Over at the Evangelical Channel on Patheos, Adrian Warnock is hosting a conversation about faith and mental illness in honor of the fact that May is Mental Health Awareness month.  Throughout the month, I hope to post blogs to contribute to that conversation, as I believe that it is a crucial conversation for Christians and all people of good will to be having.  This week, Warnock is asking bloggers to address how their religious communities have historically viewed mental illness and how their faith, today, shapes their view of mental illness.

When I think of the long history of the Catholic Church, of all the things that could be said about how we have viewed those with mental illness, I’m going to focus on three ideas, because I think they are the most constant and the most right (well, mostly) of the tradition.  The first comes from St. Augustine.  In his City of God, in which he covers and theologizes upon the whole of history as he knows it, he considers, briefly, the gift that is the human intellect.  What a wondrous thing it is that we have been given the ability to know our world, our selves, and even, with the help of grace, our God!  In the midst of this beautiful, celebratory passage, however, he interrupts himself to say this:

Crazy people say and do many incongruous things, things for the most part alien to their intentions and their characters, certainly contrary to their good intentions and characters; and when we think about their words and actions, or see them with our eyes, we can scarcely — or possibly we cannot at all — restrain our tears, if we consider their situation as it deserves to be considered.

One can almost see the tears of the saint on the page.  Or perhaps, those are the tears of his readers through the ages, who have known exactly what he meant.  When one’s intellect is shattered by an illness like schizophrenia, complete with its hallucinations and delusions (not to mention countless less dramatic but no less debilitating symptoms), one cannot know the world, one’s self, or one’s God in the way one was meant to.  And insofar as one cannot know well, one cannot act well.  As Augustine puts it, one acts against one’s own good intentions.  There is such a deep tragedy in this lack of understanding and the lack of full freedom that follows upon it.  But that is one thing that it seems the Catholic tradition has held onto well: the sense of mental illness as a tragic brokenness of a natural faculty.

The second idea that I want to mention is that Catholics have long considered the mentally ill to be among “the least of these” whom Christ calls us to care for as though they are Christ himself (Matthew 25:31-46).  From its earliest days, Christianity was reaching out to the poor and marginalized, and the mentally ill have been among them.  Whether in explicit service to those with mental health issues, or whether serving those who were poor, hungry, or homeless (all groups that ALWAYS include people with mental illness), the Catholic Church has a long tradition of service.

The third idea that I want to mention is one that I feel is more mixed.  Many Catholics are shaped by a sentiment expressed most succinctly by St. Ignatius of Loyola: “Work like everything depends on you, and pray like everything depends on God.”  I think that, in many ways, this can be freeing for Catholics who are concerned with mental illness.  For instance, I don’t think I’ve ever met a Catholic who thinks that mental illness should be solved by prayer rather than by psychiatry.  We are a people of the both/and!  (Note that there are plenty of Catholics, like plenty of others, who don’t seek help for other reasons; but generally not waiting for God to heal them.)

However, “work like everything depends on you and pray like everything depends on God” can have other painful implications.  It seems to promise that if you stick to whatever medication, work your program, and pray, you ought to get better.  So, if you are not getting better: are you lazy, or unfaithful? Of course, anyone who has paid much attention knows that mental illness is rarely cured but is a chronic illness that is more aptly described as “managed.”  And some people do incredibly well; others do not.  This usually has much more to do with the severity of their illness than their work ethic or their faith in miracles.   But it is very easy, especially for those who do not know that mental illness has real physiological bases, to assume that people with mental illnesses have those illnesses because they or their parents failed to work hard enough to develop the “good character” in accord with which they are tragically unable to act, as  Augustine knew over 1500 years ago.

At our very best, we know that mental illness is a tragedy, one that afflicts those who did not choose it, and we serve and care for those so afflicted as we would care for Christ.  But the range of mental illnesses and the variety of behavioral symptoms often make it hard for many of us not to judge those with mental illness as moral and/or spiritual failures.  The stigma of that judgment, for many, ends up being as big an additional burden as the illness itself.  Educating ourselves about mental illness is a great place to start.  Being courageous enough to talk about it is another.  NAMI (National Alliance on Mental Illness) is a great place to get some resources.  NAMI FaithNet may be of particular interest to churches.  Call your local NAMI affiliate and they will likely come (for free!) and offer an educational evening for your parish.  Let’s get this conversation going.