Nearly five years ago, a high-profile pastor—one who had shared bravely and publicly about his battle with depression—took his own life. In the days after his death, a call circulated widely on social media platforms for clergy with mental health issues to be removed from their posts.
I understand the motivation. The argument was made out of a concern to prevent similar tragedies. But as a pastor who has endured chronic mental torment, the simplistic appeal struck me as an example of the widespread clumsiness within the church when it comes to addressing mental illness. Prominent Christian teachers, most recently including California author and pastor John MacArthur, have denied diagnosable conditions such as OCD and ADHD even exist.
In my own ministry, my struggles with anxiety and OCD have proven to be unexpectedly fertile soil for connecting with people. Opening up about the brokenness in my mind has led to deeper relationships as God took the affliction that initially felt to me like pure deficit and put it to work. His strength, as he tells us, shows up in our weakness (2 Cor. 12:9).
So I find it heartening to see the increased attention to mental health and compassion for mental illness in our culture. Christian resources addressing the intersection of faith and mental illness are also proliferating, providing theologically grounded pathways to better care. And there are countless examples of congregations powerfully demonstrating the love of Christ to those in mental anguish.
Still, the stigma accompanying mental illness persists, and in church settings, the issue is often complicated further by ignorance or misguided theology. Clergy tend to be the “first responders” for Christians experiencing psychological distress, yet many pastors are ill-equipped to recognize or treat mental illness.
Fewer than 10 percent of people seeking counsel from pastors end up being referred to mental health professionals, even when their symptoms would warrant it. And the need is acute, with around one in five American adults dealing with a diagnosable mental illness (of widely varying severity), according to the National Institute of Mental Health—a figure that grows to a shocking one in two among adolescents.
In my early years of pastoring, I was unprepared to deal with the torrent of human need I would encounter on the job. The limited training I had received in seminary regarding mental health did little more than give me a smattering of knowledge that made me feel more equipped than I was.
Hitting my own mental wall drastically altered my understanding and gave me greater compassion. It turns out that the same verses you quote to anxious congregants sound very different when you’re the one paralyzed by anxiety.
There is unmatched comfort and strength to be found in the One who took up all our sorrows and infirmities, including those of the mind and soul. But the person of faith who is steeped in a mental crisis often must contend with a community that exhibits great unease with ongoing, unresolved pain.
I recently heard a well-known Christian speaker on the radio, forcefully declaring that people caught in depression and anxiety weren’t experiencing the anointing of the Lord. The message was clear: If you’re feeling the wrong feelings, you’re not going to receive God’s blessing. Such thinking may sound biblical but promotes a graceless gospel.
So how should the church respond to mental illness? How can we do a better job caring for one another? I asked a group of noted Christian authors, experts, and fellow sufferers to weigh in.
Steve Cuss, author and host of CT’s Being Human podcast: What a fantastic question. Mental health is where the way you see yourself, others, the world, and God is congruent with reality. You are able to think clearly, and you have access to a wide range of emotions without being swallowed up by them.
Aundrea Paxton, cohost of the Rise and Form podcast, clinical psychologist and founder of Take Heart Counseling: The Bible gives us a glimpse of what perfect well-being and health look like. In Genesis 2, we see that humans thrive when they have a strong relationship with God and others, when they take care of their physical bodies, when they appreciate and enjoy God's creation, when they have a sense of purpose, and when they feel no shame.
O. Alan Noble, associate professor of English at Oklahoma Baptist University and author of On Getting Out of Bed : Among other things, good mental health includes the ability to sit alone without distractions and not fall into anxiety, depression, or despair. It involves feeling the full range of human emotions but not allowing those emotions to override your capacity to reason or your will to pursue the good.
Why does the absence of good mental health make us uneasy? I suspect most of us feel unprepared to come alongside people with mental health challenges. Is that unique to Christians?
Hannah Brencher, online educator, TED speaker, and author of Come Matter Here and Fighting Forward : Supporting someone through a mental illness is a tough thing. That’s a reality we can’t sugarcoat or downplay.
I’ll be honest—before I walked through my own depression, I don’t think I knew how to fully show up for someone in the same pit. Walking and living through depression allowed me to understand how I needed to be cared for and then express that to other people.
Paxton: Although the church has become stronger, there are still remnants of false assumptions about how different emotions and illnesses relate to one’s faith and salvation.
What sort of assumptions?
Paxton: Assumptions of sin and shame can cause people to hide, deny, and suppress their mental health needs, which makes it difficult to tolerate these needs in others.
