Five-Question Interview with Doug Beach, National Alliance on Mental Illness (NAMI) FaithNet

1. What do you consider the most important healthcare work that you and NAMI’s FaithNet do?

We want to focus on mental health holistically. Although we often talk about the medical model of mental healthcare, just about everyone I know would endorse a holistic view that encompasses body, mind and spirit. Yet the spirit does not get the attention the body and mind do. That’s a mistake. In fact, we like to add a fourth element: body, mind, spirit, and community.

People are surprised to learn that, if persons with mental illness can get care and find community, 80 to 90% of the time they get better. Building community and providing family education does not replace medical treatment, but they are a critical component of people getting better.

The importance of spirit and community means faith communities have a huge role to play in the process. They not only provide the belief structure, but they provide community.

2. What motivates you to do this work?

My wife and I have been doing this work for about 10 years. After our son developed a mental health issue, we took the NAMI family class. It saved our family...something other families often say as well.  In one of the class sessions, we talk about self care. One of the questions we ask our family members is: How do you to get from week to week…sometimes from day to day?

It’s an important question, because the people we work with have been in crisis with very, very challenging circumstances, sometimes for a very long time. In response, 90% of the people would tell us, “If I didn’t have my faith, I would not get to the next day.”

I see this across the country. Having a family member facing a mental illness…and often there is incarceration and substance abuse associated with it … is an existential crisis. Yet the people facing these challenging circumstances are also some of the kindest, most generous people I have ever known. How is that? I think the answer is often their strong faith.

Our faith teaches us to find gratitude even in difficult times. As you study brain chemistry, you find that being grateful improves your mental health. God hard-wired us to be compassionate, caring people. It’s not just something the Bible or another holy text teaches us, it is a biological fact.

3. What are the biggest challenges you, and those you advocate for, face?

The first challenge is people’s basic lack of understanding about mental illness, and the stigma that comes from it. I think we are probably much better today in addressing stigma than in decades and centuries past, but we still have so much misunderstanding.

That misunderstanding gets in the way of early identification of illness and getting timely treatment. Mental illness usually comes on when a person is young…75% of mental illness begins by age 24. But, typically, people do not get help for 5 to 10 years after their first significant episode. And the delay in treatment increases the chance for it to become a chronic illness. 

Part of that is misunderstanding, and part is simply lack of access to care. In our case, it took us almost six months to get a psychiatrist appointment, and that is a common situation. The analogy is, if you had a heart attack or cancer, would you have to wait months to see a cardiologist or oncologist?

Many people with mental illness are unemployed or have limited income, and are uninsured.  But even if you do have coverage, in many areas of the country, there is not a psychiatrist within 100 miles.

4. What do you think the U.S. healthcare system should look like?

Number one, the healthcare system ought to be integrated. Where healthcare is integrated…that is, physical healthcare is integrated with mental healthcare…, it reduces cost and improves outcome. So, why aren’t we doing more of this? This is not rocket science: we know what to do to improve our system. Those who are affected by mental health disorders need to demand better care; we need to be more bold.

Also, there is a dramatic crisis in the lack of psychiatrists in this country. So we need health insurance that pays mental health professionals at the same rate as their peers. We need primary care doctors to be better prepared to screen for mental health issues. We need lots of other treatment team members like psychiatric nurse practitioners and especially peer specialists, who are a very underutilized part of the treatment approach.

And we need the existing parity laws enforced. They are on the books, but they are not enforced.

Everyone should also have access to affordable care. That is a mantra now in politics, but it is even more critical in mental health, because so many people with mental illness are unemployed or under-employed.

5. What role do you see people of faith and faith communities playing in making the needed changes?

Oftentimes, it is easy to sit around and say, “We have a crummy health system.” Or, “Why don’t we have a better system for transporting people to their healthcare appointments?” That is all true. But one of the guiding principles of faith communities should be: “Why don’t we just help one person?” The United Church of Christ has a great program called “WISE” Congregations: Welcoming. Inclusive. Supportive. Engaged. I think that sums up how we people of faith ought to be living …engaged with people who are impacted by mental health issues.  I am a great admirer of the French theologian Jean Vanier, the founder of the L’Arche movement.  As he observed after a lifetime of living with people who had an intellectual disability…and often a mental illness… knowing them and “helping” them changed him.  That’s the transformative part of practicing our faith.

Mental illness is a “non-casserole” illness: If you have cancer or a heart attack, you get a freezer full of casseroles. But if you have someone in your family with mental illness, your phone stops ringing. My wife and I have often had an experience that is very common for others: when people learn we have a mental health issue in our family, they often literally turn away.

So faith communities need to become communities of wellness and acceptance. We don’t have to go all over the city to find someone to help: over a lifetime, 47% of people will have a mental health issue. That means they are in our pews. Churches need to particularly engage with their youth.

In NAMI, we teach people to see the person, not the illness. If we find out someone has a mental health issue in their family, don’t move away. Move closer. Sometimes you just need to be there to listen.  Sometimes you can help someone with the simplest of needs like a bus pass or a utility payment.  Helping people with small things and being there to walk along beside them may be the difference between they’re finding a path forward or falling back into instability.

Faith leaders can also speak up in the community about the lack of resources and the struggle for access. But you can’t do it if you don’t know anything about it.

This interview has been condensed. To learn more about NAMI FaithNet, click here.