How should the church help people with mental illness?

Most people don't talk much about mental illness. And because of this silence, many of us have the misconception that mental illness is something rare, something that happens to unusual people at the margins of society.

We couldn't be more wrong. Every year in the United States, more than 25 percent of adults suffer from a diagnosable mental illness. These afflictions include serious and chronic diseases like schizophrenia and bipolar disorder, as well as more common problems like depression and anxiety disorders—and everything in between.

Most church leaders have encountered mental illness in their churches. When people seek help for mental illness, 25 percent of them go first to the church. This is higher than the percentage of people who go to psychiatrists and general medical doctors. Many people are looking to the church for help, but many church leaders don't know how to help.

The best way to help someone who is struggling with mental illness is to be real community to them. This often works best in small groups. Small-group leaders are in a unique position because they minister so closely to a few people. When mental illness affects someone, either personally or as a family issue, that person carries that burden every single day, and small groups can help them carry the load. But small-group leaders and members may not know how to help and may actually respond in ways that are counterproductive. Here are some productive ways you can respond:

Acknowledge your fears. Many of our first reactions to mental illness are based in fear, either because we see our own potential reflected in people with mental illness, because we believe people with mental illness are inherently violent (which is not true), or because we're nervous about uncomfortable conversations or situations we don't know how to handle. It's important to acknowledge these fears and to learn to separate legitimate fear from irrational fear.

Recognize and embrace the truth that people with mental illness are people created in the image of God, loved and valuable. People with mental illness are no less important than others, and people with symptoms are no less valuable than when they're not experiencing symptoms. This attitude is an important starting point for ministry.

Foster a culture of compassion and authenticity in your group. Set the example so it becomes normal for people to be real about what they're experiencing, even when that truth is not pretty. This doesn't have to mean your group is obsessed with sharing the worst about themselves with no regard for social consequences; this can be modeled in a healthy and redemptive way. Neither does it have to mean giving people an excuse to stay where they are and refuse to grow. It's just a matter of giving people the chance to be honest about who they are and the circumstances of their lives. This will go a long way toward allowing people affected by mental illness to feel less marginalized.

Watch your response. If a person announces he or she has a mental disorder, don't act shocked, try to give them answers about why they’re suffering, or try to solve the problem for them. Accept the news as you would an announcement that someone has a heart condition or a back injury. A loving and emotionally even response will show acceptance and maturity that mental illness is not always met with.

Care for them. Think about what your group is already equipped to do for someone in crisis or suffering from other kinds of sickness, and do that same kind of practical ministry: bring meals, care for their children, visit them in the hospital, and visit them at home if you're welcome. Also realize that unlike some other medical conditions, mental illness is often chronic or repetitive. So the crisis might repeat itself, and you may need to provide this kind of support again. You may even need to help on an ongoing basis for a matter of years. It's important to have appropriate expectations and to be patient with afflicted people and their families.

Consider helping financially, especially with the cost of medications and treatments. Psychiatric medication can cost thousands of dollars every month. Insurance companies tend to approach coverage differently for mental disorders, and necessary treatments aren't always covered. Many people affected by mental illness lose their jobs or are disabled for a time, with obvious financial implications.

Establish your personal boundaries and stick to them. Are you willing for group members to call you at home? Visit your home? How much time can you spend doing direct ministry outside your group meetings? Answer questions like these, tell your group about your boundaries, and apply them consistently with everyone in the group. Then stick to them. If someone violates your personal boundaries or demands more of you than you can give, grant the person the dignity of restating your boundaries rather than just ignore the person or drop out of his or her life.

Model acceptance. Set an example of acceptance during your group prayer times by sometimes praying for people affected by mental illness, just as you do for people affected by other forms of illness and injury. Without sharing any confidential information, mention people struggling with mental illness in your prayer requests—maybe someone in your family or workplace is suffering, or make your request general. Do this without passing judgment or giving commentary on people's illness. This ministry can go a long way toward creating a feeling of safety and hope.

As a group, decide what kind of behavior you will tolerate. Make those expectations very clear to everyone, and establish what action you'll take if someone violates those group expectations. Then if a person's behavior becomes a problem, follow the established process. But be sure to make clear you are addressing the person's behavior, rather than the mental illness. Don't assign an amateur diagnosis, and do not suggest that the person needs to "fix themselves" before being accepted into the body of Christ. Simply restate the group's expectations and your requirement that they be honored. Please also be gracious when forming the expectations, allowing for some latitude in social skills and focusing on what's truly important.

Work through a Bible study on mental illness. offers two great studies: Ministering to Those with a Mental Illness and Troubled Minds: Responding to Mental Illness, or read a mental-health-related book (such as my book Troubled Minds) together and discuss it. Mental illness is rarely addressed in sermons, church classes, and small groups. Bring the issue out into the open and give people permission to discuss it while wrestling through their theological questions.

Get some training. Encourage your church to host a small-group training event for all small-group leaders, perhaps through FaithNet programs, sponsored by the National Alliance on Mental Illness (NAMI).

Pray together. If someone in your group is affected by mental illness and gives permission, pray for that person as a group. But please do this in a way that does not suggest that prayer is a substitute for mental-health treatment. Simply demonstrate that you care, that you know God cares, and that you believe prayer is powerful in the life of every suffering person—and an important part of every pursuit of healing.

Call the police when necessary. If you believe a person is a danger to self or others, always call the police. Don't try to handle it on your own.

Refer to a professional when appropriate. If you believe someone needs referral to a mental-health professional for treatment, talk to the leaders in your church or contact a local Christian counselor for suggestions.

Remember, you are an example of God's love. The way you treat people affected by mental illness will probably translate, at least to some degree, into how they believe God perceives and treats them. Your attitude and actions are powerful. Please make them thoughtful and sensitive.

—Amy Simpson is author of Troubled Minds: Mental Illness and the Church's Mission and serves as editor of Christianity Today's Gifted for Leadership. You can find her at and on Twitter @aresimpson. This article originally appeared on; copyright 2013 by Christianity Today.

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