In a conversation spanning half hour segments numbering seven on the same number of separate days this Religion Writer talked with the Reverend Doctor Lawrence Michael Cameron, OAC. That is a total interview of 3 and a half hours. The subject: Mental Illness. That is the Reverend Doctor’s business and has been for 25 years as a pastoral counselor. We talked by phone to his home in Indiana from mine in Mill Valley, California.
An advocate for the mentally ill, Doctor C, as he is affectionately known, bent his comments to let the reader know of his favorable sense of hope for mentally ill people and their treatment.
He bent the direction of success for living in the world for the mentally ill in a way that says those with mental illness can have success and happiness. There is an important and positive truth in his remarks, based on psychiatric and psychological truths. Though those with mental illness may not be cured, they do and can manage their lives in a way that provides fulfillment and more normal lifestyles to live in the mainstream in a significant number of instances. He is an advocate and practitioner of this truism, as are his peers. This writer calls this a form of Christian hope and practice in the area of mental health as expressed by the Reverend Doctor.
A Congregational minister with thirteen years of education, most of his work is secular. What does a man of God see in this kind of effort in the Christian sense, so this writer wondered. Where is the Call? Obviously there is great satisfaction for him in the compassion and saving work of granting relief and health to those he helps. Are not hospitals named after the Evangelist Luke?
Also, let me say that churches have an institutional life, and the Congregational Church life is no different. This opportunity for them to have a presence in the world of helping the mentally ill in the profession of mental health is another place Christian service can help and have influence. No minor act in our day of retreat from secularism, humanism, and atheism in America. It is important to remember that Christianity has a statement to make in the world of giving people of all kinds health care in all kinds of places in the United States. Michigan is where Dr. C works, and it is one place we learn about a Reverend Doctor at work and learn what he has to say on the subject of mental illness.
INTERVIEW WITH THE REVEREND DOCTOR LAWRENCE MICHAEL CAMERON, OAC WITH PETER MENKIN
You said in our conversation in August, 2013, “Mindfulness means to embrace reality in the moment. Most people suffer from cognitive distortions (stinking thinking) and worry about yesterday or are anxious about tomorrow.” A goal of your work is to help the mentally ill through spiritual and religious methods to have more peace, even tranquility. Speak a little about how mindfulness helps to reach this goal. For those of us who do not know what mindfulness may be, talk to us about what it is in this context for the mentally ill.
The mental health professional, whether wearing the hat of a spiritual director or counselor, mindfulness has been identified as … one component of dialectical behavioral therapy (DBT) and it comes out of cognitive therapy… In the realm of spiritual work, mindfulness is the largest component.
Mindfulness is taught in every world religion in some form or fashion and we see it in Zen Buddhism, contemplative Christianity, Hinduism, Islam, all of the mystical sides of faith traditions and mindfulness is learning to be in the present moment. [These are spiritual disciplines that help the mentally ill.]
Anxiety. which is a crippling disease is about living someplace elsewhere than present. Someplace other than the present moment. Worry, racing thoughts, shame, grief, and guilt about things in the past, all of these things take us out of the here and now, and we live in yesterday and tomorrow. Mindfulness is teaching people to just be and doing what you’re doing letting everything other than the “right now” wait. It’s about being fully present to hear the other person’s question, not thinking what’s going to be done five minutes from now.
In pastoral care and counseling, in working with the person who is suffering, teaching mindfulness is central. But in the religious world it is taught to everybody. It is not particular to everybody who is mentally ill. The difficulty is that it is a lot like prayer, but people don’t use prayer until they need something or want something or find themselves distressed. Everyone should be learning mindfulness. Jesus tells people on the Sermon on the Mount, Don’t worry about tomorrow, and don’t worry about what you eat or wear. What he’s talking about is this aspect of mindfulness.
2. In your more than 25 years of ministering to those in need who are this special population, you told me regarding your approach and whether the mentally ill are a homogenous group that ask: “Why has God allowed this terrible disease.” Please explain this statement. In a way you are ministering to an individual who is disturbed, even asking the question, “Why me, God.” What is it that you start out with when meeting a new patient you plan to help? And how do you know they need you and you can help them with the God question they pose?