Brencher: I’m shocked by how many Christians still assume that mental illness is correlated with not having enough faith in God. That was expressed to me multiple times throughout my severe depression.
How did that impact you?
Hannah Brencher: The notion was very damaging, especially since I was using all my extra energy to seek God amid the struggle. I understand now, but unfortunately did not know it back then, that God is not dangling a certain level of faith over my head and asking me to get on that level before relief comes.
It has taken me a long time to see that God is a companion in the journey toward mental wellness, not a foe.
Noble: Evangelicals are by definition concerned with evangelism, and in the secular world we live in, evangelism very easily comes to be a sales pitch: “Christianity will make your life better than it currently is.” Christianity becomes just one more lifestyle option in a sea of options.
When that happens, we become very anxious about giving any indication that our lives might not be great. So, we hide our suffering even from other Christians because we don’t want to give the impression that our faith is weak or a bad witness.
What is your response when well-meaning Christians point people with anxiety disorders to verses such as “Do not be anxious about anything” (Phil. 4:6)?
Paxton: First, I would encourage them to read the whole book of Philippians. Too often we take Scriptures out of context. Second, I would remind them of the role of the Holy Spirit in empowering us to do what is good for us. We can do nothing good in our own might.
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Finally, I would focus them on verse 7 of Philippians 4, which says, “And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” The behaviors listed in verse 6 are merely to refocus us on our source for that peace.
So what do you see the church getting right in response to the current mental health crisis?
Paxton: The church has made significant strides in promoting discussions around mental health and reducing hostility toward psychology. There are now more sermons and resources dedicated to mental health.
Cuss: Many churches I work with either partner with mental health professionals or have their own clinic with state-licensed therapists. I see more preachers who share openly about mental health, and we are slowly becoming more trauma-informed, understanding the complex nature of whole-body health and trauma triggers.
And where is there still room for improvement?
Cuss: I still see many Christians and church leaders who have an anxious need to cheer people up. They do not realize that their words and advice aren’t actually for the person who is struggling but a way to assuage their own anxiety when they are in the presence of someone struggling with a complex mental health issue.
The other challenge is that debilitating mental health struggles must be treated by a trained professional, and most of us are amateurs. I don’t think we have provided enough resources to help amateurs be helpful when dealing with a peer or congregant who battles mental health.
Noble: The church needs to learn how to balance the real value of spiritual wisdom with the real value of professional mental health services. There is a danger in outsourcing all cases of mental suffering to mental health professionals. It’s easy for even Christians to professionalize things like mentorship, wise counsel, the advice of elders, and friendship. There is a similar danger in attempting to treat all cases of mental suffering only with prayer and pastoral counsel.
Are there ways the church body could be a uniquely powerful source of care?
Paxton: The church is a place where we can find the most valuable asset to address any need: hope in the works of Christ and peace in the eternal salvation of our souls. Although these truths do not prevent us from experiencing the trials and afflictions in life, our stories will not end in pain; our virtues and values can ground us during chaos; and our God is all-loving, all-powerful, and all-knowing.
Cuss: Debilitating mental health is profoundly isolating. Church can offer powerful healing community. Most people do not want our advice; they want our presence. They want to feel seen; they want a safe space to be exactly themselves.
InLife Together, Dietrich Bonhoeffer said that the first service we owe to one another is to listen. He believed that we’re doing the work of God himself when we pay that kind of attention, which is a profound thought.
Noble: It may be the single most important element of your recovery. The church, particularly as it is manifested in the local context, is a beautiful community of mutual care. The contemporary world is terribly isolating, and many people don’t have friends, let alone friends they can depend on to walk with them through suffering. It ought to be the case that every Christian has friends through their local congregation who can minister to them.
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Cuss: I have absolutely seen this happen within church contexts, and it is powerful. I know of many people with debilitating mental health struggles who say, “I would be lost without my church community.”
Conversely, though we know the singular power of the gospel for addressing mental health concerns, the very communities entrusted with that gospel often inflict religious trauma that compounds mental health challenges. How do we reconcile those two truths?
Noble: There’s nothing particularly surprising about this. It’s a phenomenon that is present in every aspect of the church.
How so?
Noble: The church teaches fidelity in marriage and yet pastors are regularly caught in infidelity. The church teaches us to give generously to those in need and yet many Christians practice what Francis Schaeffer once called the “[noncompassionate use of] accumulated wealth.” Christians fail to live up to the standard set by the Word of God. And they will continue to do so, individually and collectively, until Christ returns. This is a hard teaching.
