Disability, Justice, and Prudence

Dealing with being mentally ill, and dealing with the mentally ill, is difficult.  There are no easy answers.  Life is filled with compromises.  And its hard to know exactly what is the appropriate response.

Disability.  I was fortunate to be covered under a good disability plan when I hit my crisis point.  I ended up receiving benefits for approximately two years, which gave me a window of opportunity to devote myself entirely to the healing process.  The only major complaint I had regarding that plan and the way it was administered was with respect to the way they terminated the benefits, basically without notice and retroactive.  I received my monthly payment, and then ten days later received notice that I would receive no more.  Little opportunity to make changes.  But we survived.

One of the questions I struggle with is the degree to which being bipolar remains a disabling condition.  Does the 'potential' of manic or depressed episodes constitute an impediment for employment?  One of the struggles with dealing with the disability plan is they loved to ask the question "How are you doing right now?"  Well, even while actively cycling between mania and depression, there can be a lot of time that one is within the normal spectrum of moods.  Employers, though, are not content with someone who is able to function normally MOST of the time.  

Risk.  And triggers.  My biggest concern about returning to the workforce had to do with the possibility that the stress of work might trigger a manic phase.  Two of the potential symptoms identified with mania are

• Increase in goal-directed activity (either socially, at work or school; or sexually) or psychomotor agitation
• Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

There's that word.  Sex.  Sexual misconduct is the cardinal sin of being a pastor.  And there is the potential for it in a manic episode.  I became convinced that as I was being evaluated for return to the active ministry that my health care team was intentionally not making a recommendation lest they incur liability in the event of a manic episode involving some sort of misconduct.  And I genuinely wondered if it was wise or prudent for the Church to allow someone who is bipolar to be a pastor given the fact that manic episodes may involve sexual indiscretions.  Fair question.

But is it just?  People who own guns are more likely to shoot someone than people who do not have a gun.  But would we deny employment to a person solely on the basis that they possess a gun and hence the ability to shoot someone?  (I think about this in part because there are numerous individuals who bring their firearms to work everyday at the cabinet shop where I'm employed.)  The answer is that we rarely discriminate against someone purely on the basis of the potential for a particular behavior.

I posed the question to the former assistant to the Bishop of our synod who handles candidacy, and his response was straight forward.  "Would you approve a bipolar person for candidacy?"  "I would simply ask 'Are you under a doctor's care?', and if you are, there is no problem."

But there remains the question of prudence.  It is probably good to be somewhat cautious.  But when does caution give way to prejudice and injustice.  Given the choice of two candidates, similarly qualified, would a congregation show a prejudice against the candidate who is bipolar?  In many cases, yes.  That's reality.

And yet a certain degree of caution is in order.  One of the thoughts I have had regarding my future in the ordained ministry is that I should seek out an opportunity to serve as part of a team, under the direction of the lead pastor.  This would allow me to serve as I am able, but have the safety net of the ongoing direction of the lead pastor that would tend to preclude my heading in an unhealthy direction because of my disease.  Not a lot of opportunity for that within our synod, but its a thought.

I am deeply grateful for the small congregation I do serve at the current time.  There are questions regarding how long this relationship is viable, but they have to do with the congregation's situation not my own.  This congregation has a history of supporting a pastor through significant personal and familial issues.  They welcomed me with the words "Your health is not a matter of our concern."  I count my blessings.  

As I struggle with these issues, and in the name of mental health awareness, let me make three important observations:

1. A mental health diagnosis may be disabling, but often is not.  People who are mentally ill and significantly impaired in their ability to function should qualify for disability benefits.  People who are mentally ill but still able to function should not be disqualified for employment.  Too often, I fear, mentally ill people are considered just functional enough to not qualify for disability benefits, but not functional enough to qualify for employment.  
2. It is just to discriminate on the basis of actual behaviors.  But, especially for one who is in treatment, discriminating against a mentally ill person on the basis of potential behaviors, symptoms that are under control through treatment, is unjust.  
3. Caution and awareness is the safety net for both the mentally ill person and the employer.  As I've said many times, if I propose something with a price tag of over a million dollars, ask questions.  That's reasonable.

I am not what uninformed people think.  I'll admit my own past prejudice here.  Ignorance of mental health issues often results in judgments being made that are not fair.  I've made those judgments.  You likely have too.  And then I had to confront the reality of who I am as a bipolar person.  That's different than a prejudiced imagination.  

My deepest wish is that we might proceed to the point as a society that a mentally ill person would only have to deal with the diagnosis and treatment of the disease, and not with a social stigma attached to that disease.  Life is difficult enough as it is, let's not add insult to injury.