in my last post I indicated a distaste for the term Mental Illness. My concern arises from the way it is often used to describe grief, stress, sadness, anxiety and other situational causes of distress. It does not mean I reject every use of it.
Over the years I have developed a scale to help Pastors and Lay Helpers assess the levels of distress a member may be experiencing and what to do to help alleviate that distress.
We classify members as
Type A and B from a definition used by cell churches. Type A members do not have problems that cause serious interruptions
in work, family or church life. They will sometimes have conflicts, emotional
struggles and concerns but rarely seek out special ongoing counseling. Instead,
they receive enough support and prayer at small group meetings or Sunday school
classes. These members are strong enough to their
receive pastoral care through friends, worship, tapes and books. They account
for about 70 to 80% of a congregation and should be the focus of coaching,
discipleship, training and leadership development.
Type
A members have been divided into two levels to
differentiate the very mature from those not yet at maximum strength in mind
and spirit. Level 1 are most mature
and are strongly needed in Christian leadership. This is the goal of Christian
Discipleship and termed Teleios or mature in scripture. They are exemplary in
mental, emotional and relational health but make up only 10% of the
congregation. To equip all believers to this level of maturity is our goal.
Level
2 members have few life interrupting problems but
lack maturity in Word and works. They may range in maturity from quite healthy
to teetering on the brink of a temporary problem. A man with high cholesterol may no present heart
problem yet, but a lack of exercise and stress can bring on greater problems.
Approximately 60 to 70% of the church is in this functional group. From this
group will come most of our learners.
Type
B members have some level
of life interrupting problems. Level
3 folk experience family disputes, behavioral problems, mild depression,
light anxieties, or bad habits that disrupt daily living. Paraprofessionals,
recovery and support groups and classes are appropriate for ministry for this10
to 20% of the congregation. In churches with strong evangelistic and counseling
programs the percentages will be greater.
Level
4 members are those who have not improved with lay
care, counsel and prayer and their life interrupting issues are getting worse.
Depression, anxiety, marital conflicts, abuse issues, addictions, and eating
disorders are worsening. This 8 to 10% of the congregation will need
professional counseling as well as support from lay community and their caregivers.
Level
5 is for the very few 2 to 5% whose problems require
residential treatment with medical assistance. The issues include suicidal
ideas, violence, life-threatening addictions, and psychotic mental illness.
Teen Challenge is an example of residential treatment.
The original estimates of percentages within
each grouping came from our 30 years of counseling plus estimates in books and
journals. However, a recent research paper suggests that the percentage of
needy Type B. people has risen over the past forty years. In 1957, 19% of
respondents said they had faced a nervous breakdown. This is similar to the 20%
for those in Type B categories above. However, in 1999 this group had
grown to 27% indicating about a 10% increase.
In my opinion, the apparent increase could
be the result of people being more willing to admit their struggles. In my
youth adults did not “Share their dirty laundry in public” so emotional
struggles were kept out of sight.
Type A People have no serious life interrupting issues that are not handled in a healthy manner. They are normally able to carry out their daily and weekly tasks at work, home and church. Type A Members usually Respond well to Stressful Events and do not Over React to losses, disappointments and challenges.
Type A 1 persons are the most resilient and peaceful even when people around them crash. They tend to bounce back from accidents, grief and bad news. They rise to the top of most groups and are quickly recruited to positions in the church.
Type A 2 persons show some small aspects of Reactivity and lack of peace. If they show symptoms of chronic worry they are able to recover fairly quickly. The focus of Discipleship is to prepare them for leadership.
The classes in great relationships, listening, mutual caring, marriage enrichment, etc are easily mastered by Type A members. It is from the Type A Group that we hope to recruit most Helpers, leaders, Elders, etc.
Type B Members have various levels of Reactivity and instability.They all suffer from various aspects of life interrupting issues. However, they all have strengths, talents, gifts and abilities that allow them to contribute to family, friends and society. By an over focus on Mental Illness we can lose sight of their positive attributes.
Level 3-This is what almost all stressed and reactive people present in life. It may be the norm for most of us who develop bad habits, stinking thinking, imperfect interpersonal; relationships and low levels of anxiety and sadness. One of my former teachers called it "The Worried Well" because they do not have a deeply serious mental illness but they have developed poor ways of managing themselves and their relationships.
Psycho-educative classes and groups of peers that encourage each other, teach great relational skills, renewed thinking, prayer and meditation are the best ways to move them from Level 3 up to Level 2. Lay Care at a Peer Helping Ministry is also greatly desired along with A.A., and Healing Services.
Level 4-These folks have developed bad habits of thinking and feeling and behaving that may require a Counselor with patience and wisdom. Their anxiety, sadness/depression can be life interrupting at home, work and school. Peer Care through small groups, pastoral care, Psycho-educative classes, etc is critically important to support people in their recovery.
Level 5-A very small percentage of members with serious anxiety, depression, drug use, anger issues, etc that require medical and even residential care.
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