Christian mental health stigma & finding care

Churches pray openly for cancer, surgery and broken bones. When depression, anxiety, addiction or suicide are never named, people who struggle with them may feel they do not belong.

In 2021, more than a third of Protestant pastors said they rarely or never spoke about mental illness in sermons or large-group teaching.

Comments like “Rejoice in the Lord”, “Count your blessings” or “Worry is a sin” are often meant kindly. But they can make a person feel their illness is a spiritual failure.

Kinder things to say

• “I’m so sorry you’re going through this.”
• “How can I help this week?”
• “I’m praying for you, and I’m glad you’re getting support.”
• “You’re still welcome here, exactly as you are.”

Christians believe life has a spiritual side. But treating depression, anxiety or psychosis only as a spiritual attack, sin or lack of faith can keep people from the health care they need.

In many families, there is pressure not to “air dirty laundry” or bring shame on the family name. This can make it very hard to seek help, especially for young people and for parents.

Protecting your family’s privacy and getting care are not opposites. Counselors keep what you share confidential, with a few safety exceptions they will explain.

Some people fear being removed from leading worship, teaching, volunteering or ministry if they share a mental health struggle. This can push them to hide until they reach a crisis.

Healthy churches make room for rest and recovery without shame, and welcome people back to serve when they are ready.

Many Christians fear people will think they are not praying enough or trusting God enough. Some fear being seen as weak, or as a bad example.

In close communities, a private struggle shared once can quickly become widely known. That fear is understandable.

Ways to protect your privacy

• Share with one trusted person first.
• Say clearly, “Please keep this between us.”
• Ask for prayer in general words, like “a health struggle”.
• Talk with a counselor, who is bound by confidentiality rules.

Smiling on Sunday while struggling inside is exhausting. Church was never meant to be only for people who have it together.

“When one member suffers, all the members suffer with it.” (1 Corinthians 12:26, WEB) Paul pictured the church as a body that feels each other’s pain.

When a pastor, priest or bishop shares their own struggle, it shows that faith and mental health struggles can exist together. It also makes it easier for others to ask for help.

Most pastors in the 2021 survey (86%) said they feel equipped to recognize when someone may need a medical referral.

Ideas

• See a counselor outside your church or denomination for privacy.
• Talk with a trusted colleague, mentor or denominational care contact.
• Take real rest, including time off.
• Share with your board or elders when you feel ready.

Clergy can

• Listen, pray with you and remind you that you are loved
• Offer sacraments, such as confession or anointing of the sick
• Help with spiritual questions, guilt and meaning
• Connect you with counselors and support groups they trust
• Support your family

“Is any among you sick? Let him call for the elders of the assembly, and let them pray over him, anointing him with oil in the name of the Lord.” (James 5:14, WEB)

The American Psychiatric Association Foundation’s guide for faith leaders encourages clergy to recognize when someone needs professional care and to help them connect with it.

A good pastor will know their limits and help you find a licensed professional, while continuing to support you spiritually.

You might ask

• “Will this stay between us?”
• “Do you know a licensed counselor who works well with people of faith?”
• “Can you keep praying with me while I get other help?”
• “Is there a support group in our church or area?”

The Association of Catholic Mental Health Ministers (catholicmhm.org), founded in 2019, helps parishes and dioceses start mental health ministries, with training, resources and networking. Membership is free.

By 2024, hundreds of parishes in about 50 to 60 U.S. dioceses had started mental health ministries with its support. Ask your parish or diocese whether one exists near you.

The Assembly of Canonical Orthodox Bishops of the USA set up Mental Health Ministries in 2022. It offers a Directory of Orthodox Christian Mental Health Professionals and other resources, at assemblyofbishops.org.

Its work grew out of a task force formed with OCAMPR, a pan-Orthodox association of health professionals, psychologists and clergy.

Mental Health Grace Alliance (mentalhealthgracealliance.org) offers free Christian support groups called Grace Groups, for people living with mental health difficulties and for families, with free digital workbooks. It says its groups complement professional treatment.