The population of the mentally ill is not homogenous. You cannot look at it as if it effects a certain population. Mental illness knows no class, no race, and no educational level. Mental illness like any other illness can occur to any human being. No one is immune to sickness whether it is physical or mental.
John Jones was born into what seemed like a typical family and one of his parents suffered from an organic disorder called Schizophrenia. Research has indicated that there is a possible hereditary link to some mental illnesses. Just like there is to some physical illnesses. If there are cardiac issues in your family of origin than it may affect you, too. Schizophrenia is one of them; Bipolar Disorder is one of them. Both may be inherited. So the particular illnesses can be linked to the family you are born into. Someone in your family has it. John Jones at age 22 has a psychotic break and leaves college in Ohio and ends up in California. In this episode he is discovered to suffer from Schizophrenia when he is placed in a hospital after being found just wandering on the street.
Client B, Sally Smith’s, normal regular life is interrupted by an experience of a trauma and she experiences the loss of income. His normal life seemingly is turned upside down by the trauma and she goes into a deep clinical depression. There is also research that shows the majority of incarcerated people, the longer they are incarcerated, the more likely mental illness will set in. We in no way have a system that rehabilitates prisoners. They are at risk of decompensating, including risk of mental health.
Not everybody asks the question, “Why me God?” That is a concern for some, but not for everyone. There are some who do ask that question. They wonder, “Why me?” When a person asks, “Why would God make this happen?” it indicates that the person has some faith resources. They came up with the question. They have come to believe there is a God. They believe God is involved with our immediate lives. We know they believe in a God who has something to do with them, intervenes, participates, and changes human lives. That helps us diagnose that they have some faith resources. That opens the door to explore what resources they have and mobilize those faith resources. It’s not my job, my calling, to try to get them to believe like I believe. What we want to do is see where their at and the only effective treatment for them is to mobilize what they have and make it work for them.
We explore what else have they’ve seen in their lives, where else have they noticed God in their lives. The question is a great question because it opens the door to help them seek out, for we find out what the person’s real questions are. Are the underlining questions, does God not like me, does he not want me. In the Judaic-Christian tradition, Job searches all these questions that are put forth by his so-called friends and they ask him “where did you sin in you life?” Rabbi Harold Kushner, when he lost his son to a terrible disease, wrote the book, “Why do Bad Things Happen to Good People,” to explore the question. Every world religion has explored this question. Some say, “You deserve it.” “It must be God’s will.” One school of thought teaches that in human moral development, the most mature learn to embrace the issue of ambiguity.
I teach that it takes both hands. That it takes both hands to approach this question of living with ambiguity: to handle it, to deal with it. God is involved with our lives. God does love us. Terrible things happen, but we don’t know why. Together they aren’t logical. On one hand, God is all powerful and all loving, on the other hand bad things do happen. That is ambiguity that take two hands to hold onto two truths that seemingly contradict each other, but yet they exist together and we experience them together in our living.
If a person is coming to me in the County Mental Health System we have a process. We do a mental health assessment and than a treatment plan which is person centered. What does the person want? Quite often people say, clients say, I want to stop hurting, feeling bad. I want to have the voices in my head go away. I want to stop cutting.
Some use cutting as a way of coping with internal pain. Quite often they will gash or make superficial cuts on their arms, legs or stomachs. They find some psychological relief by afflicting controlled pain on themselves above this uncontrolled pain they have. It is maladaptive, it doesn’t last. It hurts them.
Again my meeting them depends on their needs. Some people don’t want to be depressed any more. Or they want better relationships. The treatment plan may include psychiatric medication. We may refer them to a psychiatrist. It has been proven that talk therapy and medication have the same efficacy, but when used together you have even greater results.
3. The stigma of mental illness follows those who have been or are mentally ill. That is a given. Talk about the stigma of mental illness in the Church, among parishioners, and even explain by example the result of stigma in someone’s life that fits the profile of being or having been mentally ill.
