One afternoon, I received a call from a professor who had found something disturbing on a student's drafting table. As dean of students, I went to investigate and discovered a rash of obscene and violent messages depicted in both art and written form. So I confiscated what would be needed to document the handbook violations and assigned a member of our residence life team to track down the artist.

Close to midnight, I heard from a staff member that our missing student was seen running around campus with his shirt off in the pouring rain. They encouraged him to come in and get dry, but he refused. He bunkered down in a dumpster and was convinced he was in tremendous danger.

With my job title and my degree in counseling, guess who was called in for garbage duty?

It took a while to get this young man out of the dumpster and into the dorm, and even longer to get him to go to the hospital with me for an evaluation. Once there, thanks to a release the doctors encouraged him to sign, his history of mental illness was revealed. We learned his supply of medications was depleted, and he had stopped receiving the stabilization he needed to function appropriately.

We gave him every opportunity to return to school and to complete his degree, but it didn't work out. He eventually returned home to enroll in long-term psychiatric care.

People on campus thought we expelled him for his behavior, but that couldn't have been further from the truth. We just don't disclose mental health situations over the campus e-mail. Even when accused by others of treating the student unfairly, we kept private information private, and suffered the complaints.

The lessons I learned in my decade serving at a Christian college have served me well in my new role as a pastor. I didn't expect to find so many people affected by mental illness, meds, and their effects.

According to the 2005 Boston University Slone Epidemiology Center survey on the patterns of medication use in the United States, in any given week, 81 percent of adults in the U.S. are taking at least one medication, from insulin to Ritalin, from blood pressure pills to Prozac.

Given that staggering number, it's obvious that a sizable percentage of the people in our congregations are on medications, some of which are mood altering or psychotic behavior stabilizers.

Does this change the way we counsel? Does this change the way we preach?

On the college campus, it became more difficult with each succeeding year to deal with medical issues when evaluating a student's behavior and mental health. This became even harder to assess once the Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996.

HIPAA was instituted by the U.S. Department of Health and Human Services to address the use and disclosure of personal health information. The law was made for all the right reasons; unfortunately, it doesn't always work for the benefit of those who are being protected. Armed with the appropriate consent forms, we college administrators were usually able to learn of the students' medical histories so we could stay alert to their wellbeing.

Colleges are all about developing policies, even for ministry. But what about the local church? How can we uncover the medication issues involved in our body? What do we disclose to the staff or leadership team? And what if the leaders are the ones on Zoloft?

Too often we discover a troublesome medical history by accident—or by incident. And although most pastors aren't medical professionals constrained by HIPAA, we still feel hamstrung about sharing personal medical information.

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Fall 2007: On the Margins  | Posted
Counseling  |  Law  |  Legal Issues  |  Pastoral Care  |  Pastor's Role
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