(Continuing the examination of the mental health crisis from part 2 of this series.)

             Looking next to the functional angle of mental illness’s impact, we see societal statistics describing how such illness alters one’s ability to function at home or in society as well from the personal angle.  Considering marriage and its success rate as a good indicator of a person’s functioning in the home setting, survey results by researchers suggest that mental illness both decreases the incidence of marriage as well as increases the rate of its failure in divorce rates.  In the report published in the Acta Psychiatrica Scandinavia (Breslau 2011), researchers described their findings from a 19-country survey.  All mental disorders studied demonstrated an increased odds ratio of 1.2 to 1.8, meaning a 20 to 80% increase in divorce. The negative impact of mental illness on life’s closest relationship of marriage can likely be extrapolated to other personal relationship struggles.

             The ability of those with mental illness to function in broader society can be extrapolated from their capacity to handle employment.  In an online publication by Psychiatric Services, Luciano and Meara report how the severity of mental illness impacted employment rates. Looking at data from a survey in 2009-2010, they found that while those without mental illness reported an employment rate of 75.9%, those serious mental illness reported only a 54.5% rate.  Beyond this statistic, the percent of survey respondents with serious mental illness that reported incomes under $10,000 per year was 38.5% while it was only 23.1% in those without mental illness.  From the positive angle, this shows that many individuals suffering with mental illness are pushing through and working under the burden of their illness, yet it does demonstrate that many appear hindered from life functioning by their condition.

             At the personal level experienced by many of us, our own or our families’ struggles in mental health have hindered our functioning at these same levels of life.  Other family members have had to step in to provide financially or to support others sufficiently so that employment is not lost.  Other family members have dealt with the aftermath consequences of marriage discord and divorce.  While mental illness is not required for divorce, when it is a part of the divorce, the challenges of life post-divorce family dynamics can be even more challenging for all involved.  In each situation you live through or are living through, the shared weight lies heavy on many shoulders.

             The spiritual angle completes the view that most people should consider in understanding the scope and magnitude of the mental health crisis.  Examples of clearly sinful behavior which are known to correlate with future mental illness include abortion, drugs and alcohol abuse, and homosexuality.  We must come to some conclusions of how to view mental illness in terms of sin as both a contributing factor for the person and in response to the person.  On one hand, the majority who see little or no spiritual component to mental illness promote a dangerous and simplistic approach.  They ignore this critical spiritual portion of the problem and thus undermine any hope of fully resolving it.  By denying any spiritual component, they make guilt and shame challenging to deal with while preventing the adequate handling of sinful behaviors which contribute to the mental illness.

             On the other hand, there are some who might lump any or all mental illness into the category of sin or its effects.  This simplistic approach makes it easier in one sense to respond to all mental illness with a “repent and change your attitude”.  So much harm is done by those in this camp as they ignore the factors already discussed as well as more to be discussed in the next section. 

             Between these two extremes, from those acknowledging the contribution of spiritual factors come a variety of potentially sinful options for responding to other’s mental illness.  While lack of compassion for the weaker brother can lead to sinful responses, overindulgence of one’s sinful behavior can also hinder efforts to overcome such patterns of sin.  Sometimes between these extremes, the emotional impacts of mental illness on friends and family may lead them to respond out of frustration, despair, or anger further amplifying the impact of sinful behavior and deepening a cycle for everyone involved. These sinfully inappropriate responses can further exacerbate both the depth of the mental illness and the obstacles to overcoming it.

             Instead, we must consider a Biblical view of how we should respond individually and societally.  When approaching an individual’s mental illness, the contribution of spiritual factors to the illness must be considered for full resolution.  Then the societal response, whether at the level of a family, a community or a church as well as the national level, must not ignore these spiritual factors if a proper and successful response is to be implemented.  A better approach of addressing the sufferer’s condition in the context of family and as a church will be discussed later.

             As a physician caring for many of these individuals suffering with or without actual mental illness diagnoses, I can add a further angle combining both personal and professional.  I look at the reported statistics on the increase in mental illness and can believe it as more patients present for evaluation in my office of these conditions.  Simultaneously, we are seeing more of the secondary physical complaints mentioned earlier in terms of chronic pain syndromes, irritable bowel type complaints, insomnia, and more.  We see how patients’ relationships are affected by their mental health symptoms as well as how they are struggling to function at home or at work.  For those willing to discuss the spiritual aspect, we hear their guilt and shame for not living up to other’s expectations along with their occasional despair in feeling alone or losing hope of recovery.  While we should never base a societal level response on the report of one doctor’s experience, my professional experience echoes the statistics being reported and I hear similar stories from other providers directly and indirectly.  I agree that we have a growing problem that is not being adequately addressed. 

               Before we give up hope of such an exhaustive understanding and return to the simplistic solutions offered by the world, we should recognize that omniscience concerning the mental health crisis is not the goal, but sufficient understanding so that we can eventually move towards a solution to the crisis that has a chance of success.  While we will never be able to identify and to fully understand the totality of factors contributing to even one person’s diagnosis of mental illness, we can understand enough about the nature of the individual’s condition or the societal patterns that we can plan and enact a response.  Understanding the root causes in the next section will overcome the immensity of the big picture and allow an appropriate response. For now, if you want more statistics on the impact of mental illness on functioning, go to The National Alliance of Mental Illness website on its “Mental Health By the Numbers” page where many insightful statistics are offered.  Statistics and experience show a growing problem.  The situation affects mental, physical, relational (isolation), spiritual and societal health and function.  The mental health knot is tightening while civilization unravels.

               Having examined the state of mental health from these various angles already encourages us to look for upstream foundational causes of such a complex crisis. Each of these angles offers a different perspective which will lead us in the next section towards finding remediable root causes. The potential causative factors must somehow answer the challenges of these psychiatric, physical, relational, functional, and spiritual angles at the individual and the societal levels.  We wean to untangle the whole knotted shoestring of the mental health crisis rather than just a portion of it. 

Bibliography:

Breslau, J., et al. “A Multinational Study of Mental Disorders, Marriage, and Divorce.” Acta Psychiatrica Scandinavica, vol. 124, no. 6, 30 Apr. 2011, pp. 474–486, www.ncbi.nlm.nih.gov/pmc/articles/PMC4011132/, https://doi.org/10.1111/j.1600-0447.2011.01712.x. Accessed 13 Oct. 2023.

Luciano, Alison, and Ellen Meara. “Employment status of people with mental illness: national survey data from 2009 and 2010.” Psychiatric services (Washington, D.C.) vol. 65,10 (2014): 1201-9. doi:10.1176/appi.ps.201300335

National Alliance on Mental Illness. “Mental Health by the Numbers.” NAMI, National Alliance on Mental Illness, Apr. 2023, www.nami.org/mhstats. Accessed 13 Sept. 2023.