Stigma in mental health is recognized, and in Michigan there are mandated anti-stigma programs. The more we educate the public the more we do away with the stigma. Tipper Gore who suffers from depression did a lot to destigmatized mental illness. Since it does carry a stigma, people who need help wait for years and have torment and discomfort because they didn’t seek the help …. Some wait for years … due to the stigma involved. That’s one of the areas where stigma affects people. People need and/or want to get help but don’t because of the stigma. No one wants to be labeled crazy. We live in a society of self-reliance, where nobody wants to seek out help.
It’s counterproductive, for instead of seeing themselves as someone with an illness, they see themselves as an illness. This makes treatment even more difficult. People live with mental illness…and they have been managed, not cured. People have been able to live successful and productive lives. It means being part of a community, and contributing to that community in a meaningful way, and having a certain sense of self satisfaction, and a certain degree of happiness.
In the movie “Beautiful Mind,” what I remember, I thought it ended well; the teacher was able to be able to be diagnosed and be able to continue to teach. Whether he had other breakthroughs in physics and mathematics…who is to say how many we have in a lifetime… Mental illness is also culturally biased, in some locations, schizophrenia, dissociative, or people who hear voices and see things, are considered gifted or holy. Sometimes they are Shamans, or spirit guides … they were not ostracized they had a particular function in that culture. People who are bipolar and in a manic state, seemingly become almost superhuman and creative and have special, even superhuman insights. There are painters and poets, people who become even more creative in these manic states. But when depression comes they can become suicidal. The meds make them stable, keep them level. They sometimes begin to miss those manic episodes and stop taking their meds. They want that feeling of super humanness and creativity again. The problem is that the disease swings both ways, and they can do some bizarre stuff and some very creative stuff. So it is a very dangerous thing to go off their meds.
Stigma comes from fear, and when people in the general population don’t know about the mentally ill they may think they will be hurt by them. So they deal with them differently. When people don’t know and are afraid they react in all sorts of ways.
The same with people in the Church. Churches attract all sorts of people. Churches tend to be homogenous. If people seem different from us, if they are in any way, shape or form out of the ordinary, they are ostracized. And so a place where primarily one would think they would find reception and acceptance, it can be a place which is harmful and hurtful. When people don’t fit a certain mold come to a Church, they aren’t going to fit a certain community that systemically demands a certain amount of conformity. And there is ignorance in some faith communities where they tend to view people with mental illness possessed or of the devil.
Exorcism is something that is recognized by the American Psychiatric Association. In Diagnostic Statistical Manual Number 5, they list one of the causes of certain dissociative diseases as possession. There is scientific recognition of a particular phenomenon that is supernatural in character.
That isn’t saying everyone with mentally illness is possessed. It is that certain people with mental illness can have disassociative episodes because of possession. Exorcisms is something found performed worldwide: Typically in the Roman Catholic tradition a psychiatrist will go in to discover if with the subject they are talking about a psychiatric condition or not. If it is a psychiatric condition regarding the subject, they will deal with it. If not, an Exorcist will come in. An Exorcist will not come in until they rule out psychiatric causes of the illness.
Mental illness is a medical condition that has certain pathology; it can be both acute and chronic. It is something that is treatable and it has to do with brain functioning. It is better called a brain illness, and people would better understand it as behavioral health…rather than mental health.
Mental illness has to do with brain activity, moods, everything generated with the organ of the brain. This is not to be confused with other conditions, like conditions where people are just plain bad. There are people who are just bad people. They may suffer from a character disorder: narcissistic personality disorder, borderline disorder and the likes. These are what we call Axis II people. Mentally Ill people are Axis I. Characteralogical disorders are Axis II. They can behave very poorly. People who are axis II, to use the jargon of the street, aren’t crazy. Axis I people can be insane if untreated. Axis II people are more difficult to treat because it is not an illness but rather a character issue.
On top of that, they are people who are just evil. M. Scott Peck, author of, “The Road Less Traveled,” and, “The People of the Lie,” looks at evil as a mental category. He subtitled his book, “The Hopes of Healing Evil.” In his last chapter he tells about witnessing demon possessed people while in Africa and of exorcisms. He concludes that some of the phenomena of evil manifested in the world go beyond our present scientific understandings.
