Global Mental Health Challenges:Exploring Strategic Roles for
Churches and Faith-based OrganizationsBradford M. Smith, PhD Fred
C. Gingrich, DMinAACC, Sept. 24, 20151Objectives1. Summarize the
recommendations of the WHO Mental Health Action Plan and the NIMH
Grand Challenges in Mental Health Initiative that are most relevant
to faith-based organizations.2. Describe the advantages and
challenges of faith-based organizations involvement in global
mental health.3. Critique the approaches presented as examples of
faith-based mental health programs.
2When Jesus saw the crowds, heProclaimed the good newsHealed
every disease and sicknessHad compassion on the harassed and
helpless.The harvest is plentiful, the workers few. Ask the Lord of
the harvest, to send out workers into his harvest field.Matthew 9:
35-38Lausannes emphasis on holistic missionThe claim that Jesus is
the truth must be demonstrated in the Christian praxis of attending
to human pain and meeting human needs.The Lausanne Movement
(www.lausanne.org)Lausanne Committee for World
EvangelizationTheology Working Group
The Cape Town Declaration on Care and Counsel as
MissionIntroduction & ChristianHolistic and
SystemicIndigenousCollaborative
www.belhaven/careandcounsel/
Global Mental Health: Integration & CultureJPC, 2014,
Summer, 33(2)
For example: The case of prayer camps in
Ghanawww.youtube.com/watch?feature=player_detailpage&v=XHqdTUlcD4UGlobal
Mental Health: The NeedNearly 450 million people are affected by
mental illness worldwide
Depression is the leading cause of disability worldwide
Mental illness accounts for 15% of the global burden of
disease
Global Mental Health: Consequences of Mental IllnessPeople die
youngerHave more health problemsGet worse medical careThey
sufferLess productiveAre poorerRelationships are less
fulfillingTheir children are impactedGlobal Mental Health: The
Treatment GapThe gap between the number of people with disorders
and the number who actually receive evidence-based care is as high
as 70% to 80% in many developing countries.
Care and Counsel as MissionWhat business are we in?Railroads or
transportation?
An Unpopular MessageDeveloping nations must stop aping the
North's mental health services and use strategies tailored to their
own needs, --Vikram Patel, psychiatrist and senior lecturer at the
London School of Hygiene & Tropical Medicine
http://www.scidev.net/global/health/opinion/mental-health-in-the-developing-world-time-for-inn.html
Uninterested?The biggest challenge is that most mental health
professionals in the developing world (psychiatrists, clinical
psychologists, psychiatric nurses and social workers) seem
uninterested in responding to the treatment gap.--Vikram
PatelSpecialist Mental Health ProfessionalsBut in developing
countries, if we continue to focus almost entirely on hospital or
clinic based patient management, the specialist mental health
professions will remain, at best, only a marginal player in
improving mental health care.--Vikram Patel (2003)
WHO Pyramid of Mental Health Services
Task-shiftingDeveloping countries are already advocating and
evaluating this sort of task-shifting strategy for a wide range of
other health concerns, such as maternal and child health.
Non-specialist healthcare workers should become the front-line
of mental health services in poor countries and be incorporated
into the core of mental health provision.--Vikram Patel
Who is WHO?The World Health Organization is a specialized agency
of the United Nations (UN) that is concerned with international
public health. It was established on 7 April 1948, headquartered in
Geneva, Switzerland. The WHO Action plan complements WHOs mhGAP
(mental health gap action programme) focused on expanding services
in low resource settings.
Overall Goal of the Action PlanPromote mental well-being,
prevent mental disorders, provide care, enhance recovery, promote
human rights and reduce the mortality, morbidity, and disability
for persons with mental disorders.
WHOs Comprehensive Action Plan: ObjectivesStrengthen mental
health leadership and governanceProvide comprehensive, integrated
and responsive mental health and social care services in
community-based settings.Implement strategies for promotion and
prevention in mental health.Strengthen information systems,
evidence and research for mental health.
NIMH Grand ChallengesNational Institute for Mental Health
(www.nimh.nih.gov)Transforming the understanding and treatment of
mental
illnesses.http://www.nimh.nih.gov/about/organization/gmh/grandchallengesCollins
PY, Insel TR, Chockalingam A, Daar A, Maddox YT (2013). Grand
challenges in global mental health: Integration in research,
policy, and practice. PLoS Med 10(4): e1001434.
doi:10.1371/journal.pmed.1001434
New DirectionsCentral role for community based careGreater
emphasis on human rightsIntroduces notion of recovery and away from
a pure medical modelAddresses social determinants of mental health:
income, education, housing, social services as part of a
comprehensive response.
