One of the most enigmatic passages in the Bible is story of the attempted sacrifice of Isaac found in Genesis 22. In this story, Abraham, who, up to now, has been seen as a nearly heroic figure of the faith, comes dangerously close to killing his son. The story raises serious questions about God, the kind of God who might demand such an action of anyone, but also and as importantly about Abraham himself. Could Abraham have heard God incorrectly or have been listening to voices other than God including other internal voices? Put more bluntly, was Abraham losing his mind, experiencing some form of mental illness?
We know Abraham was very old at the time of the binding of Isaac. The biblical narrative indicates he was 100 years old when Isaac was born, and this story occurs up to two decades after that. Advanced age typically goes with some degree of physical frailty. Together these increase the likelihood of some form of cognitive impairment or mental illness being present. Some psychologists draw parallels between Abraham in this story and the presenting symptoms of various forms of mental illness (schizophrenia and psychosis, to name two).
So which is it? Is Abraham a hero or a dangerously deranged victim of mental illness?
Or has he perhaps been a hero who, in this stage of his life, is grappling with mental illness?
And in any of these scenarios, how do we seek to understand and respond to him, and to those around us who are showing signs of cognitive impairment or mental illness?
How do we act to minimize potential damage to self or others that persons dealing with these challenges face or may inflict while maintaining the dignity of all persons involved?
First, we must not hide from reality. This is a challenge in our current context. Less than fifty percent of all persons who have an Alzheimer’s diagnosis are ever informed of their diagnosis. At any given time, within any congregation there are members (estimates I have seen range between 19 and 25%) which already have undiagnosed mental illness, and at least some of these are already raising concerns with others because of bizarre statements, actions, and intentions. Do we ignore the warning signs? Do we hope they go away by themselves? Do we act simply to preserve ourselves or our institutions? If we do any of these things, what does this mean about how we are caring for the individual before us?
Second, we must, as individuals and congregations, be ready and committed to play an active role. I am haunted by a personal experience of a family reaching out to their church for help because the medical community was not taking their son’s chronic mental difficulties seriously nor actively treating them. They asked for assistance in convincing both their personal physician and the county mental health office so their son could be committed to a mental health facility. Just days after they reached out to their church, their son saw what he called demons and then shot 12 people killing six of them. I often think about how this story would have ended if my church had prepared ahead of time a list of mental health resources which we could have drawn upon immediately when his family requested assistance.
Third, this means we need to train our congregations in appropriate care for persons and especially older adults with cognitive disorders and mental illnesses. The fastest growing age sector in the United States is older adults. The largest proportion of persons in many our congregations are also older adults. As older adults live longer, the rates of cognitive impairment and mental illness also increase. So one step in bringing the light of day to cognitive impairment (including but not limited to dementia) and mental illness is to build training about these issues into the regular curriculum of the church, whether through Sunday School, special emphases, small group studies, or other means, with church staff or others with professional experience in the congregation working alongside local organizations who regularly offer such training.
As you take up your role as a church as eyes, ears, hands, and hearts with people who are facing cognitive impairment or mental illness among older adults, remember, we are here to help you! Contact me (firstname.lastname@example.org)! I’ll be glad to consult and connect you to the resources and people who may be most helpful for you where you are.
Selected Resources for Church Leaders
- UMC.org article on mental health and older adult ministries »
- National Directory of Mental Health Treatment Facilities [PDF]
- Alzheimer’s Association website »
- Alzheimer’s Foundation website »
- “Clergy against Alzheimer’s” devotional book, Seasons of Caring »
- Discipleship Ministries Older Adult Ministries on Dementia and the Church »