Cuss: For every positive story I hear of the church being helpful, I hear two that cause significant harm. I think the religious trauma is compounded by a few dynamics:
We do not realize the spiritual power we hold as church leaders, so our words carry significant power. But so does Scripture, so when we “prescribe” the Bible, we can unintentionally do damage.
Some religious leaders simply do not understand the nature of mental health, and they see it through a simplistic dichotomy of angels and demons, or they prescribe some Christian version of “Look on the bright side.” Many Christian leaders do not know what to do or say in the face of someone’s overwhelming or complex pain.
It is vulnerable to share your inner world and journey, and when someone prescribes a simplistic and incorrect Christian solution, it does real damage and further isolates you.
Paxton: I believe that two things can be true at the same time, especially when it comes to God. Firstly, as humans, we are broken and flawed, and therefore, we will hurt others. Secondly, God can work through imperfect humans in a powerful way. No human will ever be able to perfectly reflect the fullness of God's character, but God is not limited by that.
Let’s turn from the church to your own experiences with mental illness. Victory in Christianity is often equated with being entirely freed from affliction. Yet I keep coming back to the apostle Paul’s unremoved thorn and how God’s strength showed up more in that ongoing weakness than in a miracle cure for him.
Noble: So far, God has asked me to endure the suffering of mental illness. I hope and pray and work for recovery, but I rest in the knowledge that, ultimately, I will be healed, even if it’s not in this life. This is the posture I encourage for everyone suffering. Hope, pray, and work for your recovery—advocate for yourself! But put your faith in Christ and accept that you may be asked to endure and glorify Christ in your weakness.
Brencher: I believe God’s power shows up in me through daily life and walking out a lifestyle that supports my mental health. I take medication for my depression, and I have for almost a decade. I don’t know if I will be on it for the rest of my life, but I do know that it enables me to thrive daily, which matters most to me.
So you feel your prayers have been answered in spite of the ongoing battle?
Brencher: I don’t think my story is less than because I did not get a miraculous healing. I think healing is something that I am exercising and leaning into every single day, and there is so much power in that.
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Paxton: The end of my parents’ marriage was a significant experience that led me to study psychology. Although it was a painful time that left many wounds, I have seen God use it for his good. When I sit across from my clients, I sometimes have the privilege of working with them long enough to see how God was present with them in their pain and later used that pain as a steppingstone in their lives.
In your own history of suffering, do you have examples of ways you experienced grace and healing through Christian community?
Noble: Times too numerous to count. Nearly all the grace and healing I have experienced has come through community, through friends who were willing to call me when I sent them a panicked text, through friends who shared wise counsel, through friends who gave me firm but necessary admonishment.
Cuss: I have so many tangible examples of experiencing love and care when I was not well. The most poignant was a Sunday morning when I learned that a friend had taken his life. I got the news about an hour before I preached, and I was in shock but didn’t recognize it as shock. So, I went out to preach and completely unraveled in front of everyone. My congregation cared for me so well, in that those who were close to me came closer and took care of me. Those who weren’t close left me alone. Sometimes care means giving someone space rather than smothering them with care.
Brencher: In my walk with depression, I will never forget those who showed up physically– bringing meals, driving me to appointments, holding me, making cups of tea, and sitting with me in the storm. Their presence brought me back to life.
It sounds like we agree on the power of Christian community and relationships. But what would you say to someone who desires that but has not yet found such a church family?
Noble: I’m sorry this has not been your experience. These communities exist, but you will need to be intentional. If you are not an active participant in the cultivation of friendship, it will not happen.
Brencher: I constantly have to remind myself that the church is made up of people, and we, people, get it wrong all the time. Keep looking for the places that know grace and power. Keep looking for the people who will walk with you through the rain. If you encounter people who can only take you at your best but not in the storm, those are not your people.
Aundrea, you get the closing word here. Knowing that pastors can’t force anyone to seek professional help, what might be some indicators of when it is time to refer a congregation member for more than spiritual care?
Paxton: Support for mental illness should always involve a community of people. However, if any of the following are evident, a mental health professional should definitely be one of those people:
Any safety risk involving self-harm, substance use, or suicidal thoughts or actions
When the distress a person is sharing is impacting their ability to function on a daily basis or causing persistent and/or increasing distress
Significant changes in appetite, sleep, energy level, and social engagement
A long period of no change to a poor mental state or resistance to change
I encourage pastors to consider having a mental health professional they trust who can be an ongoing consultant and support for them personally.
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