The right frame of mind

The church has a fundamental role to play for people battling mental health issues.

By Andrew Humphries

We take it for granted that any church, including the Uniting Church, should be a home for those marginalised in society due to mental health issues.

Surely, we say, at the very least acceptance lies at the heart of what any church, or faith community, should be offering those in need, and any person facing mental distress should expect to find they are welcomed and, more importantly, not judged.

But what if that isn’t always the case?

What if, somewhere along the line, that most fundamental right a person has of being accepted is ignored and, in some cases, turns to rejection?

For Professor John Swinton, from Aberdeen University in Scotland, such questions are at the heart of mental health, religion and spirituality and formed the basis of an online presentation he delivered earlier this month.

Organised by Synod of Victoria and Tasmania disability inclusion advocate Rev (Deacon) Dr Andy Calder, John’s presentation dealt with the fundamental question of whether religion and spirituality supported or hindered mental health.

As a former mental health nurse, and now a Minister within the Church of Scotland, John is uniquely placed to consider such a weighty issue and, for some people of faith, his answers may make for some painful reflection.

“In my recent work I have been thinking about what role the church should play in relation to mental health,” John says.

With that in mind, a recent study he conducted which explored the spiritual lives of people living with schizophrenia, bipolar disorder and major depression offered plenty for him to ponder.

“The idea was to put to one side our assumptions of what people with diagnoses such as these should be experiencing and really try to listen to people’s own stories, and it was fascinating,” John says.

“Lots of interesting things came up, but one thing that was very clear was the question, ‘what kind of church do we need to be as a place of welcome and belonging to those who appear to be different’?

“The church should be a church of the marginalised, but very often we fail in that central task.”

That’s a comment Andy, as a disability inclusion advocate, also can relate to.

“Oh absolutely, yes that resonates with me,” Andy says.

“I think the church, as an expression of God’s love in the world, is there to embrace all people and not exclude anyone, whether that be people who live with stigma or shame or a sense of not fitting in (as part of) wider societal circles.

“The message of the Gospel is much more powerful in that people can find sanctuary within the life of the church, but, as John says, that is not always the case.

“We need to keep talking about why it isn’t always the case and get to the foundation of what our expression needs to be.”

The church needs to offer sanctuary to those with mental health issues.

And while a certain stigma remain attached to those with mental illness, Andy suggests it is a bit more complex than that.

“It’s a mixed story, in that sense,” he says.

“Some people will speak very warmly and very appreciatively of the home that they find (in the church), the friendships that nurture them and the support and pastoral care they receive, so I don’t want to discount any of that.

“Other people, though, have said the opposite of that and indicate it is more difficult for them because they don’t find a welcoming place, and that could be for all sorts of reasons.

“There may be a sense that some of the healing narratives in the stories that have equated mental illness with shame and sin and bringing bad omens to (a person) and the rest of their family meant they have consciously or unconsciously had a perception of being pushed away from the church.

“Perhaps it hasn’t always been a place of healing for a number of people and that is what we wanted to unpack: some ways in which giving expression to our theology might be helpful and which things aren’t as helpful.”

John points to the experiences of Alice, who took part in his study, as an example of the church failing to provide an environment in which mentally ill people can thrive.

“When I was in hospital, I met some really interesting people,” says Alice, a Christian with schizophrenia.

“I met Jesus at one point and he’s a 50-year-old man from London.

“Being Jesus seems to be a common mental health issue but, yeah, he was Jesus or an Old Testament prophet, it just depended on the day.

“I met a lady who thought her face was falling off and all this kind of stuff and it’s so fascinating what people’s brains can do to them.

“I think for all of us, because we were all in it together, there’s a sense of community that I find I’ve definitely missed a lot.

“And we’re the nuttiest community out there, and we used to just sit around in a circle and smoke up a storm and swear and drink and whatever, but we understood there was no need to explain if you start talking to a corner.

“Everyone would just go, ‘ah, she’s off her meds again’.

“No one would care, there was a real sense of family and I haven’t found that again.”

John says Alice’s experience, and her admission that she had been unable to find that sense of family within her church, pose a fundamental question around what the church should be offering people like her.

A church that embraces those with mental health issues can make a world of difference.

