Clerical guidance

Lecturer and practitioner Alan Pringle and his colleagues
highlight how a tailored programme can assist clergy in
understanding and supporting people with mental health
problems.

The Department of Health’s guide to  mental health
promotion, Making it Happen,¹ acknowledges that
standard one of the National Service Framework for Mental Health
puts health promotion into the spotlight.

Making It Happen suggests that partnerships built with
schools, faith communities and neighbourhoods and which go beyond
the traditional spheres of health care could be beneficial in
providing a better service for people with mental health problems.
As the document states: “Effective health promotion depends
on harnessing expertise, resources and partnerships across all
sectors.”

Although there are many recent examples of the church working
closely with people who have mental health problems,^2,3
we found that members of the local church community appeared to
have a limited knowledge and experience of working with such
people.

This group of people included vicars, support workers on church
projects and members of organisations such as the Salvation Army.
Copsey⁴ has outlined the benefits to be gained from
closer working between local faith communities and mental health
professionals, but also found that there was a marked gap in this
area.

In response to these findings, Reverend Rick White, chaplain for
the Millbrook Mental Health Unit in Nottinghamshire and other local
mental health services, suggested that a regular meeting of clergy
could help educate and offer a forum for peer support. He and I,
along with Sandra Crawford, the senior nurse at the Millbrook,
approached local clergy to find out their views and identify topics
to be covered.

From the responses it emerged that there was no mental health
education or training for the clergy during their training or when
they are curates. The same was true for other church organisations.
Most of the participants had gained knowledge from experience
“on the job”. The majority of responses asked for any
sessions on the subject to have an educational input. The replies
also gave a list of topics that it was felt useful to cover and
from this we drew up a year-long programme.

Each session ran for two hours. The first hour was given over to
education with myself or Sandra Crawford leading the session in a
teaching role. We ensured that other staff, including community
psychiatric nurses and the local mother and baby team leader,
contributed to the teaching. The second hour, led by myself and
White or Crawford and White, was a discussion on how clergy has
dealt with problems and what strategies might be developed.

The sessions ran on a drop-in basis, with clergy selecting the
sessions they felt were appropriate. Some clergy attended for
specific sessions only while others attended every session.

The initial evaluation of the project is positive. Participants
have valued the educational input and have increaseed their
understanding of the experience of people with mental health
problems. Some have commented on how they have put the knowledge
gained into practice when dealing with members of the community.
They have also valued the support gained from the discussions with
other participants during the sessions.

Several recurring themes came through in the discussions:

– As clergy are often in the front line they are approached by
either people with mental health problems or their relatives for
help and support in dealing with mental health issues.
– Clergy often work in isolation and have a limited support network
when dealing with people with mental health problems.
– Clergy often feel that the community – and sometimes the church –
expects them to deal effectively with people who have mental health
problems, despite having little or no training.
– A programme such as the one introduced at Millbrook can help the
clergy work effectively with people with mental health problems.
This in turn can help those in the community with mental health
problems and their families.
– Some participants said that the development of a contact service
for local clergy to receive help, advice and support would benefit
them.
This course has run for a year, as intended, and is being formally
evaluated.
Initial feedback from interviews with participants includes these
comments:
– “We discovered quite early on in our ministry that there
was a high incidence of depression and mental illness among the
people we were meeting.”
– “In the parish work we deal with situations ranging from
those who suffer from anxiety or depression through to more severe
mental illnesses.”
– “I thought the sessions were excellent, informative and
in-depth. They were also reactive to the needs of the people who
attended.”
– “I thought the sessions were valuable. I had quite a
limited knowledge of mental illness, so I think the sessions really
opened up how complex the issue is.”
– “In a sense, it put into perspective some specific cases of
people that I knew. I could place them more easily in the whole
thing and have a better understanding for what was going on for
those people. So it had an immediate effect and still
does.”

The Department of Health claims that many of the factors
influencing mental health care lie outside the formal structure of
health and social services, and the contributions of clergy to
discussions during this programme appeared to confirm this. Often,
participants recalled how members of their communities had
approached them in the first instance rather than health
professionals or social workers.

Although the programme had resource implications for the trust
in terms of allocating staff and rooms for the sessions, it appears
that the relationships formed with the faith communities, and the
knowledge and support gained by them, can help local people with
mental health problems.

Those who choose initially to access the church can have an
improved level of support and help through an increase in the
knowledge and confidence of those members of the clergy who are
often in the front line for mental health care.

Topics discussed

The clergy group meetings programme at Millbrook Mental Health
Unit covered the following subjects:

– Schizophrenia
– Depression
– Personality disorders
– Challenging behaviour
– Local resources
– Spiritual aspects of mental health care
– Post-natal depression
– Medication and mental health
– Self-harm
– Substance abuse
– The Mental Health Act 1983
– Electroconvulsive therapy

Alan Pringle is a lecturer practitioner at both the
Millbrook Mental Health Unit and the University of
Nottingham

References

¹ Department of Health, Making It Happen:
A Guide to Delivering Mental Health Promotion, DoH, 2001
² R Carter and S Golant, Help Someone with Mental
Illness: A Compassionate Guide for Friends, Family and Care
Givers, Time Books, 1998
³ B Schneider, More Prayers for Climbing out of a
Hole, Project Stop, 1993
⁴ N Copsey, Keeping Faith: The Provision of
Community Mental Health Services within a Multi-faith Context,
Sainsbury Centre for Mental Health, 1997

Background reading

Department of Health, Mental Health Promotion and the
National Service Framework Updates: vol 2 issue 8, 2001,
from

www.mentalhealth.org.uk/html/content/updatev02i08.cfm