The Church and Mental Health
(The Invisible Congregant)
A person at a conference once shared with us, “When someone comes home from having knee surgery, half of the church brings food, stopped by and sent cards.
When my husband came home from the hospital after a suicide attempt, our fridge stayed its usual empty.”
Most of us know someone who is in counseling, on medication, or has even taken his or her own life as a result of a mental illness. There are many difficult issues for Christians to talk about, and mental health would certainly be near the top of that list. Yet, this is a conversation the Church needs to have. Suicide may be one of the most complex and demanding topics of all. Over the past few years, the discussion has felt forced, especially when the event is connected to high-profile suicides of prominent Christian leaders or their family members and close associates.
A question we tend to ask pastors in conversation is, "If you knew that 50% of your congregation was struggling with adultery, would you speak to it in your sermons and special messages?" Invariably, every pastor to date has answered this question with a YES. Unfortunately though, there is a disconnect somewhere, because we know statistically 50% of our congregations are dealing with mental health issues to some degree, yet the average pastor speaks on the subject once every 3 years.
It is this exact disconnect that identified the need for us to create the Church Suicide Foundation. For years we have spoken at special events at churches, worked with youth groups, conducted the Sunday sermons, and more. With the creation of this new program though, we also work directly with church administration to educate, help develop programs and processes, build groups for support, and create a local resource database for referring people in need.
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Mental Illness & Christian Faith Research (by LifeWay Research)
Most pastors indicate they personally know one or more people who have been diagnosed
with clinical depression (74%), bipolar disorder (76%), and schizophrenia (45%)
59% of pastors have counseled one or more people who were eventually diagnosed with an acute mental illness
22% of pastors agree that they are reluctant to get involved with those with acute mental illness because previous experiences strained time and resources
38% of pastors strongly agree they feel equipped to identify a person dealing with acute mental illness that may require a referral to a medical professional
The most frequently used learning resources for pastors have been reading books on counseling (66%) and personal experience with friends or family members (60%).
23% of pastors indicate they have personally struggled with mental illness of some kind
The response of people in church to individuals’ mental illness caused 18% to break ties with a church and 5% to fail to find a church to attend
17% of family members in a household of someone with acute mental illness say their family member’s mental illness impacted which church their family chose to attend
53% of individuals with acute mental illness say their church has been supportive
Among individuals with acute mental illness who attended church regularly as an adult 67% say their church has been supportive
68% of pastors but only 28% of family members in a household of someone with acute mental illness indicate their church provides care for the mentally ill or their families by maintaining lists of experts to refer people to - THERE IS A MAJOR COMMUNICATION ISSUE HERE
7 Reasons Why Church Is Difficult For Those Touched By Mental Illness
Twenty or so years ago, Dr. Stephen Grcevich found himself in a board meeting at church, listening as his children's ministry director described the challenges some of their most committed members were experiencing in maintaining their church involvement after adopting children from orphanages in Eastern Europe, and the steps the church was taking to support them.
As a physician specializing in child and adolescent psychiatry, he wondered whether church participation was a problem for the types of families served by their practice—kids with anxiety, depression, or ADHD, and parents who were often receiving treatment for a mental health condition. He began informally surveying families about their church involvement during follow-up visits and was floored by some of the stories they shared.
In Dr. Grcevich's experience, families in which a child or parent is being treated for a mental health condition are significantly less likely to regularly attend worship services or participate in small groups, Christian education, or service activities than their friends or neighbors. Given that one in five children and adults in the U.S. experience at least one mental health condition at any given time, their families represent a large population desperately in need of tangible expressions of the love of Christ and the spiritual benefits associated with active participation in the life of a local church.
Evangelically-minded churches have made great strides in recognizing the struggles common among persons in the church with mental illness. Where we have much work yet to do is in connecting with individuals and families outside the church and formulating strategies for welcoming them into our worship services and including them in activities most critical for making disciples.
A first step to effective outreach and inclusion is to recognize why church involvement is so difficult for families affected by mental illness. Here are seven potential barriers to church involvement for persons with common mental health conditions and their families:
1. Stigma: Our churches are widely perceived by outsiders to be unwelcoming places for persons with mental illness. According to one study by LifeWay Research, 55% of respondents who never attend worship services disagreed with the statement, "If I had a mental health issue, I believe most churches would welcome me."