In other words, why would Alice feel more accepted among her fellow patients, rather than within the embrace of her own church?

“Why is it that Alice, a lover of Jesus, can’t find the kind of loving, accepting community that she encountered when she was with people that society claimed to be mad, within that place that claims to be the home of the friends of Jesus?,” John wonders.

Part of the problem, he suggests, is that many people of faith find it difficult to know how to deal with someone like Alice.

“Earlier in Alice’s’ story she talks about the way that she has been alienated from her church community by stigma, negative attitudes and the tendency of some to equate her experiences of voice hearing with the demonic,” John says.

“So she has persistently found herself alienated, devalued and rejected from church communities who choose to describe her situation in profoundly negative terms.

“The community Alice found in hospital just accepted her as she was and didn’t try to explain her situation. They just saw her as Alice.”

There is, John says, also at times a theological barrier standing between someone like Alice and acceptance within the church.

“The problem for the churches Alice had been involved with was theological,” he says.

“The churches yielded to the temptation to use ill-thought through theological assumptions to explain her situation, with disastrous consequences.

“Take for example the issue of ascribing the demonic to Alice’s experiences and her voice hearing.

“What is going on here? When you look at Jesus’s encounters with the demonic in the Gospels, we see firstly that most demonic activity was manifested in physical problems.

“We don’t normally ascribe the demonic to physical illness, but if we were to be consistent then presumably we should.

“Why, then, would we ascribe the demonic only to mental activity.

“This perhaps tells us something about the problem of living in a hypercognitive society where we are obsessed with our minds to the extent that we often associate them as something central to our humanness.

“So when something goes wrong with our minds we worry about our humanness or the humanness of others.

“But there is more. If you place the experiences of schizophrenia as it is laid out in the diagnostic manuals psychiatrists use, you will see that there is very little similarity, if any, to the symptomatology of schizophrenia.

“And yet many people seem to ignore this and just jump to conclusions that are inappropriate, ill-informed and dangerous.”

Professor John Swinton hopes recent research can begin the conversation about better understanding mental health issues.

John hopes his research can be a step towards opening up a conversation that allows us to better understand the issues, and practice our care of those with mental illness more carefully and faithfully.

“I think we need to begin by teaching and preaching around issues relating to theology and mental health,” he says.

“I came across one gentleman recently who created a liturgy around depression.

“He ran it in his church and afterwards was amazed at the number of people who came to him saying that they had had depression for years but had never felt safe or able to tell anyone within the congregation.

“When we take these issues into the heart of our worship lives, we create spaces where healing conversations can occur.”

That healing conversation, says John, may be as simple as telling someone else about our own mental health challenges, safe from the fear of humiliation and rejection.

“Now that takes time and a lot of sensitivity,” he says.

“Churches are not always safe places and if someone decides to make themselves vulnerable and is then rejected or, worse, ignored, it can be damaging.

“So opening up our liturgical lives to mental health issues takes time and much care, but it is vitally necessary. In the end, the only people who can really give insight into the nature of mental health challenges are people who live with them.

“So telling and listening to stories within safe spaces is absolutely crucial for the development and sustenance of healing conversations.”

Like John, Andy stresses the need for an open and honest conversation around mental health and how the church deals with everything that surrounds such a complex issue.

Such a conversation, he hopes, can represent the first step in offering a more welcoming environment to those who may feel marginalised by the church.

“We’re getting into big territory now, aren’t we?” he says.

“I think a significant part of it is that we address the issue and that we have conversations and reflections on it from the pulpit, or we look at something like Bible studies or a discussion group where people are invited to talk about their own experiences.

“It’s important the conversation is held in a safe and well-cared for context, where people can speak as much or as little as they want to and not feel judged or have inappropriate things said to them.

“We don’t want a situation where someone has a sense of being blamed or shamed, when we know that people’s lives are often more complicated than they appear on the surface.

“It has to be done in a non-judgmental environment and how you create that is the challenge for any culture, not just the church.”

Discussion around mental health needs to be done in a non-judgmental way, says Professor John Swinton.

It is a conversation, John says, in which the views of mental health and other disability advocates need to be respected, welcomed and encouraged.

