20 November 2011
The Feast of the Reign of Christ
As a way to begin, it came to me of the importance of stories and how Native Americans and other groups throughout history have told stories about their lives or community as a way to communicate themes and ideas to each other. This is a tradition that is often lost in our very Western linear world but that our Native American brothers and sisters still retain as part of their culture. When I have been at meetings with tribal groups, I am often reminded that stories can be important and speak at a deeper level to us.
Therefore, in thinking about this sermon, I’m going to share three stories and some major themes within each of them—the first story is Paul’s story and his Letter to the Ephesians; the second story is a recent story of a youngster who was abandoned at Children’s Hospital and was written up in the Post; and the third story is about a movement within the children’s mental health field to create systems of care and my own involvement in this field over many years.
Each story has some critical themes or challenges in them, including my story.
My hope is that folks will discover for themselves some “super theme” that emerge out of these stories.
Story #1—Paul’s Letter to the Ephesians
Starting with Paul’s story, let’s look at the context for his Letter to the Ephesians. Ephesus was located at the mouth of the Cayster River on the west coast of the Roman province of Asia (Asia Minor) in what is now western Turkey. It was an important commercial port city. Ephesus was a major population center and the capital of the Roman province of Asia. It contained a theater that was one of the largest known of all that have remained to modern times. It was a center of learning and was positioned near several key land routes in western Asia Minor. It was a bustling town on many trade routes, with many independent communities surrounding it. Can’t you just see the bustling metropolis that Ephesus was in those days?
The Church in Ephesus was started by Paul while returning from his second missionary journey (probably around 53 AD). He only stayed briefly, promising to return. Paul’s Third Missionary Journey (54-58) saw his return to Ephesus where he stayed for about three years (probably 54-57). When some of the Jews who had negative feelings against the gospel of Jesus began persecuting those who believed in Jesus, Paul turned to the Gentiles. From Ephesus the gospel spread throughout the whole province of Asia. At the end of this three year period, Demetrius, a silversmith, led a riot in Ephesus attempting to get rid of the young church there, for its teaching on one true God was harming his business. Guess what his business was? It was making idols. Anyway, this uprising seems to have confirmed Paul’s feeling that it was time to leave, and so he said his good-byes to the elders and fellow Christians of the Church, charging them also with its leadership. Paul never visited Ephesus again
However, later Paul was imprisoned several times for his Christian witness, and it seems most likely that the Letter to the Ephesians was written from prison in Rome in the early 60’s AD. While in prison, he had the freedom to receive friends and send letters to others. He also wrote letters to the Philippians, Colossians and Philemon, during this period of imprisonment. It would seem that the Ephesian letter was meant to be received by a much wider community and dealt with general issues. While there is some controversy about whether Paul himself really wrote this letter, overall, the Letter to the Ephesians explained Paul’s view of the 1) unity of the Church under Christ and 2) the way Christians should relate to each other in view of this and under God’s plan.
Given this historical background story, in our scripture for today (Ephesians 1:15-23) Paul reminds this little group of Christians that God’s power as demonstrated by His resurrection of Jesus signals the greatness of God and his “mighty strength” to accomplish deeds here on the earth. The message for his group of followers and for us is that God is in the Power Position—God’s power as shown through a risen Christ– even when the darker powers of the world seem to be dominant.
So, how do we know that God’ power is moving in the world? Since this seeing was as difficult in the ancient time as it is in our modern world given many negative things happening, (remember that Paul is writing this Letter from prison) Paul prays for his Christian friends and for us, that God will “illumine the eyes of our hearts” – so our eyes can see the whole and not just the negative or our own narrow vision of reality. This is the HOPE to which God through Christ is calling the disciples in Ephesus —that together they can become “aware of the hope to which He is calling you” ……that they can see the possibilities for a better future…… that we can take part in creating that future, ……..and that His Power thru Christ is at work above everything else.
Story #2—Troubled Boy Stranded at Hospital
I’m shifting now to the second story but also need to say that one never really knows all of the reality of a situation mentioned in a paper but this Post story does serve as an example.
On Oct 27th 2011, the headline, “Troubled Boy, 10, is Stranded at Hospital,” ran in the Washington Post and told the story of a boy, age, 10 who had been abandoned by his mother who lived in PG county after being placed at Children’s Hospital in DC in early September. He was place initially by his mother after he stabbed his cousin in the eye with a pencil and spoke of killing himself. He had been violent, depressed and a danger to himself and others when he was admitted. However, it was now 2 months later, his emergency treatment had ended at Children’s but he still needed on-going help as he was a child with serious mental health challenges. Various diagnoses include attention deficient hyperactivity disorder, manic depression, and bi-polar disorder had been given to describe his problems. This was a child with a serious and chronic emotional disturbance (SED).
His mother recognized that he needed further help and had refused to just take him home which many parents often end up doing until they are forced to face the next crisis. Therefore, he essentially was abandoned at Children’s Hospital. His mother, a resident of Prince George’s County, and PGs Child Protective Services Dept. were not enthusiastic about taking responsibility for this child. The Dept had said that it needed at least 60 – 90 days to find a placement. He had also been suspended from his school in late August so the education system did not feel that it was responsible for him in any way and the local mental health systems probably had little resources to help him. The state of Maryland was pretty quiet about this situation.
