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         Mental Illness
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‘Out of the depths

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A Practice Profile in a Mental Health Service

Mark Boyce

My role as a Chaplain is varied and constantly evolving, and adapts to the needs of the people that I see. My chaplaincy role is supported and financed by the Uniting Church, whose insight and preparedness to support this role deserves recognition. I am also grateful to the Mental Health Service which, over a period of time, has recognised people’s spirituality and the need to have a Chaplain working in the service.

As a Chaplain to the Northern Adelaide Mental Health Service I work within the Lyell McEwin Health Service. The hospital is currently undergoing major renovations and there will be a new 30-bed Psychiatric Unit on site by Christmas 2008. The Mental Health Service provides a service to approximately 1600 people in the Northern Area. Currently my role is divided into four main areas. Initially I have a responsibility to the regional hospital in the northern metropolitan area of Adelaide. In the hospital we have a team of Chaplains who work very ecumenically to provide a pastoral service to all those in the hospital. I have a main responsibility for the Psychiatric Unit, and also provide a resource base for the other chaplains around mental health. I am on call as part of the team, and also take referrals from other wards in the hospital in regard to mental health matters. Offering support to staff within the mental health community is part of my task. Additionally, I have a role to those in the community who experience mental health issues and often have referrals from people in the community. There are a number of people in the community that I continue to support on a regular basis, and I also make connections with local congregations, with the idea of assisting congregations to provide places for people with mental illness to be able to come and worship and have a supportive community.

A part of my task is to work alongside churches in the local community. I provide a consultancy service to church leaders and people in congregations, facilitating groups around issues that deal with mental illness, supporting people in local congregations who experience mental illness, and trying to create an environment that is friendly towards and supportive of people with mental health problems. I realise that the church as a community has a role to play in people’s recovery, and it is important for me to support this and enable the church to provide safe spaces for people who experience mental illness.

People began to ask to come to church with me. The particular church I attended had a 10 am service and was basically a 4-hymn sandwich that often hindered me from worshipping God, and did not relate to the group I was working with. (A 4-hymn sandwich is a service that has everything sandwiched between 4 hymns!) I felt that people needed a more contemporary, interactive and tactile service. A group of us from the morning service arranged an evening service preceded by a meal, and served coffee and tea afterwards. We chose to run an evening service because many of the people that I worked with found it hard to get up in the morning, and the service format allowed people to interact more freely. We started once a month and now meet on a fortnightly basis. People who have experienced illness come to worship with us and feel accepted and valued.

Another initiative was the development of a worship service at one of the community day rehabs. For some people the thought of going to church was not an option: they found it hard to enter a church for fear of being stigmatised, and some also held the belief that God would not accept them because they were not good enough. Nevertheless, they wanted a way to worship, and so the idea of a church service at the rehab unit itself was developed. The service was developed by the clients, which incorporated their definition of worship The service is 40 minutes long, must always have communion and is more tactile (using candles and rocks). The sermon itself comes from people talking about what the scripture means to them.

Some of the resources we have developed have come from people’s experiences and needs. A psychologist colleague and I have developed a manual on grieving and mental illness. It is not fully completed, but still I use it for people that I work with. We realised that many people grieve over having a diagnosis of mental illness. There are many losses and changes involved: loss of job, status, role, power, friends, family, housing, experiencing stigma…and the list goes on. We worked on developing a 10-week group process manual to assist people in their recovery. Another resource is a group program that I facilitate at the day rehab programs. This program began through a group that together would generate the topics to explore, and as facilitator I would generate some ideas. Topics were then discussed as a group with the idea of creating a program that valued people’s experience and allowed them to use the knowledge gained to continue people’s recovery in a healthy manner. The topics covered are:

• To assist participants to change or adapt their perceptions of people who experience mental illness and for people to use language that does not isolate or blame and that maintains a holistic focus. Often carers will be so focused on the illness that the people who experience the illness get lost, or blamed, or made to feel that they are useless or worthless, or lesser than others.