The Mental Health Ministry of the Local Church
by Howard J. Clinebell, Jr.

Chapter 12: Minister and Laymen Work Together for Mental Health

A Creative Partnership

The key to the release of a church's mental health potentialities is the development of a creative partnership between the minister and a core-group of laymen who have caught a vision of these potentialities. Only thus can the healing-growth approach enter dynamically into the life stream of a local segment of the Body of Christ.

Laymen outnumber clergymen approximately three hundred to one. Obviously, any program must involve laymen as full partners if it is to have more than superficial effects on a church and its community. One of the reasons why churches have not stimulated the growth of their members more is the passive follow-the-leader posture of many lay persons and the one-man-show self-image of many ministers. This situation retards the spiritual maturing of everyone involved. Furthermore, it is profoundly unbiblical.

A deep-level cure for the "spectator-itis" of laymen and the one-man-show orientation of ministers seems to be emerging in the "lay renaissance" -- a contemporary movement of profound significance for the mental health mission of our churches. This grassroots movement is growing spontaneously, on many fronts, with the rediscovery of the New Testament truth that every Christian has a ministry simply because he is a Christian. The New Testament Greek word "laos," from which "layman" and "laity" are derived, refers to all Christians! The "ministry of reconciliation" was given to the whole church (II Cor. 5:18), not to a set-apart, professional ministry. All are a vital part of the healing community. The layman is no second-class Christian. He is a minister in the life stream of his community and world. No Christian can really delegate his personal ministry to another. Every Christian is a shepherd (pastor) to others. The clergyman is simply a shepherd of shepherds, all under the great Shepherd. The clergyman is set apart by the church to provide leadership in the ministering community which is the church. His set-apartness is a matter of function, not a difference of spiritual responsibility. The clergyman's central job is to train his people for their ministry to the world. He is a teacher of teachers, a counselor of counselors, a pastor of pastors.( This conception was set forth in The Purpose of the Church and its Ministry.) He is a "playing coach" on the team which is the church.( This phrase is from Samuel Shoemaker's book, Beginning Your Ministry (New York: Harper & Row, 1963). In the words of the author of Ephesians, the minister's primary job is "to equip God's people for work in his service" (Eph. 4:11-12, NEB).

During World War II the persecuted Christians threw a ringing challenge at comfortable, culture-adapted Christianity when they declared: "The first duty of the church is to be the church." It is my conviction that a local church works best for mental health when it is true to its mission as a church, not when it attempts to become a mental health agency. Its rich contribution to mental health is the result of the overflowing vitality of its spiritual and interpersonal life as a person-centered, God-oriented organism. The distinctive source of a church's vitality is the growing awareness among its members that they can become (in New Testament terms) the people of God (a community bound together by a glad commitment to the kingdom which is both among us and yet to be fully actualized), the fellowship of the Holy Spirit (a ministering family in which the life-renewing Spirit of God can be experienced), and the Body of Christ (his instrument for serving human need in all areas of life) .( For a discussion of the New Testament conception of the church, see Grimes, The Church Redemptive, pp. 21-68.)

When this New Testament picture of the church is taken seriously by Christians, salutary things begin to happen. Individuals and groups come alive. A new kind of minister-layman relationship emerges as the sense of mutual ministry grows. Laymen become "salty Christians" (Hans-Ruedi Weber, Salty Christians (New York: Seabury, Press, 1963), p. 33.) -- determined to be the "salt of the earth" by exerting a redemptive influence in their labor unions, corporations, clubs, or schools. Thus, the renewal of the church is coming with the pouring of its healing life into the world's wounds through the everyday ministry of dedicated laymen. This is the context within which a church's greatest contribution to mental health is made. Growing laymen, experiencing the empowering love of God, often see a dedication to mental health as a vital way of implementing their personal ministries of reconciliation.

The Minister's Roles in Mental Health

As the respected leader of a church, the minister sets the tone of its program and its interpersonal climate. He does this by the kind of person he is, the quality of his relationships, the sort of people he attracts to the church, the motivational influence of his leadership, and his own passion for making that church a need-satisfying fellowship with a dynamic concern for helping lift the load of humanity. In order to be fully effective a church's mental health thrust requires the minister's enthusiasm. He is the key man in inspiring and training laymen for this ministry.

A revealing study of a cross-section of the Protestant ministry by sociologist Samuel W. Blizzard distinguished six practitioner roles in which parish ministers engage: preacher, teacher, priest., organizer, administrator, pastor.( These roles are discussed in S. W. Blizzard "The Minister's Dilemma," The Christian Century (April 25,1956).

I would add a seventh -- prophet. As we have seen in the preceding chapters, each of these roles is a door opening into a whole realm of mental health opportunities.