“One church I visited recently had a preaching team and, before any sermon was preached, it had to be preached to the team, who then commented and critiqued in order that it was the best it could be,” John says.

“They are (now) considering having someone with a disability and someone with a mental health challenge as part of that discernment group.

“That way the preacher can be encouraged not to fall into the kinds of traps that alienated Alice and to develop a mental health homiletic, that is, a way of preaching that takes cognisance of the various mental health needs within any congregation.

“So the key is creating spaces within the structure of our community where the voices of people with mental health challenges can be heard.

“This means that we don’t just think in terms of developing a “mental health ministry”, but rather think through what it means to be a mentally healthy community within which all people are noticed and valued.”

Underpinning John’s work is his role as Director of the University of Aberdeen’s Centre for Spirituality, Health and Disability, which he established in 2004 to explore the relationship between spirituality, health and healing and the significance of the spiritual dimension for contemporary healthcare practices, as well as the theology of disability.

“The centre is designed to bring together theologians, practitioners, ministers, lay people and people living with disabilities to discuss important issues around theology, health and healing, with a view to enhancing understanding and practice,” he says.

“The key thing about the centre’s research agenda is that it develops research intended to inform practice.

“So we hope that the work we do is scholarly and rigorous and we also hope that it makes a difference in, and for, God’s creation.

“My role as the centre’s director is to guide the process and to shape the agenda.

“I am actively involved in the research, but some of what we do relates to other research projects across the university and beyond.

“I guess you could say I am a researcher and a research facilitator.”

A mental health kit for congregations is available by clicking here

Professor John Swinton worked as a nurse in the mental health field before studying theology.

Son of a preacher man

If a movie was ever made around the life of Professor John Swinton, it would be a ripper.

The theologian and mental health advocate has packed plenty into his 64 years and it’s a fair bet he will achieve a great deal more.

From the first 14 years of his life in Glasgow to an early career as a nurse working in the mental health field in Aberdeen to higher study in theology and then ordained ministry, John has seen and done just about everything.

“Yes, I suppose I have had an interesting and varied journey,” is his modest way of summing up his life to date.

With a father as a parish minister, it would seem that a life of faith was an obvious step for John, but that wasn’t quite the case, as he explains.

“Well, the truth is that I was a son of the manse which, for many of us, is not necessarily the best way to start our spiritual journey,” he says.

“They say that ministers and policemen’s children are the most rebellious.

“You have a lot to live down and to live up to, so I was always around church but never really took it seriously.”

And that may have been it, until a group of friends in Aberdeen opened his eyes to the possibilities offered through embracing God.

“I had an encounter with some friends who had just become Christians,” John recalls.

“The last time I had seen them we had enjoyed a wild night out in Aberdeen city, but this time they had all changed.

“They all had Bibles under their arms. Apparently, a charismatic evangelical preacher had become the minister in a small town just outside the city and his ministry had been, to put it mildly, impressive.”

The impact on his friends was, for John, a life-changing moment.

“The thing that changed me was the change in my friends,” John says.

“All of my life I had been around church and I knew the theory very well, but the practice, less so.

“But when I saw the change in them, I began to think there might be something in this.

“So that was when I made a commitment to Christ and, well I’d like to say it was all downhill from there, but there have been peaks and valleys.”

And those peaks and valleys, suggests John, represent the whole nature of faith.

“That is the nature of discipleship,” John says.

“Being a Christian is not a theory, it is a deep and all-embracing practice – that is probably why I ended up as a practical theologian.”

John’s early career as a mental health nurse did much to shape his view of the world and was also the springboard to his decision in 1989 to leave nursing and study theology.

“I worked for 16 years as a nurse in Aberdeen in the area of psychiatry and then within the area of intellectual disabilities,” he says.

“These were formative years for me and spending my early working life with people who had such broad and interesting life experiences certainly changed the way I look at the world.

“There is much to be learned from listening carefully to the experiences of people who are living what some would say are unconventional lives.

“So these years were crucial for me in terms of shaping and forming me into the person that I am and enabling me to become the kind of theologian that I have become.”

When John left nursing to study theology in 1989, he thought initially he would end up in hospital chaplaincy, where he did work for a while.

