Today’s blog post is an open response to a question I received in an e-mail a couple of days before Christmas from a highly respected and valued ministry colleague and friend.
Is mental illness a disability? Many of the definitions (NAMI, etc.) for mental illness that I find do not include the word “disability.” Would I expect to find a person with mental health struggles (depression, bipolar, schizophrenia) to be a part of our disability ministry at XXXXXXX Church? No. For me, mental illness is a separate…and much needed…ministry within the church. Is this a topic that the special needs community would expect Key Ministry to address?
How do you define “disability?”
Webster’s Dictionary defines disability as a condition (such as an illness or an injury) that damages or limits a person’s physical or mental abilities.
Under the Americans With Disabilities Act, an individual with a disability is a person who: (1) has a physical or mental impairment that substantially limits one or more major life activities; OR (2) has a record of such an impairment; OR (3) is regarded as having such an impairment.
The World Health Organization defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).
How do you define mental illness?
The National Alliance for Mental Illness (NAMI) states that a mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning.
The U.S. Centers for Disease Control defines mental illnesses as disorders generally characterized by dysregulation of mood, thought, and/or behavior, as recognized by the Diagnostic and Statistical Manual, 5th edition, of the American Psychiatric Association (DSM-5).
I’ve been pondering this e-mail for several weeks…because of the person who sent it and the questions they raised …questions that are absolutely fundamental to the future direction of the disability ministry movement and fundamental to the future mission of Key Ministry.
I was very surprised by my friend’s first question, because in my mind, the answer is so clearcut. Is mental illness a disability? ABSOLUTELY. The answer is so obvious that the question seems absurd. Here’s a 2011 article in Pediatrics examining trends in the prevalence of developmental disabilities in the U.S. from data obtained from the National Health Information Survey…for the purpose of this survey, developmental disabilities are defined as lifelong conditions arising in early childhood as a result of cognitive or physical impairment or a combination of the 2.
Note that ADHD is listed as the most common developmental disability. Autism is, by the definitions above, a mental illness. Remember the controversy when then diagnostic criteria for autism were revised last year by the American Psychiatric Association?
The National Institute on Mental Illness (NIMH) makes the following statement, based upon data compiled by the World Health Organization (WHO):
Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada.
My colleague’s next question is far more interesting…and the subject of our next post.
Would I expect to find a person with mental health struggles (depression, bipolar, schizophrenia) to be a part of our disability ministry at XXXXXX Church? No.
Why wouldn’t we expect people with the most common cause of disability in the U.S. to be served by our existing disability ministries? My colleague is absolutely right…they’re NOT currently being served. Why not? Is that a good thing or a bad thing?
I very much encourage or readers to add their thoughts and comments.
Pictured: Tasso in the Madhouse by Eugene Delacroix
Confused about all the changes in diagnostic terminology for kids with mental heath disorders? Key Ministry has a resource page summarizing our recent blog series examining the impact of the DSM-5 on kids. Click this link for summary articles describing the changes in diagnostic criteria for conditions common among children and teens, along with links to other helpful resources!