The 2023 warning from Thomas Insel, the former director of the National Institute of Mental Health, was pretty stark:
Our nation is facing a new public health threat. … Feelings of anxiety and depression have grown to levels where virtually no one can ignore what is happening. … 90% of Americans feel we are in a mental health crisis.
They are right. The evidence from both clinical research and government assessment indicates a rapid increase in prevalence, need, and cost of mental health services in virtually every category (e.g., suicide, addiction, and trauma) and virtually every demographic and age group.
There are many reasons for this crisis, both within the church and in society at large. Countless studies have looked at factors as diverse as marital breakdown, the prevalence of racial injustice, and the use of smartphones at key stages of emotional development.
It’s likely that any number of factors may be contributing. But we propose that underneath all of that is a well-intended but ultimately harmful tendency to devalue the help the church can offer to many people in crisis.
Indeed, it is not too much to say that mental health care is the evangelism, church-growth, discipleship, and church-engagement method of the 21st century. Rather than funneling people out of the church, we can view mental health as an opportunity to draw people in.
For 50 years, society has created a professionalized mental health culture as the primary means of caring for those in distress. Initially, in order to access insurance coverage, the counseling profession began redefining most psychological needs as having a medical pathology. But over time, this resulted in licensed counseling becoming the standard of care for all life stressors.
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Now, just to be clear: Much about the rise of skilled professionals has been extremely helpful. Sophisticated, empirically validated research has uncovered key ways to address mental health disorders and challenging life issues. Specialists apply precision and clarity to complex problems. And state licensing standards ensure that therapists have a high level of training, skill, and ethical adherence.
To speak directly to the clinician: You have made a significant difference in the lives of untold numbers because of your expertise and care.
The downside of this trend, however, is that vast numbers of people—those with diagnosable disorders and those with significant life pain—flood therapists’ offices. With therapy as the treatment path for all levels of pain, the capacity for care is overwhelmed.
Imagine the panic of a parent whose eighth grader deeply struggles with academic anxiety and needs a counselor but must wait three months for an appointment. Three months! By that time, the child may have failed the eighth grade and internalized the idea that nothing is ever going to change.
Meanwhile, in the church, we have become increasingly uncomfortable with addressing mental health concerns. Like their secular counterparts in medicine, business, and education, most church leaders see “referring out” as the thing to do.
We often hear the rhyme that one pastor used on our survey, “When in doubt, refer out.”
Thus, when help seekers come to the church, they may talk to a pastor, but much of the time they are also referred to a mental health professional. On our national survey, 67 percent of pastors and church leaders fully agreed with this statement: “If a person’s presenting issue is primarily psychological rather than spiritual, the church’s primary mental health service should be to refer to a mental health professional.” Only 12 percent disagreed with that statement.
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It’s our perspective that referrals are indeed often needed. Yet there’s an unintended consequence to this overall pattern of referring out: People are being funneled out and away from the church at a time when people need the church most!
Of course, there are times when people need more help than a pastor or a ministry can provide. But in many cases, churches are letting professionals do what the church was intended to do. It is time to stop thinking of “mental health care” as essentially synonymous with “professional counseling,” and instead see it as just one more everyday example of Galatians 6:2: carrying each other’s burdens to fulfill the law of Christ.
Our book, When Hurting People Come to Church, explores in far greater detail than we can offer here what this looks like, practically speaking, for local congregations with varying size and resources. The key is that laypeople within the church can be trained to listen and walk alongside those with basic needs.
This is not therapy, but presence, and is important even when we also refer to clinicians. For example, a new mom with postpartum depression might be referred to a counselor and connected with a woman in the congregation who went through the same thing 20 years ago. They talk, pray, share experiences, and get together for regular lunches—something a licensed counselor is not permitted to do.
Imagine how this approach would shift the way we think of church outreach, human care, discipleship, and evangelism!
The church has a historic opportunity to reclaim its central role in attending to human suffering. Our vision is for the church to step into this original design: to be the primary place where the love of God, redemption through Jesus, and the power of the Holy Spirit are experienced by the culture.
Jesus’ metaphors of salt and light suggest that we are to bring life to the world. He entered into the culture by healing the leprous outcasts, giving sight to the blind, and restoring the woman at the well. In our day, we can bring comfort and healing to the isolated and lonely, help people see their great worth in God’s eyes, and support the transformation of those in recovery.
For years, we have tended to think of mental health ministry as only being about helping people with specific, defined, and diagnosed disorders such as depression, anxiety, and personality disorders. Let’s think bigger. Think of the church as the on-ramp through which people address their life pain.
After all, much of the culture already does. According to a 2020 British study, “In America, as many as 40% seek support from clergy for mental health concerns, with studies identifying that individuals with … mental health diagnoses were more likely to seek support from clergy alone, than psychiatrists and psychologists combined.”
Let’s pause with that for a moment: These researchers, seeking ways to improve mental health services in the United Kingdom, looked “across the pond” and noted that for many in the US, the first step to obtaining mental health services is through the church.
The church doesn’t need to become the center of the solution; it already is. We just haven’t always realized or accepted this role. So we have the need, we have a culture with a near-desperate cry for aid, and we have a church capable of delivering the needed care as part of the Great Commission.
We are in the midst of a massive human crisis—people are experiencing distress and isolation in proportions never seen. And Christians are uniquely positioned to address it: We have churches in every community, each composed of ordinary people who are willing to care for others, many of whom want to be taught how to come alongside someone in pain.
Mental health care is not only an option for the church. It is a duty to God and our neighbors in need.
Shaunti Feldhahn is a best-selling author, popular speaker, and social researcher whose work helps people flourish in life, faith, leadership, and relationships. Her books have sold more than 3 million copies in 25 languages.
James (Jim) N. Sells is the Hughes Endowed Chair of Christian Thought in Mental Health Practice, a licensed psychologist, an author, and a professor of counseling at Regent University, Virginia Beach, Virginia.
Adapted from When Hurting People Come to Church: How People of Faith Can Help Solve the Mental Health Crisis by Shaunti Feldhahn and James N. Sells, releasing in September 2025.
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