Do You Send a Get Well Card to the Psychiatric Ward?

1. Do You Send a Get Well Card to thePsychiatric Ward? Ministering to those Affected by Mental Illness Vickie R. Carpenter, NCCU, 2007

2. What do you know about mental illness? • 1 in 4 families is affected by severe and persistent mental illness in their lifetime. • 1 in 5 suffering from manic-depression who are untreated will commit suicide. • Mental Illness is a “no fault” disease. • Over 50% of homeless have a brain disorder. • Mental Illness is a brain disorder. • Stigma and discrimination prevent people with brain disorders from seeking treatment. (Strobel, 1997)

3. Many still think: • Mental Illness is caused by: Laziness Promiscuity Violence Sin Substance Abuse • Those with mental illness should: “Just snap out of it” “Just pray for healing” “Just stop avoiding responsibilities”

4. When did the brain become disconnected from the body? • Mental health is often a taboo subject • Health insurance usually sets strict annual limits on amount of care patient can receive • Mental issues viewed as a condition, not a true medical illness • Mental patients feel their disease is inferior to other medical problems

5. When did the brain cont. • Viewing mental health issues as symptoms rather than behaviors will reconnect the body with the brain • Mental Illnesses are biological in origin with environmental factors possibly triggering an existing genetic predisposition to the illness • Like epilepsy, MI is a biological brain disorder • Some medications used to treat epilepsy are also used to treat mental illnesses (Lakhan, 2007)

6. The Diagnosis • Attention Deficit Hyper Active (ADHD) • Depression • Bipolar • Schizophrenia • Obsessive-Compulsive Disorder (OCD) • Post Traumatic Stress Disorder (PTSD) • Panic Disorder, General Anxiety Disorder(GAD) • Eating Disorders (Bulimia, Anorexia)

7. ADHD • Attention Deficit/Hyperactivity Disorder • Most common reason children are referred for mental health services • Difficulty paying attention: uncompleted task, can not listen to complete instructions, easily distracted • Hyperactivity: continuous fidgeting, problems sitting for any length of time, always on the go • Impulsivity: blurting out answers before questions are completed, can not wait their turn, acting without considering consequences (Durand and Barlow, 2006)

8. ADHD: who knew? • Alexander Graham Bell: invented telephone • Terry Bradshaw: football quarterback • Jim Carey: actor • Prince Charles: future king of England • Winston Churchill: failed 6th grade • Walt Disney: creator of Mickey Mouse • Galileo: astronomer, inventor • Magic Johnson: basketball • Salvador Dali: artist • Mozart: composer (Neu beCALM’d. 1997)

9. Depression • May develop suddenly without warning • Can’t work or perform daily chores • Inability to enjoy anything • Feeling of worthlessness, suicidal • Sometimes physical pain • Diminished ability to think or concentrate • Even infants can become depressed • Up to 20% of those in nursing homes • Lifetime prevalence is 4.9% (Durand & Barlow, 2006)

10. Depression: who knew? • Patty Duke: actress • Brian Wilson: musician (Beachboys) • Diana: Princess of Wales • Brooke Shields: actress • Buzz Aldrin: astronaut • Terry Bradshaw: football • Jim Carrey: actor, comedian • Drew Carey: actor, comedian • Robin Williams: actor, comedian • Rodney Dangerfield: actor, comedian (Scimelpfening, 2007)

11. Bipolar • Depression alternates with mania • Unipolar: only one of the above • Mixed state: experiencing both at same time • Mania: excessive elation, grandiosity, inflated self esteem • Racing thoughts, decreased need for sleep, excessive involvement in pleasurable but risky behaviors • Severe impairment in normal functioning • Hospitalization often required (Durand & Barlow, 2006)

12. Bipolar cont. • During mania, person feels invincible, can work nonstop; excessive spending • Person does not want to give up this extremely productive capabilities • Resist treatment: behavior seems reasonable to them • Pleasurable state so many stop medication to return to manic state • Lifetime prevalence: 1.3% (Durand & Barlow, 2006)

13. Bipolar: who knew? • Edgar Allen Poe: writer • Virginia Wolf: writer • Mark Twain: writer • Jane Pauley: TV news reporter • Theodore Roosevelt: former president of U.S. • Robert Schumann: poet • Jimmy Hendrix: musician • Ludwig van Beethoven: musician • Rosemary Clooney: musician • John Strugnell: biblical scholar (MH today)

14. Schizophrenia • Disabling disorder • Perceptual, emotional, intellectual deficits • Loss of contact with reality visual and auditory hallucinations, delusions • Paranoia, depression, mania • Inappropriate emotional responses • Social withdrawal, suicidal • Feared due to extreme bizarre behaviors • Nothing to do with multiple personalities (Garrett, 2006)