Here is a summary of the major ways in which a minister can contribute to the mental health of his congregation and community:

1. Inform and motivate his congregation, with regard to both mental illness and positive mental health. Many who hear him in his preaching and teaching roles are in attitude-molding positions as parents, teachers, and community leaders. Psychologist Gordon W. Allport writes:

2. Select and train a small group to become mental health leaders and infiltrators within the church and community. If a number of dedicated laymen are exposed to the mental health needs of a community, particularly if these needs are personalized by visits to mental health facilities, some will respond with an Isaiah-like, "Here I am. Send me." An ad in the London Times read: "Brilliant speaker wants first-class cause." In every church there are members with unused talents who can be challenged by the freshness and obvious value of a church's mental health emphasis. A person serving on a committee charged with guiding a pastoral counseling service knows that his self-investment is paying significant dividends.

3. Initiate action. After the educational groundwork has been laid and a nucleus group trained, the minister is ready to work with that group in deciding on the most urgent unmet mental health need. After planning strategy, the group can move into action. The nature and goals of this mental health action should be determined by the unmet needs of a local situation. Organizationally the minister may prefer to work through an existing committee on social problems or create a new mental health task force responsible for this one area.

4. Present the Christian message in a growth-stimulating way. As a congregation's best trained interpreter of the message, the minister has a responsibility to test and retest his presentation of that message against criteria of healing and growth (see Chap. 2).

5. Encourage the development of a growth-oriented program of Christian education by personally helping to motivate and train healthy persons as teachers. From a mental health standpoint being a teacher of teachers is one of the minister's most important roles (see Chap. 6).

6. Guide the development of a variety of creative groups including a network of small, family-modeled nurture groups. The minister's personal involvement in leadership training activities may be his outstanding contribution in this area (see Chap. 7) .

7. Support persons in crisis and counsel with the disturbed. The minister has both a preventive and a therapeutic opportunity in this area of service (see Chaps. 10 and 11) . The "Mental Health Counselors" (called for in the Joint Commission's Report), a group between the psychiatrist and the "care-taking" professions, already exists to the extent that clergymen are effective counselors.

8. Help to instill "unconditional positive regard" for persons into all the administrative procedures of the church, so that the total organism of the church can become an instrument for mental health.

9. Function as a community mental health leavener. Because of the status which his position gives him in the community, a minister can have great influence in sparking mental health action by arousing a lethargic citizenry to their mental health responsibilities. Collectively,the country's 364,475 ministers represent a major community mental health resource (outnumbering psychiatrists thirty-three to one).( In 1960 there were approximately 11,000 psychiatrists.) Unlike psychiatrists, clergymen are present and influential in almost every community. A professor of psychiatry accented the role of clergymen when he stated: "We recognize the minister as one of the first lines of defense in the mental hygiene movement."( D. M. Kelley, Bowman Gray School of Medicine, quoted in "The Role of Religion in the Psychoses," by Wayne Oates, Pastoral Psychology (May, 1950), p. 80.)

The Importance of the Minister's Mental Health

John Wesley once wrote: "You have need to be all alive yourselves, if you would impart life to others." (From a letter to Zachariah Yewdall dated December 3, 1780, in The Letters of John Wesley Vol. 7 (London: The Epworth Press, 1931), p. 40. Of course it is not possible to be "all alive," if this means being perfectly mentally healthy. Nevertheless, Wesley's basic idea is valid and important.) The minister's (or layman's) fundamental instrument of health or harm is interpersonal relationships. The quality of these determines his long-range influence on people and this quality is determined by the degree of his own mental health. As Wayne Oates puts the matter: "Religion may either facilitate mental health or breed and maintain mental pathology, depending upon the mental health and methodology of the representatives of religion. ("The Role of Religion in the Psychoses," p. 35.)

A minister who suffered severe emotional deprivation in his childhood relationships, and whose self-esteem is therefore damaged, will subtly manipulate his flock in ways that will cause them to feed his exorbitant need for approval and love. If this need to manipulate is severe, he will become what Flanders Dunbar calls a "pathogenic agent." He will relate in ways that intensify guilt, dependence, and fear, blocking growth forces and infantilizing those around him. (An extreme example of this is the right-wing radio "prophet" whose paranoid message attracts a huge crowd of frightened, angry people. Such a person is a spawner of sickness who encourages hate and delusion in the name of religion.)

On the other hand, the relatively healthy minister naturally relates in ways that stimulate mutual trust and personal growth. As an accepting, loving person, he will automatically strengthen the mental health of those about him. To the degree that he really cares about people for their own selves, he will be a source of health and growth. He will enter into honest (and sometimes painful) encounters with his people rather than stay in the detached safety of professionalism. Ross Snyder has said, "No person has earned the right to be pastor of a church or teacher of a class until he has risked himself with his people." (From "A Church as a Learning Community," a paper presented to the United Church Assembly (January 29, 1962), p. 6.)