To explain more of the difference between evil people and those who are mentally ill I say: The mentally ill who are not being treated can’t make it through the day. They can’t figure out how to make it from point A to point B. They can’t figure out what to do to live. People who can make a plan to strategically assault a movie theatre, or set bombs off, or arrange for mass murders to occur are just plain evil. The untreated mentally ill can’t figure that out and make it happen. Only a person who is evil and has their full mental capacities can do such things.
What of your career in working with people with these maladies of disturbed personality and maybe even soul. How did you get started, and why do you stay at this work? What of your background and training, and if someone wants to explore this area of ministry for their own work, what do you suggest they take a look at early in the game of making a decision in favor of the work? How do they know they have a Call to this ministry?
In seminary most ministers who are from a mainline denomination take one course in pastoral care. They do not receive anything other than an introductory course so they can make referrals as they recognize that someone who has come to their office needs help beyond their expertise. If clergy desire more than just an introductory training, there are ways to pursue that. There is chaplaincy, hospice, military chaplaincy, police chaplaincy and the other side is pastoral counseling. There is a set of criteria, including classroom training and hands on clinical work.
I helped pay for graduate school with a Federal work study position and was sent down to the regional alcoholism clinic in Columbus, Ohio. I thought I would work there pushing a broom or doing office clerical stuff, and instead, was given an office and was told I was going to be an Outpatient Alcoholism Counselor. I was 22 years old and only had a Bachelors degree majoring in religious studies from Albion College. I knew nothing about addictions. I threw myself into learning and studying and took a great interest and spent a lot of time going to AA meetings and listening and asking questions. After receiving a Masters of Divinity degree at the Methodist Theological School in Ohio, I enlisted in the U.S. Army for three years and when I received my Honorable Discharge I took some counseling and guidance courses at Eastern Michigan University, then a Doctoral at Ashland University in Pastoral Care and Counseling.
I continued to take clinical pastoral education for chaplains and then went on for another doctorate at Trinity Seminary in Spiritual Anthropology. In the field one continually needs to keep trained and renewed as the field changes rapidly.
I went the long extended route. There are seminaries that offer masters in counseling and social work. Seminaries now offer masters in pastoral care and counseling; also joint counseling and social work degrees and addiction studies. A person doesn’t have to go the route I went with thirteen years of higher education beyond high school. If people are interested, or think they have a calling to this kind of ministry there are more efficient ways to go.
If a person wants to look more into this ministry before committing to the time and expense there are many lay programs they can look into to get a sense of this type of ministry. Stephen Ministries is an international program for churches that train people to help people by coming alongside other lay people who are experiencing some kind of difficulty. They receive training in grief counseling, in active listening, in crisis counseling and a host of other areas so they can be present with someone and offer support to them in a critical time of need like the loss of a spouse, child, home or job.
They are like a “professional friend.” If you are going through a difficult time, a Stephen Minister can walk beside you and you can get a taste of what it is like to be a helping professional in this area. There are also several lay counseling programs, where lay people are trained in being present for other people in a non-judgmental way. They are taught how to be more human, and listen more deeply. A lot of times people who have troubles need someone to listen to them. It’s rare these days to get someone to listen to us. It is beyond a good friend, it is someone who has some specialized training.
We’re talking about working with the mentally ill; it is a specialized ministry that is going to take some specialized training and education. It isn’t just for someone who thinks they are a good listener. There are many hurdles to jump and roads to travel. The first thing one does is become very self-aware; know their issues so they don’t get in the way. So they know what their buttons are and know their own inner dynamics. If you feel called, if you feel called you will end up in it. If you feel called you will end up in the ministry because of and by God’s will. You are going to be helping people who can be in dire straits. Successes you won’t see, for they go off and live their lives. What you will see are people who are going to need your help until well. It is a job that doesn’t offer a lot of completion. You don’t come out with a finished product. I am convinced that if it is not of God you certainly won’t last long in the work.
4. Let me ask a nuts and bolts question. How do you work with individuals needing your ministry? For example, where do you meet with them? Give us an example? Do you also work in groups of people, and is this on the ward? I assume you are walking a ward sometimes. Explain how so?
