My DH's youngest son is preparing to leave on his state-side mission at the end of this month. We are aware that he has recently been diagnosed with Bipolar Disorder and is in the process of settling into a med regime to help it. He sees a counselor once a week and doesn't feel this is enough, according to his own admission.
Is this something that must be disclosed before he goes on the mission?
What is the stance of the Mormon church about seeing a psychiatrist while on his mission? A counselor?
Is anyone familiar with the guidelines of the church missionary department and can provide some light on this subject?
We are very concerned for his mental state should he fall short of the full two year mission. His uber-TBM mother would not be above failing to mention this in order to be sure he goes on said mission. I have to repeat, we are VERY concerned about his mental state should he need to come home for medical reasons.
As background, we are the shunned non-believers that cause all of the world's problems, so we are not directly involved with this son. Despite the rebuffs, we care tremendously and hope someone can help answer these questions.

I don't think the church acknowledges officially mental disorders. Even if they did it wouldn't matter on a mission. ANY medical problem is ignored until it absolutely can't be ignored anymore.

If I remember correctly in the back of the companionship study manual there were "Warning Signs to Look For" and mentioned several signs of mental illness. I checked off several of those things about myself. I mentioned it to my MP, he jus shrugged it off. I felt I was weak and lacking. A missionary had an actual breakdown that required hospitalization. He got to go home. I wondered what he did to show that he had had a breakdown.

Keep in close contact with your DH's son. Give him a cell phone. Give him money for a cell phone. Something, anything, to get him to know that he can contact you anytime and that you will go get him, or the RFMers will get him back to you by driving him and handing him off. Tell him about all the stories you have heard of people coming home. Make him understand that it is not a big deal.

In short don't expect the church to do anything.

ask the many young college students who suffer from homesickness and/or put on 10 pounds their first year of school. Add the stress of following a rigorous schedule of a missionary and all the pressure that goes with it.

Any amount of stress increases the risk of mental illness; even moreso for those who are predisposed to it.

Be there for him.

Wowsa!

My son went on a mission almost five years ago. He had Aspberger's... high functioning autism. He is very high functioning and we were told, by all the priesthood leaders who knew him, it would not be a problem. We filled out the paperwork which had all kinds of questions about medication and mental health questions, in addition to physical health questions. We answered it all honestly of course, we were good Mormons.

When his call was delayed beyond the expected time, I received a call from the Stake President saying that "Salt Lake" had a problem with his papers and wanted him to see a church mental health expert.

I took my son in and the man said, "WHERE IS YOUR HUSBAND? This is to be an interview with ALL of you." No one had said anything about that previously.

Anyway, long story short, this man asked me and my husband personal questions about our marriage, our mental health, our family history of mental health etc.

I did not want to answer his questions, saying I could not see what our personal issues had to do with our son serving, but he said if we didn't comply our son would not go on the mission.

I went home in tears feeling so violated...

Anyway, I am really confused by your post because as far as I know, they had/have really tightened the standards for missionary service. For people with the issues your step-son has, if they knew about them, they would exclude him from full-time service as far as I know.

If his mother lies on these forms, she is risking him... A mission is a crazy place to be... the stress and isolation is tremendous. The guilt trips are horrific. A young man with the issues you describe should not be subjected to something that will create so many stressors in his life when he is vulnerable with a recent diagnoses and trying to get the meds correct and balanced, which takes a lot of time and expertise.

On the mission, they move them around a lot. He would have a hard time finding continuity of care. This would be a disaster.

I remember reading in the Ensign magazine something about how the bar was raised as far as eligibility for full-time missionary service. Missions are costly and they really aren't very effective at bringing in converts... so they have tried to limit service to those who don't have big issues...

My son was allowed to go. While on his mission he was told that any disobedience by him could have eternal consequences... that if he did something wrong it could cause someone to not join the church and that would be on his head for eternity.