A study of these church-based, peer-led groups found that members reported better recovery and fewer symptoms over time. The study had no comparison group, so more research is needed.

Fresh Hope for Mental Health (freshhope.us) runs Christian peer support groups in person and online, for people with a diagnosis and their loved ones.

NAMI FaithNet, from the National Alliance on Mental Illness, is an interfaith network of members, clergy and congregations working to make faith communities welcoming and supportive for people and families living with mental illness. Many local NAMI affiliates run FaithNet programs.

Common types

• Licensed therapist (psychologist, counselor, social worker, marriage and family therapist): trained and licensed by the state to treat mental health conditions.
• Christian or faith-integrated counselor: a licensed therapist who brings faith into therapy if you want it.
• Pastoral counselor or lay counselor: offers spiritual support; may or may not hold a state license.
• Spiritual director: walks with you in prayer and faith; not a mental health treatment provider.

Licensed professionals must meet training standards and follow ethics rules, including confidentiality. Every U.S. state has a licensing board website where you can look up a counselor’s name and check their license.

Some people call themselves “Christian counselors” without a license. They may offer spiritual support, but they are not trained to treat conditions like depression, trauma or OCD.

Places to start

• Ask your pastor, priest or church friends for names they trust.
• FindTreatment.gov, a free U.S. government locator for mental health and substance use care.
• SAMHSA’s National Helpline (1-800-662-4357), free and confidential, 24/7, in English and Spanish, for referrals.
• The Directory of Orthodox Christian Mental Health Professionals (Assembly of Bishops).
• Your doctor, insurance plan or employee assistance program.

Be cautious if a counselor

• Mocks or dismisses your faith
• Pushes their own beliefs on you, religious or not
• Tells you to stop all medical care and rely only on prayer
• Cannot tell you their training or license
• Makes you feel unsafe, shamed or pressured

SAMHSA’s National Helpline can connect you in English or Spanish. Many therapists list the languages they speak and the communities they serve.

Questions to ask

• “Have you worked with people from my background or church tradition?”
• “How do you include family and community in care?”
• “Do you offer sessions in my language?”

With your permission, a counselor and your pastor can work together, for example to plan support during a hard season. You decide what is shared.

Good first people

• A friend who keeps confidences
• A small group leader you trust
• Your pastor, priest or a deacon
• A church member who has shared their own struggle

You might say

• “I’ve been struggling with anxiety, and I’m getting help. I’d love your prayers.”
• “I’m going through depression. Could you check in on me now and then?”
• “I’m not ready to share details, but I need some support.”

If someone blames your faith or shares your story without permission, it is okay to set a boundary and turn to others. You might talk with a pastor about what happened.

Ideas

• Pray for people facing depression, anxiety or addiction in services.
• Preach on lament, Elijah, or Jesus in Gethsemane, and connect it to mental health.
• Invite someone to share their recovery story, if they want to.
• Mark Mental Health Awareness Month in May.

In 2021, 68% of churches kept a list of mental health experts to refer people to, 40% had a plan to support families, and 20% trained leaders to recognize symptoms.

Steps a church can take

• Keep a list of local counselors and crisis lines, and make it easy to find.
• Train staff and volunteers in mental health basics.
• Start a peer support group or host one.
• Make a plan for supporting families in crisis.
• Put 988 on the church website and bulletin.

When someone is in the hospital for surgery, churches bring meals and visit. People in mental health treatment need the same practical care, and often get far less.

“Bear one another’s burdens, and so fulfill the law of Christ.” (Galatians 6:2, WEB) That includes burdens of the mind.

Reach out now

• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free, confidential, 24/7. Text and chat are also available in Spanish.
• Crisis Text Line: text HOME to 741741, 24/7.
• If a life is in danger, call 911 or go to the nearest emergency room.

Free help

• SAMHSA’s National Helpline: 1-800-662-4357 (1-800-662-HELP). Free, confidential, 24/7, in English and Spanish.
• FindTreatment.gov: search for mental health and substance use care near you.

Find A Helpline (findahelpline.com) lists free, confidential helplines in over 175 countries. If you are in immediate danger, call your local emergency number.