Mental illness is still murky territory for those who experience it, their families, and their church.

Not long after Rich Salazar moved to DeKalb, Illinois from California, he found himself knocking at the door of St. Mary's Church. The then-college student had recently been diagnosed with bipolar disorder and was in crisis mode. Unable to reach his mother at work and not knowing where else to go, Salazar told himself, "I have to go to church."

Father William Schwartz answered his knocks and, although the parish was closed for the evening, invited him in. "He talked to me, calmed me down," Salazar says. The priest called his mother and told him he could stay at the church as long as he needed. "He was very kind. I told him the church has never let me down."

That's when Schwartz responded, "Someday it might."

For many Catholics experiencing mental illness and their families, the church can be both a place of welcome and alienation. Just as society has struggled with how to deal with those with mental illness, U.S. parishes and dioceses have found the area equally challenging.

Many in Catholic mental illness advocacy agree with Chicago Deacon Tom Lambert when he says, "As a church we're just beginning to address the issues on a church-wide and institutional level."

The National Institute of Mental Health estimates that one in four Americans has a mental disorder. Of those, one in 17 has a serious mental illness such as major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, or borderline personality disorder.

To Portland, Oregon psychiatrist Dr. Thomas Welch, those large numbers mean that every Catholic is affected by mental illness in some way. "The people next to you in the pews may have a mental illness or have family [members] who have mental illness," he says. "By virtue of Baptism, we're all equal members of the church, and we need to be mindful of that."

Shrinking stigma

As research has shown that mental disorders aren't just moods to be shaken off or, in severe cases, uncorrectable issues requiring time in a mental institution, the stigma once attached to them has slowly been eroding.

"The church's response parallels society," says Dorothy Coughlin, the Archdiocese of Portland's director of the Office for People with Disabilities.
Nancy Kehoe, a Society of the Sacred Heart sister and psychologist in Cambridge, Massachusetts, remembers a time when there was a lot of secrecy around mental illness. "If a nun had to be taken to the psychiatric ward in a hospital, there was a lot of shame in having a psychiatric disability," she says. "It wasn't even known to people immediately around her where she went."

On the flip side, Kehoe recalls the public nature of a Cambridge-area pastor who took leave for a few months. Upon his return he announced to his parishioners that he was experiencing depression and would be stepping down to serve a smaller parish and continue dealing with it. But, Kehoe notes, a pastor openly addressing his struggles with depression "was unusual even in 2009."

New Jersey psychologist Kenneth Herman started practicing in 1955 and says that at the time the Catholic clients who came to see him dealt with a lot of guilt, anxiety, and fear over their faith in everything from eating meat on Fridays to sexual issues. "It was a sin if you thought anything that was considered negative," he says. "You got the wrath of the church, and that produced a lot of guilt, especially with people who were a little fragile emotionally."

While Herman doesn't believe the Catholic Church did it intentionally, he says, "The church had an opportunity to send a lot of positive messages, but they didn't." By the time he retired a few years ago, Herman says he saw a change in how Catholics viewed their faith.

Author Therese Borchard writes about how guilt has played a large role in her own struggles with bipolar disorder in her new book, Beyond Blue (Center Street). But she also says that Catholicism is the perfect tradition for those with a mental illness.

"I think the Catholic faith, especially with all its traditions and rituals, can give you a kind of safety," Borchard says. "I joke that there's a saint for every disorder, and if you run out of saints there's always St. Jude for hopeless causes."

Today the church takes more of a holistic approach to mental illness. Welch describes a "synergy between religion and psychology" where there is an awareness of the biological, social, psychological, and spiritual aspects of a person suffering mental illness.

In Kehoe's eyes, suicide is the biggest area of attitude change for the Catholic Church. The Catechism of the Catholic Church still describes it as "gravely contrary to the just love of self," but since the 1983 revision of the Code of Canon Law, suicide is no longer listed as a reason to prevent a Catholic burial.

"Suicide is not a sin anymore," says Kehoe, who in her recent book, Wrestling with Our Inner Angels (Jossey-Bass, 2009), talks about working with suicidal patients. "Other religious traditions have not taken that approach yet."

A real disability

Mental illness outreach within the Catholic Church has often emerged from other disabilities work.

Connie Rakitan, a member of the Archdiocese of Chicago's Commission on Mental Illness, is the founder of Faith and Fellowship, a support group for people with severe mental illness. She thinks there's been a vast improvement in the "sensitivity and sophistication" of understanding mental illness, but that church outreach in that area has taken more time compared to the outreach to those dealing with physical disabilities.

"It is way easier to build a ramp than it is to deal with a person who comes to church talking to herself, which might be a manifestation of some of the more severe symptoms of mental illness," she says. "I don't think that the church is ready for that yet."

Recent Baylor University studies reflect this attitude. A 2008 study showed that almost one-third of a group of 293 Christians who approached their various churches about mental illness were told that they or their family member didn't really have a mental disorder. A 2009 Baylor survey of Texas Baptists found depression and anxiety were the maladies most often dismissed by clergy. Repeated studies have also shown that it is clergy to whom people most frequently turn when they are first in mental distress, not mental health professionals.

Like many working in Catholic mental illness advocacy, Lambert, the deacon from Chicago, has a personal connection to mental illness. His daughter was diagnosed with a serious mental illness 20 years ago, and he and his wife first sought resources through the National Alliance on Mental Illness (NAMI), a leading nonprofit organization that was founded in 1972.

"NAMI recognized that churches are a natural ally," he says. "Churches understand compassion. Churches understand justice."

NAMI has since extended its faith-based support to include working with interfaith groups and incorporating a website, nami.org/namifaithnet, to help users connect with religious groups. While groups like NAMI grew in the 1980s and '90s, the Catholic Church still lagged behind in terms of a mental illness network.

To help, the National Catholic Partnership on Disability (NCPD) created the Council on Mental Illness in May 2006. Lambert, Rakitan, Welch, and Coughlin are all members. In July 2009 the council began a mental illness initiative that has included creating a DVD, webinars, downloadable resources, and workshops.

The church "had always advocated for all people with disabilities, but we hadn't done enough for people with mental illness," says Janice Benton, the executive director of NCPD, which began in 1982. "We also want to have an informal network of people around the country who are doing outreach to people with mental illness."