One day, he was walking across a basketball court and it wasn't the preparation day... and his kneecap slipped and he injured himself. He was not playing basketball, and he was there fellow shipping inactive members. In the next zone conference, he was made to stand up and was used as an example of disobedience. He was publicly humiliated. Also, his mission president wouldn't let him go to a doctor. He was an eye doctor and he thought it would be just fine. (He would see out of that knee nicely the rest of his life!)

I finally called and spoke with the mission president and said my son needed a doctor. He relented but said, "You know, if they find something wrong, I will have to send him home and you know that won't make him very happy. They get so upset when they get sent home early." (Yeah, I know a woman whose son committed suicide because they sent him home early because of a mental health issue... don't I know it!)

Well, in a couple weeks our family left the church and we went and picked him up from his mission and brought him home ourselves... He was out 7 months.

I seriously doubt if the church knows about your step-son's condition they will let him serve full-time away on a mission. But they might find a stake missionary position for him, or he could work with the full-time missionaries doing splits... but that wouldn't have the glory his mother is seeking to have through him...

Whatever power or influence you have DO NOT let this be lied about on his papers. Contact Salt Lake yourself if you have to.

Missions create mental illness and stress in young men at a very vulnerable time in their lives. Healthy ones crack, and cracked ones can totally break.

A friend of mine told me a dear friend of hers had a son who returned from his mission and hung himself immediately after getting home...from our bridge here is Salem, Oregon...

Bad things can happen to young men that crush them when they are isolated from their friends and families.

Only two phone calls a year home. One on Mother's Day and one on Christmas...

Do whatever you can to prevent him from leaving his support structure.

Best,

A Musing Grace

The church is VERY aware of the mental problems missionaries have on missions.

A couple of months into my mission I started to emotionally break down. My Mission President arranged for me once a week to call a Psychologist in Salt Lake (from Argentina) who is SPECIFICALLY assigned to help missionaries. His advice was crappy and eventually I was transferred to a bigger city where the mission office paid for me to see a psychiatrist and go on antidepressants. Eventually I had to come home four months short of the 18 month mark due to depression, but it was considered a Medical Release just like anything else.

MANY missionaries end up on antidepressants during their missions. It's something people don't talk about (and the church knows but doesn't publicize), but they should. If your DH's son comes home early, give him a Homecoming and a party. He served just as much a mission as someone else, maybe more! He won't be the only one in his mission on medicine to try to get through a crappy two years!

I became suicidal after a couple of months on the mission and was sent home early. And then went back to an LDS college. Not a fun experience - lots of shame, guilt, and loss of self-esteem. I am still trying to get over it a decade later. A mission is not a place to go if you already have emotional problems. The stress and anxiety will only get worse and it may take years to get over a horrible experience like that. I feel resentment for being pushed into an experience like that just because I was looking for acceptance.

I am SO GLAD my son had decided to not go on a mission. It sure wouldn't help his condition either.

I'm a teacher and I've worked with bipolar kids. I would not want to see a young person who is battling a serious mental health issue to have to endure the stresses of a mission. Beyond that, it can take a lot of time to find the correct medication, and dosage of medication, that is effective for each person. I would be very concerned about the continuity of care for your stepson.

I think it would be best if your husband intervened and made sure that church officials are well aware of his son's condition.

All he needs is a Priesthood blessing and everything will be fine. Wink Wink, nod nod, know what I mean, know what I mean.

The father of a friend of mine was a mission president, and told me that they frequently had to send back young men and women due to mental illness. Some of them were very serious, involving cases of schizophrenia. This, according to the MP, was age-related in that the illnesses begin manifesting themselves around that age, compounded by the usual stress of the missionary situation. It's probably a good idea to at least be prepared for his early homecoming, but better not to even send him.

