I recently completed a research project which sought to identify characteristics of congregations in which people with chronic mental illness were full participants. In this article I will briefly describe the project, present the theological reflections of the participants, report the research findings, and offer my own theological reflection on the research project and findings.
Description of Research Project
 A simple exploratory qualitative research method was utilized in which six Evangelical Lutheran Church in America congregations were studied. Three congregations were represented in each of the two types of congregations studied for this project: (1) Chronic Mental Illness Congregations, those congregations who accept, welcome, and support those with chronic mental illness, and (2) Diversity Congregations, those congregations who accept, welcome, and support diversity. The twofold approach was designed to broaden the research and to gain more participants.
 The Chronic Mental Illness (CMI) Congregations were nominated by a person with chronic mental illness or a person with a family member who has chronic mental illness. The basis for the nomination came from the individual or family member feeling welcomed, accepted, and/or supported by their worshiping congregation with their experience of chronic mental illness.
 The Diversity Congregations were identified by synod staff. Congregations nominated for this aspect of the study were congregations who had a reputation of welcoming diversity, i.e. those who are "different" from the mainstream culture of the congregation. Congregations tend toward homogeneity. Nancy Ammerman, in Congregation & Community, states that each congregation has a culture of its own, a way of acting, speaking, and socializing new members. She writes, "People simply do not expect a congregation to be ethnically or economically diverse, and the practice of choosing a congregation (rather than being assigned to one) increases that homogeneity." Since people with chronic mental illness add diversity to and challenge the homogeneity of congregations, I speculated that a congregation which was welcoming of diversity would also be welcoming of those with chronic mental illness. This speculation turned out to be true in the three Diversity Congregations studied.
 Data for the study was collected through interviews with pastors, individuals (in the CMI Congregations only), and a focus group from each congregation. During the interviews, open-ended questions were asked in order to learn about the participant's congregation and his or her experience in the congregation. In addition to the interviews, I attended Sunday morning worship service(s) at each congregation in order to get a "sense" or a "feeling" of the congregation. Since I believe that worship is the center of congregational life, this was another way to experience the congregation.
Theological Reflections of the Participants
 The participants were asked how they thought their congregation came to be accepting, welcoming, and supporting of diversity or those with chronic mental illness. A variety of theological themes were suggested, such as the priesthood of all believers/body of Christ, Holy Communion as a "Welcome Table" for all people, grace/gospel preaching, the theology of the cross, and simultaneously saint and sinner.
Priesthood of All Believers/Body of Christ
 A pastor of one of the Diversity Congregations used the concept of priesthood of all believers to talk about the ministry of welcoming the developmentally disabled as full participants:
I was thinking about this [the priesthood of all believers] today. Each one of us is a member of the body of Christ. We all bring our brokenness to the table, but in spite of our brokenness, God works through us in amazing ways. Some of our brokenness is very visible…with either a physical or a mental handicap, or, there is a much less visible [brokenness], but still apparent: weaknesses, addictions, depression, just struggling with life issues, not having everything all together, but still this [ministry of welcoming the developmentally disabled] is a very visible way of saying, "You know what? Despite our brokenness, we all are part of the body of Christ. We all work together and we uphold each other and we support one another as a body."
 One CMI Congregation and one Diversity Congregation celebrate Holy Communion every Sunday. The focus group participants in these congregations talked about the importance of this for them because it modeled inclusion and equality. The members of one such focus group stated it this way:
Mr V: It was incredible to me when I first started here that this was a congregation that had communion every Sunday. And so that is a place of inclusion. I'm a firm believer in that because no matter what culture you're from or whether you're mentally ill or whatever, it's a welcome table and you experience that every Sunday regardless of who you are.
Ms L: And you're equal with everyone else.
 The members of the other focus group saw the weekly celebration of Holy Communion as a welcome table and central to their congregation's ability to welcome all people. One member reflected:
I'm sitting here thinking about the welcoming that we give to all types of people, especially the welcoming that is extended to our children, of all ages. And I think that is one of the reasons why…it doesn't matter who we are, who you are. When you come to this church you are accepted. And the children in this congregation are accepted. They are invited to church. There is a children's sermon. There may only be one person there, but they are there and they might be making some noise and they might be, but they are learning too, and they are part of this family. And they are given communion. They don't have to go through a set of instructions because we do believe that this is God's gift to us, not something that we have to do. So I think that in itself-it doesn't mean you have to be of any age or any mentality.
