Mental Health and the Church: Strategies for Faithful and Compassionate Ministry

Introduction

Peace I leave with you; my peace I give to you. 
Not as the world gives do I give to you. 
– John 14:27 (ESV)

It has been said that much of the world is in a mental health crisis, especially in this post-pandemic era. “At least one in five, and in some parts of the world perhaps as many as one in two, people experience mental ill health during the course of their lifetime.”¹ This has serious implications. Estimates show that mental illness accounts for almost a third of all years lived globally with disability.²

More concretely, in the Asian city of Singapore where I live, more than one person a day on average committed suicide in 2022, with poor mental health often being cited as a significant contributing factor. Among young people (ages 10 to 29) in Singapore, suicide is the leading cause of death.³ One author rightly states, “Beyond doubt, mental health is one of the topmost felt needs in the Asian community.”⁴ Such a sentiment is echoed in statistics coming from other developed nations in the West.⁵  

Such data indicates that mental health challenges are already the lived experiences of Christians globally. Hence, the church must learn how to respond faithfully and compassionately to this reality. This chapter aims to help the church (1) define what mental health is; (2) explain why it is important to promote mental health, and (3) give concrete strategies for how to do so.   

I. What is mental health?

According to the World Health Organization (WHO), mental health is “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.”⁶ While this definition has some inadequacies, it makes a helpful distinction.⁷ Mental health is not fundamentally about the presence or absence of mental health conditions.⁸ Rather, it is critical to distinguish between having a mental illness (like depression or anxiety) and having poor mental health. WHO further observes that while “people with mental health conditions are more likely to experience lower levels of mental well-being… this is not always or necessarily the case.”⁹ It is entirely possible, as theologian Marva Dawn points out, to be well even when we are mentally ill.¹⁰

The reason for such complexity is because mental health is a multifaceted phenomenon, produced by the interaction among the biological, psychological, social, and spiritual dimensions of an individual’s life and more.¹¹ So, while a person’s genetic makeup (biology) might predispose them to a mental illness, they could still be mentally healthy due to a combination of healthy lifestyle habits (biology), therapeutic and pastoral support (psychology), and a supportive faith community (society/spirituality). This multifaceted understanding of mental health thus provides a holistic approach for churches to minister to those with mental health conditions (see especially Section III).

II. Why should the Church care about mental health?

There are at least four reasons why churches ought to care about the mental health, especially of its members. First, as already observed above, mental illness is the lived experience of many individuals, both in our churches and in the world. The Church is called to reach all of them with genuine love and care. A church that ignores mental health is irrelevant to the felt needs of its members and mission field.¹²

Second, persons with mental health conditions are often marginalized in society. The Bible frequently reminds us of God’s special heart for those who are alienated and excluded.¹³ The Great Commission’s call to go forth and make disciples of all peoples (Matt. 28:19) surely includes persons with mental illness. Thus, churches that seek to be faithful to Jesus ought to take mental health seriously.

Third, Christian discipleship and mental health go together. While the Bible never uses the terms “mental health” or “mental illness,” mental health is a frequent concern of Scripture. Consider, for example, how many virtues listed in “the fruit of the Spirit” (Gal. 5:22–23) are concerned with aspects of mental well-being (e.g., joy, peace, patience, gentleness, self-control). Moreover, it has been demonstrated that healthier forms of religiosity are correlated with better mental health outcomes.¹⁴ Thus, if a church considers discipleship as a core task, mental health care should be a key dimension of its discipleship curriculum, with mental health literacy considered to be an essential ministry skill.¹⁵

The fourth reason why the church ought to care about mental health is that given mental health’s social and spiritual dimensions, the teaching, culture, and practices of our churches can contribute significantly to the mental well-being of our members. The converse is also true: ill-founded theologies or practices in churches might be disabling and be an added factor in producing poor mental health.¹⁶ For example, in Singaporean churches, it is not uncommon for Christians to mentally burn out due to a culture of excessive service and sacrifice – I myself have been a casualty of this. If churches do not pay adequate attention to mental health, especially structurally and culturally, they might end up compounding these challenges rather than being an oasis of God’s shalom in an anxious world.¹⁷