The vast majority of ministers are reasonably mature, healthy persons. There are, however, certain mental health hazards in the ministry against which every minister needs to develop strategies of defense. One hazard is the contemporary professional identity diffusion of the ministry. Kaleidoscopic social changes have blurred the clearly focused pre-World War I sense of "who" and "why" the clergyman is in his community.

A part of some ministers' quiet sense of futility stems from the fact that the search for a new, relevant ministerial identity is far from complete. It is helpful to be aware that at least some of one's inner uncertainties are symptomatic of broad historical uncertainties. The present situation makes it very important for the minister to find a sturdy sense of personal identity so that he will not need to lean so heavily on his professional identity.

Another ministerial health hazard consists of the variety of threats to his sense of self-worth. In our culture, where status and financial compensation are closely linked, ministers who are underpaid often suffer from gradual attrition of their self-esteem. However strong one's dedication to his calling, it is hard to escape the feeling that society puts a low value tag on one's services. A National Council of Churches study revealed that two thirds of our ministers are in substantial debt and that three fourths of these are not able to reduce their debt loads. (W. A. Pleuthner, "Let's Pay Our Ministers a Living Wage," This Week (February 2, 1959). Since 1939, ministers' salaries have risen 105 percent as contrasted with 149 percent rise in the cost of living. 67 percent of ministers face serious problems in providing college educations for their children.( From a study by the Ministers' Life and Casualty Union.)

Ministerial discounts, clergy fares on public conveyances, exemption from military service, and so forth, confront the clergyman with other mental health hazards. The first two of these are backdoor forms of remuneration which are distasteful to many self-respecting clergymen. Any form of special treatment by society exposes one to the trap of believing that one really is a special kind of human being. Such arrogance interferes with one's ability to establish authentic relationships.

Chronic loneliness poses another serious mental health hazard for ministers and their wives. Although he is surrounded by people, a minister may be hungry for relationships in which he can function as a peer rather than a professional leader. Some men find satisfying peer relationships with other professional people in the community. Others find renewal in a continuing small group experience with fellow ministers. One such group on the west coast hired a clinically trained chaplain to serve as therapist. Through honest sharing they were able to resolve some of their conflicting feelings about the ministry. Another group of ministers and their wives meet regularly with a well-trained clinical psychologist in a personal growth group.

Other mental health hazards faced by the minister and his family are the factors which make parsonage family life difficult. Since the minister's family is uprooted frequently, it is doubly important that family relationships be strong, supportive, and satisfying. Unfortunately, ministers sometimes sacrifice their families to the demands of their churches. The minister's wife faces more frustrations and fewer gratifications than her husband. It is essential for her mental health and his that they take a regular day off each week. Parsonage families who regularly set aside a block of time for shared activities are on the right track. A survey of ministers' wives showed that less than half of the churches encouraged their minister to take a regular day off.( G. Keohler, "The Minister as a Family Man," in The Minister's Own Mental Health, pp. 159-66.) One minister asked his officials to fill out questionnaires indicating how much time they felt he should spend each week on each area of his work. He found that to meet their desires would require an eighty-two hour work week.( See the Reverend Wesley Shrader, "Why Ministers Are Breaking Down:" Life (August 20. 1956), p. 95.) In order to protect himself and his family from unwarranted demands, the minister has to master the fine art of saying "no."

The constant pressure to set a good example is another mental health hazard faced by ministers and their wives. Because they must please so many people and live an exemplary life they often feel that they must always hold themselves rigidly in line. Psychiatrist Harry Stack Sullivan once remarked, in his own inimitable way, that swallowing too much anger will ruin one's belly. As repressed ministers demonstrate, it will also deaden one's spontaneity and hamper one's relations with people. If a minister is to stay psychologically alive, he must find constructive ways of channeling his human feelings and drives. An understanding wife and a sharing group in which he can let down his hair are helpful. He also needs the "courage of his own imperfections" so that he can free himself from the need to please those who make unfair demands for neurotic reasons.

Closely related is the hazard of feeling that one must repress honest doubts. Some of the most tortured ministers I have met are those from conservative churches who felt forced by the threat of job loss to mouth doctrines in which they no longer believed. Whatever one's doubts, the price of ignoring them is a reduction in the vitality of one's faith. Talking them over candidly with a trusted person outside one's church is one constructive way of handling doubts.