 All three of the CMI Congregations talked about God's grace as making their congregations more open and accepting to others. A man whose son lives with severe depression believes that the congregation to which he belongs came to be accepting of those with chronic mental illness because of the weekly proclamation of the Gospel, i.e. one is accepted by Jesus not based on what one does or believes, but on what Jesus Christ has done on the cross. Not only is this Gospel word important for him to hear every week, but it is also important for him to hear that his son is accepted by Jesus. A couple from another CMI Congregation, whose daughter lives with bipolar disorder, reiterated the importance of hearing gospel preaching. They know because of the gospel of Jesus they are accepted and not judged by God. Mental illness doesn't render the gospel null. A woman who lives with debilitating depression spoke of members in the congregation living out God's grace and acceptance. At the congregation where she belongs, she says, "I was never labeled but I was cared about." She describes the gospel as "Jesus sitting in the dirt with me."
 One of the CMI Congregations has as two of its values "Grace Alone" and "All People are Welcome." These are more than words framed on the wall. They are actually lived out in this congregation. A focus group member from this congregation talked about the difference of this congregation from other congregations that proclaim God's grace.
I think this is a place that takes its theology very seriously, much more than probably any other church that I have been connected with. This is a place with a very strong commitment to grace, a very strong commitment to be centered in Christ and the theology of the cross. And I think that that has probably informed where we are going with this in a sense. And so I think that it's a very clear outcome of that process. And people really getting that and feeling that. I think other congregations I have been a part of have had more of a mixture of tradition and more of a mixture of theology that in some ways may make it more difficult to be clear about this kind of a statement … But it's saving grace. You know you've fallen down and received that grace it's very hard to not extend that to someone else.
 When asked her reflections on how the congregation came to be accepting and welcoming of ethnic diversity, a pastor from one of the Diversity Congregations, also pointed to the gospel of Jesus Christ. She said, "The gospel is what holds us together and spins us out."
Theology of the Cross
 The father of a daughter who has bi-polar disorder shared how it has helped him to apply the theology of the Cross to living with his daughter. For him the theology of the cross meant, "Basically loving the person and accepting them and trying to serve them."
 A member of a Diversity Congregation described his perspective this way:
For me…theologically it's about the theology of the cross. And that is Christ meets people at the margins. That's where Christ is. And so as hard as it is, that's what continues to bring vitality. This is-we push against it and we push against it, but by God we always end up following Christ in the margins.
 One CMI Congregation has a strong commitment to peace and justice. One member of the focus group from this congregation talked about how this focus can sometimes cause a congregation to "take itself too seriously" because one may think "We got a corner of the market; we know what the kingdom's supposed to look like. And I don't think that's allowed here. It just doesn't go very far … It's that saint/sinner thing-we all know that about ourselves … So I think that's also really important to the welcome part."
 The focus group in this congregation used the theological concept of simultaneously saint and sinner as an equalizer. Even though many of the members of the congregations are quite successful in their professions, when they gather together as a congregation no one is better than another. Each member is simultaneously saint and sinner.
 A total of sixteen interviews were taken for this study. The interviews were used as the primary source of data. The data from the Chronic Mental Illness Congregations and the Diversity Congregations was analyzed together and separately. Data analysis of both the Chronic Mental Illness Congregations and the Diversity Congregations revealed two attitudes toward people which informed the congregation's perspective of those with chronic mental illness/diversity. The first attitude toward people, which appeared in all six congregations, was that each person is a child of God. A second, related attitude toward people, also present in the congregations studied, was that all people are gifted by God.
 An examination of the Diversity Congregations alone revealed an inclusive approach. The Diversity Congregations saw their members who added diversity to their congregation as fully integrated into the life of the congregation instead of a separate ministry of the congregation. This inclusion came from a conscious decision not to hide away those who are diverse (including those with chronic mental illness) rather than attempting to disguise difference.
My Theological Reflections on Research
 In reflecting on the findings of this study in conjunction with the participant's theological reflections, I see the attitude that everyone is a child of God running through the participants' responses. This basic theological theme that everyone is a child of God seems so simple, yet it becomes profound when congregations live this out and people with mental illness experience this acceptance and welcome as full participants.
 The woman, mentioned above who lives with debilitating depression spoke often of the importance of being befriended by a woman in the congregation. Little by little she
was asked to do some things within the church. One time I was asked to pray-I was passionate about prayer-pray for people when we would have the anointing services. One time [the pastor] asked me to maybe speak for ten minutes, me and a Spanish woman. To just give like a little mini-sermon. And then I would sing at the services here and a lady who passed away had asked that I sing at her funeral, and I didn't even know that she heard me sing, and so out of this singing, the chaplain who trains chaplains here [at the residence where she lives] asked me to start doing the liturgy or being the minister of worship. So I've been doing that every two weeks for the past two and a half years. And that also started because I was at [this congregation]. I think I started to feel like I had something to give. I can do the things that I didn't think I can do.