This perception may be fueled by the stories shared by persons who reported negative experiences or left the church entirely after seeking help for a mental health condition. Similar to Job's friends who sought to support him in his grief and loss, many church leaders and attendees are quick to assume that suffering associated with mental illness is a consequence of personal sin or to suggest the persistence of illness is a consequence of insufficient faith or an inadequate prayer life.
2. Anxiety: One in 15 American adults experience social anxiety disorder—a condition resulting in significant fear and distress in situations where their words or actions may be exposed to the scrutiny of others. How many social interactions might a first-time visitor to a weekend worship service need to navigate at your church? Persons with agoraphobia frequently experience intense fear, heart palpitations, breathing difficulties, excessive perspiration, and nausea in public places where their ability to leave unobtrusively is limited. How might they feel if there are no seats available near an exit at a worship service, or if a well-meaning usher directs them to a middle seat near the front of the church?
3. Expectations for self-discipline: The Bible clearly equates self-control with spiritual maturity. Most mental health conditions can negatively impact executive functioning—the cognitive capacities through which we establish priorities, plan for the future, manage time, delay gratification, and exercise conscious control over our thoughts, words, and actions. When children struggle with self-control in the absence of obvious signs of disability, we're often quick to make assumptions about their parents. One mother in describing her family's experience in looking for a church with two school-age boys with ADHD observed that, "People in the church think they can tell when a disability ends and bad parenting begins."
4. Sensory processing: Heightened sensitivity to light, touch, noise, and smell isn't limited to persons with autism spectrum disorders but is often also associated with anxiety disorders and ADHD. For someone with sensory processing differences, the hustle and bustle around entrances and exits before and after worship services, the volume of the music performed during the praise and worship time, expectations for greeting fellow attendees with handshakes or hugs, and the aroma of strong perfume or cologne worn by fellow attendees may all produce intense discomfort.
5. Social communication: Churches are intensely social places, and Scripture is clear that we were created to live in community with one another. Some people with common mental health conditions struggle to pick up on language cues essential to day-to-day interaction—body language, facial expression, eye contact, tone, and inflection of voice. They may fail to pick up on the "unwritten rules" for conduct and behavior common in many churches or misinterpret interactions with church leaders or fellow attendees.
6. Social isolation: Persons with common mental health conditions are less likely to have friendships and social connections that produce invitations, worship services, and other church activities. Persons with depression frequently withdraw from social activities, and many with anxiety disorders actively seek to avoid them. Kids experience more difficulty making or keeping friends who will invite them to Awana or youth group activities. Their parents often encounter great difficulty finding qualified child care so they can socialize with friends and neighbors or participate in small groups at church.
7. Past experiences of church: Many families impacted by mental illness carry with them the baggage associated with past negative experiences of church. Kids with mental illness often inherit their predisposition for their conditions from their parents. If mom or dad experienced a condition during their childhood and teen years affecting their church involvement, the likelihood that they'll seek out a church for their family as a young adult is markedly diminished.
Families touched by mental illness represent an enormous potential mission field literally living within the shadows of our steeples. A first step for pastors and church leaders seeking to minister to them is to identify potential obstacles to their participation in worship services and other activities most critical for discipleship within your church and consider how those obstacles might be overcome.
The Invisible Congregant
Mental health and illness have always been one of society’s greatest curiosities and infatuations. With popular films and shows such as Silence of the Lambs, The Shining, and Criminal Minds, or infamous killers the likes of Ted Bundy and Jeffrey Dahmer, one can barely escape the enchantment of psychological drama.
Spoiler alert: Mental illness is not as exciting as it looks on the big screen.
The church’s history with mental illness is rocky at best. In her book, Madness: American Protestant Responses to Mental Health, the Rev. Dr. Heather Vacek, associate professor of Church History at Pittsburgh Theological Seminary, explores the successes and failures of addressing mental illness from colonial times through the modern means of today.
At the core of the church’s mishandling of mental illness is the belief in a relationship with sin. Great sin must be the event preceding complex psychological or demonic infestation. Biblical passages offer this same terminology and etiology. In Matthew 9, Jesus rids a man of physical paralysis by proclaiming the forgiveness of his sins, and similarly whilst casting out demons.
But while popular verses like Philippians 4:13 bring many of us strength and peace, do they also protect us from having to interact with the complex and often taboo nature of mental illness?