15. Schizophrenia cont. • 3,000,000 Americans will develop schizophrenia in their lifetime • Economic burden $20,000,000,000 annually • Prevalence: 1% of the population world wide • All social classes, cultures equally vulnerable • 1980: 20 years after first hospitalization: 22% fully recovered 43% improved 35% remained the same 56% were fully employed (Garrett, 2006)

16. Schizophrenia: who knew? • Vincent van Gogh: artist • Lionel Aldridge: Green Bay Packers • John Nash: Nobel Prize Winner • Meera Popkin: Broadway: Cats, Miss Saigon • Eduard Einstein: son of Albert • Picasso: artist • Mark Vonnegut: son of Kurt (writer) • Vaslov Nijinsky: Russian dancer • Mother of Alan Alda: actor • Mary Todd Lincoln: wife of Abraham (Schizophrenia.com, 1996)

17. Obsessive-Compulsive Disorder (OCD) • Obsessions are intrusive or nonsensical thoughts, images or urges that the individual tries to resist or eliminate • Compulsions are the thoughts or actions used to suppress the obsessions and provide relief: rituals (hand washing, repeated words) • Culmination of anxiety disorders: debilitating avoidance, major depression, panic attacks; all occurring simultaneously with OCD symptoms (Durand & Barlow, 2006)

18. OCD cont. • Compulsions bear no logical relation to obsession, actually reinforce obsession • Most common rituals: checking (prevent imagined disaster), ordering, arranging (symmetry) washing, cleaning (contamination) • Hoarding is a type of OCD • Prevalence is 2.6% • Is remarkably similar across cultures • Therapy and medications have 50% to 85% success in treating OCD (Durand & Barlow, 2006 )

19. Obsessive-Compulsive Disorder: who knew? • Albert Einstein: inventor • Donald Trump: entrepreneur • David Beckham: soccer player • Michael Jackson: musician • Kathy Lee Gifford: actress • Martin Scorsese: film director • Ludwig van Beethoven: composer • Michelangelo: artist • Thomas “Stonewall” Jackson: Civil War General (Girlshrink Article Archive 2003)

20. Post Traumatic Stress Disorder (PTSD • Caused by any traumatic event: war, physical assault, natural catastrophes, death of a loved one • Feelings of fear, helplessness, horror during event • Event relived through flashbacks or nightmares • Avoidance of talk of trauma and trauma recollections • Startle response • Up to 30% of soldiers returning from Iraq (Durand & Barlow, 2006)

21. PTSD cont. • Can be delayed for years, reason unknown • Anxiety about uncontrolled emotions • Cognitive Therapy (reliving the trauma with assistance of therapist) very positive outcome • The broader and deeper the network of social support, the less chance of developing PTSD • Stress creates cortisol in the body • Support from loved ones reduces cortisol • Prevalence in general population 2.2% • Vietnam POW’s: 67% developed PTSD (Durand & Barlow, 2006)

22. Eating Disorders • All encompassing drive to be thin • Anorexia nervosa: person eats minimal amounts of food • 20% die within a few years, 5% more within 10 years with 50% of these deaths being suicide • Widespread: grew dramatically 1960-1995 • Bulimia nervosa: out of control binge eating followed by purging • Mortality rate from eating disorders is highest for any psychological disorder (Durand and Barlow, 2006)

23. Eating Disorders: who knew? • Karen Carpenter: musician • Paula Abdul: musician • Jane Fonda: actress • Anna Freud: Sigmund's daughter • Cathy Rigby: gymnast • Mary Kate Olsen: actress • Audrey Hepburn: actress • Dianna: Princess of Wales • Nadia Comaneci: gymnast ( Eating Disorder Referral and Information Center, 2007)

24. Toll on the person • Blow to self image • Become spectator of life • Angry that their life has been unfairly taken away • May become totally engulfed by the illness • Identity becomes confused • Being around what used to be normal reflects their brokenness • Question the meaning of their existence

25. Toll on the family (severe and persistent mental illness) • Confusion and frustration • Incompetent and helpless • Financial drain • Harbor self blame for person’s illness • Person with illness may continually blame family for their illness • Level of family stress creates divorce • Some have stated mental illness is worth than death: you mourn the loss of the person as you knew them along with hopes and dreams over and over

26. Stigma is a killer • Stigma keeps people from seeking help • Causes isolation when symptoms flair • Denial of illness • Refuse medications • Resist hospitalization • Fire doctors, social workers, mh professionals • Self directed blame: shame, self destruction • Blame directed at others: anger, rage • Question the meaning of their existence

