‘Spiritual support groups’ create space for Catholics with mental illness

“God, by no means, has abandoned people with mental illness”

More than one in five adults in the U.S. lives with a mental illness. One in 25 lives with a serious mental illness, such as schizophrenia or major depression.

For Deacon Ed Shoener, these statistics are more than mere numbers. In 2016, his daughter Katie died by suicide, after a long struggle with bipolar disorder.

Shoener penned an obituary that honored his daughter and exhorted their small Scranton, Pennsylvania community to support those struggling with a mental illness. To his surprise, the message resonated far beyond its intended audience.

“I didn’t want a lot of gossiping or murmuring as to what happened,” he told The Pillar. “So I was just quite open — ‘Katie had bipolar disorder. She died by suicide, but she’s not defined by those conditions, and we need to do better in helping people with mental health challenges.’” 

“You know, much to my amazement — because neither Katie or I are a celebrity — this thing went viral and got picked up and covered all over the world, literally.”

Many people reached out to Shoener to affirm their sense that the Church should be more present for people living with mental health challenges, as well as for their families.

Shoener thought that response was confirmation of work he had already begun within his own parish, before Katie’s death: spiritual support groups for those suffering with mental illness.

The deacon initially had the idea to start the groups after Katie tried to join a support group in Columbus, Ohio, where she was living at the time.

“She finally got up the guts to go to a meeting, and she got there, and there was a sign on the door saying the meeting was canceled for the day. And that kind of broke my heart,” he said.

“Talking to Katie and other people, I thought it would be a good idea to have a spiritual support group, not a clinical but a spiritual support group, a faith-sharing group, and, you know, make sure we never canceled the meeting.”

The distinction between the spiritual and the clinical is important: The support groups are not treatment, and they are not intended to replace professional care. Rather, they provide a space for their participants’ faith and mental health struggles to intersect, which is not always the case in a clinical setting.  

“This ministry is just a ministry of understanding and accompaniment, and encouraging people to get mental health care,” said Shoener.

Shoener told The Pillar he has connected with other Church leaders around the country who share his dedication to mental health support. 

Among them is Bishop John Dolan, then-auxiliary bishop of San Diego, who himself has lost three siblings and a brother-in-law to suicide.

In October 2019, they formed the Association of Catholic Mental Health Ministers (CMHM), which offers educational and training resources for those interested in starting spiritual support groups within their own communities. Today the association has nearly 1,500 members globally, Shoener said.

Shoener continues to facilitate two support groups at his parish, the Cathedral of St. Peter in Scranton: one for those with mental health challenges and one for caregivers of individuals with mental health challenges. Two additional facilitators ensure that they don’t have to cancel a meeting if one of them is sick or out of town.

“God, by no means, has abandoned people with mental illness,” said Shoener. “So it’s important that his Church minister to them.”

Talking openly about faith and mental health

A spiritual support group meeting usually starts with a  prayer, followed by a time for sharing. In Shoener’s group, the facilitators ask everyone how they’re doing on a scale of one to five, five being “not so good,” and then let the fives share first whatever they need to talk about.

There’s time for socializing, often with refreshments. Toward the end of the meeting, participants make time for some sort of extended prayer, he said: a rosary, for example, or the Stations of the Cross. 

The format can vary from place to place. 

Kate Fassbender, who worked for CMHM while her ministry with individuals with dementia slowed during Covid, told The Pillar that the frequency of meetings is determined by the needs of each group. Some meetings end with personal reflection and prayer rather than a structured group prayer.

The success of the groups depends on the safety of their environment. All meetings are confidential — Shoener also noted that they’re held in off-times at his parish to reduce visibility — and participants are asked not to offer each another advice or correction, focusing instead on offering a listening ear.

“And kind of individually, the group sets their own ground rules in addition to that,” explained Fassbender. “So if we see each other at Mass, how do we acknowledge each other? Do we ignore each other? Do we acknowledge why we know we exist other than the fact that we’re both members at the same parish?”

Meetings typically run between 60 and 90 minutes, she said, and participants often linger.

“It’s where we can share our experiences of faith and mental health and the challenges of staying close to God in the midst of what can sometimes be a very difficult situation, a lot of suffering,” explained Shoener, who himself lives with depression. 

“It’s not all bad,” he added. “There are moments of recovery, and there are moments when people do well — so we share stories of our struggles, but also successes and good news.”

Likewise important are the groups for people who support someone living with a mental illness — mostly parents, he said, but occasionally grandparents or siblings.

“As you can imagine, when you have a kid and your kid, you know, out of the blue attempts suicide or has to be admitted to a psychiatric unit, you wonder where God is and where the Church is and where to go to find support,” said Shoener. “Take it from me: It can be a very isolating experience.”

Parents tend to come to meetings during seasons of crisis. Those living with mental health challenges, Shoener said, are remarkably consistent.