Another hazard faced by ministers and their wives is the tendency to restrict personal satisfactions and recreation. Any profession which demands as much giving as the ministry, requires time for taking in activities -- hobbies, reading, attending concerts, loafing, and nonchurch centered social relations. The ministry requires disciplined study and hard work, but creativity in these can be maintained only by alternating with periods for recharging the batteries. Samuel Johnson once remarked, "Sir, the life of a parson, of a conscientious clergyman, is not easy. I have always considered a clergyman as the father of a larger family than he is able to maintain." (Quoted by C. W. Gilkey, "A Well Proved Ministry," Pastoral Psychology (February, 1957), pp. 9-10.) The drain of having a considerable number of disturbed, dependent people constantly drawing on his emotional resources makes it imperative that a minister have replenishing experiences. One who brags (or complains) that he hasn't taken a day off in the last month is asking for serious trouble, as well as displaying his indispensability complex.

Hierarchical systems of church government pose mental health hazards for ministers who have not resolved their authority problems. Some comply with authority in ways that make them feel emotionally castrated; others defy authority in rebellious, self-hurting ways. Even if a minister's feelings toward authority are relatively mature, he may have problems in coping with whatever elements of the "stained glass jungle" are present in the ecclesiastical power structure of his denomination. Many men who resent hierarchical systems continue in them because they cannot relinquish the dependence and security they offer. Clergymen in denominations in which the ultimate authority is vested in the local congregation suffer from the insecurity of being vulnerable to the whims of power groups within their churches.

The most dangerous hazard to a minister's health is spiritual emptiness, the loss of a powerful sense of being the glad captive of one's mission in life. Young ministers sometimes leave seminary with heads full of facts about religion, but their hearts are strangely cool because they have not found a growing faith into which their knowledge can be integrated. Unless a maturing faith is found, the person either leaves the ministry or by middle age is like a salesman going through the motions of peddling a product in which he does not believe. The only way of avoiding this hazard is for a minister to work continually on his intellectual, emotional, and spiritual growth.

Fortunately, the vast majority of ministers and their wives overcome these hazards and live remarkably productive lives. Offsetting the frustrations are a host of deep satisfactions which rise from an effective ministry. These include the respect in which they are held in the community, the genuine appreciation they receive for work well done, the privilege of being invited to be with persons in their brightest and darkest hours, the satisfaction of communicating ideas that are important, the security of being surrounded by people who have affection for them, and the deep sense of well-being that comes from self-investment in significant work which helps lighten the load of humanity and makes for a better world.

Preparation for a Person-Centered Ministry

To some extent, the maximum release of a church's mental health potentialities depends on the caliber and character of its minister's training. Optimal training for a person-centered ministry includes three things: (a) Experiences which lead to the understanding of one's religious heritage (through the study of Bible, theology, and church history), of contemporary revelation regarding man (through the study of developmental psychology, anthropology, group dynamics, education, abnormal psychology, and so forth), and to the ability to meaningfully correlate these two bodies of truth. (b) A period of clinical pastoral training, and (c), opportunities to discover and resolve one's inner problems (through individual or group psychotherapy), and to develop a tough, growing faith.

Seminary education is essentially conservative and therefore changes slowly, In spite of this, the basically interpersonal nature of the ministry is receiving some consideration (though not enough) in the rethinking of theological education which is occurring in many places. The Niebuhr-Williams-Gustafson report on theological education, states:

To send a minister forth from seminary without his having confronted himself and human need at a deep level is to graduate him without the very insights which can allow him to make his message relevant to live human beings. Realizing this, some seminaries are using small, modified-therapy groups in which students experience self-encounter and gain awareness of their relationships. Several seminaries are requiring every student to have one quarter of clinical training -- an experience of working for three months in a mental hospital, correctional institution, or general hospital under a carefully trained chaplain supervisor.( The two national, nondenominational clinical training groups are The Council for Clinical Training, Inc. (475 Riverside Drive, New York, New York) and The Institute of Pastoral Care (P. O. Box 57, Worcester 1, Massachusetts). If all seminaries would do this, the mental health impact of the churches could be doubled in one generation.

Clinical pastoral training is, without a doubt, the most efficient way of vitalizing one's ministry to persons. Carl W. Christensen, instructor in neurology and psychiatry at Northwestern University Medical School, declares:

Anyone who works as closely and constantly with people, as an effective minister must, benefits tremendously from the increased openness to himself and others which usually results from having psychotherapy. A west-coast minister gives this testimony concerning his personal analysis:

The parish minister has limitless opportunities to communicate with others from the center of his own life. It is assumed, often over-optimistically, that his life has a center and that he has not only found his way to it, but that he has found it to be reasonably acceptable. I would say that the most significant aspect of an Educative Analysis for the parish minister is that it helps him to accept the center of life and to speak from it.... It makes him more aware of himself as a person and more aware of others as persons. It gives him a deeper understanding of the forms and institutions of religion and helps him use those forms and institutions with more reliance on his feelings.... It helps him to shape them to ends of self-expression and self-realization.( H. B. Scholefield, "The Significance of an Educative Analysis for the Parish Ministry," The Minister's Own Mental Health, pp. 328-29.)

