of following Christ's example, we may have to change our
ideas about what it means to be human beings in relation to others. We
may have to rethink how we should go about providing pastoral care. But
if we open ourselves up to our own and others' vulnerabilities, if we
are willing to take the risk, we will go some way to providing a safe
place for sufferers and those close to them. The relationships we find
ourselves in may not be conventional, but we will be enriched by them,
and we will see God at work in ways we could never have imagined. (pages 147-8)