First, let me say you are in my prayers. Mental illness is nothing sort of a roller-coaster ride for parents (and spouses). My son is bi-polar. It is an awesome sign that your son recognizes his disorder. That is a HUGE step. Many bi-polars never get there. My son's bi-polar is stress induced. He joined the Marine Corp. at 18 when it began to manifest. Because of the structure, he did okay during his 4-year tour of duty but because of the cumpulsive nature of bi-polar, developed a very distructive gambling habit. It's taken years for him to finally admit his bi-polar, learn to trust the people who are there to help and get his life back on track. He knows to manage his stress and keeps in contact with his support system (counselor and family). There is light at the end of the tunnel!!
On the mission field, your son will be under a LOT of stress. He will not be able to reach out to his established and trusted support system. To do so whould be seen a sign of a weak teatamony...more stress and if compulsive tendancies occur (which they probably will) it will most likely separate him from any support he may find on his mission.
Bi-polar is a serious disease and should be managed as such. Unfortunately, mental illness is still misunderstood and stigmatized and the mormon "culture" can exacerbate the distructive nature of the disease.
Bottom line: Missions are NOT a one-size-fits-all deal (IMHO)!!!!
Wishing you and your family the best on this journey. BTW, a really great book that helped DH and I was "I'm not sick and I don't need help" by Xavier Amador.

Why send a bipolar patient on a mission? Life alone is stressful enough.

He needs to be stabilized on meds, adjustments will be needed every so often, so he can live a productive life.

A mission might seriously de-stabilize him, with repercussions for many years to come.

This is an excellent link, from a TBM perspective, however:-
http://lds.org/ensign/2007/03/missionary-health-preparation?lang=eng&query=missionary+medical+conditions

sometimes the bipolar condition gets to the terminal stage even without the big time stress of going on a religious mission.
My adult son refused help even after the initial suicide attempt, and left his meds in the bottle.
do every thing you can to stop this young man from going on what can be a Suicide Mission.
One success, a family member came home early because of mental problems and got help and is now being a productive citizen, even though still a Morgbot.
Librarian

I am a physician and a NeverMo. I have performed roughly half a dozen physicals for missionaries. (all of these had been my patients as teenagers and now needed me to complete the medical report---I was not performing physicals on people I didn't know, or whose parents I didn't know). I live in CA in an area that is 2% LDS (southern Orange County), but there are no LDS family practitioners or internists (I am the latter) in area area of over one million inhabitants (lots of dentists, and some LDS in areas like Dermatology that keep regular hours).

The form is about eight pages long and will be reviewed by the Medical Review Committee of the church. On page one there is a release of information section that the applicant must sign. As I recall, the applicant releases the information to the Review Committee, but NOT to the church at large. Big difference between the two, since this means the local leaders cannot be given the info without violating the HIPAA laws, which govern medical privacy. The MTC Medical Review panel is composed of retired LDS physicians.

About 3/4 of the form deals with physical issues: history, physical exam, immunizations, TB status, etc. The last page or two deal with mental health history and a final page where the doctor may summarize his or her conclusions about the candidate's fitness to serve, along with restrictions: e.g., someone chronically ill would need to be in a city with good medical care, etc.

I did one exam for a patient who was being coerced into serving and who pleaded with me to help him find a way out of serving. Problem was, he was a 6'3" 300 pounder playing football at a Div I college (non-LDS school, full scholarship). If he left on a mission, he would lose the scholarship.

In researching how to help him, I found an article in DesNews (ten years ago) about the Review Committee. Of interest was the fact that roughly half of the physical exam forms are completed by doctors who are not LDS, and that the committee concurs with the hometown doctor's recommendation >95% of the time. The article pointed out this is one of the very few situations where TSCC actually takes the advice or opinion of nonmembers seriously.

In the case of my football player patient, he did have asthma which had sent him to ER a few times in college, so I could trump up that issue, which would probably keep him stateside and out of rural areas, but it wouldn't be enough to disqualify him. Fortunately for him, I found a loophole on the mental health section. I simply wrote the truth: that the patient told me that he did NOT want to serve a mission and that he was being coerced into doing so by local leaders, with the parents as bystanders (parents were not rabid TBM but would not stand up to local leaders). I wrote that I felt this constituted a very serious impediment to mission service and that most likely such a mission would end in failure.

