Religious & Spiritual Leaders

Through education, collaboration and the building of tools for intervention, you can help young people who may be suffering from early psychosis, possibly before they find themselves in a crisis situation. This help is often in the form of recognizing possible signs of mental illness, familiarizing yourself with the language useful to engage with that person, and knowing the best resources in your area to access for care.

According to a nationally representative general population survey of people ages 15–54, it was estimated that approximately one quarter of people seeking mental health care look to a member of the clergy before contacting a service provider. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360908/)

Wang, P. S., Berglund, P. A., & Kessler, R. C. (2003). Patterns and correlates of contacting clergy for mental disorders in the United States. Health services research, 38(2), 647–673. https://doi.org/10.1111/1475-6773.00138

Many people who describe their personal experiences with stigma report feeling shamed or judged for their illness. Delays in getting care are often fueled by stigma surrounding serious mental illness.

Religious leaders can help minimize these feelings of personal shame by fostering inclusivity and openness. It is important to always maintain a positive, shame-free environment to help uplift the safety of all young people. This security and trust can help to bolster pathways for disclosure regarding any mental health concerns an individual may have about themselves or their peers. Religious leaders and their organizations set the tone around mental health awareness. They can formally provide learning resources for young people and their parents that includes normalizing and hopeful language about psychosis.

Situations that require prompt or immediate referral:

When a young person demonstrates threat to their personal safety and/or to the safety of those around them (for example, suicidal behavior, severe aggressive behavior, self-mutilation like cutting, or other self-destructive behavior).

Thoughts of suicide should always be taken seriously and be cause for referral. While a person may not share these thoughts with you, close family members and friends may be aware of concerning behaviors, like withdrawal, giving items away, or suicide attempts, and/or expressions of hopelessness, and bring these to your attention. A person who is expressing suicidal thoughts or behaviors is having a psychiatric emergency and immediate psychiatric evaluation / consultation should be sought. It is important to become familiar with local crisis services in your area. Keep contact information for your local crisis services on hand for easy reference in a crisis. If a person is in immediate risk of self-harm, or has engaged in self-injurious behaviors, call 911/Emergency Medical Services and specify that this is a mental health crisis. In some areas, a responder with Crisis Intervention Training can be requested.

Notice the level of distress and planning:

• How much distress or discomfort do you notice?
• How well is he/she/they managing or coping?
• Are they capable of taking caring of themselves?
• Does there seem to be potential for danger, either to themselves or to others? (e.g., Do they have a plan for suicide/harm? Do they have access to the means by which to carry out that plan? Do they have a past history of attempts/behavior? Do they express desire to die/go to sleep and never wake up? Do they have a support network?)

Ways to Make a Referral for Mental Health Treatment:

• Find ways to communicate clearly about your concern and potential need for referral.
• Make this a collaborative process.
• Discuss similarities and differences of professional clinical care and faith support.
• Reassure support along the healing journey and that beginning professional help does not mean the spiritual support will end.
• Understand preconceived notions that can hinder the process of asking for and receiving professional mental healthcare.
• Have a list of local professional resources at hand.
• Remain connected and check in often, providing necessary spiritual encouragement.

These experiences vary from person to person. Symptoms may be frightening and seem very real to the person having them and may include:

Voices or auditory hallucinations

Hearing single or multiple voices, which can be simple or complex, abusive, neutral or soothing. People may hear whispers or clear/distinct voices; they may describe changes in their hearing acuity (e.g., hearing things from another room); they may describe indistinct or clear noises or sounds (e.g., buzzing/ringing) which are new and/or distressing. They may tell you directly that they are experiencing these perceptions, or you may notice cues in their behavior such as: they may appear to be talking to themselves, looking somewhere and you don’t know why, or focusing on certain body parts.

Tactile or somatic sensations or hallucinations

Body sensations or feelings that are new and strange. These are sometimes described as electrical charges or feeling something crawling on a body part. People sometimes feel that a part of their body has changed in some significant and troublesome way (e.g., bigger/smaller).

Unusual or delusional thinking

Persistent beliefs not shared by others. A young person may report thinking other people are watching them or that they are under surveillance, feeling very good at certain tasks, having a connection to a famous person, or any number of thoughts that are different and unusual. They sometimes report that television, music or other media are communicating directly to them. You may also notice that a student is pulling away in social situations, seems uneasy with others, or makes comments indicating suspiciousness about others’ intentions.

Depersonalization and/or Derealization

Feeling they are an outside observer of their own thoughts, feelings, and actions. Examples are feeling that their speech or movements are uncontrollable or controlled by outside forces, that parts of their body are distorted, or feel their memories are not their own. They may feel alienated from their surroundings, or disconnected from people (as if they were separated by a glass wall). Their surroundings may seem distorted, colorless, two-dimensional or artificial and they may have misperceptions of time and space.

Cognitive disorganization
A person’s speech and writing may become disorganized and/or tangential. They may draw connections between words or terms that seem illogical or non-sensical, or they may have more difficulty than usual following conversations.

Slowing of speech, movement and motivation
A young person may demonstrate changes in the amount, tone, rate, pitch, or rhythm of speech. Psychosis may slow people down and significantly lower one’s motivational energy.

Depression and demoralization
Many individuals with psychosis experience significant depression and/or demoralization.

Coordinated Specialty Care: A Treatment Team

Our programs and programs like ours will typically offer a team of people who will help. Each program is a little different but will often include:

Psychotherapy
Talk therapy to help build personal skills of resiliency, management, and coping.

Supported Employment & Education Assistance
Help continuing to engage in or adjust to school and work goals while receiving care.

Medication Management
If necessary, finding the best medication at the lowest possible dose.

Peer Support
Guidance from those currently on their own recovery path.

Case Management
Skills and support to organize the practical issues presented during treatment. This includes communication with other team members.

Family Support and Education
Tools designed to keep family members engaged and informed.

• Education and training for religious leaders and staff members on the mental health needs of their population
• Utilizing religious facilities and outreach platforms to promote the availability of mental health supports