Too often the treatment of mental illness focuses exclusively on the science of biomedicine, on pathology and cure. Deeper questions about how best to support human flourishing are set aside as irrelevant to the clinical practice of medicine. An initiative at Duke Divinity School aims to change this.

The Theology, Medicine, and Culture (TMC) initiative, which was founded in 2013 to engage communities and institutions on fundamental questions about human flourishing, fragility, and death, has identified mental health as a core area of focus. Its goal is to move healthcare beyond a medical model of mental illness and explore how theological thought and tradition can inform medicine, and at the same time, transform the way the church engages with mental illness and medical practice.

“Mental illness is a major cause of suffering and disability, present within every Christian congregation,” says Warren Kinghorn, M.D., Th.D., assistant professor of psychiatry and pastoral and moral theology, and a faculty leader of the initiative. “TMC aims to equip and empower Christian communities to develop new ways of responding to illness and suffering -- including mental illness -- that work alongside and yet are not dominated by modern medicine.”

Drawing faculty and students from theology, medicine, public policy, and other disciplines, TMC is engaging these issues by fostering conversations among students and faculty; by providing opportunities for health professions students and practicing clinicians to seek theological training at the Divinity School; and by the creation of a certificate in Theology, Medicine, and Culture within the Divinity School curriculum. In addition, TMC plans to facilitate a multi-year collaborative of congregations called “Reimagining Medicine” that will invite and equip congregations to engage creatively with the challenges of suffering and illness in their communities. Aiming to equip and empower congregations to respond to persons with mental illness, TMC is also co-sponsoring a February conference in Houston, Texas, that considers historical examples in which Christians have introduced transformative and innovative ways of walking with people with mental illness and will link this to the work of congregations today. 

“We need to look at how we might learn from the ways that Christians have creatively and faithfully responded to mental illness in the past,” Kinghorn said. “Historical examples, including Juan-Gilaberto Jofre, a Spanish monk who in 1409 founded the first western institution for the mentally ill; the community of Geel, Belgium, which pioneered community mental health care; and the Mennonite mental health centers of the 20th century all point to a theology that is still relevant to caring for people who struggle with mental illness today.”

The TMC initiative, which expands on the work of the earlier Duke Institute on Care at the End of Life, will also focus on end-of-life care and on ways that clinicians experience their work with the sick as a calling. TMC will complement other Divinity School initiatives such as the ongoing Clergy Health Initiative, an initiative funded by The Duke Endowment that aims to improve the health and well-being of United Methodist clergy in North Carolina. 

The TMC initiative is directed by Ray Barfield, associate professor of pediatrics and Christian philosophy. In addition to Kinghorn, affiliated faculty include Richard Payne, Esther Colliflower Professor of Medicine and Divinity; Amy Laura Hall, associate professor of Christian ethics; Allen Verhey, Robert Earl Cushman Professor of Christian Theology; Esther Acolatse, assistant professor of the practice of pastoral theology and world Christianity; and Farr Curlin, associate professor of medicine who holds a secondary appointment at the Divinity School.

TMC will co-sponsor a conference, “Walking Together: Christian Communities and Faithful Responses to Mental Illness,” Feb. 6-8, in Houston, Texas. The conference will be held in collaboration with sponsors including Reimagining Life Together and the Hope and Healing Institute at St. Martin’s Episcopal Church.