The result was that he did not receive a call, and the ward/stake leaders were told only that it was for "medical reasons", which most assumed to be his asthma. The MTC Review Committee maintained their medical confidentiality per HIPAA regulations, and had they breached confidentiality, they could have been sued by the patient, or I could have reported them to their medical board for violating HIPAA (TBM or not TBM, most doctors know these rules and abide by them). Ward gossip was evenly split between "asthma" and "unworthiness" as the reason he wasn't called. Luckily he was 2400 miles away from the ward spider web.

In your son's case, the board will most likely concur with your hometown doctor. Is this doctor LDS? Does he/she know your and your son's wishes? As far as whether I'd even recommend a bipolar patient for such service, I'd need to know:

1. How long has the person been diagnosed?
2. Is there medication involved? How long has the person been taking medication? When was the last medication change? Do blood levels of the drug need to be monitored?
3. What are the patient's counseling/therapist needs? How often does the person need to see a therapist or psychiatrist?

Personally I'd want to see 6-12 months of stability on the current regimen before recommending anyone for service. Missionary service is stressful and can throw people off kilter if their mental status is tenuous.

The other issue is whether the doctor is LDS. Either way, if you or your son are doing this just to go through the motions (ie. being medically rejected is better than coming home early or rejection for lack of worthiness), and if the doctor is not LDS, you may need to educate the doctor on why a medical rejection is what you want (i.e. if you want the MD to recommend "no service"). If your doctor is LDS, it will be harder and the doc might bend the evaluation in the church's favor "although the applicant is only recently diagnosed with bipolar disease, I feel he will make a fine missionary". If the doctor is LDS but sympathetic to your concerns, perhaps you can be honest with him/her (I've never met a female LDS physician in my life, but I digress.).

If on the other hand you and your son DO want him to serve, but are concerned for his health, this needs to be addressed with the doctor, particularly if Doc is LDS. i.e. "we are supportive of our son's mission but do not want to place his health in jeopardy, so we feel it is vital that you recommend exactly what he needs: weekly counseling, monthly psychiatrist visit, etc. If the doctor spells this out on the form, most likely it will be heeded, as per that DesNews article (review committee concurs with hometown MD >95% of the time). Since the doctor doing the exam is most likely NOT the person treating your son for mental health, a letter from that professional (psychiatrist or whatever) to the doctor doing the evaluation form would be helpful, especially in term of the recommendations for continued mental health care.

You are welcome to e-mail me with any concerns, or of course use the forum discussion board if you prefer.

PS the football player in question married a Catholic girl back east and today is the father of three never-Mo children. I first found the RFM board while researching what I could do to help him avoid service. Prior to him, I had done several physicals for candidates who appeared eager to serve.

Outside the church, this is also a real problem.

Many people with severe mental illness are dumped by social services, courts, and corrections into AA, and other 12 step programs. Of course these people are not only unqualified to deal with these problems but also often counsel vulnerable newcomers to stop taking all prescription medication.

This is in addition to the fact that criminal predators are not only allowed but encouraged to network anonymousy. The recenct home invasion, rape, torture, murder, and arson of a Conn (or was it Delaware?) physician was the work of a AA sponsor/sponsee team, and both were there as a requirement by corrections.

It is unfortunate that people are dumped into this organization (faith) that continues to recieve unearned admiration and undeserved credibility.

I re-read your original message and now realize his application is already in the pipeline.

Do you know what his primary doctor wrote in the application? Was this MD fully informed of your son's problems? If in fact he is taking psychoactive medications, that would have been a red flag for the review committee. But I don't think he should see a church psychiatrist. An evaluation by an independent psychiatrist would be most appropriate, since that individual will have the son's--not the church's--best interests at heart.

I am bipolar..stress is what causes my symptons to emerge...as long as no stress, and daily medications I am pretty normal...without meds and high stress....l have tried sucide 4 times...if you love him...withdraw his paperwork, get meds balenced, seek ongoing medical help...keep all stress out of his life as much as possible.... a missions may kill him...

Dear Ex-momom,

I had obsessive compulsive traits before my mission. I lived in Provo and I was weak and bullied into serving. Because of my mental illness I was not accepted socially by the other missionaries and I failed miserably.

Adding to this was hardcore doctrines in the MTC and the mission field telling me that I didn't have faith in God, because with him any problem is curable. I nearly committed suicide on multiple occasions because I felt dirty and flawed.