EmphasesEmpowerment of people with mental disabilitiesNeed for a
strong civil society including promotion and prevention activities
including suicide prevention.
Civil societyOrganizations of persons with mh disordersFamily
member and carer associationsMh and other related
NGOsCommunity-based organizationsHuman rights based
organizationsFAITH-BASED ORGANIZATIONSDevelopment and mh networks
and associations of health care professionals and service
providers
Where from here?Reduce stigma by educating pastors, church
leaders, congregations, and communitiesIntegrate mental health into
church health ministries or include both when starting up.Advocate
for the just allocation of resources for mental health at all
levels.
Use comprehensive strategies that include a continuum of care:
education, prevention, screening, support and group approachesOffer
services to the community as a witness to ChristCollaborate with
other community groups and agencies.
Utilize task-shifting to increase resources by training
laypeople and volunteers for appropriate work while providing
supervisionAddress social factors impacting mental health like
poverty and racismInclude indigenous approaches to healingConsider
using available technology integrated with personal contact
Broaden training for counselors to include program development,
community approaches, supervision.Develop forums, networks, and
partnerships for mutual learning and collaboration.
Is anyone doing this? Denominational statementUnited Methodist
Church: Ministries in Mental
Illness(www.umc.org/what-we-believe/ministries-in-mental-illness)StigmaIncarcerationDeinstitutionalizationMisunderstanding
of faithResponses: healing, congregations, communities, clergy
support, legislation, seminaries
Saddleback Church, CARick & Kay WarrenSignature
Issues:Purpose driven lifeCelebrate RecoveryHIV/AIDSPEACE
PlanOrphan CareDaniel Plan (physical disabilities)Hope for Mental
HealthAnnual Conference: Oct. 8-10, 2015www.saddleback.com
Saddlebacks mental health ministryC Care and support for ind.
and familiesH Help for practical needsU Utilize volunteersR Remove
stigmaC Collaborate in community resourcesH Offer hope- The church
has responded to crisis needs, but not so well to chronic mental
health needs- dont fix them, friend them (I have called you friends
(John 15:15) Saddleback activities advertised on websiteSuicide
loss support groupAutism Spectrum Disorder support
groupDepression/Bring back the hopeBipolar workshopEating Disorders
support groupThe Gathering on Mental Health and the Church
conferenceLiving Hope & King of Kings Baptist Church, Cape
Town, SAJohn V Thomas founded Living Hope (non-profit) in 2000, and
has been Senior Pastor of King of Kings Baptist Church in Fish Hoek
since 1987. (www.livinghope.co.za) Living Care (health care)Living
Grace (homelessness & addiction)Living Right (HIV/AIDS
education & prevention)Living Way (economic empowerment)
a journey toward wholeness in which both helpers and the
person/community in need are transformedArmonia , Mexico CityThe
PEWS ProgramPromotingEmotionalWellness and SpiritualityImplementing
a Mental Health Ministry Committee in Faith-Based Organizations:
The Promoting Emotional Wellness and Spirituality Program.
Williams, L., Gorman, R., and Hankerson, S. Social Work in Health
Care, 53:4, 414-434, DOI 10.1080/00981389.2014.880391.Program
GoalsEducate clergyReduce stigmaPromote treatment seeking for
depressionEducate clinicians about the importance of assessing
clients spiritual beliefs, by:
Forming partnerships with church staff and senior
pastorUtilizing community based participatory approachFlexible
implementationCommunity-based participatory research (CBPR)A
methodology in which mental health professionals, researchers, and
community members are equal partners throughout intervention
planning, development, and implementation.An especially promising
approach for African Americans, many of whom distrust healthcare
professions due to the Tuskegee Syphilis Study and enduring racial
discrimination.Program elementsFormed a PEWS Advisory Committee
composed of three ministers, one mental health consumer, one lay
community leader and four mental health providers.Sponsored a
Spirituality and Wellness Conference at a trusted venue.Conference
included mental health leaders and faith-based leaders.Governmental
and community nonprofits, academic institutions, and hospitalsPEWS
CurriculumDay 1 (2 hours)Welcome and IntroductionPre-TestOverview
of Mental health Issues and treatmentEffective communicationDay 2
(3 hours)Communication and helping techniquesDay 3 (2 hours) Crisis
interventionDay 4 (3 hours)Referral and community linksPosttestQ
and AQuestions to think aboutHow significant are the WHO and NIMH
documents?What concepts from the Cape Town Declaration and the
twelve recommendations particularly resonate with you?What kinds of
information and connections would help you in what you are
doing?
