How Pastors Can Be Mental Health Advocates - BioLogos

Clergy are often the real front door for many people of faith seeking help for mental health disorders like OCD. How can they best care for those in their care?

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I liked what a Foursquare church did: they had two elders willing to learn psych and counseling and paid for college for them; one went on to get a master’s. Both were consecrated as elders for life.


If church leaders were instrumental in helping with OCD in the early days, why not so much today?

If you are saying that the church helped with mental health back in the day but not so much today, I disagree. For example, the Catholic Church, and probably other churches as well, used to view suicide as a sin, a moral weakness. When Beethoven’s nephew, Karl, shot himself in the head he was forced to undergo clerical counseling. They didn’t know to attribute suicide to depression.

And today, there are wonderful resources available, depending on the church. My Episcopal church has partnered with two other Fifth Avenue churches (St Pat RC Cathedral and the Presbyterian church) to hire an “ecumenical social worker” to serve the needy people who come by for help. (Think of Lazarus at the rich man’s gate.) Homelessness and drug addiction is often associated with mental illness.

The Episcopal Church also has a number of Resources and Training available for serving the mentally ill. I’m sure other denominations do as well.

What happens today depends on the church and the area. In some parts of the world today mental illness is seen as a spiritual problem and the suffering people are chained up in prayer camps.


i think largely, these things are driven by lifes experiences. I don’t think we are generally born with mental health problems anymore than we are born alcoholics or gay. Given that, is should come as no surprise that it is often considered by traditional religions as being treatable through spiritual connections as its often a state of an habitual thinking process…sure it can be driven by damage to the brain from chemicals such as drugs, however, these are still unhealthy lifes choices that result in spiritual issues. As a biblical example shows us, the demon/s that christ drove out into a herd of pigs gave the individual superhuman strength. I am not saying that all mental health patients are possessed, however, i am not surprised that to some extent we could claim that they are chained by the devil and his angels. I see a lot of homeless people in my work travels in Melbourne…most of the ones i see are off their rockers unfortunately and its a vicious cycle they live.

I have yet to meet anyone who chose to be an alcoholic, and I’ve met only one who claimed to have chosen to be gay.

Being born with mental health issues would be more likely than either of those, though, given the complexity of the brain and how easy it is for a mutation to occur that resulted in a brain not working quite right.

Besides that, it’s been shown that epigenetic changes can trigger mental health issues, PTSD being the “poster malady”.

This would seem to me to require believing that everyone is born with a well-functioning brain. Given how many other organs are observed to not be functioning quite right at birth, this seems fancifully optimistic.


Sometimes. But often there are brain abnormalities involved and there is a hereditary element.
People with bipolar disorder or other mental problems sometimes attempt to treat themselves with drugs or drinking. Or they could be victims of some kind of trauma, like PTSD or conversion “therapy”

We should never attribute mental illness or brain abnormalities like epilepsy to demon possession. (Although BioLogos has plenty of people who believe in demon possession, even moderators.) Where is the author of the original post?

For a wonderful story of how a journalist and then a community took care of a former Juilliard student who developed schizophrenia, read the book The Soloist: A Lost Dream, an Unlikely Friendship, and the Redemptive Power of Music by Steve Lopez. It’s also a good movie. I told a professional musician friend about it and he said that schizophrenia is common in professional musicians.

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Well i have plenty of experience in this area…one side of my entire family Aunties, Uncles, and cousins on that side (of which there are a lot of them) predominantly got involved in alcohol, drugs, domestic violence, dole bludgers…the works. I have broken up fights with family members, picked up a drunk step grandmother out of the gutter when i was in my late teens to put her into a car… I can categorically state, they all chose that pathway…not a single one of them had no choice!

I have also worked in the security industry (in nightclubs, sportsclubs, and pubs) for a year and a bit whilst i took some time off teaching, and very few of these individuals demonstrated that they were spellbound by this terrible habit.

Im sorry but i have almost zero tolerance for alocholics and drug addicts when it comes to the nature verse nurture debate on origins of these addictions. I accept there are biological tendencies, but I’m certain its mostly poor life’s choices.

of course, but your statement here reinforces my point…these are not biological choices, they are choices made with influences of social conditioning. Indeed the consequences you speak of themselves are driven by social issues. A social dilemma has driven a person to make a choice to engage in alcohol and or drug abuse. This is a choice.

I think we could also include eating disorders in this discussion…ultimately the only way to exit the disorder is to make a choice to live/eat differently.

To keep this conversation on topic and to remain true to the topic title, I do not tend to take the kind and caring Christian line in my response to this subject, i have far too much bad personal experience in the area with extended family and a short time in work. I am fundamentally opposed to the idea that political correctness fixes anything. What it does do is convince us that someone talking about the problem will result in a miraculous cure. The only real fix is just plain hard work!

I’m at a bit of a loss as to what to say. Adam, I am sorry your family has suffered so much with various addition behaviors. It tends to make us hardened when we see the harm that it has caused. It is a terrible problem, and one society and the church has not done well with addressing in the past, though there has been some improvement in the last few decades, with such group supports such a Celebrate Recovery in addition to AA, which does a fantastic job.