Socially, your son will be seen by the church as flawed and defective for the rest of life if he returns early. If he doesn't go, people will much more accepting later. The church breaks people down at the MTC. It imposes its own perceptions about life that are not reality based. Because your son is having a difficult time with reality now, sending him on a mission could mean that he will never find his way back to reality. Think about this very very carefully.

Make sure that your son KNOWS that you love him the same whether he stays home or returns early. Tell him he can stay with you and have all the peace and time to recover that he needs.

I wish you the best and you son too. Mental illness saps the joy from life. But with intervention, patience, and kindness from parents and family it can be managed well and people can have good lives. Please love your boy no matter what the church does to him. Make sure he knows that Jesus loves him the same. When I mentally broke in the mission field a missionary tried to molest me during that time of weakness. Try to keep your son home. Try to keep your son home.

Thanks for all the replies. I'm lucky to be married to such a caring woman as Exmowife. It's of course, my son we are referring to.

The fly in the ointment is this: due to my leaving the church years ago this particular son wrote me out of his life Christmas of 2009. Since then, we have had no contact. He just can't accept after serving a mission & being BIC I would walk away from it all. His mom is uber-TBM. So the situation is complicated.

At this point I plan to email his mom & express my concern over his mental stability to go on a mission. Afterall, she has to bear in mind that I know what missions are like & she never had the experince.

Side note. When my wife read the reply from you Pt Loma I knew who wrote it before she told me. You are always very insightful! Thanks!

Thanks for the kind words, Travis. I may not own a Harley but we see eye to eye. ;)

I am so grateful for all of the heartfelt responses. My own son has severe mental illnesses; so did his father. Stigma and ignorance play a large role in the social denial of accepting brain illnesses as physical illnesses. I do my best to advocate and educate for many disorders, but it will take many more to make enough of an impact in this social issue.

Thank you for the information, it is very helpful. Thank you for your prayers, I am sure they make a difference. We will do what we can to ensure that DH's son is spared tremendous pain in the mission field, but I am not sure he will not find more pain in staying home, should that come to pass, as that is not his mother's wish.

It's a Concourse 1400 and a DRZ400 that we own, Pt Loma. I can not ride a Harley - too much vibration and noise, not enough energy to the power of the machine.

As one who suffers from bipolar disorder, along with severe OCD, I would say going on a mission could be a breakdown waiting to happen.

I take medication, and have been in therapy since I was 17 (I'm in my late 40's now). I still battle with symptoms everyday, and I've required hospitalization many times over the years, just to stabilize and get my meds balanced.

I'm glad he has you, and that you're so concerned. There's such a huge emphasis on serving a mission, and it can be extremely stressful for even the most "stable" young man or woman.

If he has you, at least he will have a relative to take his part if conflicts arise about "to go, or not to go".

Stay in close contact with him, and let him know you're on his side, no matter what.

In spite of his illness, he's very fortunate to claim you as a relative.



Edited 1 time(s). Last edit at 08/08/2011 10:37PM by hapeheretic.

Maybe he can serve an administrative mission, or even be an e-missionary answering questions in the "ask a missionary" chat. I've read articles about other would-be missionaries, who had health issues that prevented them from serving in other environments, serving in that capacity (I think they lived in the MTC so it was still an away-from-home, rules-bound experience). Perhaps something like that would provide more stability and be a healthier experience for him. If he could do something like this, he'd avoid the (unfortunate and ridiculous) "shame" of not serving, and also avoid situation that might trigger an episode.

I also mentioned administrative mission, like perhaps assistant to mission prez, or something like that. However, I don't know much about them. Maybe someone else can weigh in? As long as he "has" to go, anything that would keep him from a tracting situation, and also the constant change of relocating, would be much healthier for him.

OP- even if he has written you out of his life, you can still contact his therapist and express concerns and urge the therapist to write a letter to the "powers-that-be" in SLC.



Edited 1 time(s). Last edit at 08/10/2011 08:19PM by wittyname.