Supporting People with
Mental Illness in Your
Hosted and Moderated by
Dorothy Coughlin, Director
Office for People with
Archdiocese of Portland in
Supporting People with
Mental Illness in Your
Thomas Welch, MD
Physician, Adult & Forensic
Sharon Collver, SNJM
Chaplain, Oregon State
Parishes Need to Know
about Mental Illness
• Many parishioners or their
family/friends are dealing with
mental illness
• Parish staff (clergy, religious
educator, secretary, janitor,
groundskeeper) are often the “first
responders” to people experiencing
mental health crises
What is mental illness?
• Many different conditions
• Can occur at any age to any one
• Range of severity
• Encompasses biological,
psychological, social, and spiritual
dimensions of the individual
Severe and Persistent
Mental Illness (SPMI)
• Schizophrenia, bipolar disorder
(manic-depressive illness),
schizoaffective disorder
• Some types of major depressive
disorder, obsessive compulsive
disorder (OCD), posttraumatic
stress disorder (PTSD)
Not considered SPMI
(But can co-occur)
• Intellectual disabilities (mental
retardation and developmental
• Dementia (Alzheimer’s, vascular)
• Substance use disorders
(drug/alcohol abuse &
Importance of an Accurate
• Not to label or criticize a person
• Helps direct treatment
• Allows more accurate prediction of
course of illness and prognosis
Importance of Proper Care
• Relief of suffering
• Improvement in functioning and
quality of life
• Strengthening the Body of Christ
• Promoting the Reign of God
Psychotic Symptoms
• Hallucinations
• Delusions
• Disorganized Speech
• Catatonia
• Negative Symptoms
Psychotic Symptoms
• Often characteristics of SPMI
• Can be present in many other
• Psychotic does not refer to a
person’s character
• Schizophrenia is not split mind or
split personality
• A sensory perception that has the
compelling sense of reality, but is
not actually perceived through the
• Can be auditory, visual, olfactory,
gustatory, or tactile
Auditory Hallucinations
• Can be perceived as inside or
outside one’s head
• May feel others hear thoughts, put
thoughts in their head, steal
• Often are demeaning, critical, but
can be pleasant
St. Teresa of Avila
• In Interior Castle (1577) wrote of
• Delineated various types of
auditory perceptions
• Noted that most often the
experience was “a fancy” due to
“real melancholy” or “feeble
• A firmly held false belief based on
an incorrect inference about reality
• Not widely shared by others in
one’s culture (including culture of
the Church)
• Types: grandiose, persecutory,
erotomanic, jealous, somatic
Disorganized Speech
• Usually an indicator of thought
• Can be tangential, flight of ideas,
illogical, unintelligible
• Bizarre motor activity
• Can include: immobility, excessive
activity, assumption of unusual
body postures, and echoing sounds
or movements
Negative Symptoms
• Severe deficits in functioning
• Diminished range or intensity of
emotional expression
• Speech characterized by brief,
empty, incomplete replies
• Difficulty initiating activities, loss
of interest or pleasure in activities
• Depressed, “blue,” sad
• Irritable
• Absence of emotion, flat, blunted
• Euphoria, elevated, expansive
Depressive Symptoms
• Changed appetite, weight
• Altered sleep
• Difficulty concentrating
• Loss of interest in activities
• Fatigue, restlessness, lethargy
• Feelings of worthlessness,
thoughts of death
Manic Symptoms
• Inflated self-esteem, grandiosity
• Decreased need for sleep
• Talkativeness
• Racing thoughts
• Excessive activity, risk taking,
spending, traveling
Types of Responses
• Biological: Medication, general medical
• Psychological: Psychotherapy,
counseling, behavioral interventions
• Social: Family support, employment,
socialization, friends
• Spiritual: Parish community,
sacraments, prayer, scripture
Your Parishes
• Attend
• Welcome
• Include
• Accommodate
• Pray
• Learn and Teach
• Know
• Pay attention!
• Who is at Mass? Who is missing
from Mass?
• How do people interact with one
another? With a new person?
• Greeters, ushers, clergy
• Parishioners
• Church buildings
• Invite people with mental illness to
participate in parish activities,
volunteer, bring up the gifts
• Use person-first language
• Encourage parishioners to bring
their family members who have
mental illnesses to Mass, events
• Companionship
• Pacing, talking, appearance
• Analogy of arthritis or lung disease
• Does not mean acquiesce!
– Minimum expectations apply to
– Inappropriate or dangerous behavior
must be pointed out so the person
has the opportunity to correct it.
• Praying with and praying for
• Prayers of the faithful
• Homilies
• Message of hope
Learn and Teach
• Seminars
• Parish nurses, health fairs
• Host NAMI or other support groups
• Faith formation
• Peace and justice committees
• Local resources for emergency
responses and crisis management
• Local options for mental health
• Hospitals, group homes, and other
residences for people with mental
illnesses in your parish
• Resources for further information:
– National Alliance on Mental Illness:
– NAMI FaithNet:
– Pathways to Promise:
The Flame of Faith Within
• People of faith with mental
illnesses exhibit a wide range of
expressions of their faith.
• Their faith experience may be
colored by symptoms of mental
illness, but the flame of faith
within each one remains.
Patients in psychiatric
hospitals might…
• Attend worship services offered on-site
or prefer to take a pass to a local
• Read the bible or other religious
• Talk freely to other patients about their
faith even to the point of proselytizing
• Request a religious symbol or article
Patients in psychiatric
hospitals might…
• Request a visit by a chaplain or clergy
member, especially at times of loss or crisis
• Spend quiet time in prayer and contemplation
• Seek spiritual direction
• Need help staying connected and/or
reconnecting with a faith community upon
their discharge from the hospital
• Participate in a prayer service or group
Patients in psychiatric
hospitals might…
• Practice their religion, talk about their faith,
and seek spiritual support, just like someone
hospitalized for any other medical problem!
Finding the Flame
• In people experiencing psychotic
symptoms including religious delusions:
– Listening for the kernel of reality beneath
the symptoms
– Inquiring about their faith history
– Inquiring about the “God language” with
which they were raised
– Acknowledging their experiences; affirming
what appears rooted in their religious
Finding the Flame
• In people who are recovering from psychotic
symptoms including religious delusions:
– Supporting their insight into what had been
– Acknowledging the frustration and disappointment of
finding learning the “voices” were not real
– Sharing scripture or other accounts of healing,
deliverance, conversion, etc.
– Praying in thanksgiving for recovery
Prayer Service or Group
• Environment: quiet music, soft lighting,
breathing for relaxation or an opening
preparatory/gathering song
• Read a passage from scripture or other
• Facilitate a discussion of what people
were struck by in the passage
Prayer Service (continued)
• Share a psalm or other prayer
• Invite people to offer their prayers
for others and for themselves
• Sing a closing song together that
reflects the theme of the service
• Consider modifications based upon
the participants’ religious, racial,
ethnic traditions
Other Considerations
• Providing quiet, safe place
• When a priest or parish staff
person experiences a serious
mental illness
• Suicide
• Click the Q & A button
• Type in your question and send
• We will respond verbally to the
whole group and try to answer as
many questions as we can.