27. This is where the church steps in! • Compassionate service is a core challenge as a Christian • Deliver a message of acceptance from both God and the local congregation can provide support. • Carry out the usual support system: • Provide food, transportation, socialization • Cards and phone calls of encouragement • Prayer • Visitation • Be a friend: if you don’t know, ask

28. Verses of comfort • Psalm 57:1 “Be merciful to me, O God, be merciful to me, for in you’re my soul take refuge; in the shadow of your wings I will take refuge, until the destroying storms pass by. • Matthew 11:28-30 “Come to me all you that are weary and are carrying heavy burdens and I will give you rest. • Hebrews 13:5 “….God has said, “I will never leave you or forsake you.”

29. Verses cont. • Luke 8:26-29 The story of the man called Legion is told. People with mental illness were banished from their communities in biblical times due to fear of behaviors. Jesus sought out this man and healed him. Legion wanted to follow Jesus but Jesus sent him back to his community. A man with mental illness became the first evangelist to the Gentiles.

30. Luke 10:31-35, 37 • 31)A priest happened to be going down the same road, and when he saw the man, he passed by on the other side. 32)So too, a Levite, when he came to the place and saw him, passed by on the other side. 33)But a Samaritan, as he traveled, came where the man was; and when he saw him, he took pity on him. 34)He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him.

31. 35)The next day he took out two silver coins[a] and gave them to the innkeeper. 'Look after him,' he said, 'and when I return, I will reimburse you for any extra expense you may have.' •  36)"Which of these three do you think was a neighbor to the man who fell into the hands of robbers?" •  37)The expert in the law replied, "The one who had mercy on him." Jesus told him, "Go and do likewise."

32. SO…………………..Do you send a get well card to the psychiatric ward? • Response from an employee in the adult admissions unit at John Umpstead Hospital, the NC state psychiatric hospital: • “Absolutely!  This is their right...to receive and send mail.  It really does pick up their spirits. It also picks up their spirits to be able to send cards or letters.  Our department helps patients to make cards and I mail them.”

33. Resources for further insight • www.mentalhealthministries.net • www.naminc.org/nami_and_communities_of_ faith.htm • www.nccmentalhealth.org • www.pathways2promise.org • www.min-ucc.org • www.faithnetnami.org • www.congregationalresources.org/ mentalhealth.asp • www.adnetonline.org

34. Resources cont. • Helping Someone With Mental Illness: Compassionate Guide For Family, Friends and Care Givers; Rosalynn Carter, Susan Golant;1998 • Ministries on Mental Illness, by the General Board of Church and society of the UMC;2002 • A Path Through the Sea: One Woman’s Journey from Depression to Wholeness; Lillian V. Grisham; 1993 • Strength for His People: A Ministry for Families of the Mentally Ill; Pastor Steven Waterhouse; 1994

35. References • Durand, M. & Barlow, D (2006). Understanding and defining mood disorder. In M. Taflinger, K. Makarewycz, D. Moneypenny, & S. Harkrader (Eds.) Essentials of Abnormal Psychology (4th ed., pp. 208-261). Belmont, CA: Wadsworth • Eating Disorder Referral and Information Center (2007, March 20). Famous people who have died from Eds. Retrieved March 20, 207, from http://www.edrefferal. com/ Celebrities_who_died_or_have_Eating_ disorders.html • Garrett, B. (2003). Psychological disorders. In Garrett, B. (Ed). Brain and behavior (pp. 364-395). Belmont CA: Wadsworth • GirlShrink Article Archive (2003). Famous people with obsessive compulsive disorder. Retrieved March 19, 2007, from www.girlshrink.com/articles/article/ 2334483/31830.html

36. References • Lakhan, S. (2007, March 23) When did the brain become disconnected from the body? Retrieved March 26, 2007, from http://www.brainblogger.com/2007/03/23/when- did-the-brain-become-disconnected-from-the body • MH today (n.d.) Famous people with bipolar disorder. Retrieved March 20, 2007, from http://www.mentaltoday. com/bp/famous_people.html • Neu beCALM’d (n.d.) Famous people with ADD/ADHD. Retrieved March 19, 2007, from http://www.adhdrelief. com/famous.html • Schizophrenia.com (1996). Famous people and schizophrenia. Retrieved March 22, 2007, fromhttp://www.schizophrenia .com/famous.htm • Strobel, S. (1997). Creating a circle of caring: the church and the mentally ill. Raleigh, NC: NAMI-NC.