III. How can the Church respond faithfully and compassionately?

If a church recognizes that mental health is a primary concern, how can it respond effectively to promote mental well-being? There are at least seven strategies that churches can adopt. First, churches must know their role in the mental health landscape. The local church must not aim to duplicate what mental care professionals do. While it may be helpful that some church members have professional medical expertise, the local church must recognise it often has a complementary role to play, seeking to partner with mental health professionals, not replace them.¹⁸

What is this unique role? As John Swinton, a leading theologian on mental health, observes. The church is not called to become a community of psychiatrists; it is called to become a community of persistent, patient love. Psychiatry and mental health professions have their place. But their tasks are different (although complementary) from the tasks of the church.¹⁹

The phrase “a community of persistent, patient love” has two important emphases. It reminds us that Christians ought to love those with mental health challenges with the love of God. This is something that mental health practitioners may not be able to do in a clinical setting. Second, that love must be expressed in a way that is persistent and patient. We should give our time freely to others who struggle with their mental health. By “slowing down and paying attention to God’s time”, we become open “toward the possibility of gentleness” to another.²⁰ This is something that a busy mental health professional with a heavy caseload simply cannot do.

A second strategy is to ensure that church leaders (pastors, lay leaders, small group leaders) develop mental health literacy.²¹ If leaders misunderstand mental health, they will wrongly address potential issues in their congregation. It is with sadness that I have often heard church leaders simplistically describe our young people as a “strawberry generation” who are easily emotionally bruised, whose mental health challenges can be simply addressed by helping them toughen up.²²

This simplistic stereotype ignores the profound social and cultural changes experienced by youth today that are a primary driver of poor mental health.²³ Instead, church leaders need to help young people navigate these changes. This is only possible if those leaders have a better awareness of mental health issues.

Specifically, church leaders need to grow in their theological understanding of mental health. Too often, mental health is naïvely and narrowly understood as a lack of faith, demonic possession, or simply, personal sin.²⁴ Such one-dimensional perspectives can produce stigmas and worsen the mental health challenges of individuals. In contrast, a more robust theology of mental health allows church leaders to minister in a more holistic and nuanced manner.

A third strategy is to provide clear avenues for counselling within the church. This could involve dedicated clergy or trained lay persons who act as “first responders” for those with mental health challenges.²⁵ A secondary function of such individuals is to provide triage services, that is, to refer individuals to more skilled professionals.²⁶ To complement such “in-house” services, churches can produce a list of local members.²⁷

Another benefit of making mental health services readily available to members is that it provides a resource for church leaders themselves. Church leaders, especially clergy, are especially susceptible to mental health challenges.²⁸ Due to the confidential nature of their work, it is often difficult for leaders to find support within their own churches.²⁹ Because of this, church boards that oversee pastors and other ministry leaders need to make mental health consultation services readily available to them outside of the church, and even provide funding support as part of their staff benefits package.

The fourth strategy is to address mental health holistically. Mental health has biological, psychological, social, and spiritual dimensions. In our hyper-cognitivised world, there is the tendency in some faith traditions to address mental health as a purely psychological phenomenon.³⁰ Such traditions might be tempted to address mental health only through pastoral counselling and Bible study. However, it has repeatedly been demonstrated that adequate rest, a balanced diet, an active lifestyle, meaningful social participation, and involvement in group and spiritual activities (including support groups) are all helpful to one’s mental health.³¹ The Bible teaches an integrated view of the person; so, churches must reflect a holistic approach in how they address mental health.³²

The fifth strategy a church can adopt is to put appropriate safeguarding processes in place to protect individuals with mental health challenges. Churches, for example, might identify those with dissociative disorders³³ with demonic possession, and hence, “treat” them through exorcism.³⁴ The problem is that Scripture rarely associates demonic possession with the symptoms of what we define today as mental illness.³⁵ Moreover, some researchers have argued that  “exorcism seems to make the condition worse, with published scientific evidence of adverse psychological and spiritual outcomes”.³⁶ Thus, robust safe-guarding procedures must be present to avoid unjustified interventions and other forms of potential abuse.³⁷

