Hearts Made Whole: A Pastoral Response to Behavioral Health in

30 Pages·2011·9.73 MB·English

Hearts Made Whole
A Pastoral Response to Behavioral Health in West Virginia
W
hen I search for a way to During my first six years as Bishop,
describe the rich diversity and I have joined the people of West Virginia,
the complex beauty of this traveling those roads and highways upon
Mountain State that has been which so many depend. I have come to see
entrusted to my pastoral care, the highways which wind their way across this
I invite those who are not from Mountain State, joining its major cities and
West Virginia to think in terms small towns into a life-giving system, much as
of regions: my Brother Bishops of Appalachia did in their
 there is the Northern Panhandle, once 1975 Pastoral Letter This Land is Home to Me:
heavily industrialized and still “Ribbons of highway,
maintaining a few functioning plants, can become like so many arms,
and dealing with an economy in which instead of crushing life,
transition and steady population loss; reach out to make it fuller,
 there is the Eastern Panhandle, large to bring to others
parts of which are influenced by the beyond the mountains,
expanding suburbs of the Nation’s the promise of their vision…”
Capital and which continues to The great ribbons of highway which cross West
experience a population and economic Virginia’s hills and mountains can bring people
increase; to the promise of their vision and can lead them
 there is the greater Kanawha Valley with to the services they need in life. For many of
Charleston, our State Capital, at its our people, this means following highways out
center, which has an identity all its own and far away from home for services, especially
in the state and seems blessed with a for much needed services in the area of health.
certain economic stability;
For this reason, I wrote in my first Pastoral
 there is the Morgantown and Clarksburg Letter, A Church That Heals, that
corridor, an area laying at the crossroads
“We are far from the place called health:
of the state and rich in educational,
‘a state of complete physical, mental and social
medical, and economic opportunities;
well-being and not merely the absence of
 and there are the Southern Coalfields disease or infirmity.’ The road to this place of
and the great forests of the southeastern health and well-being requires that we develop
region of the state, whose natural a healthy, vigorous and just environment of
resources have and continue to fuel social networks and mutual relationships that
nations and whose people are so often supports the health and well-being of all of us.”1
distant from the services they need.
In the fifth year since issuing A Church
West Virginia is not any one of these regions—
That Heals: A Pastoral Letter on Health and
though each one has its own unique character,
Well-Being in West Virginia, I find in my travels
its own natural beauty. West Virginia is all
across the state that there has been a wonderful
of these regions and the interplay between
sense of progress, especially among the people
them. West Virginia is, most importantly, the
of our parishes. Health fairs and healthy living
wonderful people who live in these regions and
programs have begun, new partnerships with
travel between them each and every day.
Hearts Made Whole 1
Catholic Charities West Virginia and other As people of faith, we are called to bring those
service organizations have made access to at suffering from addictions and, or, mental illness
home services available to those in need, and out of a place of loneliness and isolation. Above
fresh attention has been given to programs and all, we cannot forget that,
partnerships that have been quietly working “For Jesus, healing is never just the
well for many years. There are many at work healing of the body but also mind, heart and
each day, across the Mountain State, taking care spirit”; healing “is about hearts made whole,
of the needs of the sick and poor because we are sins forgiven and a world healed.”3
A Church That Heals.
As a people of faith, we are called to do our best
At the same time, I have become to bring our suffering brothers and sisters home.
increasingly aware that one area where we,
Those “ribbons of highway” that might
as a state, remain “far from the place called
lead to a place called health, the roads that so
health”—especially in terms of creating an
many in West Virginia must drive each day for
environment of mutual regard and effective
work, for health care, and indeed for the basic
care—is in our response to those suffering from
needs of daily life, called my mind to that road
chemical dependency and those living with
that went down from Jerusalem to Jericho, on
mental illness. West Virginia’s Department of
which a man fell in with robbers (Lk 10: 29-
Health and Human Resources includes these
37). The Parable of the Good Samaritan recalls,
issues under the title of “behavioral health” and
as Pope Benedict XVI has said,
I will use that expression here to mean both
mental illness and chemical dependency. Our
State Legislature has acknowledged that,
“the behavioral health system in West
Virginia is rapidly moving toward a state of
crisis.”2
Thus, while there are signs of hope in both
federal and state laws which seek to ensure
that behavioral health issues are treated with
equal concern to physical illness, to promote
healthy practices, and to coordinate health
initiatives among state agencies, there is still
an area of great concern.
