Nary An Unpublished Thought







April 9, 2008: ACSWP #2, A Policy Statement on Serious Mental Illness

Recommendation #35 is the second of the multiple ACSWP papers coming to the 218th General Assembly. This one seeks approval of a policy statement.

Approving a policy statement means that:

A “policy statement” establishes the fundamental principles that guide the denomination’s social witness. From this policy base a strategy is developed, a program is defined, and personal social witness is empowered. The most current policy document produced in conformance to the requirements of 2.a.–g. of this document (Manual of the General Assembly) and adopted by a General Assembly shall be the policy in force. Any previous policies and statements, having been examined and considered by the group producing the new policy, shall be superceded by the adoption of the most current policy. When requests for policy statements are made, the most recent policy statement shall be given; however, past statements shall be included in full response to requests for information.

The majority of the recommendations and the supporting papers were very helpful. Appendix B to the Study Document was a helpful bibliography and resource citation.

What was helpful?

a. The approach was helpful. In the study paper, this paragraph stuck out to me:

As the Church incarnates the love of God that was so evident in Jesus, we experience the joy of the reign of Christ. (cf. Gal 6:2) The Presbyterian Church (U.S.A.) through this policy acknowledges its complicity in the suffering of people living with serious mental illness, people often exiled from our congregations and our civic communities. Through this policy, we seek to address our ignorance, prejudice, and fears. We acknowledge our call from the Lord to bring comfort to those in exile. Through this policy we seek to be reconciled to one another so that we may become the blessed community celebrating God's gifts to all. We acknowledge that our words must be accompanied by action. Therefore, through this policy we offer ways by which the healing touch of Christ may come upon our faith community, and also upon the more extensive communities in which we live.

By observation and anecdotal evidence, my impression is that these are accurate indictments of church people. I confess that I struggle to know how best to reach out when we have new/first-time visitors with identifiable serious mental illness. I appreciated naming this response, being able to "acknowledge" (confess) it, and being given tools so that I am equipped for the next time.

b. The recommendations were helpful. The fourth recommendation would instruct "the Stated Clerk of the General Assembly to send a letter commending (a series of organizations) for including spiritual assessment and religious history when designing care plans fully informed by cultural awareness." It is an encouragement to continue the trend of incorporating a spiritual dimension to physical health care. Chaplains, deacons, visitors all have a tremendous impact on the recuperative process. It has not always been recognized and it is a good thing for the church to express that affirmation. Further, as will be discussed later, the cost for making this affirmation is minimal -- only a few letters, but the impact is potentially substantial.

Another helpful suggestion was to "urge sessions and congregations to do the following: ... l. Encourage all members to prepare a Psychiatric Advance Directive (PAD), which specifies plans for their treatment in case of a mental health emergency." An example is provided in the appendices. The health care professionals I know -- and yes, I am now projecting outward to the larger world -- have been consistent in advocating Advance Directives. It is an easy way to provide peace to those who are required to make decisions in the event of the patient's inability to do so.

In terms of reading the report critically, there were only two relatively minor things to mention:

1. The cost of fulfilling the recommendations.

For example, #2d would direct "the Office of the General Assembly (OGA) to publish the entire report 'Comfort My People: A Policy Statement on Serious Mental Illness" with appendixes (ed. note: 39 pages) and a related study/action guide; distribute it to the middle governing bodies and their resource centers, to session, and to libraries of the Presbyterian theological seminaries; and make additional copies available for sale to aid study and implementation efforts in the church. Then #5 would "Direct the Stated Clerk of the General Assembly to send a letter encouraging the middle governing bodies, sessions, and individual members of the Presbyterian Church (U.S.A.), and its ecumenical partners to give prayerful attention to this policy statement as a help in responding to serious mental illnesses in their families, congregations, and in the communities where they live, minister and work."

Could we get in the habit of sending e-mail and publishing electronically? Yes, I did just commend the idea of sending letters to a few organizations; but those were letters addressed outside the family, there were only a few of them, and hard copies on bond paper from the church do make an impression. Sending within the family -- couldn't we e-mail it and save the paper and postage?

In #6, there are a whole series of "urge the Presbyteries to provide..." suggestions (educational opportunities, training, continuing education, etc.) Many presbyteries are strapped trying to cover basic ministry expenses; it comes across like adding weight and expectations to presbyteries struggling to stay afloat.

In #11 and #12, more advocacy from the Washington Office and United Nations Office are directed. These seem like boilerplate recommendations for each of the ACSWP reports. Although these are advocacy positions, it seems like it would be good stewardship for commissioners ought to have in mind the scope of their current job description before adding new responsibilities.


2. The focus of some of the recommendations.

Among the things suggested for presbyteries in #6e is, "require mandatory continuing education credits for pastors on issues of pastoral care such as serious mental illness, addiction, domestic violence, child abuse, and other pertinent health-care issues." In the list of contributors and participants of this report are a number of health-care professionals who are accustomed to mandatory continuing education. As part of the call package for ministers of word and sacrament, there is alotted time and resources for continuing education. However, it is left to the discretion of the pastor to discern how best to utilize those resources. Providing accountability for making sure that the "mandatory" courses are completed is more than most presbyteries would be willing to take on. And there is no point in mandating something that will not be mandatory.

#6g is to "encourage pastors to preach sermons and provide Bible studies about serious mental illness." I would rather pastors preach about the gospel; but am fully amenable to encouraging preachers to include in sermons illustrations about how God calls us to extend grace and compassion to those with serious mental illness.

Simple amendments at the GA could address my little quibbles. There is a lot of good material in this report. I hope it does not fly under the radar or get missed because of more controversial business.