Exhibit A: While completing an internship in an adult and adolescent psychiatric hospital, I took on a patient who will go by the pseudonym Dillon. Dillion is a male in his mid-20s and struggles with intellectual disabilities, schizoaffective disorder, substance abuse, homelessness and incarceration – a mental and social Molotov cocktail. Born to parents who also struggle with addiction and instability, Dillon had few constants in his life.
His one crutch – attending church every Sunday.
When it was time to seek intensive care, only a faith-based program would suffice. Dillon traveled to an unfamiliar area to seek the support and structure needed to survive.
A local pastor who ran a half-way home took Dillon in. Thinking this would be where is problems would end, Dillon soon faced the harsh realities of stigma in the church.
After a mild increase in psychotic symptoms, Dillon appeared on the psychiatric unit, and after some adjustments to his medication, it was soon time to leave. I called the pastor to tell him he could pick Dillon up, but was informed that he was no longer welcomed.
“Why?” I asked. With too much ease, the pastor told me Dillon had been relying on prescribed medication for his illnesses, which went against the church-based program’s philosophy.
Dillon’s one last chance, the one place where he always felt at home, had turned their back on him.
After pleading with the pastor to reconsider-—even diving deep into Matthew 25’s call to shelter the homeless—Dillon and I were left to face the reality that the church just made him homeless yet again.
Dillon’s case may be extreme in diagnosis and experience, but allow me to return to the opening paragraph. Why does the church struggle with even the most common materializations of mental illness: depression, bipolar disorder, self-harm and suicide?
Much of what the church does—or doesn’t do—is in response to its leadership.
A 2016 study conducted by LifeWay Research and published in ChristianityToday revealed the horror and reality that only seven percent of church pastors discuss mental health with their congregations “once a month” or “several times a month.” Meanwhile, 92 percent of pastors reported talking about mental health in sermons or church functions “once a year, rarely, or never.”
It is imperative that pastors speak openly about mental health—their own trials or in general. Fear of speaking on tough or taboo topics in church is profoundly counter to the church’s objective of being a safe and welcoming place for peace-seekers and those in need of care.
Famous mega-church pastor and author, Rick Warren, was compelled to speak to his massive congregation and followers around the world in the aftermath of his son’s suicide.
Warren said to his congregation, “There is no shame in diabetes, there is no shame in high blood pressure, but why is it that if our brains stop working, there is supposed to be shame in that?”
So how do churches tackle the topic of mental illness?
It starts with the acknowledgment that depression, suicide, addiction and the like are common realities. While they differ from other ailments in their physical location, the experience is as painful and inconvenient as a stroke, heart attack, fall or hip replacement.
Once we see psychological ailment in the same light as physical ailment, only then can we grow. This happens through large and small group conversations and allowing those who struggle to struggle openly.
It is as simple as opening the church doors to regular Alcoholics and Narcotics Anonymous (AA and NA) meetings. This shows the congregation and the community that those with psychological angst can find respite within these walls.
It is as simple as having guest speakers who can inform and lead if it is out of the pastor’s wheelhouse.
It is as simple as not being afraid to visit or call. The common response is, “Well, I don’t know what to say.”
From someone who has dealt with personal mental health trials for over a decade, I will let you in on the secret: just have a normal conversation as if they were experiencing any other ailment. “Get well soon” and “thinking of you” mean the same to the depressed congregant as it does to the one who broke a leg. We – and I say “we” because I’m in the box of Christians with mental illness – just want to feel supported.
And finally, talk to the young people. Our younger generations are the most accepting, understanding, and inclusive among living generations. They are exposed, either by experience or knowing someone, to the realities of depression, anxiety, self-harm and suicide.
The church’s youth hold the answers and the drive many churches seek, and it is time to tap into that as well.
The conclusion is simple in that, though mental health is complex, the response is contrarily simple. It boils down to basic actions of care, compassion and understanding. It doesn’t – or shouldn’t – require a bold awakening.
We, the church, have the power and the resources to change stigma surrounding mental health and medication. We just have to use them.
As Ellen DeGeneres always reminds us, “Be kind to one another.”
Dewey Mullis recently received a Master of Arts in Clinical Counseling from Moravian Theological Seminary and currently works with Pinebrook Family Answers in Allentown, Pa. This article originally appeared on the Board of Cooperative Ministries Spotlight Blog.