Today, people from a variety of backgrounds recognize that we have a deteriorating mental health problem in our society which began before 2020, but has been exacerbated by it. While many will debate the causes, severity, and details of this problem, most admit that we live in an age of heightened sadness and anxiety expressed in a variety of symptoms and diagnoses.  We can look together at statistics further below with some general agreement, but as soon as solutions are offered, divergences begin.  We may agree that something must change, but how we view the problem determines how we believe that we should respond.  While we may be able to address our own or our family’s mental health issues, the collective societal response is best exemplified in the political proposals of those in leadership across various offices.  These legislative proposals concerning mental health care demonstrate our leaders fundamentally flawed beliefs about the mental health problem.

                Before considering the statistics, my simple definition of mental health according to worldly standards includes someone feeling good about life, having the absence of significant “dis”-ease which hinders functionality and productivity in daily life.  This plays out not as a complete absence of emotional fluctuations as with a science fiction robot. Instead mental health is viewed as an  spectrum of emotions which includes some degrees of sadness, anxiousness, joy, mourning, and other emotions.  The intensities match the context of the situation, and their duration is appropriate for the circumstances without significantly interfering with life functions.      

               While the world’s general view of mental health tends towards a focus on individual’s absence of “dis”-ease, a Biblical view of health informed by Biblical support emphasizes a Hebrew term “shalom”.  Shalom encompasses a more wholistic and positive view of health.  It includes physical and mental/spiritual health as well as relational health with God and with other people.  This shalom focuses on the presence of “well-being” rather than just the absence of negative symptoms. (for a further explanation of shalom and other Biblical words regarding health, see prior essay). 

               The world’s approach is to aim against “dis”-ease, rather than towards shalom. If we as Christians believe that God’s goal of mental health for us should be shalom for people as both individuals and in community, then we should evaluate whether the approach taken by the world and by our governmental leaders will lead to shalom or away from it.

               Assuming for the moment that the methods of assessment by the authors of the following surveys and studies are valid and portray a relatively accurate picture of the state of mental health in our nation, we see that we truly have a problem.  Elsewhere we can address the shortcomings of these methods and the factors they measured, but for now let’s take them at their face value.  A December 2022 edition of the journal Pediatrics reported on their comparison of mental health diagnoses reported in primary care between the year prior to COVID beginning in February of 2020 and two periods after this watershed in 2020 and 2021.  They found that eating disorder diagnoses in children almost doubled from 9.3 visits per 1000 patients per year to 18.3.  They also found the overall annualized mood disorder visits increased from 65.3 per 1000 patients per year to 94.0.  Basically, this second statistic indicates that almost 1 in 10 visits in pediatric primary care were for a mood related symptom. 

               In another study by the Center for Disease Control and Prevention reported by the Pew Center for Research (LINK) in 2021, high school students were evaluated on their self-reports of mental health symptoms.  In public and private high schools, 37% reported that their mental health was not good during the pandemic and 44% reported that in the prior year, they had experienced sufficient sadness or hopelessness for 2 weeks or more which led to their stopping some activity. 

               From the website by the National Alliance on Mental Health (LINK), we find further disturbing statistics.  Their “Mental Health by the Numbers” paint enough of a picture that we don’t need to go any deeper.  They list the following in a longer list on their site:

• About 1 in 5 adults in the U.S. experience some mental illness each year.
• About 1 in 6 children between the ages of 6 and 17 years experience mental illness each year.
• For children aged 10 to 14 years, suicide is the second leading cause of death.

               Numbers like these can tell us that a problem exists and that the current response does not appear adequate.  However, they do not necessarily explain how to change this situation. A much deeper look into the root causes of this situation would be needed and is not in the direct scope of this essay.  Neither will I provide support for my belief that there will always be some prevalence of mental “dis”-ease in a fallen world where sin is still rampant.  Until the New Heavens and New Earth, there will always be some degree of poor mental health.  For now we turn our attention to the response of our political leaders and what their response tells us about their view of the problem and its roots.

               We can gain a sense of how our Tennessee legislators view mental health by considering a few of the recent bills they proposed in the 2023 Special Session called by Governor Bill Lee for August of 2023. This session is now adjourned and the following bills were not passed, but these bills can be returned or refiled to committee and the Senate or House floor for consideration in the next session in January of 2024.  We as a state still must contend with these bills for better or worse and with the worldview foundations of our legislators which underlie these bills’ proposals.

