On the Challenges of Spiritual Leadership and Caring for a Child with Mental Illness Several years ago I received a call asking me to come home early from a rabbinic seminar in Jerusalem, Israel. My son had slipped into a severe depression that led to a hospitalization. I needed to be near to support and advocate for him. I told my colleagues that I had a 'family emergency,' changed my flight arrangements, packed and hurried to the airport. I got there early for a post-midnight flight and found myself with a long wait. I located the small synagogue at Ben Gurion Airport and searched the book of Psalms for a passage that would help me through my journey. I came upon Psalm 34:19. "The Lord is close to the broken-hearted; those crushed in spirit He delivers." קרוב השם לנשברי-לב ואת-דכאי-רוח יושיע Karov Hashem l’nishbarei lev, v’et dakei ruach yoshi’a. I lost track of time as I meditated, chanted and sang the words. I was so absorbed in my prayer that I almost missed my flight. I will always remember that night of supplication and prayer. Through the years as I have watched my son face his mental illness with courage and tenacity that psalmist's line remains close to my heart. In Hebrew, "crushed in spirit-dakei ruach” is the ancient source for the current Hebrew word, "dika'on," meaning depression. It is only in recent years that I have been able, with my son's encouragement, to acknowledge his struggle and to share mine as a parent and rabbi. I had been a pulpit rabbi for 16 years and a spiritual leader of a thriving congregation in Seattle for 10 years when my son began to show signs of mental illness. After the symptoms started, we immediately sought therapeutic help for him. As his illness grew more serious, and he began to isolate himself, we entered a period of several years of chaotic intervals between traumatic events and extended periods of anxious calm. During his later adolescent years, when his illness was in its most difficult phase, it became very difficult to balance my duties as a spiritual leader of a large and growing congregation and the need to care for my son and protect his and our family's privacy. One of the great challenges for parents who care for early onset mental illness in their children is the strain that illness puts on the family and at the workplace. This is even greater for men and women in the clergy who already face demanding jobs that require attentiveness to the needs of the flock and focus on the array of tasks needed to lead and maintain a congregation. One of the great challenges of caring for a loved one living with a mental illness is continuous unpredictability. As our son got sicker, emergency calls became more frequent, interrupting meetings and work obligations. While it must have been obvious to attentive congregants that something was amiss, I would explain away the interruptions as I sought to keep my family’s challenges private. The most difficult challenge was the shame, the shame my son felt, and the shame we felt as parents. My son felt ashamed by his illness, a very common feeling that comes with mental illness. The shame expresses itself in self-isolating behaviors such as removing oneself from social interactions with peers and a radical turning inward from other family members and friends. As our son felt shame in his life and withdrew, we his parents, living within the very public and social context of the congregation also began to withdraw. I began to invent excuses why I could not attend the celebrations following life cycle events. I came to dread the social time after Sabbath morning services and the 'shmoozing' at congregational fundraisers. The worry also had its corrosive impact at work as I became more and more distracted from my demanding duties and grew impatient with needs of congregants who sought my help. I could not at the time find a way to acknowledge the challenges I faced while protecting my family’s privacy. Unfortunately, I had only a minimal awareness of NAMI at the time. Many years later I became involved with NAMI and eventually was trained to be a NAMI Family to Family teacher. I have learned about the critical importance of self-care for family members. In retrospect I wished that I had conveyed to the congregational leaders my need for extra time for self-care and private time with my family. I believe they would have responded positively to my requests. But the other more difficult issue I faced how to push back and overcome the shame I felt so strongly during those years. The intense feelings of shame made it difficult for me to protect the private, while finding the resources to lead in public. With many years of reflection and new awareness about the impact of mental illness on all types of families, I believe that learning to face the spiritual-emotional challenge of shame and the self-imposed stigma is a core concern. Recognizing shame and its distorting impact is a very critical step toward finding healthier ways to manage the unique demands of caring for a loved one with mental illness while also protecting your loved one's privacy. Fortunately, at this writing, my son has learned to better cope with his illness and was able to complete his undergraduate degree and is now a graduate student. He has found a way to be more open about mental illness with his peers and teachers. His family members have come along with him. We are now better equipped for the journey through the hard times that mental illness keeps hidden in its storehouse. With his permission I am able to speak publicly about caring for a loved one living with mental illness and help others who live in this reality. The psalmist writes in Ps. 51:15, "You will not despise a contrite and crushed heart." If God does not despise those who live with mental illness, then we in imitating God’s ways must also overcome our shame to care and love with a free spirit our loved ones who are in our care. And to teach an ever widening circle how to find compassion and support for those who live with the crushed heart from mental illness.