While this youngster’s story is pretty discouraging and seems unique, in reality there are many young people and their families—young children, adolescents, young adults–who are often struggling with some type of mental health problem and some are pretty serious problems. Family members have many of their own stories of desperation as to how they live with their children with serious mental illnesses and how they try to receive services for them and family advocacy organizations have tons of desperate stories by family members.
Concrete numbers about the prevalence or rate of mental health issues in young people are sobering and include the following:
• 20% children and youth have a mental health problem (1 in 5)
• 1 in 10 youth have a serious emotional or behavioral problem (Friedman, R. Katz-Leavey, J., Manderscheid, R., Sondheimer, D. 1998)
• 20 million children and youth suffer from serious disabling mental illness
• 10% of young children have problematic behaviors with 4-6% having serious emotional and behavioral disorders (Raver, C. and Knitzer, J. 2002)
• Suicide: ~30,000 a year [80/day]
• Only one-third of children and youth get help from formal services.
So this story of the little boy at Children’s is pretty depressing and not that unusual—we have a youngster who obviously has significant mental health problems and who was being abandoned by most of the major systems that are suppose to support children — his family system, the education system, both the medical and mental health systems as well as the child protective system.
So how do we see something different with the “eyes of our heart” or even respond this situation without being totally depressed. Is there any indication of God’s power in this boy’s situation or in others like it? Is there a possibility for a better future for him and other youngsters like him?
Story #3—Building Systems of Care for Youngsters and My Role in that Process over the Years
Over the last 35 years, I have had the privilege with many others to be involved in a “movement” that helps states and communities in building “systems of care” for children and youth and their families with serious mental health problems. Isn’t that a great term, systems of care?
The concept of a system of care was created by a group of people over 25 years ago with expertise in children’s mental healt issues and comprised a definition and a set of core values and principles that would guide the child-serving public systems in how they should serve children with problems in order to reach better outcomes for both the child and their family. The system of care approach or concept with its various values and principles has shaped the work of nearly all states, communities, tribes, and territories in the children’s mental health field and even in other child-serving systems such as juvenile justice, child welfare, and education.
I’m going to read the definition and its three core values because it is a value system that has spoken to a number of both child-serving systems as well as some adult systems too. If you take away the language, children and youth, and substitute the word, individual or elder person, or person with illness, you can see how it is a guide for good treatment that is individualized and caring.
A system of care is: A spectrum of effective, community-based services and supports for children and youth with or at risk for mental health or other challenges and their families, that is organized into a coordinated network, builds meaningful partnerships with families and youth, and addresses their cultural and linguistic needs, in order to help them to function better at home, in school, in the community, and throughout life.
Systems of care are:
1.Family driven and youth guided, with the strengths and needs of the child and family determining the types and mix of services and supports provided.
2.Community based, with the locus of services as well as system management resting within a supportive, adaptive infrastructure of structures, processes, and relationships at the community level.
3.Culturally and linguistically competent, with agencies, programs, and services that reflect the cultural, racial, ethnic, and linguistic differences of the populations they serve to facilitate access to and utilization of appropriate services and supports.
For the last 18 years I have been doing this work with my colleagues at the National Technical Assistance Center for Children’s Mental Health at Georgetown University—which is part of the Dept of Pediatrics in the Medical Center. The National TA Center was one of the early describers or voices of a system of care and in its national role, provides training and technical assistance to help states, communities, tribes and territories build a collaborative system of community based services for children with mental health problems and their families. We work mostly with those persons in states or jurisdiction who are in the public sector and are responsible for services for those children and families who depend on the public system—in most cases children with SED need the public system as they have exhausted their parents’ private insurance. We are system builders with others in states and communities as they try to implement the core values and principles in a system of care—it is one thing to believe in the value of family-driven care and quite another to implement policies and practices that are family driven–no small task.
The children’s mental health field has shown positive evaluation results over the last 25 years as the approach has been implemented through grant funding in over 181 communities across the US including a number of tribal communities, Puerto Rico, and Guam.
We know that for a child like the little boy at Children’s, that if PG County had designed and implemented a collaborative, cross agency system of care with its emphasis on individual and wraparound services and supports, this child and his mother probably would not have been caught between various agencies and organizations.
If we can see the whole and see with the “eyes of our heart,” we see that this movement continues to grow both nationally and internationally and is vital as states are grappling with their new demands of the Affordable Care Act and decreased state funding for services overall.
Our latest adventure or task with states and jurisdictions is to assist 21 states/3 tribes and a territory as their system builders push their systems of care to encompass the entire state or jurisdiction. To do this work, we are using a number of strategies to provide technical assistance but one new one is a coaching model with each jurisdiction. This is an exciting new relationship-based model to help the state system builders move forward in their efforts and not get completely burned out. As a coach we have a number of roles but one important one is to help state leaders keep a balance between the real world of day-to-day issues that they face while at the same time helping them to see a broader vision. We have all been assigned a certain state and will be working with them on an individual basis over this next year as they state creates a strategic plan for expanding systems of care.
So, we end these three stories—one which is historical and two that are present day…..One that is depressing and two that are more hopeful.
It seems that Paul is serving as our coach as well as a coach to his fellow Christians in Ephesus. He is reminding them as well as us, through articulating a broader vision to them, that in the end, God through the risen Christ, is all powerful, even in spite of the negative or dark powers on earth. He is reminding them and us to look with the eyes of our hearts and to be aware of the Hope that Christ brings into the creative order and that we can take part in designing that future creation. God’s Power through Christ is at work above everything else.