There are a couple of answers. Right now I’m working for the County Authority that oversees all individuals who have Medicaid or are indigent. [Example: When speaking yesterday with Dr. C in interview, we were interrupted by a call from the County Jail. What happened was, in his words as an example of who he works with…] …the policeman brought someone to the jail and the individual talked about hurting themselves and wanting to die. The protocol is to take everything away from them and put that person in a padded body suit. Then they are put in a tank (large windowed room to be observed). This in Van Buren County, Michigan—in PawPaw—that’s near Kalamazoo… Then they call the mental health authority that is on duty that night, which was me who at this moment as we speak and I am notified someone has been placed on self-harm watch.
This protocol happens when someone indicates they will harm themselves. When they utter a suicide threat they are put in a padded vestment and placed in the tank. While in the tank there is a camera on them so they are in real time being observed. There is nothing in the tank but a stainless steel toilet and a cement pad to sit or sleep upon.
They call (the police) and report to us that someone is on self-harm watch and we evaluate the prisoner who must stay in that room and suit until we release them. There the prisoner is considered safe from self-harm, and we cannot have them in better care. If they are on medication that is given them at designated time, but the jail does not give medication that can calm them down.
To do so is a civil rights violation. They can’t chemically restrain a prisoner, and can only keep restraints on a prisoner for two hours. Unless a nurse gives the okay to restrain longer due to extraordinary circumstances. That’s the law in Michigan. I believe that is a State law.
I went to the jail and there is a log sheet where there is an annotation I look at and then I observe the person and have them brought out and handcuffed to a bench. There I spoke to them and did a mental health assessment.
The person I went to see was a white female, mid-thirties, who had swallowed some items attempting to kill herself. It was her first time in jail and she was really stressed out. She was oriented times four. She knew the circumstances, but still had racing thoughts of killing herself. Therefore she was kept on suicide watch, remained in the gown in the tank, and was there until her regular hearing.
She was charged with receiving stolen property. She had no history of mental illness, and was not in our system. Her condition and situation was reactionary to a very stressful situation. She could think of nothing that was worse than that, being in jail…
While I was there in the jail, I received a second call which was regarding an African American male prisoner…and he said he just wanted to die. He had no history of mental illness. He had no plan. He said he would never kill himself and he said was that he “felt like” he just wanted to die. So I cleared him to join the regular population. He was given his jail uniform and was taken to his cell with other people.
Suicide is something we take very seriously. If someone says they are going to hurt themselves or take their lives, it is taken serious–nothing is taken lightly in that regard. We check out all of those things.
If someone says they want to die, we can’t take that as just an idle threat or manipulation. It needs to be looked at by a professional to be ruled out that it is something they won’t do. [Later in the interview we will discuss suicide as a separate and special topic of the matter of both religious and spiritual concern in the area of mental illness and as a health issue.]
In the clinic setting in a private office they may have individual therapy. In that modality they would come every other week to receive that therapy. Typically once a week is ideal. Since we work with limited resources and they have limited insurance or Medicaid once a week is ideal but we can only see them every other week. That’s because of budget restraints. In the County system we have several clinics. I am at the main clinic and carry a case load of 90 people. I am seeing patients one on one and in groups. There are seven slots available Monday through Friday for an individual or a group, that’s seven a day. The group’s range from four to 8 people in a session and I run three groups. A group is in a group room. We’re not in a hospital setting. I do go on the ward to the hospital when I am working the “on-call.” Most of the time I am in the emergency room evaluating a client.
Being distant isn’t how you want to be in a counseling or crisis situation. That isn’t good clinical practice. A police officer who must distance themselves from persons because their service is entirely different. Our profession is to fully enter into–to be with them. That’s what therapy is about. It isn’t about being a detached presence; it is about being incarnational, and it’s about being there with them. You help by listening deeply and sometimes you can give them the advantage of having an extra set of ears and eyes that might be able to see many different options and possibilities that they can not see at that time. People become stuck, myopic, when in crisis. Those in crisis do have choices and personal power. There are things that can be done, but because of the crisis they are in they may be unable to ascertain what those things are.