Part of the answer to this crisis will be
to devote more funds to proven prevention
strategies and treatments, a matter for
legislatures, but a great deal of the answer lies in
our response, as individuals and as members of
“the work of Jesus, the Good Samaritan
communities, to those dealing with addictions
of humanity. When he passed through the
and with mental illness. In A Church That
villages of Palestine proclaiming the Good News
Heals, I observed that
of the Kingdom of God, he always accompanied
“We know that a sense of being loved
his preaching with signs that he worked for the
and supported best predict health. In contrast,
sick, healing all those who were prisoners of
isolation and loneliness best predict disease and
every kind of disease and infirmity. The health
injury.”
of the human being, of the whole human being
2 Hearts Made Whole
was the sign chosen by Christ to manifest God’s
closeness, his merciful love, which heals the
mind, the soul and the body.”4
The Lord’s work as the Good Samaritan is
carried on in the Church, for as Christ has
done, we too are called to do. Indeed, the
Church, as she listens to the story of people’s
sufferings, wants to be the Good Samaritan,
to pour the wine of compassion and the oil of
forgiveness into their wounds. In the process of
preparing this pastoral letter, several listening
sessions were conducted throughout the state
and the stories of those living with behavioral
health issues emerged. To me, the image of the
Good Samaritan became all the more real and
compelling after hearing the results of these
listening sessions, results that I will share with
you in this pastoral letter.
The Parable of the Good Samaritan
is, first and foremost, presented as an answer
to the question, “Who is my neighbor?” After
inn and cared for him. The next day he took out
telling this parable of the man who falls in with
two silver coins and gave them to the innkeeper
robbers, the two men who walk by him and
with the instruction, ‘Take care of him. If you
ignore his desperate state, and the Samaritan
spend more than what I have given you, I shall
who stops and tends to his needs in a beautiful
repay you on my way back.’”
way, Jesus does not conclude by saying that the
A Church that heals, that mends the hearts of
neighbor is the one who is in need. Instead, he
our brothers and sisters living with behavioral
asks,
health issues, becomes for them the Good
“Which of these three, in your opinion,
Samaritan and makes a real investment of
was neighbor to the robbers’ victim?”
compassion and mercy in their care and
The answer comes:
recovery.
“‘The one who treated him with mercy.’
As we travel these ribbons of highway,
Jesus said to him, ‘Go and do likewise.’”
we inevitably see many individuals who, like
To be a neighbor to another is to offer
the man who fell in with robbers, are living with
compassion, to take care of the other. Indeed,
the affects of behavioral health issues. “No one,
as the parable itself acknowledges, the solution
regardless of whatever wrong he or she may
to another’s problem might not be immediate, it
have committed, is outside the loving concern
may be costly, and may require a commitment
of the Church.”5 Instead, the Church responds
over time:
with compassion and understanding. As I
“a Samaritan traveler who came upon think about our brothers and sisters living with
him was moved with compassion at the sight. behavioral health issues, I recall that the human
He approached the victim, poured oil and wine mind is one of the finest gifts in the universe. It
over his wounds and bandaged them. Then he allows us to consider the possibility of slipping
lifted him up on his own animal, took him to an
Hearts Made Whole 3
the limitations of space and “if you can do anything,
time and living in eternity have compassion on us and
in a situation where the help us” (Mk 9:22).