Early on, though, he knew that he wanted to be a practical theologian.

“So I finished my degrees, worked at Glasgow University for a year and then got a job at Aberdeen University, where I have been ever since,” John says.

Along the way, he became an ordained minister in the Church of Scotland and is Master of Christ’s College at the university, with responsibility for ministry candidates for the Presbyterian Church of Scotland.

While he has achieved so much, John believes there is still much to do.

“I still have a passion for people living with disabilities and those experiencing mental health challenges,” he says.

“There is still a lot of work to be done within the church and within theology to enable our communities to become places of belonging within which all of us together can find welcome, peace, hope and understanding.

“So I think that is what drives me: the hope and the promise of the Gospel.”

Rev (Deacon) Dr Andy Calder.

‘To belong I need to be missed’

For Andy Calder, the opportunity to make use of Professor John Swinton’s vast knowledge is always an opportunity too good to turn down.

That’s why Andy was delighted to invite John, both a friend and colleague from afar, to deliver a presentation via Zoom earlier this month on the issue of whether religion and spirituality support or hinder mental health.

“He is obviously a very impressive fellow and his application of theological concepts and principles, and analysis of theology in relation to people with disabilities, is right up there in terms of international scholarly contributions and input,” Andy says.

“A couple of times when he has been here in Australia I have invited him to give presentations at conferences we have held.”

Andy says a simple but effective phrase, “to belong I need to be missed”, informs so much of the valuable work John has done in the mental health field, work which gives the marginalised a voice.

In fact, with John’s permission, Andy was able to use the phrase over a decade ago as the title of a research project which investigated the experiences of people with disabilities from Buddhist, Christian, Jewish and Muslim perspectives, in relation to disability and inclusion in faith communities.

“I think the phrase really sums up a lot of the work he has done in mental health and dementia, and he has written widely and is a very engaging presenter,” Andy says.

“I had contact with him through my own PhD studies and through an international gathering called the Summer Institute on Theology and Disability, and John is one of the faculty members who brings people together who have an interest in this intersection of spirituality and disability.

“I find he is always generous with his time and you never feel any request, large or small, is ignored.”

Andy says John’s extensive career as a nurse gives him a unique perspective on the issue of mental health and spirituality and the ability to easily pass on the knowledge he has gained.

“I think his work as a mental health nurse has provided him with a really solid foundational basis for an integration of the practical and theoretical,” Andy says.

“He has an ability to be able to listen carefully to people and take on board their situations and then frame that and put it into a theological context (which) speaks to people who read texts and scriptures and can then see the linkages with people’s lived experiences.”

John has been published widely within the area of mental health, dementia, disability theology, spirituality and healthcare, qualitative research and pastoral care.

In 2016 his book, Dementia: Living in the memories of God, won the Archbishop of Canterbury’s Ramsey Prize for excellence in theological writing.

Dementia is, John says, something that is fundamentally misunderstood.

“Dementia is one of the most stigmatised and feared conditions,” he says.

“People are more afraid of dementia than they are of cancer, but why might that be? Well, the reason is that we are afraid that if we have dementia we somehow lose ourselves.

“We can battle cancer and indeed it can be perceived as a noble battle, but we can’t battle dementia in the same way, because the cognitive capacities we need for the battle leave us over time.

“So, we are deeply fearful of dementia (and) the problem is that within Western culture we have a particular understanding of the self.

“In order for me to be me, I am expected to remember the past, be able to bring the past into the present and then project onwards into a hopeful future.”

So what happens when that is no longer possible?

“If I can’t do this, people start to say things like ‘he is not the person he used to be’. Why? Because it looks like I can no longer tell my own story,” John says.

“We tend to think that we are the stories we tell of ourselves and if we can no longer tell that story we are no longer ourselves.

“My book challenges this and points out that as Christians, it is not our own story that counts.

“We discover who we are through who we are in Christ. It is God’s story that informs us of who we are.

“It is God’s memory that holds us in our identity. Our damaged brains do not determine who we are, God does.

“We are who we are as we are remembered by God. The book works all of that out in more detail and offers pastoral insights and practices that can help us all to live faithfully together, even in the face of significant challenges such as dementia.”

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