We do a treatment plan with the person and ascertain what they really want, and learn what they want to accomplish. They say, I want to manage my moods better, or stop having hallucinations. We help them explore those things. If they say, They want to be happy, we explore what that means.
In this particular position of working for the County the people who are patients are any person within the boundaries of the County, any people living within the County, citizens, or visiting: or if they are arrested and put in the jail. This is the client population we work for and with.
The county is comprised of several ethnicities: a large Hispanic, a smaller African American population, the majority Euro American. We have clients who range educationally with masters degrees, high school educations, some that haven’t completed high school. We are in an agricultural seasonal community and the agricultural industry is a huge part of the community.
We have towns, like Lawrence where the high schools are largely Hispanic. So we have some areas that are heavily ethnic to one degree and a great influx of immigrant workers as well. The mix of mentally ill is the same as the population mix.
Who is your supervisor in this specialized and unusual work?
There is a plethora of organizations, depending on where one gets their credentials from, determining who their supervisor will be. For me, specifically, I have the director of Outpatient Services as my immediate supervisor. His credentials are 30 years as a social worker, and psychologist. He is licensed by the State and is hired by the agency to work in that capacity.
In the setting where I am, there are other clergy with a secular license like myself who are not working as a minister but as a clinician, who just so happens to be a minister.
I work with psychiatrists on the medical staff and we work as a team. We have several disciplines: psychiatric nurses, social workers, substance abuse counselors. They are people I work with, but the MDs also provide supervision with us, and do case management and do consultation with us, and prescribe medications. We work in tandem as we use a team approach to wellness.
The lines are blurred between pastoral and secular when it comes to spiritual and mental health practices. A lot of people in the substance abuse area work with the 12 Steps, which is a spiritually based program. Dialectical behavior therapy strongly promotes mindfulness in its program which comes from Zen Buddhism and Christian contemplation. The American Psychiatric Association categorizes spiritual problems and people can come for help with those issues. Spiritual reality has been recognized since the beginning of cognition. Psychotherapy and psychoanalysis is a new kid on the block and has only been around for less than 200 years.
There is a mental health code that we follow in the State of Michigan and the agency supervisor … takes a look at all we do. It is quality control and he makes sure all therapists meet standards and accountability.
In private practice…I supervise and have several graduate students who serve under me. I mentor and supervise their work. In every discipline there are standards and rules concerning who can practice without a supervisor and who needs someone to supervise their work. Psychologists with a Masters degree have to work under a fully licensed PhD, psychologist. Counselors with a limited license need to work under the direction of a fully licensed counselor.
Not only is supervision given by immediate bosses, there are associations with standards, and each County and State have their own laws and people who monitor those working in the field. The work is looked at by the State and by the associations to be sure standards are met. Your work is critiqued by different levels of the government managing mental health.
6. Perhaps you’ve heard it said that in order to be a parishioner, in some Churches more than others, one must have the ability to understand basic ideas: Be able to read the Bible and grasp some of it; sit to hear a sermon; or go through worship; understand what it means to worship. If not able to do so, I’ve heard it said lack of this competence means the individual may not participate in a life of faith. What say you to this?
I have always taught; “Bad history always equals bad theology.” If you look at history the majority of the people in the Christian faith during many centuries of its existence, could not read or write. Only the clergy could, and not always all of them. For people in the Middle Ages education was reserved for only a few. People would come to faith without the ability to read or write. The reason St. Francis put together a Crèche (Nativity Scene) was because people could not read or write and the Crèche was a visual Gospel for them. And that was a reason for a lot of stained glass in churches also. Stained glass told the Bible Story in pictures.
So reading and writing was not indicative for people of the faith for a vast majority of its history. If today, they can’t read or write, they still can participate in the faith. One’s level or ability to understand things of faith is not determined by one’s ability to read or write or by one’s health status. Mentally ill people are like everyone else. Some can read and write and some have difficulties. Some can understand things in ways others can not. The mentally ill can participate in University teaching, or even the Presidency. There is evidence Abraham Lincoln suffered from melancholy. We call it depression today. Mental illness does not make you unable nor exclude you from having a deep, great faith. If a person with diabetes doesn’t control their diabetes they can’t come to Church because they are to sick. If you manage your condition, you can live normally. So it goes with mental illness.
