In caring for the sick, the Church, in its activities, is faced with many different situations from the lives of the afflicted. Different perceptions on health and disease, the complexity of approaching patients burdened with various illnesses, cooperation with medical staff, and communication with the families of the sick are the structure behind these multifarious pastoral activities. Pastoral care of the ill is a challenging sphere within the Church, requiring continuous reflection and discernment of the current state in terms of developments offered by modern society. The focus of the scientific research in this doctoral thesis is the pastoral care of the mentally ill in society and the opportunities society offers, which enables this study to address issues directly related to unveiling perspectives of church activities in this area of pastoral care.
The doctoral thesis Pastoral Care of Mentally Ill Adults in the Republic of Croatia is divided into four chapters. Although the central theme of this paper is the pastoral care of the mentally ill, it was necessary to set up a broader contextual framework related to the communication of health and disease as determining factors in human life as a whole. It encompasses the biblical description of health and illness, which opens with the concept of man as God’s creation and the understanding of health and illness from our contemporary point of view, and relies on the concept of man as seen and represented in today’s society. In order for the research results to remain within the scope of this work, the study is limited to those experiences that directly deal with the objective of this work and examines the current state of pastoral care of mentally ill adults in the Croatian health system today. The first chapter, Mental Health and Mental Illness in Light of the Theology of Health and Illness, opens with the theology of health and illness centered around the biblical notion of health and these two inseparable realities of existence and explores mental health and mental disorders in this context. All those involved in the pastoral care of the mentally ill – medical staff included – will face not only religious matters, but also questions concerning the origin of the disease, and will find themselves in situations where they will be able to answer them. This chapter highlights the basic characteristics of the following mental disorders: depression and schizophrenia. The criteria for choosing specifically these disorders are their high incidence and complexity of treatment. Because this paper is focused on the current state in Croatia, it shall describe elements of post-traumatic stress disorder as a consequence of the Homeland War, present to this day, and its permanent side effects on Croatian veterans and their families, but also other civilians who have suffered numerous traumas. To understand mental disorders and for the sake of clarity of research, this chapter will draw attention to key concepts and terms related to the concept of mental illness. The second chapter, Position and Role of People with Mental Disorders in Today’s Social Context, is about understanding health and illness as we see it today. Also presented are difficulties directly related to impaired mental health. In this sense, the social environment of the mentally ill poses great challenges for the organization of medical and other care, especially because of the stigma and prejudice that are deeply rooted in all levels of society. Discrimination and stigmatization of the mentally ill often lead to internalization of the stigma, or self-stigmatization, which makes it difficult to lead a life inequality, and hinders the functioning and integration of mentally ill people into the community. The third chapter, Theological-Pastoral Discernment of the Current State of Pastoral Care of Mentally Ill Adults, is based on the sacramental source of pastoral care of the sick, the main elements of which assess opportunities for active participation of the mentally ill in the life of the Church. From a theological-pastoral view, the pastoral care of mentally ill persons calls for the involvement of the Church community in the salvation of souls, through the proclamation of the Word, liturgy, and prayers, as well as service and witness of Christian charity. These dimensions thus act as the structural walls of the Church’s holy community and are indispensable elements of theological-pastoral discernment. Particular emphasis is placed on today’s pastoral care in hospitals and welfare centers. The work of church marriage and family counseling centers in the Republic of Croatia has also been recognized in the pastoral care of the mentally ill. The final, fourth chapter, is entitled Perspectives of Pastoral Care of Mentally Ill Adults. The first part presents the dynamics of pastoral care of the mentally ill. The essence of a pastoral encounter with a mentally ill person is always Jesus and his approach to the sick, as a fundamental determinant in the encounter between them and the Church. To understand the condition of the mentally ill, in highlighting the positive effect of interdisciplinary dialogue, we reach a recommendation for action and recognize the challenges of pastoral action with the mentally ill. One opportunity for action is hospital pastoral care. It takes place in a specific environment and as such contributes to reducing tensions between psychiatry and religion, and becomes the place to strengthen Christian faith and hope in the lives of the mentally ill. Pastoral care of the mentally ill should also direct attention to unraveling the possibilities a sick person has to overcome everyday difficulties. In other words, pastoral care for the mentally ill must gear towards helping discover healthy potentials that every person possesses, regardless of their mental disorder. Through service and witness to Christian charity, doors open to integrating the sick into the community of faith and life and contributing to its quality. In this sense, a perspective of action that may contribute to the pastoral care of the mentally ill ought to be carried out within religious congregations, especially those whose charism, guided by Jesus Christ, have devoted their lives to serving the sick. The pastoral care of the mentally ill necessitates a relationship that is reflected in the link between the mentally ill, their families, and the parish community. Regarding the assigned objective of the research, scientific-theological analyses examined the dynamics of a pastoral approach to the sick, and in light of today’s social circumstances pointed to the possibilities of finding opportunities for action. Pastoral care, as part of a holistic approach to the treatment of the mentally ill, requires an evangelization of the sick and the community as a whole and addresses quality of life according to the Christian understanding of health and disease. Providing pastoral care for mentally ill adults calls for a variety of interactive approaches that work together towards recovery, and promote the quality of life of the mentally ill. It is necessary, therefore, to develop suitable pastoral models, to strengthen and broaden existing ones, and to enable the sick to grow in faith, despite their illness and lack of mental and often physical strength. With this in mind, it is important to continuously acknowledge human dignity and emphasize that no one is any less human because of their illness. Even in sickness and reduced mental or physical strength, man is created in the image of God, with inalienable value and dignity, and holds a place in society and community of the people of God – the Church.