“They keep coming back because it does help them in their recovery,” he said. “It helps them to openly talk about their faith, and be reassured by hearing the stories of other people that God has not abandoned them, God’s with them in these struggles. They get a great deal of strength by praying together.”

Maintaining appropriate boundaries

While spiritual support groups might aid participants in their recoveries, Shoener emphasized that they cannot replace mental health treatment.

“An important part of this ministry is to realize our boundaries, to realize that we don’t do anything in the way of treatment, that we recognize these illnesses as real illnesses, and mental health care and psychiatric treatment are gifts from God, too, just like any other medical care,” he said.

Most participants already work with a professional clinician or care team when they begin attending meetings, explained Jennifer Housel, executive director of CMHM. Some clinicians familiar with the ministry even refer their clients to the support groups.

“Some people who are considering beginning a mental health ministry are concerned that someone’s going to come in who has severe mental illness who is not in any kind of recovery or treatment process, and we can reassure them that, most often, people coming to mental health ministry are already somewhat on their path in recovery,” she told The Pillar.

“It’s the college professor who doesn’t want his colleagues at the university to know he lives with a mental illness,” described Shoener. “It’s the high school teacher, it’s the clerk in the store.”

Fassbender noted that organizers prefer that practicing clinicians are not directly involved with the support groups, to avoid blurring their professional boundaries.

But would-be facilitators need training before they can start a ministry. The organization offers many educational resources themselves; they also use the Mental Health First Aid curriculum, which in large part teaches trainees how to recognize which situations need a referral to clinical health care and what is appropriate for a lay person versus a clinician to offer.

Some dioceses have struggled to get ministries off the ground, Fassbender said, because they are concerned about legal liability regarding suicide risk. But as long as the support groups stay within the “ministry” realm — that is, facilitators are not claiming to run a practice or offer treatment — there are no liability issues, she explained.

“It really is just accompanying, listening, understanding, and reminding the person living with mental illness that the Church has not abandoned them,” she said. “That God has not abandoned them.”

But while the ministry’s sensitivity requires education and extra care in its implementation, some of the obstacles that come up are more ordinary: hesitant parish leadership, for example, or schedule disruptions.

“It’s just the same obstacles that anybody has with any parish life ministry,” said Housel. “This ministry is like every other ministry and will have those same bumps and challenges that, hopefully, with God’s grace, can be overcome.”

Growing awareness

The Diocese of Phoenix, which has been led by Bishop Dolan since last year, is now beginning to implement a diocesan-wide vision for supporting people living with mental illness.

Maricela Campa, who leads the diocese’s Office of Mental Health Ministry (and is a board member of CMHM), told The Pillar that the goal is to run spiritual support groups first in its deaneries, then in individual parishes. 

Currently the office is at work giving clergy, religious, and lay staff a kind of “Mental Health First Aid” training, she said. 

Bishop Dolan also instituted an annual Mass of Remembrance for People Who Died by Suicide, which the Phoenix diocese holds in September, Suicide Prevention Awareness Month.

But there are even more accessible ways by which parishes can let people living with mental health conditions know that they are not alone. 

“Talk about it in homilies,” said Housel. “Talk about it in prayers of the faithful — just to include in your prayers of the faithful, ‘Today we pray for all those who struggle with mental illness and for those who love those who struggle with mental illness.’ … It can have an enormous impact on something that they may feel like is unseen and not wanting to be seen.”

On an individual level, Shoener encourages rooting out the stigma associated with mental health challenges  — both in how people view others living with mental illness and in their own hesitance to seek professional help when they need it.

“Most people will go get treatment if they have an ache or a pain, for physical treatment,” said Shoener. “A lot of us are reluctant to acknowledge we have a mental health problem, and we won’t go get the treatment.”

Within Catholic circles, there can be a tendency to “over-spiritualize” mental illnesses, Campa observed.

“That’s the awareness that we’re trying to raise through education,” she said. “If somebody needs [mental health care], it’s out of your scope of work, it’s not okay to continue to say, ‘Just go pray about it a little bit more.’ Or, ‘You’re not praying hard enough.’”

“Even more seriously, if you’re starting to think about suicide, if that’s something that’s crossing your mind, you’re not a bad Catholic,” Shoener urged. “That’s just something that’s going on in your mental health and your brain … Go see a doctor and get some treatment and try to understand what’s going on.”

Shoener hopes the Church continues to become more involved in supporting people living with mental illnesses. And he believes that they in turn have a lot to offer the Church.

“They have a lot to show us about how to live with suffering, how to live with humility,” he reflected, “and how to live with the grace of God in your life in the midst of all of this.”

If you are in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

This article is part of The Pillar’s solutions-oriented series highlighting parishes across the U.S. You can read more from this series here.