So many incidences reported in the press paint the mentally ill as evil, so there is the “good vs. evil” aspect of those who are mentally ill. You wrote in an email: “…look at the subject of ‘mental illness vs. evil’ in light of the press of late and the shootings that have occurred in the movie theatre, at the schools, etc.” Is this a matter of good vs. evil?
Anytime we are shocked with a story when someone does something as horrendous as taking the lives of people in a movie theater people say that “they must be mentally ill.”
Someone who is mentally ill and not being treated typically can’t function at a high level. They can’t make appointments; they can’t keep two thoughts straight in their head. They decompensate. They can’t plan and execute a savage incident. They are not mentally ill people who do these things. They are evil. There is a distinction.
People are afraid of the wrong thing. People should be afraid of the evil. People sometimes equate those suffering from mental illness with acts of violence because they don’t act normally, they don’t seem in control and people think they are a threat. Mentally ill people are feared because people fear they will harm them…
The media always seems to equate insanity with murders. That is just not the case. There is a line of demarcation between mental illness and evil.
There are competency laws that ask, Were you in full control of your actions? Did you know what you were doing and were you aware of the possible consequences of your behavior? If they are not well, they do not know the consequences. They jump thinking they will fly.
Somebody who is evil makes a plan, carries that plan out with intent and knows the consequences. The man who goes in the theatre and he carries out methodically his very detailed plan is not mentally ill. Somebody who is mentally ill and is not being cared for can’t even figure how to put toothpaste on a toothbrush.
The issue we have is we don’t want to believe there is evil. We want to attribute bad things happening because of someone or something. If we are losing jobs, we blame it to illegal immigrants. When Germany’s economy was bad, that blamed it on the Jews. If we can demonize something we know and understand we feel in control. We don’t understand or can’t readily point out evil so we feel out-of-control.
Suicide you say is a large part of your work. You write by email, “…we should look at the subject of ‘suicide’ as this is a huge part of our work…” Please let us leave this an open ended question, so please comment on suicide.
Suicide is a prevalent phenomenon that affects persons suffering from mental illness, including teenagers who are not mentally ill. Teenagers are suffering from being bullied, not having the life skills or coping mechanisms. In the arena of mental health, suicide is something we pay close attention to because when a person is stressed or is having complications with their medications or not following the doctors’ orders or a life event occurs that would push them into a dark place, not having the necessary skills or the ability to cognitively process the larger picture–then suicide becomes a real issue. For they are not viewing suicide as a means to death, they are seeing it as a means to relief—stopping the pain.
Teenage suicide is prevalent throughout our country. We have a three pound brain. The last pound develops when we are teenagers. With that comes the ability to think abstractly. Teenagers argue for they have this new toy so they can think abstractly and argue. It is the third pound of their brain. So because it is something that is new to them, they like to try it out and they argue with adults. This is, after all, a good way to grow into their newly found abilities… However, when they experience stressors they don’t default to their newly grown and discovered rational abilities so there reasoning can be very unsound.
We know in the Gay and Lesbian, Bisexual and Transgender community in the United States, the suicide rate among teenagers is even higher because they are experiencing the feelings that are confusing to them. Sexuality is confusing period. When you are attracted to persons of the same sex and everything in the culture is counter to that those sexual feelings and ideas become very stressful in nature and confusing.
When society has norms that are contrary to what a person is experiencing as normal for them, this can become really confusing for them. When they cannot come to terms with these things it is confusing to them. Their teenage angst already present is complicated and magnified because of their orientation and what use to seem like a world they once knew is now a harmful, hurtful and frightening place for them.
They may come to the place where they see the only way to stop the hurt is to kill themselves. That’s how they really look at it: They look at it as stopping the pain. They say things like I just want the pain to stop. I want to stop hurting. Rarely does a person say, I am thinking about suicide. That, thinking about suicide, is a very rational thought process. Stopping pain by killing ones self is not rational.
