For depressed mother whose world collapses around her, faith proves barrier to getting mental health help

Juana reached out to me when she was pregnant. She was an immigrant from Guatemala seeking to escape war and poverty, while I was working as a perinatal case manager who made home visits to pregnant low-income women in Los Angeles. During our first visit, she shared with me her history of drug addiction and depression, which included suicide attempts. She also confided that these struggles arose because she was sexually abused since she was a child and was a victim of domestic violence during her relationship with her previous partner, in Guatemala. Juana had three grown children in Guatemala and a 9-year-old and a 5-year-old here. Her pregnancy was considered high-risk due to her osteoarthritis, a condition in which the cartilage protecting the body’s joints wears down. 

Juana had a very intense pregnancy; she was in pain the majority of the time. She was on bed rest the last few months, and this only aggravated her depression. When I suggested she see a psychologist, she declined. Her pastor told her that she did not need one, that all she needed was prayer to be well. I agreed that prayer was powerful but encouraged her to see a therapist as well because, I told her, you should use multiple tools to be well, not just one.

She had to have a cesarean birth at 38 weeks. Juana began breastfeeding after she gave birth, despite hearing from her doctor that this would be harmful to her health. She fed her baby a combination of formula and breast milk for the first six months, and then I helped her to slowly wean him off the breast.  This was especially difficult for her, she said, because she breastfed all of her children for at least two years. Her 17-year-old daughter, Estefania, had recently arrived from Guatemala and was helping her care for her other children. Despite the help, Juana’s mental health began to decline. And still she refused to see a therapist.

Then came the bombshell. Juana had a severe mental health crisis when she caught her daughter Estefania in the same bed with her husband. There they told her they were in love and were having sex. They kicked Juana out of her own home, while her 5-year-old son stayed behind. When she called me crying desperately one day, I suggested she file a police report for statutory rape since her daughter was a minor. I also urged her to stay in her home and kick her husband out. She returned to her home, and soon after her husband and daughter left.

Juana’s 5-year-old son was deeply traumatized from the behavior he witnessed between his sister and father. I suggested she seek therapy for him, which she did through his school. He went to a school counselor who referred him to help. He slowly started doing better, while Juana on the other hand was getting worse. She had a hard time getting out of bed and was wracked by body aches. We ended our visits, as we always do, when her youngest child turned 2. But I still checked in with her by phone sometimes. During one of our phone visits, she told me she forgave her daughter because she was an innocent victim, but she could not forgive her husband.

Juana is not alone. I have had several clients with mental health disorders that have refused professional help due to the influence of their pastor or priest. One of my clients was even institutionalized, partly because she refused her psychologist’s recommendation to take antipsychotic medication and instead followed her priest´s suggestion that all she needed was to pray for the voices in her head to leave. With the help of her psychologist and her family, she was ultimately able to take her medication and slowly regained her sanity.

While I believe in the power of collective prayer, some people need more than prayer to feel better and get well. Faith and mental health care are not mutually exclusive. Church leaders should encourage their congregants to seek mental health therapy if needed, host mental health groups, or even have a professional therapist visit church grounds. This already happens in some churches in Southeast Los Angeles, such as Saint Gertrude Catholic Church, and it works well. I believe that faith and science cannot work against each other in our community. Otherwise, too many people like Juana won’t get the mental health help that could lessen their suffering.

The last time we spoke, Juana was living with her sister, since her depression had worsened to the point she could not take care of her children any longer. Her sister had encouraged her to go to therapy after witnessing her declining mental health. I provided her with several referrals but she still refused to seek out professional help. She continues to believe that prayer is all she needs to feel better.

Martha Escudero is a former perinatal case manager for low-income mothers in Los Angeles.

[Photo by Michael Carian via Flickr.]