From the Editor: When she wrote this article Dr. Jude Boyer-Patrick, served as the medical director of Thrive Behavioral Services in Baltimore, Maryland. She practiced adult, child, and adolescent psychiatry. We hope to honor her work, service and the wise counsel she freely shared, even before she became a physician. She passed away in November 2022. This article from the Message Vault first appeared in March/April 2015.
I looked at Steve as he slumped in the chair—a thin, tall 17-year-old
Hispanic teen. His oily shoulder-length hair fell over his face as he hugged
his stomach and looked to the ground, refusing to meet my gaze. He
refused to speak to me. He sat flanked by his mother on his left side and his
therapist on his right as his mother began to tell his story.
It started approximately four years ago when his mother ran with
her three children to escape an abusive relationship. She relates that “we
moved from state to state, and from city to city within those states.” They
moved between five states and multiple cities, with Steve having to change
schools. The family moved to Maryland after his mother met a man online
who sent her money and told her that he would provide for her and the
family. When they arrived things were not what he had promised, and the
family ended up in a shelter.
Over the course of several months, Steve’s mother was able to secure
government housing because of her own mental health issues, and Steve
returned to high school. However, early in the semester while he was
walking down a hallway after school, someone attacked him from behind.
He was placed in an armlock and shoved to the ground, and his backpack
and money were stolen. At that point he refused to return to school, and
further, he refused to leave the house. He rarely spoke to anyone and paced
around the home paranoid that someone was going to get him. His mother
was desperate to get him help so that he could feel safe enough to leave the
house without a panic attack, and return to school.
Research from the National Institute of Mental Health shows that
“mental disorders are common throughout the United States, affecting
tens of millions of people each year.” According to a study published in
Psychiatric Services, October 15, 2014, “mental health is the number one
cause of disability in the United States, touching the lives of roughly 20
percent of Americans.” Steve is but one.
The top mental health disorders seen in psychiatrists’ offices across
this nation are: mood disorders, personality disorders, eating disorders,
attention deficit hyperactivity disorder, phobias, anxiety disorders, panic
disorder, schizophrenia and autism spectrum disorders. These are just a few
of the issues I treat in my office.
My patients are from a community near a major metropolitan city on
the East Coast. They are young and old; male and female; Black, White,
and Hispanic. It matters not if they are educated; most of my patients
receive government subsidies. Each day brings a new challenge: the mother
weeping because she came home to find her 19-year-old son hanging in
his bedroom because his girlfriend had just broken up with him. Another
patient in despair because multiple back and neck surgeries failed to
alleviate her constant daily pain. There are the children who are bullied in
school and do not want to return; the teen girl who was sexually molested;
the young man who has no motivation to do well in school because he
cannot focus, and barely tries anymore; and the families struggling to stay
together after financial reversals; single mothers and children living in
shelters; a young man living in his truck; a father finding his 14-year-old
stepdaughter hanging from a closet—the only thing written on the note
was Psalm 57; the parents grieving over the loss of their 19-year-old college
student who died of an accidental heroin overdose.
Some of my patients struggle to survive, and the struggles are
worsening. When the economy is bad and jobs are scarce, mental health
issues increase astronomically. It is a trickle-down effect. Lack of money
takes its toll on patients, some of whom already have limited resources.
Just trying to do the basic things necessary to function daily makes the
depression and anxiety worse. When the state cuts back on food stamps
the patients feel even more helpless. What do you say to the mother of
three who is working part-time and because she is bringing in a small
income, her food stamps get cut from $322 to $82? She says, “Just because
I’m working part-time they take my food stamps. They cut my insurance
too, and I haven’t had my medicine for a month. How am I supposed to
work my job without my medication, and if I don’t work how will I live?”
These are the faces I see, the faces that I feel called to minister to, and
yet in some ways, it is easier working with those people than working with
members of my church.
In my opinion, the bigger crisis for me as a Christian psychiatrist is the
struggle that I see on the faces of my fellow Christians, and the difficulty
they have in reaching out for help because of guilt and shame. We rarely,
if ever, talk about mental health issues in the church. We come to church
and smile, and hide the pain that is inside as we try to pretend that
everything is OK. There is no rationality to it. If a congregant was suffering
from a physical illness, he or she would not hesitate to go to a primary-care
physician. If medication were recommended, it would be taken. The church
clerk or the pastor would then invite the church to pray for the member
who was either in the hospital or recovering at home.
Never would someone recommend that we pray for a person who
has an emotional illness. Have you ever heard someone say from the
pulpit, “Let’s pray for Brother A because he has depression”? Or “Let’s pray
for Sister B because her daughter is suffering from an eating disorder”?
Or “Let’s remember the C family because their father has just lost his job
and has begun to abuse alcohol again?” It is just not done. I recently met
someone at a church discussion on depression who admitted that when a
friend came to her to try to talk to her about her emotional issues, she said,
“Let’s just pray about it.”
Please understand that there is nothing wrong with taking emotional
issues to the Lord in prayer, any more than it is wrong to pray for someone
who is having surgery. However, if the person needing surgery goes to a
surgeon, then the person suffering from a mental disorder needs to go to a
mental health professional.
Believers must recognize and address all of the issues with which
we are faced—mental and physical. Every new person who comes to
Christ also brings his or her issues. People in the church still struggle with
addiction to drugs, gambling, pornography, etc. Others struggle with issues
having to do with being gay, Lesbian, or transgender. The church must be
a reservoir of hope to those who need it, and a safe harbor for all. We must
learn to identify those within the church who can be called on to help
direct someone to the appropriate care. Only when we address both mind
and body will we be on the path to making ourselves physically and