Sixth, in addition to church leaders, the congregation must grow in their awareness of and compassion toward mental health issues. This could take the form of preaching on mental health, Christian education courses, or small group Bible studies.³⁸ A particularly good resource for this is The Sanctuary Course, a robust program that includes a book, videos, and discussion guides. It features Christian mental health professionals, pastors, theologians, and persons living with mental illness.³⁹ Furthermore, inviting individuals with mental health challenges (including church leaders) to share their spiritual journeys in a church setting could be very helpful. Such practices can normalize open and biblically-grounded discussions about mental health, which will help remove the stigma surrounding mental illness.⁴⁰

Since earlier data showed that youth and young adults are especially struggling with their mental health, developing programs that specifically address their needs should be promoted. One researcher reflects, “Engaging young people authentically and relationally and putting real resources into their mental health communicates a care and concern on behalf of religious leaders and adults for young people that young people often assume isn’t there.”⁴¹ For example, one denomination in Singapore specifically incorporates mental health training in one of its programs for young people.⁴² Further, the church could train parents and grandparents to understand the mental stressors present in today’s world and how to intervene in meaningful ways. In this way, the whole family unit is able to provide support. The same applies to youth pastors and leaders who frequently interact with young people.

Seventh, as a strategic practice, churches could perform yearly mental health audits. Such audits can consist of (1) questionnaires surveying church members,  and (2) organizational reviews that reveal how their culture and practices may promote or hinder mental well-being.⁴³ In particular, since mental health and discipleship are intimately intertwined (see Section II above), churches may wish to develop concrete measures of mental health as an evaluative indicator for the efficacy of their discipleship programs. Such measures, reviewed on a regular basis, will help to ensure that local churches treat mental well-being as an essential aspect of their core ministry.

Conclusion

Mental well-being is one of the critical issues of our age. This chapter has sought to explain (1) what mental health is, (2) why the global Church ought to be concerned, and (3) seven strategies that local churches can employ to respond faithfully and compassionately. In the same way that Jesus calls us to serve the last, the lost, and the least, churches can reach out to those marginalized by mental health challenges. In this way, another fruitful mission field will be ploughed and worked in obedience to the Lord Jesus.