               We look first at SB7079 and its companion bill in the state House, HB7035 which proposed loan repayment incentives to mental health professional students in exchange for a required number of years of their service in Tennessee.  The beliefs or assumptions of legislators can be deduced from this proposal.  They appear to believe that we have a shortage of mental health providers and by raising that number, we can improve mental health.  They appear to believe that experts in mental health can alleviate the problem.  They appear to believe that more money spent on these experts will alleviate the problem.  By not mentioning any other potential resources like family, church, or community, they suggest a belief that these factors are not important especially when considering that no other legislation in the special session addressed those factors.  They appear to believe that the views of mental health professionals, which in general conflict with the previously stated Biblical view of health, can solve the problem.  I believe these are plausible inferences to make from their proposed bill.

               We look next at SB 7032and HB 7066 which proposed the coverage of at least three mental health telemedicine visits to youth.  Besides many of the same appearances gleaned from the previous bill, we can add a few more.  The legislators appear to believe that children should be able to freely access these services without parental involvement as that is not mentioned in the bill.  The bill has no mention of the ability of parents to oversee either the individual mental health care of their children, nor have any say in the collective work of that system.  Beyond that, while the bill has possible provisions for further visits beyond three initial visits, the legislators appear to believe that short term interventions can be sufficient for such chronic issues.  That is a debatable opinion and this bill, if ever passed, will undermine parental rights.

               We next look at SB 7016 and HB 7076 which proposed adding 1 school counselor per every 250 students in the public school system.  This would add over 3800 new counseling positions in 1800 schools across the state at a potential cost of about 280 million dollars.  Again we see the appearance that legislators believe mental health experts know best for our children and should have access to children potentially without parental involvement or even parental awareness at times.  They also appear to believe that schools are a good location for such services.  This fits with the central role school frequently plays in the life of families, shaping their activities and relationships around schools’ calendars and connections.  (This dovetails with the mindset of the federal government since the schools receiving federal funding are no longer required to get parental consent for mental health services source. LINK.)

               We finally look at SB 7074 and HB 7069 which proposes that Tennessee seek federal waivers through Tenncare to receive more federal money to increase mental health services in Tennessee.  The legislators proposing this bill clearly believe that federal government money flowing into Tennessee is a good option to meet the need for mental health care.  They would appear to not be concerned about any regulations that such money would bring from the federal government that would dictate how Tennessee mental health provider treat Tennesseans with mental health problems. 

               In summary, our governmental leaders appear to believe in the following principles behind their solutions:

• Experts can solve the problem
• Government money from the state or federal government can fix the problem
• Other resources like family, church, and community do not play a role in a solution
• Understanding the root causes of the problem are not necessary for a solution
• For children’s mental health, parental and family involvement are not necessary
• Without a mention of the contribution of sinful behavior to the issue, they don’t consider it a factor

               Are these principles ones which Tennesseans agree with?  These foundational principles regarding what our legislators believe about mental health and the relationship between parents and children give me great concern as a Christian parent and a Christian physician.  I should not be surprised as much of our society sees little problem with these foundational principles.  Even our churches and their leaders don’t quite understand that a Biblical approach to mental health should aim at shalom rather try to resolve “dis”-ease of a worldly view of mental health.  I would argue with Psalm 11 that the righteous must consider what to do next in the face of the foundations being destroyed and having been replaced by faulty worldview foundations.  It is high time to return to Biblical principles including the striving for shalom rather than the reduction of “dis”-ease through more governmental mental health intervention.

In future blogs… What should the role of state or federal government be in mental health? 

Bibliography

Potter MD, E. (2023, June 1). True Health: What does it include in Biblical terms? (Part1) – Whole Person Whole Life. Whole Person Whole Life. https://wholepersonwholelife.com/true-health-what-does-it-include-biblical/

Mental health and the pandemic: What U.S. surveys have found. By John Gramlich Pew Research Center. March 2, 2023.  Accessed August 30, 2023. https://www.pewresearch.org/short-reads/2023/03/02/mental-health-and-the-pandemic-what-u-s-surveys-have-found/

National Alliance on Mental Health. Mental Health By the Numbers. Last updated: April 2023. Accessed September 4, 2023. https://www.nami.org/mhstats

Hoge, A. (2023, August 29). Biden Expands ObamaCare For Mental Health Services at Schools to Psychoanalyze Children 0 to 21. News with Views. Accessed September 4, 2023. https://newswithviews.com/biden-expands-obamacare-for-mental-health-services-at-schools-to-psychoanalyze-children-0-to-21/