Call a Professional! I’m in Over my Head! – Part 1

October 11th, 2012 No Comments

Sunrise over grass seeds at the Clay County Fair.

As the alto section leader for my church choir, I often told the singers, “If you need anything, give me a call!”

And she did.  She was overwhelmed by simple things, like having to answer the phone at work.  Some days she never made it out of bed.  She went days without bothering to eat.  Other times, she said there was no reason to live.  I did everything I knew to encourage her and remind her of God’s love for her.  Late one cold, December night, she was waiting at the end of my long country driveway when I arrived home.  She took off her coat, and I saw her arms — long, narrow slices with a sewing scissors from her purse freshly carved while waiting to talk to me, she explained.

As a lay person, I was in over my head.

Similar scenarios play out in the lives of caring leaders and friends every day provoking the question, “How do I know when I need to get someone to professional help?”  At the PTSD educational seminar recently held for clergy, this was one of the questions asked.  The diversity of situations and emotional well-being issues make this a difficult question to answer, and yet, there are some resources to help you make that decision.

The first tool I’d like to introduce to you is called the Personal Health Questionnaire-9.  It is a free, 9-item assessment that can be completed in 5 minutes or less that gives a very accurate appraisal of clinical depression.  The counselee assesses, on a scale of 0-3, how bothered she has been, in the past 2 weeks, by 9 topics.  She also assesses if these problems are affecting her ability to function.  The validity of this questionnaire is so accurate and helpful that I recommend you give it to every person you counsel or mentor or for whom you are concerned.

The PHQ-9 website includes a scale ranking the scores on level of distress: minimal, mild, moderate, moderately severe, and severe depression.  The ranks can be a guide as to when professional help should be involved.  Any ranking of moderate depression or higher should prompt a call for professional help, and mild levels of depression should be monitored for increasing distress.  Keep in mind that anytime a person states that she has thoughts of hurting herself or killing herself or hurting someone else, professional assistance should be sought immediately.

While this is not the post for an in-depth discussion regarding depression, here are several important facts from the National Alliance for Mental Illness’s (NAMI’s) website:

  • Mental illnesses are serious medical illnesses. They cannot be overcome through “will power” and are not related to a person’s “character” or intelligence.
  • By 2020, Major Depressive illness will be the leading cause of disability in the world for women and children.
  • The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological (e.g., medicine) and psychosocial (e.g., counseling) treatments and supports (parentheses added).

As these facts indicate, clinical depression is a common condition.  Additionally, depression oftentimes generates self-harming thoughts that range from cutting or starving oneself to suicide.  But the good news is that depression, like most mental illnesses, is treatable.

So before you get in a situation that feels too intense for you, familiarize yourself with the PHQ-9 and habitually incorporate it into the first appointment when meeting with counselees.  This is one significant step in determining if you need to refer to a professional counselor, therapist, or psychiatrist.

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