One of the major values of a period under a skilled therapist is that it gives one a delicious experience of grace -- the unearned acceptance which is the heart of any genuinely therapeutic relationship. This experience can bring to life for the minister the central truth of the Christian faith. Unless it has come to life for him he cannot communicate it to others. It is true that any profound human experience confronts a person with himself and that any profound relationship brings grace to life. Unfortunately, profound experiences and relationships are rare in our society and most of us work overtime to avoid them. Clinical training and psychotherapy are two experiences in which self-confrontation and depth relationships are hard to avoid. In speaking of clinical training for theological students, Reuel Howe says: "They will be plunged deeply into life, many of them for the first time, and come up gasping and dripping, ready to learn about life." (The Church and Mental Health, p. 243.) Both clinical training and psychotherapy are excellent means of enhancing the capacity to relate authentically and in depth.

Here are some of the ways a parish clergyman can sharpen his interpersonal skills:

1. Clinical training. If a minister has an enlightened congregation who will grant him a three-months "sabbatical" for a post-B.D. quarter of full-time clinical training, he will find this to be one of the great learning experiences of his life. Since it will add a depth dimension to his ministry, it is to the congregation's advantage that he have this experience. If full-time clinical training is impossible, a minister should enroll in a one- or two-days-per-week program in a nearby hospital. Several accredited chaplain supervisors have developed such programs for parish ministers, with valuable results.

2. Supervision of one's counseling. Clergymen in most parts of the country are discovering that one of the most rewarding forms of training is available at their doorstep. Individually, or in small groups, they simply make arrangements with a clinically trained person -- psychiatrist, social worker, chaplain, psychologist, pastoral counseling specialist -- to provide weekly or bi-monthly supervision of their counseling. Most mental health professionals are glad to participate, since it provides them with a stimulating opportunity to teach. Ideally, such supervision should extend over at least two years. The financial costs are modest, particularly if done in a group. Most ministers who have had supervision regard it as one of the most useful experiences in their entire educational careers.

3. Personal psychotherapy. If a minister is aware of creativity-depleting inner conflicts or is dissatisfied with his degree of effectiveness in relationships, he should not hesitate to enter individual or group psychotherapy. (It is crucial, of course, that the therapist be highly competent.) Though expensive, therapy will be among the best investments he has ever made, paying dividends in professional creativity and in both personal and marital happiness.

4. An academic "retread" through seminary extension courses or graduate programs in pastoral care and counseling. Sound degree programs include supervision and clinical experience. Disciplined reading in the mushrooming pastoral care literature and in the major journals, Pastoral Psychology and the Journal of Pastoral Care, is essential to continuing growth in one's interpersonal ministry. Exciting things are happening in this area, with which the pastor should keep abreast.

The Layman's Mental Health Ministry

As indicated earlier, the layman who is awakened to his opportunities plays a vital role in strengthening the mental health impact of his church. At many points, he has opportunities which the clergyman does not possess. Here are some facets of a layman's mental health ministry:

1. He can help select an emotionally mature minister and then back him in a person-centered ministry. The choice of an emotionally healthy minister is the essential factor in developing a church's mental health potentialities. An alert layman should utilize his influence in helping to select a man who gives evidence of a high degree of personal maturity and of the ability to be a "playing coach." The committee which interviews candidates should be composed of the most perceptive laymen in a church, including, if available, persons trained in interpersonal sensitivities. Such a committee should apply a typical criteria in considering a candidate: Does he care about people for their own sakes? Does he relate openly and honestly? Is he fully aware that he is a human being? What is the quality of his relationships with his wife and children? Would I like to be on a team of which he is coach? Is the gospel really good news to him personally? How sturdy is his self-esteem?

A layman should work to make sure that the salary which is offered is adequate to attract a minister with solid self-esteem and to prevent economic insecurity from hampering his effectiveness once he is hired. This is the only course consistent with the church's enlightened self-interest, not to mention Christian charity. A minister who is underpaid, who sees his family go without needed dental work, who cannot afford the books and recreation he must have to stay on his toes is crippled in his most basic function -- establishing creative relationships.

A layman should encourage his minister's desire to take additional clinical and academic training in pastoral counseling. (Seventy percent of ministers in one survey expressed a need for such training.) Like his counterpart in medicine, a growing minister needs regular post-graduate educational experiences to broaden his horizons and keep him up to date in his field. I shall always be grateful to the lay leaders of a Long Island church who made it possible for me, as their pastor, to have a quarter of clinical training ten years after completing seminary. Those years in the ministry had made me acutely aware of my inadequacies in meeting many pastoral care problems. This sense of need helped make that clinical training an invaluable experience.

