Rev. Sheryl Wurl on chaplains and mental health patients

Learning from the Mentally Ill

Yelling unintelligibly, the patient jumped off the gurney on which he’d been lying quietly and tore off his clothes. Instantly, patient and security officer were struggling on the floor, both shouting while the rest of us stood back yet as close as six feet away. There was a “pop!” then shrieking from both officer and patient, followed by an intense, burning sensation in our own eyes, noses and lungs: the officer’s mace had been discharged.

I was on-call chaplain that night and we already had three people in trauma bays, with another arriving via the helicopter. Wheezing, tearing-up and coughing, we tried to calm people while, at the same time, preparing for what was coming in from the helipad. Later, I approached the maced officer and then the sobbing patient and his stoic grandmother, asking how I might help. The officer said he was fine; the grandmother asked for prayer to help this grandson who’d been troubled since returning last year from active duty in Iraq; the patient pleaded for “a bullet in my head.” I held his hand instead, murmuring that he was not alone, until he was transported to a nearby inpatient facility.

Just another night at a level-one trauma center, trying to meet the needs of mentally ill people who have few resources and are served by health care professionals with little or no training in mental health care.

I’m lucky in this regard because the places I trained included psychiatrists and psychologists, as well as mentally ill patients and their families. However, I now supervise CPE students at an institution that has neither a behavior health unit nor the staff that such a unit requires. So, my students don’t have the same opportunity I had for engaging appropriately with, and learning from, people with mental illness.

Yet this population is making greater use than ever of our emergency department. Chaplains frequently are asked to intervene, and we respond to a wide variety of situations. Since CPE students have weekly on-calls and report numerous interactions with mentally ill patients, this topic is a vital part of our CPE curriculum at the University of Tennessee Medical Center.

Using the basic premise of clinical pastoral education—that patients are our teachers and that each person is a living human document of divine presence in the world—I used the Internet to ask chaplains for stories of experiences with people who have mental illness. In particular, I asked chaplains to share what interactions with mentally ill people have taught them about mental illness, about themselves, and about the injunction to “love one another.”

Respondents have sent reflections about such concepts as human frailty, goodness, patience, compassion, humility, and kindness. They generously acknowledged mistakes, hubris and fears, thereby inviting my CPE students to accept their own growing edges. I am still collecting responses and plan to post submissions on a web page for general viewing sometime in September 2006. Anyone wishing to be included may send reflections to me at swurl@mc.utmck.edu or call 865-544-9707 for further information.

 

Do you have thoughts about professional practice you’d like to share with your colleagues? Send an e-mail info@PlainViews.org.