Missionary Mental Health, Member Care, and a Metaphor - by Mary

The purposes of person's heart are deep waters,

but the one who has insight draws them out.

-Proverbs 20:5:

Spoken:

"We boarded a plane and flew to a remote village in Papa New Guinea for a month of intensive language learning..."

"Her blood pressure dropped, as we scrambled to push IV fluid into her emaciated body...she survived the night, it was a miracle!"

"Since my arrival, the other missionaries have been so helpful with showing me the ropes, I'm so grateful!"

"Our daughters have to cover their heads every time they leave the house; at first they didn't like it, but now they realize it helps keep us safe from the local men..."

What do all the above quotations have in common? They are what you might expect to see in a newsletter, blog, or prayer email from a missionary overseas. Growing up, my parents supported several long-term missionaries, and every time a new prayer-letter arrived she would pin it to a bulletin board in our kitchen. I used to read those letters while eating breakfast, digesting stories about remote African villages, heroic medical rescues, brave Bible smugglers, persecuted churches, inspiring sacrifices. I would look at all the pictures -- smiling nuclear families, doctors with arms around their healed patients, newly dug wells, ongoing building projects -- and dream of the day when I could become a doctor and work overseas, perhaps taking similarly inspiring pictures and/or sharing similarly classically heroic stories. 

As you may have guessed, I am foreshadowing my main point: missionary life is often not ideal, heroic, glamorous, or inspiring. With just six months in Africa myself, I have heard, seen, and personally experienced numerous challenges that I am not able to share or, if able, not comfortable. The years of expectations of what missionary life would be like left me with a feeling of just that - expectations of what missionary life should be life, instead of what it is like. Behind every of the above phrases, now I know there are behind-the-scenes experiences that too often go unshared...

Unspoken:

"Alone in the remote village, I began to have trouble sleeping. I never knew following my calling to serve God overseas would feel this lonely. I shared feelings of depression with my mission agency; their reply encouraged me to trust God and committed to pray for me, but didn't give me any other options for support and treatment. Why do I still feel sad all the time?"

"My patient died a day after I wrote the prayer letter. I've had nightmares of her resuscitation and find myself going over and over in my head what I could've done differently. I feel guilty all the time about losing patients, though I know logically there was nothing else I could've done."

"The other missionaries were helpful at first, but now I wish they'd leave me alone. I feel as if they are interrogating me about theology and picking apart any differences of opinion, even on disputable matters."

"My daughters don't seem to mind covering their heads, but I mind and am starting to notice my own resentment. My nearest expat neighbor is hours away, and never seems to struggle; how can I confide in her, or anyone, without appearing like a complainer?"

Over time, missionaries and mission agencies have begun to recognize the need for 'member care': ideally, this would include a confidential, safe forum for people to share, process, and begin the process of healing from experiences, emotions, and illnesses related to their calling. Some agencies like AIM have over the years developed centers for such work, such as Tumaini Counseling Center in Nairobi, Kenya, with a new satellite site in Kampala, Uganda. Others, such as SIL, have counselors and therapists on staff at major hubs. Still others are in a phase of investigating the whys and hows of member care and/or in the meantime can tap into resources available from other agencies.

Our time in Nairobi:

We spent two weeks observing and learning at Tumaini Counseling Center (http://tumainicounselling.net/). The wisdom, patience, experience, mentorship, and faith of the psychiatrists, psychologists, social workers, and staff were invaluable. I left with a longing to learn more about trauma counseling and member care. One particularly poignant metaphor used by staff came on our last clinic day. Displaying a picture of a "Purple Heart," a staff member described how these are awarded to service members who have been wounded in battle. She then went on to describe how missionaries struggling with mental health issues are just as much "wounded in battle." The battles are numerous and varied, but the motive remains the same: individual sacrifice and suffering for a greater cause. Given the stigma, discrimination, guilt, and shame that often surround mental health struggles, I am encouraged and challenged to look for metaphors and similes that can reframe the discussion and encourage people to seek care and healing. 

For anyone interested in learning more about Member Care, the following links have good resources and information:

• Tumaini Counseling Center Resources Page
• Mental Health in Missions Conference
• DocsJoiningHands