By Nathaniel P. Morris on December 22, 2016
Last year, a news column circulated the web, announcing the American Psychological Association had decided to classify strong religious beliefs as mental illness. According to the article, a five-year study by the APA concluded that devout belief in a deity could hinder “one’s ability to make conscientious decisions about common sense matters.” Refusals by Jehovah’s Witnesses to accept life-saving treatments, such as blood transfusions, were given as an example.
Of course, this turned out to be a fake news story. But it still drew legitimate media coverage and outrage from readers. Fact-checking websites like Snopes had to point out the column was satirical.
To many, this was a ridiculous stunt. But for me, a physician specializing in mental health, the satire hits home in many ways. My colleagues and I often care for patients suffering from hallucinations, prophesying, and claiming to speak with God, among other symptoms—in mental health care, it’s sometimes very difficult to tell apart religious belief from mental illness.
Part of this is because the classification of mental illness often relies on subjective criteria. We can’t diagnose many mental health conditions with brain scans or blood tests. Our conclusions frequently stem from the behaviors we see before us.
Take an example of a man who walks into an emergency department, mumbling incoherently. He says he’s hearing voices in his head, but insists there’s nothing wrong with him. He hasn’t used any drugs or alcohol. If he were to be evaluated by mental health professionals, there’s a good chance he might be diagnosed with a psychotic disorder like schizophrenia.
But what if that same man were deeply religious? What if his incomprehensible language was speaking in tongues? If he could hear Jesus speaking to him? He might also insist nothing were wrong with him. After all, he’s practicing his faith.
It’s not just the ambiguities of mental health diagnoses that create this problem—the vague nature of how we define religion further complicates matters. For example, the Church of Scientology argued with the Internal Revenue Service for years to be classified as a charitable religious organization and to qualify for tax-exempt status. The Church eventually won this battle in 1993, a major step towards becoming a mainstream American religion.
According to Going Clear: Scientology, Hollywood, and the Prison of Belief, a book by Pulitzer Prize-winning author Lawrence Wright, Scientologists believe in alien spirits inhabiting human bodies. Many believe they have special powers, like telekinesis and telepathy.
This puts mental health professionals in a tricky, cultural bind. Before 1993, should mental health professionals have treated patients expressing these beliefs as psychotic? After 1993, as faithful adherents?