Ministering to Mental Illness
Mental health is a rising concern in the United States, and pastors are on the front lines of ministering to people with all kinds of mental illness. Most likely you have counseled and cared for people with anxiety, depression, bipolarity, or even schizophrenia and paranoia. Like most pastors, I took a few counseling classes in seminary but I am not a clinically-trained or licensed counselor. My advice comes from the place of a pastor trying his best by the grace of God to minister to my church and community.
Give good pastoral care
What we offer people is unique, and uniquely helpful for mental health. We offer the power of the Gospel, we guide towards Spirit-empowered transformation, we shepherd to the effectiveness of prayer, we provide the solid foundation of the Word. The fruit of this care is enormously beneficial for mental health. If someone has come to meet with a pastor or church leader, they are not likely looking for psychological evaluation, but spiritual direction. That we can offer in abundance!
Don’t try to diagnose
This has happened to me numerous times. We have an inclination that someone has a particular mental disorder. They are showing all the familiar signs of it (e.g. mood swings, personality changes, hyperactivity and depression.) However, it is important that we stay in our lane and not attempt to diagnose without the psychological or clinical credentials to do so. Just as we would not diagnose cancer or heart disease without a medical license, we should be cautious not to do so when it comes to psychopathology.
Refer out for additional help
There are times when we offer our very best pastoral care, and problems still persist that require more specialized care. One doesn’t necessarily need to replace the other; we may continue to meet with someone who is simultaneously getting clinical help. Make use of those in the broader church with differing gifts and specialist training. Solid Christian counselors abound. For example, The Boston Center for Biblical Counseling is a gem.
Work with professionals
I was invited to sit in with a church attender’s therapist for a single session. This particular therapist was not a professing Christian, but I learned some invaluable lessons on how to minister not only to that particular individual but others as well. I still use that experience today in caring for people. Typically, if it comes up in conversation, I will try to reinforce the counsel of a therapist to someone I am offering pastoral care. Seldom (though not never) should we put ourselves at odds with clinical professionals.
Encourage church community
Almost always, mental health is improved in the context of a Christian community. This is one of the tragic casualties of declining church attendance: "There is strong scientific evidence that supports the correlation between church attendance and improved physical and mental health...the mental health picture we saw in our study was sad for the dechurched, showing such low self-reported figures on anxiety, depression, loneliness, and suicidal thoughts" (The Great Dechurching). Encourage people to meet others in the church in particular who may have similar struggles.
Set clear boundaries
Many individuals with mental illness will not be able to set boundaries. Pastors may need to articulate parameters, both for the good of the individual and the good of the pastor and congregation. There is a time to cease meeting, limit phone contact, or restrict someone from attending services until they receive the help they require. Many pastors have a deep store of patience, but to spend it all on a single person may be detrimental to your family and church. Boundaries by Cloud & Townsend remains an outstanding resource.
We will feel inadequate. We will feel helpless. That is okay. We can’t fix all the world’s problems. That’s the work of the White Rider called Faithful and True! What we can do is shepherd people to Him. We can genuinely care about human beings, and ask God for wisdom on how best to minister to them. If we do that humbly and consistently, by the grace of God, we’ve done our job.
Rick Harrington is a pastor at First Baptist Church - Haverhill in Massachusetts and the Provost of the (upcoming) BCNE Multiplication Center. He is the author of the books "How to Find a Church: Seven Steps to Becoming Part of a Spiritual Family" and "The Weight of Preaching: Heralding the Gospel of Grace".