Being a member of this congregation has contributed profoundly to her mental health. Even though she still lives with depression, she has found a place that accepts her, encourages her, and invites her to participate. To accept every person as a child of God, who is gifted by God, seems simple. It is something we teach pre-school age children in Sunday School along with the song "Jesus Loves Me." It does not seems deeply theological, but when a congregation lives this out by greeting each individual as a child of God and acts this out by incorporating the gifts of all individuals into the congregation, this has a deep theological effect on all individuals, especially those with chronic mental illness, because they encounter the love of God and experience the joy of giving.
 An elderly woman who lives with chronic mental illness was eager to talk about the congregation to which she belongs. She says she felt "enfolded" from day one and invited to participate wherever she wanted. Living on Social Security, she does not have money to support the congregation but she volunteers. She used her skills as a secretary to volunteer over 70 hours. She figured at $5.75 an hour she is "tithed up to about the year 3000. Isn't that a good feeling?"
Throughout my research of these six congregations, I noticed the ability of persons in these congregations to hold creative tension. There is tension of a child of God having mental illness, of people with different ethnic backgrounds finding a way to worship together while honoring differences, of people with developmental disabilities having something to teach. These are radical tensions in our world today. It is tension between life in this broken world and life in the healing Spirit of God. Even in this age in which we focus on reason, persons with mental illness are seen as being possessed by a demon (this refers to treating the person in such a way which de-humanizes the person) and therefore the person cannot be a child of God. Mental illness causes tension for us because it affects the part of our being which we hold near and dear, our ability to rationalize and think our way through life, to be self-sufficient and independent.
 A theologian of the cross sees God both hidden and revealed in the cross. This theology is grounded in the tension of the cross, the tension of the "now" and "not yet" of the rule of God in the world, and the tension that people are at the same time saint and sinner. Children of God have mental illness and have gifts to offer. This is a tension that needs to be held if congregations are to be places where people with chronic mental illness are full participants.
 To conclude my theological reflections on these six congregations studied, I would like to quote what I wrote in Congregations as Trinitarian Communities:
As these congregations participate in the life and work of the Triune God, the individuals are invited into this dance of the Trinity. In these communities the love of God is at work welcoming each person as a child of God, the grace of Christ is at work accepting each person and the gifts they have to offer, and the community of the Spirit is supporting each person within a community of love and grace. The priesthood of all believers seems to be more than an impracticable ideal highlighted at times when volunteers are needed in these congregations. Rather, the priesthood of all believers is lived in the life of the Trinity where each is dependent on the other to make the whole. The priesthood of all believers exemplifies what it means to live as Trinitarian communities. Yet this does not make the congregations free of struggle or strife. As Luther states in his commentary on Romans and Galatians, each and every person is simultaneously a saint and a sinner. However holding the tension between saint and sinner keeps them grounded in what it means to be a community of individuals. In the Trinity there exists the incarnate One who entered into our humanness. This One holds the tension of the human and divine (death and resurrection) within the love and community of the Trinity. The tensions are not hidden away or resolved in the Trinity or in these Trinitarian communities, but embraced and engaged as an essential part of community.
© July 2007Journal of Lutheran Ethics (JLE)
Hollie Holt-Woehl, Congregations as Trinitarian Communities: Accepting, Welcoming, and Supporting Those with Chronic Mental Illness, Thesis (Ph.D.), Luther Seminary, 2007.
Chronic mental illness refers to persistent or recurring brain disorders that cause severe disturbances in thinking, feeling, acting, and relating. I have chosen to focus on the chronic or persistent aspect of
mental illness because, in my experience as a parish pastor, I have noticed that members of the congregation will respond with great love, concern, and support when a tragedy or illness over takes one of
their members. However, if tragedy or illness continues to linger longer than a few months, members will often begin to wane in their love, concern, and support for the afflicted individual. Some members,
as they lose patience with afflicted individual, even begin to blame the afflicted individual for not getting better.
The designation of Chronic Mental Illness Congregations and Diversity Congregations in this article is not for the purpose of labeling the congregations but for the purpose of describing the congregations in
Nancy Ammerman, Congregation & Community (New Brunswick: Rutgers University Press, 1997), 56.
For more information on methodology, data analysis, and congregations studied, cf. Holt-Woehl, Congregations as Trinitarian Communities.
Personal interview, June 18, 2006.
Focus group interview, July 30, 2006.
Ms M, Focus group interview, August 1, 2006.
Personal interview, August 29, 2006.
Ms D, Focus group interview, October 9, 2006.
Personal interview, June 6, 2006.
Personal interview, August 11, 2006.
Mr V, Focus group interview, July 30, 2006.
Focus group interview, August 1, 2006.
Personal interview, August 29, 2006.
Personal interview, May 11, 2006.
Volume 7, Issue 7