Endnotes

1. Christopher C. H. Cook, Isabelle Hamley, and John Swinton, Struggling with God: Mental Health and Christian Spirituality (London: SPCK, 2023), 12.
2. Daniel Vigo, Graham Thornicroft, and Rifat Atun, “Estimating the True Global Burden of Mental Illness,” The Lancet Psychiatry 3, no. 2 (February 2016): 171–78.
3. Samaritans of Singapore, “Highest Recorded Suicide Numbers in Singapore Since 2000,” July 1, 2023, https://www.sos.org.sg/media/press-releases (accessed 27 May 2024).
4. Edmund Ng, “Mental Health Literacy as a Ministry Skill: Basic Ways to Equip Church Leaders in Asia and Beyond,” Lausanne Movement, January 24, 2023, https://lausanne.org/about/blog/mental-health-literacy-as-a-ministry-skill (accessed 27 May 2024).
5. For data on youth, mental health, and spirituality in the United States, see Springtide Research Institute, The State of Religion & Young People 2022: Mental Health (Winona, MN: Springtide Research Institute, 2022). According to this report, 47%, 55%, and 57% of young people say they are moderately/extremely (i) depressed, (ii) anxious, and (iii) stressed respectively. 
6. World Health Organization, Mental Health Factsheet, https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response (accessed on 27 May 2024).
7. Cook, Hamley, and Swinton (Struggling with God, 22–23) observe that this definition (i) omits any mention of the family, which is an important contributor to mental health; (ii) it assumes that schooling and employment are available; (iii) makes no mention of spirituality at all.  
8. Sometimes referred to as a “mental disorder” or “mental illness”. In this article, I will use these terms interchangeably. 
9. World Health Organization, Mental Health Factsheet. Emphasis mine. 
10. See, for example, her chapter discussing depression in Marva J. Dawn, Being Well When We’re Ill: Wholeness and Hope in Spite of Infirmity (Minneapolis, MN: Augsburg Books, 2008), 211–23.
11. American Psychiatric Association Foundation, Mental Health: A Guide for Faith Leaders (Washington, DC: American Psychiatric Association Foundation, 2018), 13.
12. For a thick description of such felt needs, see the stories in Jonathan Cho et al., eds., Mental Health and the Gospel Community, Good News for Bruised Reeds 2 (Singapore: Graceworks, 2019).
13. See, for instance, Deuteronomy 27:19; Psalm 146:7; Isaiah 1:17; Zechariah 7:10; Luke 14:13–14; James 1:27 and many more.
14. See John Swinton, Spirituality and Mental Health Care: Rediscovering a “Forgotten” Dimension, PTS (London: Jessica Kingsley, 2001), 33–34. For a more recent review of literature, see Larkin Elderon Kao, John R. Peteet, and Christopher C. H. Cook, “Spirituality and Mental Health,” Journal for the Study of Spirituality 10, no. 1 (January 2, 2020): 42–54, https://doi.org/10.1080/20440243.2020.1726048.  
15. Ng, “Mental Health Literacy.”
16. See the discussion in Wen Pin Leow, “Changing Our Minds: A Theological Introduction to Mental Illness,” in Mental Health in the Gospel Community, ed. Jonathan Cho et al., Good News for Bruised Reeds 2 (Singapore: Graceworks, 2019), xiii–xvi.
17. As Walter Brueggemann artfully observes, “Thus I have come to think that the fourth commandment on sabbath is the most difficult and most urgent of the commandments in our society, because it summons us to intent and conduct that defies the most elemental requirements of a commodity-propelled society that specializes in control and entertainment, bread and circuses… along with anxiety and violence.” Cf. Sabbath as Resistance: Saying No to the Culture of Now (Louisville, KY: Presbyterian Publishing Corporation, 2014), xiv. 
18. Cook, Hamley, and Swinton, Struggling with God, 81.
19. Jean Vanier and John Swinton, Mental Health: The Inclusive Church Resource (London: Darton, Longman & Todd, 2014), 94. Emphasis mine.
20. John Swinton, Becoming Friends of Time: Disability, Timefullness, and Gentle Discipleship (London: SCM Press, 2016), 74.
21. “For many churches, the decision to initiate a mental health inclusion strategy is the direct result of pastors, church leaders, and key volunteers seeking to become better educated about the needs of persons with mental illness.” Cf. Stephen Grcevich, Mental Health and the Church: A Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions (Grand Rapids, MI: Zondervan, 2018), 111.
22. See, for example, Han Ei Chew and Vincent Chua, “Singapore Youth: In Defence of “Strawberries,”” The Straits Times, September 19, 2022.
23. See the insightful discussion on the loss of narrative meaning and its impact on the mental health of youths in Justin Brierley, The Surprising Rebirth of Belief in God: Why New Atheism Grew Old and Secular Thinkers Are Considering Christianity Again (Tyndale Elevate, 2023), 46–48. For a more detailed discussion, see Jocelyn Bryan, “Narrative, Meaning Making and Mental Health,” in The Bible and Mental Health: Towards a Biblical Theology of Mental Health, ed. Christopher C.H. Cook and Isabelle Hamley (London, UK: SCM Press, 2020), Loc 355-723 (eBook version). 
24. See the discussion of negative lay theologies in Marcia Webb, Toward a Theology of Psychological Disorder (Eugene, OR: Cascade Books, 2017), 8–22.