perfect love of God is the Like the Good Samaritan,
center. In the quest to we as the Church do not
achieve this happiness, turn away either from the
which lies at the end of sick person or from the
life’s many roads, some family in need. Rather,
lose their way. Indeed, it being mindful of the Lord’s
often takes a lifetime to assurance that “everything
achieve a solid foundation is possible to one who
for faith. “No matter what has faith,” we reach out to
other superficial attractions both the sick person and
allure us, no matter how the network of family and
many times we may have friends gathered around the
fallen, the human spirit ill person, striving to build
remains always attracted to from family and friends,
freedom, and our Lord has to the local congregations
entrusted to the Church the and communities, to the
message of the truth that sets us free” larger community, radiating circles of support
(Jn 8:32).6 As a Church that heals, we are called for those who are in need. Just as the illness
to approach those whose minds and hearts have of an individual can affect all those around
become clouded by chemical dependency or the person—as can be heard in the father’s
troubled with mental challenges, to offer them almost desperate plea, “if you can do anything,
a hand outstretched in compassion along life’s have compassion on us and help us”—so our
road, to restore the lost hope and missing love, response as the Good Samaritan must engage
and to be part of the sometimes long process not only those suffering from behavioral illness
of making hearts whole again and rebuilding but their family members and friends affected by
shattered lives and families. it as well.
In my first pastoral letter, I taught that For at least a generation, scholars in all
“The relationship of reconciliation, aspects of health have established that health,
healing and salvation are recurring themes in including behavioral health, begins where we
Luke. Jesus called his followers to repentance live, work, play, and pray.7 In a truly healthy
and to a transformation of their old attitudes Appalachia, all would have the opportunities
and way of living into a radically new set of to make choices that would enable them to live
relationships and attitudes. The Sacraments of long lives, full of well-being. Communities,
Anointing of the Sick and Reconciliation are schools, and our parish churches would work
concerned with the healing of body, mind, heart together to overcome the negative aspects of
and spirit and restoration to the community.” a family’s economic situation or background.
As a Church, we pray that those living with Recognizing that “the lower a person’s social
addiction or mental illness will always have and economic position, the worse his or her
family members, friends, and caring community health,”8 the people of faith in West Virginia,
who, like the father who brought his son to responding as the Good Samaritan, see a call to
Christ for healing with the simple plea: work together to ensure the health, including
4 Hearts Made Whole
the behavioral health, of all citizens of our state. “Today the Church is being called not
simply to change but to transform the health
It is no secret that West Virginia is,
of her communities, rebuilding and restoring
economically, a relatively poor state. Certainly
in such a way that equitable opportunities for
there can be a link between poverty of social
health are available to all and a new vision of
and economic resources and poverty of spiritual
what it means to be a healthy community is
resources. The stress of living in poverty and
created. We, as members of the body of Christ,
being deprived of access to needed services can
can no longer, however, afford to let our fellow
lead to depression and despair, which may, in
family members and neighbors wait until they
turn, lead to substance abuse. A situation arises
are broken for us to reach out and attempt to
in the lives of some that creates a continuing
support their health.”
cycle, eventually eroding all hope.
In this pastoral letter, I want to share
But before considering how we can
with you some of the approaches and practices
contribute to the well-being of our families
suggested by your fellow West Virginians in
and of our community, in order to decrease
their work as the Good Samaritan among those
the chances of our neighbors falling victim to
living with behavioral health challenges. Many
addictions and mental illness as they travel
of these approaches are inexpensive and the
along the ribbons of highway, it is important to
result of consistent effort on the part of people
assess the situation in West Virginia regarding
of good will. As people of faith, we should
addiction and mental illness.
be willing to contribute materially to proven
treatments for the chemically dependent and
for the mentally ill; we should also give careful
attention to the healthiness of where we live,
work, play, and pray. As I noted in A Church
That Heals:
Hearts Made Whole 5
Needs Not Being Met
A
study prepared for both as individuals and as members of families
Mental Health America of those affected, it is surprising to discover
has ranked West Virginia that the National Alliance on Mental Illness
among the highest gave the state a solid “F” grade for its response
in terms of rates of to serious mental illness in 2009. In part, the
depression and suicide.9 low assessment was caused by lack of places in
At the same time, the psychiatric facilities and by failures to involve
U.S. Department of Health and Human Services families and communities as effectively as they
found that the state’s population is above the could be in the overall response to mental
national average in per capita use of illegal drugs illness.13
and in the non-medical use of pain relievers.10
Aware of such findings, West Virginia’s
Average Number of Poor Mental Health Days in Past 30
legislators have taken a hard look at how Days among Persons Aged 18 or Older, by State
the state responds to those suffering from
substance abuse and mental illness. In 2006, the
legislature created a Comprehensive Behavioral
Health Commission, having found that
“the behavioral health system in West
Virginia is rapidly moving toward a state of
crisis as a result of overcrowding of the beds
in state facilities and prisons, and inadequate
community support services to prevent these
problems… these untreated problems and lack
of services are directly linked to increases in
fatalities, penal incarcerations, suicides, increase
in welfare rolls, homelessness, school dropout
rate increases, teenage pregnancy, excessive
employee absenteeism, underemployment,
unemployment, higher workers’ compensation Source: 2006 Behavioral Risk Factor Surveillance System.