Discussion QuestionsWhat are the advantages and challenges for
churches and other faith-based organizations being involved in
global mental health?What are some examples of church/FBO mental
health programs and what can we learn from them?
A comment from Rwanda:"We had a lot of trouble with western
mental health workers who came here immediately after the genocide
and we had to ask some of them to leave.They came and their
practice did not involve being outside in the sun where you begin
to feel better. There was no music or drumming to get your blood
flowing again. There was no sense that everyone had taken the day
off so that the entire community could come together to try to lift
you up and bring you back to joy. There was no acknowledgement of
the depression as something invasive and external that could
actually be cast out again.Instead they would take people one at a
time into these dingy little rooms and have them sit around for an
hour or so and talk about bad things that had happened to them. We
had to ask them to leave."~A Rwandan talking to a western writer,
Andrew Solomon, about his experience with western mental health and
depression.From The Moth podcast, 'Notes on an Exorcism'.
Selected ReferencesBerry, J. W. (2013). Achieving a global
psychology. Canadian Psychology /Psychologie Canadienne, 54(1),
5561. doi: 10.1037/a0031246Collins P. Y., Patel V., Joestl S. S.,
et al. Grand challenges in global mental health. Nature. 2011 Jul
6; 475(7354): 27-30. doi: 10.1038/475027a.Gingrich, F. C., &
Smith, B. M. (2014). Global realities, cultural diversity and
Christian responses: Introduction to a special issue. Journal of
Psychology and Christianity, 33, 99-100.Gingrich, F. C., &
Smith, B. M. (2014). Culture and ethnicity in
Christianity/Psychology integration: Review and future directions.
Journal of Psychology and Christianity. 33, 139-155.Gergen, K. J.,
Gulerce, A., Lock, A., & Misra, G. (1996). Psychological
science in cultural context. American Psychologist, 51,
496-503.Hook, J. N., & Davis, E. E. (2012). Integration,
multi-cultural counseling, and social justice. Journal of
Psychology & Theology, 4, 102-106.Inter-Agency Standing
Committee (IASC; 2008). IASC guidelines on mental health and
psychosocial support in emergency settings. Geneva, Switzerland.
Retrieved from
http://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdfMarsella,
A. J. (2011, Oct.). Twelve critical issues for mental health
professionals working with ethno-culturally diverse populations.
Psychology International. Retrieved from
http://www.apa.org/international/pi/2011/10/critical-issues.aspxMarsella,
A. J., & Yamada, A. M. (Eds.). (2007). Culture and
psychopathology: Foundations, issues and directions. In S. Kitayama
& D. Cohen, Handbook of cultural psychology (pp. 797-818). New
York, NY: Guilford.Miller, W. R. (Ed.). (1999). Integrating
spirituality into treatment: Resources for practitioners.
Washington, DC: APA.Moriarty, G. L. (2012). Where do we want to be
in 10 years? Towards an integration strategy for clinical
psychologists. Journal of Psychology and Theology, 40, 41
44.Mostert, J. H. (2012). Community psychology as socio-missional
entrepreneurship. Journal of Psychology and Christianity, 31(1),
66-70.Patel, V., Saraceno, B., & Kleinman, A. (2006). Beyond
evidence: The moral case for international mental health, American
Journal of Psychiatry, 163, 1312-1315. Smith, B.M., & Gingrich,
F.C. (2014). Psychology in the context of holistic mission: The
challenges of witness, worldview and poverty. Journal of Psychology
and Christianity. 33, 101-113Sue, D. W., & Sue, D. (2013).
Counseling the culturally diverse: Theory and practice (6th ed).
New York: John Wiley & Sons.van de Vijver, F. J. R. (2013, Nov.
1). Contributions of internationalization to psychology: Toward a
global and inclusive discipline. American Psychologist. doi:
10.1037/a0033762World Health Organization. Mental health action
plan 20132020. 2013. [Cited 1 April 2014.] Available from URL:
http://apps.who.int/iris/bitstream/10665/89966/1/9789241506021_eng.pdf.45Journal
connectionsMental Health, Religion & Culture.Journal of
Religion and HealthGlobal Health Action (public health Sweden)
http://journals.co-action.net/index.php/gha Advances in Mental
HealthTranscultural Psychiatry
Contact info:Bradford M. Smith, PhDLausanne Senior Associate for
Care and Counsel as MissionDirector, Institute for International
Care and Counsel, Belhaven University, Jackson
[email protected] Gingrich, DMinProfessor of
CounselingDenver [email protected] Copy of
PowerPointwww.belhaven.edu/careandcounsel/
Email Fred ([email protected])