25. Church leaders could be trained in Mental Health First Aid, cf. https://www.mentalhealthfirstaid.org (accessed 27 May 2024). 
26. American Psychiatric Association Foundation, Mental Health, 15–17.
27. For guidance on how to develop such a list, see Sanctuary Mental Health Ministries, Mental Health Referrals List, available at https://sanctuarymentalhealth.org/wp-content/uploads/2024/05/ Mental-Health-Referrals-List.pdf (accessed on 27 May 2024). For an example of such a list in the Singapore context, see Cho et al., Changing Our Minds, 169–73.
28. See Lifeway Research, “Pastors’ Views on Mental Illness: A Survey of 1,000 Protestant Pastors,” 2022, 29–30, https://research.lifeway.com/wp-content/uploads/2022/08/Pastors-Sept-2021-Mental-Illness-Report.pdf (accessed 27 May 2024).
29. Barna Group, “7-Year Trends: Pastors Feel More Loneliness & Less Support,” 2023, https://www.barna.com/research/pastor-support-systems/ (accessed 27 May 2024).
30. The bioethicist, Stephen G. Post, identified a key problem of our time as hypercognition – the assumption that “rationality and memory are the [primary] features that give rise to a person’s moral standing”, see Stephen G. Post, The Moral Challenge of Alzheimer Disease: Ethical Issues from Diagnosis to Dying, 2nd ed. (Baltimore, MD: John Hopkins University Press, 2000), Loc. 95 (eBook version).   
31. See American Psychiatric Association Foundation, Mental Health, 13.
32. Christopher C. H. Cook and Isabelle Hamley, “Towards a Biblical Theology of Mental Health,” in The Bible and Mental Health: Towards a Biblical Theology of Mental Health, ed. Christopher C.H. Cook and Isabelle Hamley (London, UK: SCM Press, 2020), Loc. 5136 (eBook version).
33. “Dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour.” Cf. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed., text rev. (Washington, DC: American Psychiatric Publishing, 2022), 329.
34. Cook, Hamley, and Swinton, Struggling with God, 31.
35. Leow, “Changing Our Minds,” xiii–xiv. For further discussion, see Christopher C.H. Cook, “The Gerasene Demoniac,” in The Bible and Mental Health: Towards a Biblical Theology of Mental Health, ed. Christopher C.H. Cook and Isabelle Hamley (London, UK: SCM Press, 2020), Loc. 3440–3804 (eBook version).
36. Cook, Hamley, and Swinton, Struggling with God, 31. The authors continue to say that “perhaps the most important thing to do for someone struggling with [dissociative disorders] is not to subject them to deliverance ministry.” 
37. To be clear, I am not arguing that mental health challenges cannot be caused by demonic possession (partially or otherwise) or that deliverance is never warranted. I am simply observing that Scripture does not strongly associate mental illness with demonic possession, and that the scientific literature argues against it as well. Hence, demonic possession should not be the only diagnosis available to a church or be used as a diagnosis of first resort. Rather, a holistic evaluation of the individual ought to be conducted rather than rushing to a conclusion. Even if deliverance is believed to be warranted after a careful, informed evaluation, further safeguarding practices must be in place to protect the vulnerable individual since the potential for maltreatment and trauma is significant. 
38. See (forthcoming) Wen-Pin Leow and Adrian Loh, Mental Health and the Church (working title), The Gospel Way Series (Singapore: Graceworks, 2025). This accessible primer is designed for small group use. Through reading the short chapters and discussing the questions provided in the text, this booklet will allow small group members to grow together in their mental health literacy from an informed biblical and scientific basis.
39. To access, see https://sanctuarymentalhealth.org/sanctuary-course (accessed 27 May 2024). As of the time of writing of this paper, the course is available in English and German. A youth-focused resource is projected to be released in 2024. For more information on this latter resource, see https://sanctuarymentalhealth.org/youth-series (accessed 27 May 2024).
40. For example, see my discussion of cultural shame and dementia in “Shame, Dementia, and the Church”, Feature Article, ETHOS Institute for Public Christianity, April 3, 2023 https://ethosinstitute.sg/shame-dementia-and-the-church (accessed 27 May 2024).
41. This is a quote from an interview with Josh Packard, the Executive Director of Springtide Research Institute, which maintains the largest dataset on young people and their spirituality in the United States. See https://www.churchleadership.com/leading-ideas/gen-z-and-mental-health-an-in-depth-interview-with-josh-packard (accessed 27 May 2024).
42. The Chinese Annual Conference of the Methodist Church in Singapore runs a yearly programme for young people entitled “Finding Your Place” (FYP). I have had the privilege of facilitating a mental health workshop for the youth participants of FYP over the last four years. Every year, as I lead the workshop, I see increasing interest and ever-greater engagement from the participants.  
43. For an example of a checklist for such an evaluation, see Interfaith Network on Mental Illness, Checklist for Faith Communities, 2014, https://inmi.us/wp-content/uploads/2017/04/Checklist4Faith Communities.pdf (accessed 27 May 2024).