Mental health concerns should motivate a layman to encourage his minister to do those things which are consistent with his mental health -- a regular "preacher's sabbath" away from the telephone, at least a month's vacation for recharging his emotional and intellectual batteries, sufficient money and freedom to enjoy the legitimate recreational resources of the area, and enough privacy to protect the minister and his family from excessive living-in-a-goldfish-bowl pressure. I am not suggesting that a minister should be coddled. No self-respecting minister either wants or needs this. But all of us are sensitive to the expectations and approval of others. Healthy laymen can counterbalance the pressure of neurotic laymen who tend to heighten the mental health hazards of the ministry.

A layman should back the minister's efforts to increase the proportion of his time spent in person-centered activities. Providing adequate secretarial and janitorial staff is the place to start. Some churches have the best educated (though not the highest paid) mimeograph operators in town. A minister who spends his time in such ways is wasting both his training and his potential contributions to mental health.

2. A layman should inform himself in the area of mental health and then let his pastor know that he stands ready to work alongside him in developing the church's mental health strategy. If a clergyman knows that there are even one or two key laymen upon whose informed interest and leadership he can count, he is more likely to give immediate priority to a mental health emphasis or project.

3. A layman should develop his own particular ministry to persons. Seward Hiltner's challenging question concerning a "universal pastorhood" in Protestantism must be answered affirmatively it a church's help- and health-giving potentialities are to be released. Early in this country's history, in Methodist class meetings the responsibility for pastoral care was with laymen.( The Churches and Mental Health, p. 57.) A fellowship like A.A. is a refreshing example of the ability of nonprofessional persons to be of highly significant help to each other. Every local church has a largely untapped artesian well of latent helping resources in its laymen. If this stream is to be released, each concerned layman must discover his unique ministry of pastoral care.

Supporting fellow members and neighbors who are going through crisis experiences is the foremost pastoral care opportunity of laymen. An excellent means of increasing the effectiveness of key laymen in this work is for the minister quietly to establish a pastoral care team. Such a team consists of a carefully selected and trained group of laymen including a stable A.A. member and an Al-Anon member, a lawyer, a physician, and other intelligent, warmhearted persons with a dedication to following the Great Physician. The members of the team are on call to serve when the need arises at the discretion of the pastor. The team meets regularly for continuing training in the art of pastoral care.

How the members of the pastoral care team function depends on their training and their natural skills. Their help ordinarily consists mainly of supportive relationships and practical assistance such as finding employment for ex-prisoners and recovered mental patients. (Incidentally, studies have shown that the most important factor in the permanence of a patient's recovery from psychosis is having a job and doing well at it. (Mental Health Education: A Critique, p. 39.) Human need is everywhere! An alert pastoral care team working with a sensitive pastor will find no shortage of opportunities to serve.

The danger that well-meaning, but untrained persons will do harm while attempting to help is minimized by careful selection of team members, emphasis in their training on the limitations of their helping roles, and direct supervision by the pastor or some person from the mental health professions designated by him. There exists a broad group of troubled persons whose difficulties in living do not require the services of a highly-trained professional person and yet who need more help than is available from random conversations with relatives and friends. The sick, the burdened, the handicapped, the bereaved, and the aged are among those to whom average team members can minister effectively. Several members of most pastoral care teams will have special helping competence by virtue of their professional training. Churchmen from one of the mental health professions should certainly be given an opportunity to serve on the team. The pastoral care team is a practical way of implementing the pastorhood of laymen concept.

A striking example of the effectiveness of lay shepherding is the work of the Committee on Institutions of the Louisville Council of Churches. Over twenty years ago, this group of laymen decided to take literally Christ's words, "I was sick and you visited me . . . in prison and you came to me" (Matt. 25:36). Over two hundred laymen have been involved in this project. Clergymen serve only as advisors. Thirteen groups of laymen provide a volunteer ministry in the police court, the jail, the reformatory, the general hospital, the tuberculosis sanitarium, the mental hospital, the juvenile court, and the children's homes. These dedicated laymen have helped countless sick and troubled persons. Their influence in the institutions has tended to upgrade the general treatment programs. Church women organized a committee to serve in the institutions for women. A volunteer presented a layette to a young, unwed mother in prison. The girl wept for the first time in years when she realized that someone cared about her.( George Stoll, Laymen at Work (Nashville: Abingdon Press, 1956).

Another illustration of the effectiveness of lay pastoring is the sponsorship, over the past decade, of homeless alcoholics and ex-prisoners by a dozen or so Church of the Brethren congregations. In much the same manner that many churches have sponsored refugees from Iron Curtain countries, these "refugees" from behind another kind of curtain are provided with housing, helped to find employment, and, most important, made to feel accepted by the church fellowship. These experiences are reported to have had a profound educational effect on the congregations, in addition to helping some of society's rejects.

