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Pathways to Promise|
5400 Arsenal Street
St. Louis, MO 63139
FAX: (314) 877-6405
Working with People with Mental Illness
Facilitating A Referral
To facilitate acceptance of a mental health referral, the pastor must first foster an open and trusting relationship. This allows the person to voice his/her concerns openly and honestly. The pastor should encourage the person to express feelings about the proposed referral. Once any objections or feelings of rejection are identified, the pastor should clarify why the referral is being made. And, the pastor should emphasize that he/she will continue to give spiritual support and guidance.
This process does take some planning and takes enhanced listening skills (both verbal and nonverbal). But, the goal is very important - that of getting the person to accept the referral. Furthermore, simply getting the person to the door of a mental health resource is of little value if the person arrives too frightened, angry, confused or defensive to be able to listen or work at the therapy. The person who accepts the referral out of compliance, or simply to please the pastor, family or friends, may still be closed to any mental health therapy. The goal of the referral is not to force an unwilling person to spend a few minutes with a mental health professional or a support program. The goal is to help the person go to the mental health professional and/or program or agency with openness and hopefulness.
The fear of the stigma and the blow to the person's self-esteem can be confronted by using two interviewing techniques: empathy and addressing negative feelings. These are suggestions. When dealing with someone with a mental illness, do what is most comfortable for you.
In addition if the person in need of help and/or those concerned about this person are in need of additional information about the importance of therapy and available mental health services in the community, that information should be made available quickly and in a short but in-depth form.
When the person's resistance is an integral part of a mental illness, it can be useful to point this out to that person. The pastor can explain that the person's resistance is part of the problem that needs treatment. And, that if the problem was less troublesome, the person would not feel the same way about a referral.
- Use empathetic statements, acknowledge and validate the person's emotional experience. For example, "You might feel it is beside the point to be told to see a mental health professional when the pain you are feeling is spiritual. I will continue to work with you on the spiritual issues that are troubling you. But, I think you also need some additional help with some of these problems that may have another cause."
- Addressing negative feelings others may have about people needing mental health therapy is also a way to acknowledge and validate the person's perceptions. For example, what consequence does the person most fear when others learn about the referral? Does the person have a concern about negative feelings of people close to him/her, such as family members? This is especially so when family members are people with whom the pastor has contact. A solution can be to have them return with the person and jointly discuss the referral and what it means to the pastor, the person needing therapy and the family.
Remember that feelings of depression can lead a person to believe that the illness is a punishment from God. If the person believes there is a theological connection between him/her and the illness, let that person know this is not the case. Reassure the person that God cares for him/her and the pastor will be there for the person.
Learning about the person's prior experiences, if there are any, with mental health care can help clarify objections and make it possible to satisfy or work around them. If the person displays inappropriate behavior the pastor may not be able to change it, but can respond appropriately. Remember, the pastor may be the only support that person has.
If a person is feeling rejected because of the referral, the pastor must counter this feeling. The person should be reassured that this referral is not a rejection and that the pastor will still be there to assist the person with theological and spiritual issues. This can be demonstrated by scheduling a follow up appointment shortly after the person's first visit to a mental health professional or program. If the person is hospitalized, ask for the person to give consent for the pastor to visit him/her in the hospital and to mention his/her name among those for special prayers due to being hospitalized. Affirm that the church is a place that will always be there to accept the person as they are. And, that if one is out of the congregational community for a period of time, an accepting, nonjudgmental congregation and pastor will continue as a caring community for that person. For example it is helpful for the pastor to tell the person he/she will be remembered in the regular prayer cycle.
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