costs and many other health, criminal justice,
social and personal problems which cost our
The impact of substance abuse on West
society millions of dollars each year.”11
Virginia families extends to children in the
A 2007 study conducted for the state’s womb: one study found that one out of five
Bureau for Behavioral Health and Health babies born in this state has been exposed to
Facilities estimates that 182,000 adult West substantial drug or alcohol use by its mother
Virginians suffered from mental illness and during pregnancy.14 Such children have to be
152,000 had a problem with illicit drugs or treated for addictions themselves.
alcohol.12
Meanwhile, the national Centers for
In light of the widespread impact of Disease Control and Prevention concluded in
behavioral health issues upon West Virginians, 2007 that West Virginia has the highest death
6 Hearts Made Whole
rate from drug overdoses in the nation.15 West suffering from chemical dependence and, or,
Virginia shares in a disturbing national trend mental illness would not only aid our brothers
among rural youth using methamphetamines, and sisters but also aid West Virginia society
pharmaceutical drugs, and alcohol at a greater in the long term. The U.S. Substance Abuse
rate than those in the suburbs and cities.16 and Mental Health Services Administration
reports that for every dollar
spent on substance abuse
treatment, society gains
seven dollars of savings
in greater earnings and
decreased crime.19 The
Bureau for Behavioral
Health’s report found
the state’s spending on
behavioral health to be
inadequate, often resulting
in the redirection of the
“treatment” of the mentally
ill to public services whose
personnel are in many
In November 2009, Governor Manchin told cases poorly trained or wholly unprepared
the West Virginia Partnership to Promote to address the unique needs of those with
Community Well-Being, “We are experiencing behavioral illness:
alarming trends in prescription drug abuse, “Under-funding of West Virginia’s
the use of illicit substances, and under-age mental health system shifts the burden to law
drinking.” The Governor then called for a enforcement, courts, corrections, regional
sustained effort to address these scourges.17 jail authorities, child welfare agencies, other
The massive costs associated with juvenile services and local school districts.
substance abuse and mental health treatment Under-funding mental health and substance
were summed up by the 2007 Bureau for use services shifts treatment costs including
Behavioral Health and Health Facilities study: counseling and other services to other areas of
government.”20
“This report reviews over 25 areas
It is widely known that “in counties
spanning health care, criminal justice, federal
across the country, jails have become our
costs, and other social costs to capture the
nation’s de facto mental health providers.”21
major direct and economic costs attributable
Called to responding as the Good Samaritan,
to mental illness and alcohol and other
we cannot neglect the needs of our brothers
substance use.… Our findings estimate the
and sisters with behavioral illness; nor should
total fiscal year 2006 impact to be about $3.6
we add to the burden already upon them by
billion. The combined direct and indirect fiscal
assigning their care to law enforcement agencies.
impact represents approximately 6.7% of the
Indeed, in our desire to be compassionate,
gross domestic product for the state of West
we should insist on the adequate funding of
Virginia.”18
effective treatment for addicts and the funding
Experts are clear that public funds
of programs directly aimed at treating mental
intelligently invested in treatment for those
illness within local communities.