Creative altruism is contagious. This is part of the answer to the question, "What can one person do?" A thirteen-year-old-son of a U. S. Army sergeant stationed in Italy read about Albert Schweitzer's hospital and decided to give a bottle of aspirin. An Italian radio station picked up the story. Not long after this, the boy was flown to Schweitzer's hospital with four and one-half tons of medical supplies worth $400,000 in planes provided by the Italian and French governments. His good-heartedness had started a chain-reaction of goodwill, causing many others to contribute.( The Christian Century (July 29, 1959), p. 870.)

4. A layman can implement his mental health ministry by accepting leadership in community mental health projects. A churchman who served as chairman of a volunteer task force which completed a two-year survey of mental health needs and resources in Los Angeles County put his faith to work in a broadly influential manner. As a respected leader in industry, his name helped to protect the mental health program from serious damage at the hands of the reactionary forces of the area who were attacking it. The survey helped to motivate and guide an extensive program of strengthening the mental health resources of the county.

The "Friendly Visitors" program of Pasadena, California is an inspiring antidote to the common tendency to leave the responsibility for mental health mainly in the hands of professionals. Several years ago a grandmotherly appearing woman named Mara Moser began to wonder what was happening to the families of persons who are imprisoned. She discovered that society rejects or ignores them in most cases. Confused and embittered, the wife often retreats into her dingy house with blinds drawn. Economic pressures on the family are extreme. Frequently, the children fail in school and turn to delinquency.

Instead of stopping with an indignant question such as, "Why doesn't someone do something to help these victims of society's neglect?", Mara Moser decided to become that "someone" by doing whatever she could. At first the court authorities were suspicious of her motives and would not give her the names and addresses she needed. That her only motive was the honest desire to help apparently was hard for them to believe. Undaunted, she searched the daily newspapers for the information. She persuaded the council of churches to give her efforts moral support. Eventually the council sponsored her work enthusiastically and gave her modest financial support.

Her approach was simple and direct -- a visit to each family opened by the words, "I'm from the Friendly Visitors. I would like to talk with you." Often the frightened wives would peer suspiciously through barely opened doors before admitting her. Her lay ministry is mainly one of listening, support, and guidancc. After a while, she started a weekly group where lonely wives could gather for fellowship and for learning some of the homemaking and personal grooming skills which many lack. This group experience helps to strengthen their shattered self-confidence. The fact that the group meets in the parish hall of a church is de-emphasized initially, since many of the women would not come to a church. To them, churches represent not the reconciling love of God but the society which has stood in judgment on them.

A number of volunteers from the churches have joined in the program. The court authorities, having seen the positive results of her work, now gladly give Mrs. Moser access to the names she needs. A plan for providing volunteer tutors for children from disturbed homes who are potential school dropouts has been implemented by the Friendly Visitor workers. What can one person, over sixty, with limited financial resources, no car, and the resistance of the authorities do? Mara Moser is the answer.

The Time is Now

At the beginning of this book I stated that the time is ripe for the churches to make a major breakthrough in the area of mental health. In the intervening chapters I have described how the contributions of a church to mental health can be multiplied in its various areas of work. Let me now reemphasize the strategic nature of our present situation.

For many years, the mental health movement limped along. Then came the end of World War II. The remarkable new vitality that has developed since then is apparent in the churches and in society at large. A ferment of interest in mental health matters is evident on every hand. Major advances in the treatment of the mentally ill are occurring. New, realistic hope is dawning on the horizon of this age-old problem. This moving tide of interest makes the timing right for a major advance in the churches' mental health ministries. Mental health is "an idea whose time has come."

Two factors facilitate the positive response of churches to this challenge. One is the existence of a substantial and growing group of ministers who are well trained in the field of pastoral care and counseling. Over 10,000 ministers now in churches and church-related institutions have had at least one quarter of full-time clinical training. The emergence of pastoral counseling as a specialty within the ministry and the development of new programs for advanced training in pastoral counseling both contribute to the rapid augmentation of the manpower pool of ministers who can provide competent leadership to the churches in their mental health programs. The other factor is the existence of a growing body of laymen who are knowledgeable and concerned about mental health. When these two groups come together, things begin to happen for mental health!

Over a century ago Thoreau sounded this note from a hut beside Walden Pond: "Man's capacities have never been measured; nor are we to judge of what he can do by any precedents, so little has been tried." (Walden [New York: The New American Library, 1942], p. 11.)

This is still true, both of men and of their churches. In the past, most churches have been like slumbering giants in the area of mental health. If fully awakened, they could release new forces of healing and wholeness in the stream of our world that could turn the tide for millions of persons toward that fullness of life which is mental health.

