What Is Mental Illness?

Two years ago, at the Southern Baptist Convention (SBC) national meeting in Houston, messengers adopted a resolution calling on all Southern Baptists, “to look for and create opportunities to love and minister to, and develop methods and resources to care for those who struggle with mental health concerns and their families.” The ministerial heart of compassion which motivated this resolution is to be emulated as it should awaken our hearts, collectively, toward appropriate ministry. With that said, I, however, remain concerned with our path forward in producing distinctly Christian ministry that provides love, support, and community as natural expressions of the body of Jesus Christ for those struggling with issues related to mental health.

Regardless of one’s theory of therapy, most can agree that the symptoms labeled as mental illness are legitimate and that it is incumbent upon the church to minister to those experiencing these varied vexations. Yet, the stigma associated with conditions categorized as mental disorders or mental illness suggests the necessity of highly trained medical experts to alleviate the symptoms. Hearts of compassion and desires to help are often overshadowed by feelings of inadequacy bred by this stereotype.

What is mental illness anyway? Confusion produced by the phrase may contribute to the lack of ministry within churches. The terms mental and illness are a bit paradoxical and have created a certain aura surrounding those whose symptoms are branded as such. The use of the term mental is intended to communicate the immaterial—both conscious and unconscious—aspect of man. Can the immaterial of man be categorized as a physiological disease? Adding illness to the equation attempts to bolster the scientific connection to one’s biology implying a disease-model as the explanation of such emotional distress. If that sounds rather confusing, that’s because it is.

No one seems to be able to define the term “mental illness,” yet it is rather common vocabulary. In Mad Science: Psychiatric Coercion, Diagnosis, and Drugs, Stuart A. Kirk, Tomi Gomory, and David Cohen say that, “no one knows what a mental illness is.” In an article published by The Atlantic, psychologist Gary Greenberg agreed. When asked if he could define mental illness, he replied, “No, nobody can.” The myriad of books authored by skeptics are no longer productions of isolated moralists from the past, but now insiders within the mental health community. Even the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM) does not attempt to define mental illness, but seems to prefer the phrase mental disorder. And while the phrase is defined as a syndrome characterized by inhibiting mental functioning, the symptoms described in the diagnostic criteria are intended to unveil the underlying psychobiological dysfunction—another way of saying psychological problems that are caused by biology. The DSM exists to help practitioners recognize symptoms in order to aid in “prognosis, treatment plans, and potential treatment outcomes.” In order to prescribe treatment plans designed to heal a person, a practitioner must first conclude that there is a cause, or at least a theoretical one. Historically, the DSM has proposed an “atheoretical” position regarding causality of certain disorders. The DSM-5 incorporates new language that conveys mental disorders as psychobiological in etiology. How did normal emotional symptoms become medicalized? Allen Frances, author of Saving Normal, laments that psychiatry and psychology are medicalizing normal. Kirk and fellow Mad Science authors explain that, “the more ambiguous the terms used to demarcate mental disorder from no mental disorder or emotional disturbance from emotional stability, the more behavioral territory can be annexed under the jurisdiction of the mental health professionals.”

Is it any wonder, then, that churches have abdicated this responsibility to care for the souls of those categorized with mental illness? Unfortunately, based on this model, it actually makes sense that churches would be disengaged, because many believe the root causes of these symptoms to be biological and not spiritual in essence. Once causality is proposed, whether legitimate or not, therapeutic procedures are arranged to relieve symptoms or repair theorized causes. In theological education, at least since the 1940s, secular psychology has permeated the paradigmatic structure of pastoral care and counseling. The practice of deferring and referring these more difficult, stigmatized, cases outside of the church to mental health professionals has been the modus operandi, which led pastors to believe that they were ill-equipped to handle these types of problems. The paradigm communicates something to our church members and may explain their reluctance in ministering to someone with such a label. Often we accept as true that the root cause of mental disorders is a defective brain. Yet, “many experts,” according to the Mad Science authors, “believe that no scientific evidence exists to describe the vast array of behaviors corralled in the rubric of mental disorders as ‘brain diseases.’”

My concern that we, as Southern Baptists, would adopt a system as an antidote to mental health concerns that is based upon such anecdotal and skeptical data—easily distinguishable as humanistic and behavioral in origin and essence. Until we can biblically define our understanding of mental illness and what we believe to be the cause of these serious symptoms, our ministry will lack any sort of biblical effectiveness or genuine healing. Otherwise we will remain practically ineffective, “both marginalizing ourselves from the culture and being marginalized by the mental health establishment,” as we seek to minister to those who display these real, and often debilitating, symptoms.