What Should We Take Away From Slate’s Missionary Health Article?

We posted recently about the Slate piece by Mark Joseph Stern about missionary health care, and Jana Reiss’ piece at Flunking Sainthood in response. Both are worth a read, but the gist is that Stern reported that missionaries are often denied medical care in the mission field, and Reiss pointed out that his piece lacked some key information and relied instead on shock journalism, which undermined its potential positive influence in Church policy or culture. She’s right, but there is something worth taking away from Stern’s piece anyway, especially given the much-needed attention it is attracting. After all, I was a missionary who received pretty good care when compared to the stories in Stern’s piece, and yet I still found his article consistent with my experience in many ways.

It is a shame that Stern didn’t find the numbers Salt Lake Tribune published, or that he was apparently oblivious to the article at all, but I don’t necessarily fault him for relying on anecdotal evidence. There are some stories where that approach is entirely appropriate, like a story about an individual’s health. It’s also very clear that Stern was writing to an audience unfamiliar with Mormonism and how missions work, since the bulk of the article is actually explaining details about mission life in general. In that context, I think a lot of people would be shocked to find out there is no uniform missionary health plan, and that there are cases—even if they are the minority—where leaders block access to hospitals and doctors. And we should consider how that looks to outsiders, who are unbiased with feelings of religious determination when it comes to missions.

So I wouldn’t go as far as Reiss’ rebuke. The truth is likely somewhere in between. Because as much as Stern relied on personal stories about health failures on missions, most critical responses are full of the same kinds of personal stories, but with a different outcome. Allow me to add to this discussion.

I served a mission in St. Louis from 2004-2005, leaving after only eleven months due to serious depression and anxiety. From my perspective, the Slate piece felt so familiar and consistent with my experience. Like one of the stories in Stern’s piece, I too regularly have dreams about packing up my life and returning to St. Louis to finish what I started, and when I did return my friends avoided me for a while, an unintentional ostracism caused by the uncertainty of an early returned missionary’s status.

The St. Louis mission in particular is interesting, because a few of the missionaries developed a theory on why we had been picked for that particular mission. St. Louis has fantastic medical facilities, and a surprising number of missionaries in the field had serious health issues prior to serving. My first companion, for example, once had a large tumor removed from his leg. During a district meeting, we hypothesized that the easy access to state-of-the-art medical care was a key factor in many missionaries’ assignment in St. Louis.

Like I said, this was just a theory, and maybe those connections are merely coincidence, but I’d like to think there was some practicality to mission placement besides just a spiritual prompting. Come to think of it, during my mission a senior missionary couple also faced a battle with cancer, but remained in the mission field and sought treatment in St. Louis, and they also attributed their call to the area as a sort of protection from God from illness.

There was a surprising number of missionaries with mental health issues as well. I have no idea if we were above average compared to other missions—I’m not sure if that data is available per mission—but mental health treatment was readily available, though missionaries were often too embarrassed to seek treatment, since depression can feel so similar to spiritual inferiority. LDS Family Services offered a therapist to talk to missionaries who felt depressed, and he was actually one of the most helpful therapists I’ve ever met. He listened well, and since he too served a mission, was incredibly sympathetic to our situations.

There was another, slightly unorthodox route for treating mental health in the mission. A local psychiatrist, who was also a member of the church, would meet with missionaries in the field and prescribe antidepressant or SSRIs if needed, but in lieu of an expensive trip to the pharmacy, would provide a stockpile of samples that drug companies passed out to doctors. Thus, my first experience with taking antidepressants was out of a paper bag full of pop-out foil sheets of Lexapro. To this day, it’s probably the most consistent and useful psychiatric treatment I’ve ever received. Even still, with my mostly positive experiences with mission healthcare, I always felt the overall approach severely lacking.

All of my good experiences with health care on my mission were offered pro bono by members of the church. One dentist I saw on my mission flat out told me he wasn’t giving me the best care, but the cheapest and quickest, in case my parents couldn’t fit the bill. They knew they couldn’t, so I wasn’t really in a position to complain since he was seeing me for free, but how is that okay in the first place? Especially when missionaries are required to pay their own way. Which I think is the point of the Slate piece. How can an institution as large and financially stable as the LDS church continue to send out young people into potentially dangerous situations without a guarantee of adequate health care?

So Stern practiced shoddy journalism. That sucks, but it also sucks that the conversation can’t be turned around to the more useful, “what is the problem and how can we fix it?” These stories might not be the norm, but that doesn’t mean they don’t reflect a real problem in the missionary structure of the Church. It’s like the health care debates of a few years ago, when Obamacare opponents claimed that they received excellent health treatment in America, so what’s the problem? The problem is that treatment is not universal, and in the church, “leadership roulette” is a lousy excuse for letting these kids get sick.

It wouldn’t take a lot to fix. For example, would we see a significant drop in missionaries if the monthly cost was raised enough to offer medical coverage for missionaries? Without relying on volunteer services from members? I doubt it. But even further, would it be such a bad idea to call retired doctors from the church to serve as mission medical consultants as an option for the first call if a missionary is sick, rather than the mission president’s wife, who in many cases has no medical experience? Or mission therapists, an expansion of LDS family services, to confront the ongoing struggle of mental illness among missionaries?

These are simple solutions, and worth considering as long as we don’t get distracted by bad journalism. But we’ll never get there if we don’t expose ourselves to the idea that the Church and its mission program are susceptible to flaws.