Think of the potential mental health influence of the 246,600 clergymen serving churches in our country.( Benson Y. Landis (ed.), Yearbook of Churches (1964 ed.; New York: National Council of Churches, 1964), p. 258.) As seminary and inservice training in personality development and counseling improves, clergymen will become increasingly significant contributors to mental health. Imagine the creative influences which can be released as more and more of the 319,240 churches and temples in our country become centers of healing, cells of sanity, helping to prevent mental and spiritual illnesses. The total job of fostering positive mental health obviously is too big to be done by any one group, including the churches. Every person and organization of goodwill has a role. The message of this book is that the role of the churches is much larger and more challenging than many of us had even dared to dream. If the churches, with their vast human resources of over 120 million persons, catch a vision of their potential strength in this area, they can become wellsprings of wholeness and health. What a magnificent opportunity!

Dorothea Lynde Dix (For a full account of the life of this amazing woman see Stewart Holbrook, Lost Men of American History (New York: The Macmillan Company, 1946). was probably the most remarkable woman our country has produced. A frail New England schoolteacher (retired early for health reasons) she seemed to be an unlikely candidate for the crusading role she was to fill. Yet singlehandedly she started a revolution of hope in the treatment of the mentally ill.

The day that changed her life was a cold Sunday in March, 1841, on which she taught a Sunday school class at the House of Correction in East Cambridge, Mass. There she was horrified by the sight of four insane persons chained like animals in dark, filthy, unheated cells. She returned to her home among Boston's bluebloods, too shocked to sleep, but with a fierce determination to pour whatever strength she had into a fight to correct this evil. Her struggle to achieve humane treatment for the mentally ill never faltered during the forty years which followed that momentous day in 1841.

First she collected facts, learning that treating the insane as dangerous animals was regarded by most people as perfectly appropriate, since they were considered depraved. Attendants at the jails and almshouses often charged visitors from 10 to 25 cents for visits to the "crazy house." For the entertainment of the visitors the insane were goaded to rage by being prodded with sticks. This is the way the mentally ill were treated in the United States of America, little more than a century ago!

Miss Dix proceeded to focus public attention on the situation in East Cambridge. Public officials condemned her conduct as "unwomanly," but after a vigorous battle, a stove and sanitary facilities were installed. For two years, she quietly collected a shocking dossier of evidence concerning conditions in the rest of her state. Then she wrote a remarkable document, "Memorial to the Commonwealth of Massachusetts." In direct prose, she named places and described victims -- a woman at Newton chained to the wall of a toilet, a youth at Groton with six feet of heavy steel chain connecting his neck to the wall. The gentlemen of the legislature, to whom she directed the report squirmed as she cited case after case of persons chained naked and beaten into obedience with rods. With dispatch, they set aside rooms for two hundred mentally ill patients at Worcester Hospital.

After collecting data in Rhode Island, she wrote an article for the Providence Journal, describing in vivid detail the treatment of one Abraham Simmons whom she had found chained in a seven by seven cell in Little Compton, with no window and no heat. The keeper admitted that his cell was double-walled so that he would not be disturbed by Simmons' piercing screams. She concluded her article by commenting that she supposed the citizens of Rhode Island considered themselves Christians, but she doubted if they could pray to the God of Abraham Simmons, imprisoned in his filthy, freezing cell. Overnight Simmons became a nationally known martyr. The state's legislators speedily provided better treatment for the mentally ill.

Eventually Miss Dix moved her fight to every state east of the Rocky Mountains and then to Canada. In three years, she traveled over ten thousand miles by stage, horseback, steamboats, and primitive trains, visiting over eight hundred jails, almshouses, and houses of refuge. Her courage was endless. Repeatedly she walked alone into filthy dungeons where alleged maniacs were chained; in New Jersey, after being warned that a certain man was extremely dangerous, she walked directly into his cell gently calling him by name. After staring in disbelief for a moment, the man broke down and cried. In two months he was recovered enough to work around the institution.

Everywhere she went, mental hospitals resulted from her work. She refused to have any hospitals named after her and shunned all personal publicity. She continued her fight until death stopped her at eighty. Dorothea Lynde Dix was a nonprofessional in the mental health field, and yet the impact of her remarkable life on the treatment of the mentally ill was stronger than that of any other person in our history. The fact that the task she so nobly began is still unfinished in the second half of the twentieth century should be a challenge to the conscience of every person of goodwill in our land.

To seize their present opportunities in mental health, our churches need laymen and ministers with something of the vision and courage of a Dorothea Lynde Dix. With such leaders, our churches increasingly will achieve that spirit of Christian community through which new streams of mental health will flow into our troubled world.

Readings

For further guidance on how a church can become an effective participant in the preventive and therapeutic aspects of the community mental health movement, the reader is directed to Community Mental Health: The Role of Church and Temple, Howard J. Clinebell, Jr., Editor (Nashville: Abingdon Press, 1970).