I think suicide, whether it is in the geriatric population (which indications show it is on the rise) the teenage population or with the mentally ill, it is all about stopping the pain; it is about stopping the hurt.
We should become aware of the signs of suicide. We should understand that sometimes there will be tell-tale signs, and those signs can include depression and sadness, when a person begins to isolate and withdraw…when they have periods where it is noticed they are crying and they can’t identify why they are crying, they just say they are sad. These are warning signs.
When people are talking about being tired of living, tired of dealing with things, when they say that they can’t take it anymore. All of those expressions are red flags.
One needs to take the statement seriously, and seek help. If they aren’t taking care of themselves or there are changes in their routines, like not eating or sleeping… Get them to their physician or to an emergency room. People do take their elderly parent to an emergency room for an evaluation. And not just elderly, but anybody.
This is another alternative. When a person is living by themselves and family is not around the police can be called for a health and welfare check. It’s important to do these things, for we are talking about saving human lives.
Sometimes we are also talking about taking their rights away. We are talking serious stuff. We need trained professionals to look at them to determine if they need to be in a hospital. A suicidal person needs to be in a hospital where they can receive treatment. They may not want the help but that is why an evaluation is needed, and their rights suspended in order to save them from themselves.
There is a very specific criterion that must be in place in order to take someone’s right’s away and hospitalize them against their will. Not only do they need to have suicidal ideation, but they need to have a plan, and the means, and when those three components are thought out and they utter those and say they are going to lay on the railroad tracks and the train comes by every half hour… That’s serious.
If they just have thoughts, and think of it, but don’t have a plan or means…Then crisis intervention takes place, and they don’t have to be hospitalized. And treatment can begin in the community for them.
Clergy, generally, aren’t trained in counseling. Most clergy have one or less formal classes in pastoral counseling. Ministers are able to petition for someone to be hospitalized, or to talk to the family members who can petition for the person to be involuntarily placed. I think it is extremely important to know that there are clergyperson who are licensed but the majority are not. A lot of people will go to their parish priest, minister or pastor for counseling. Going for spiritual matters, that is one thing. Going for mental illness or suicide, the clergy need to refer. That is beyond the clergy’s expertise and training. All clergy deal with numbers and budgets, but you don’t go to your clergy to do your taxes.
Because suicide effects more than just the person, sometimes the family, sometimes the whole community, there are mental health issues that are related to that. The God question comes in there, as it did with one family when their son killed himself. Sometimes a wider family becomes involved, even a community or a neighborhood. A parent deals with questions such as, where is my child. Where are they? Are they suffering? So do the friends and neighbors.
There is the religious stigma in some expressions of Christianity concerning suicide. Some believe and teach that suicide is a mortal sin that excludes you from heaven. We in our society recognize if a person is insane they don’t have a certain level of responsibility. They have a certain level of innocence. How do we hold them responsible for something they don’t know that they are doing? It is different from a willful act. It is then an action they want to take, as in physician assisted suicide. They have rationale minds and they make a willful choice to end their lives. Mentally ill persons don’t make willful choices. They can’t when decompensating, when they are sick. Their will is not theirs rather it is affected by the illness.
An addiction in our culture is seen as a disease, and one of the symptoms of the disease is the fact that without proper intervention the addict will eventually die from consuming too much of what they take: drugs, drink…the whole nine yards. Their addiction is an illness that encompasses their mental health so we treat them as well.
I personally have not had a client who has committed suicide. It can be very devastating. It is like a physician treating a patient and the patient dies. They go through a grieving process as well. Typically a review is held, a peer review to help you process it. We are in the business to save lives and restore lives. It is very devastating. [The Reverend Dr. Cameron has been in mental health for 25 years, and no patient of his has committed suicide on his watch, yet.]
As we come to the end of this interview I wonder if there is something I’ve missed or you want to add. I do hope so, and you’ll say it here. Thank you for the opportunity to learn of your work and get to know you a little bit.
Thank you for this opportunity to give voice to part of our community that often times is misunderstood and feared and doesn’t have to be. Many, many, many persons have lived lives that prove you can live a happy life, and manage you mental illness… Just because you experience a certain mental illness, that illness does not have to define you.