Hearts Made Whole 7
Along with more funding of behavioral consumers and peers are actively engaged as
health programs and funding which will prove ‘providers’ in the system. A higher expectation
financially prudent in the long term, researchers is voiced for consumers to take responsibility
call for compassionate and creative approaches for their personal well-being and healthcare
by all in dealing with those enmeshed in needs.”23
chemical dependence and, or, mental illness. In a discussion of “community based”
The WV Comprehensive Behavioral Health responses to behavioral health problems, the
Commission insisted that attitudes of rejection Commission highlights the place of family and
should be reversed: of educational institutions especially in the case
“The stigma associated with behavioral of children:
health has had a negative presence in West “Families, as they are able, should have
Virginia for too long. Addressing the stigma participation in decisions regarding children
issue often gets low priority and little action.… and in the therapy of the children/youth. Early
West Virginia has clearly not done nearly identification and intervention is essential,
enough stigma reduction associated with mental which would require adequate funding of
health.” school-based programming.”24
Reducing stigma is certainly in part a As the testimony of the many people
matter of investing dollars in education efforts, across the Mountain State who participated in
but it is largely a matter of sustained effort by the listening sessions reveals, both economic
people of good will. And this is precisely where resources and spiritual resources, especially the
we, as a Diocesan Church, called to be the Good spiritual resources that are available in families
Samaritan, can be the most effective. Recalling and communities, should be devoted to the
the context of the parable itself, we become healing of addicts and the mentally ill. As we
the neighbor of those who are struggling with strive to make whole the hearts of suffering
behavioral health issues when we treat them brothers and sisters, each of us is called to
“with mercy,” binding up their wounds and respond as the Good Samaritan, to give with
pouring in the oil of compassion. This step, compassion and to give the best we have to
overcoming the social stigma placed on those offer.
living with behavioral health issues, is the one
where, as a people of faith and A Church That
Heals, we can and should provide the leadership
and example.
The “Common Vision” of what the ideal
situation would be in West Virginia regarding Paul Weigel,
addiction and mental illness points to the school counselor at
themes of home and community as important Wheeling Catholic
aspects in the process of healing: Elementary School,
talks to student,
“There is significant presence of
Bailey Nixon.
community-based behavioral health programs
and services with greater direct community
involvement occurring across the state, with
little or no stigma existing for the individual
and an overall improved image of the behavioral
health system in West Virginia, in part, because
8 Hearts Made Whole
What the People Said
M
y brother Bishops of Appalachia order to better understand your own challenges
wrote in their landmark Pastoral and joys, your anxieties and hopes. It was
Letter This Land Is Home To Me: my principal goal to become better informed
about the day-to-day realities that many of you
“we must continually take
face in dealing with a behavioral illness, either
time and invest creativity into
substance abuse or mental illness, in your own
listening to our people, especially
lives, in the life of a family member, or in the life
the poor. For it is they who, out of
of someone for whom you care.
their frustrations, dreams, and struggles, must
lead the way for all of us.” In these listening sessions, people
In their pastoral celebrating its twentieth from all ages, races, income levels, educational
anniversary, At Home In The Web Of Life, backgrounds, and work experiences shared
(1995), the bishops responded to that earlier their stories. Clergy and laity, members of large
call by holding extensive listening sessions and small parishes, participated. Listening
throughout Appalachia as part of the study sessions occurred in prisons, schools, hospitals,
process. In like manner, and similar to and halfway houses. Mental health workers,
the wonderful experience involved in the addictions counselors, and other medical
preparation of my Pastoral Letter A Church That professionals, social workers, officers and
Heals (2006), I asked for a wide consultation to administrators of correction facilities and
be done among the faithful and people of good the courts were encouraged to share their
will in preparation for this pastoral letter. experiences; so too were people in recovery
from various serious addictions as were those
All across West Virginia, in each of
struggling with mental illnesses or chemical
its distinct regions—from Charleston in the
dependency. Most importantly, I believe,
Kanawha Valley to Shepherdstown in the
we listened to you. What I believe we heard
Eastern Panhandle; from Weirton in the
was, indeed, pain, loss, and heartache. But,
Northern Panhandle to War in the Southern
I also believe we heard strength, will, and
Coalfields—listening sessions were conducted
perseverance.
among the people of this Mountain State in
In these listening sessions, a description
of good behavioral health was sought: how it
is nurtured, and what are the obstacles and
challenges? I specifically wanted to learn from
the good people of West Virginia, trusting in
your love of Christ, what the Church’s response
could and should be. I found your responses
touching, your hopes eloquently expressed, and
your insights truly wise.
As a result of these listening sessions,
and as a Diocesan Church seeking to respond
in the person of the Good Samaritan to our
brothers and sisters living with behavioral
illness:
Hearts Made Whole 9