I would object in part to your emphasis on choices rather than inborn tendencies.l. No doubt both are important, but like most things in life, the causes are multi factoral. The nature vs. nurture question has been looked and studied to try to get a better handle on things, and is different with different conditions, but if you are genetically predisposed to a mental illness condition, your risk is far greater. Twin studies show the risk of schizophrenia in an identical twin if the other twin has it is about 50%, as opposed to about 15% in a fraternal twin, and 1% in the general population. And no one chooses to be schizophrenic. Life choices may well be periferally involved, as such things as heavy use of weed increases the risk, but often times there are no obvious environmental factors. Similar associations may be found with bipolar disorders, depression, and so forth. Plus, it is wrong to blame the individual when they had no control of their childhood experiences and environment. We need to help them where they are now as best we can.

Recognizing the biologic causes of many mental health conditions also has the benefit of developing effective pharmacological treatments. While there is a long way to go, there are good treatments for people suffering with schizophrenia, bipolar disease, some addictions, and such, both with drugs and with behavioral therapy. To tell them they just need to work harder and make better choices is a setup for failure and can contribute to a downward spiral as they try and fail, and feel more worthless.

Certainly, our compassion can wear pretty thin, especially when loved ones are hurt in the process, but we have to remind ourselves that Christ died for them too, To be compassionate without lapsing into co-dependency is not an easy road.


we can have our agreements and disagreements on these things…

In terms of your statement about other mental health issues such as schizophrenia, the absent consideration there is historical lifestyle habits that drive these things. Despite what some studies say, i am quite sure that the vast majority of these cases are driven by poor historical lives choices that affect subsequent generations (in fact this is a biblical claim to btw).

I accept that we cannot simply demand that individuals not take “a pill” in some cases…we all know that a consequence of sin is degeneration in all living things (the bible tells us that quite plainly too), and i agree that if one is to extrapolate somewhat the parable of the talents narrated by Christ, surely we should use all our talents for good (including medical ones). Its just that i am fundamentally opposed to the automatic use of the “take a pill” solution when its very clearly obvious what the real cause of most of the issues is.

If we look at substance abuse, i would argue that quite a large number of other mental health problems have substance abuse (either currently or historically) in the mix.

might i also just recount…

  1. it is not my immediate family who have suffered from substance abuse. My own parents fortunately did not follow this pathway…and i had a wonderful ubrining with very loving and caring parents (my dad still hugs and kisses me goodbye even though I’m 51 years old that has always been his habit even with his own grand children) It was my extended family on one side and they still real from the effects of it today years later. It has been a scourge that has already badly affected 3 generations in our own family and its terrible and extremely frustrating. Now some of them have chosen differently…and the contrast in those few having made different choices is very enlightening.

  2. I will also reinforce, my short time working in security industry reinforced my views on this…what i saw in that job convinced me that there is no such thing as moderate use of drugs or alcohol and i would challenge anyone here who does drink alcohol to provide survey statistics that show the real numbers on how many individuals who drink alcohol have never been drunk!


  1. i have some very conservative views on alcohol and my family history and work have strongly reinforced my views here. Anyone who is drunk can not claim they are in full control of their mental faculties and that is exactly my point and it is this kind of issue that for me starts current, or future individuals in their care, to make poor choices and these choices lead to significant problems down the track. I will also add, i am of the view that this also applies to many other things in life.

  2. I am not a great parent, i do not propose in any way to be an expert on any of this…the above are just my views from my own experiences and non of that means i have “wonder kids” or an “exceptional home”. My family like any other has its ups and its downs. For me that most difficult is the competition between secular society and religious beliefs…its so hard to convince children that life is finite and that its important they keep God front and centre. So many distractions, God is competing with social media, movie theaters, and play. I wish i had a universal formula 100% guaranteed to counter the distractions that pull our children away from God.

3.Given my own father is a retired Christian church pastor, i should ensure i also answer that part of the question here. From my own perspective growing up as a “PK” (pastors kid):

a. All pastors need to be appropriately trained in their field. In our church denomination at least, ministers are required to complete a 4 year Bachelor of Arts degree before they can become ministers (there have been exceptions of course). And just to ensure that any naysayers are silenced, in our universities, the degree in theology is a difficult one…my education degree was far easier than what i saw my father go through in order to complete his theology degree. and his career has been extremely challenging compared with mine (and my wife - who is currently a primary teacher)

b. Minsters should be mental health advocates, however, i am concerned that society in general are increasingly opposed to this because its become politically incorrect for “the priest” to give advice on something as sensitive as mental health.

c. Minsters can be facilitators of access to the right resources however and i think this is where church can really shine in this field. Members quite often have a relationship with their pastors and that level of trust is a great way to lead people who are suffering to professional help. The church family becomes and important support and they really need to be willing to take these individuals under their wings and make them part of their own activities (i accept that is a huge call with a high element of risk, but its what i feel is necessary). Simply asking “are you okay” is not enough.

On the contrary–we are told in medical school to remind folks it is 1% across all societies–not Judeo Christian, not any other cause.
I have heard of folks recommend exorcism for a horrible, horrible disease that takes the only, strongest basis of understanding things–our brains–and turns it on its head.

These are well meaning folks–but it’s horrible, and we need to kindly remind people that schizophrenia has nothing to do with morality.

On the other hand, I do have a lot of failings, myself–and I agree we all need forgiveness and grace as parents–though that’s not related. I apologize to my kids daily. and tell them I’ll be a better dad by the time I’m 100 years old. I join you there!

I invite you to read more about schizophrenia and mental illness. It is fascinating.

In Africa, (as you know, I was a missionary kid), they were generous and compassionate people, but they could give no treatment. People with psychosis wandered about, unkempt, begging, responding to internal stimuli, fearful.

Many people tried to help them with food, but it was a sad situation. In areas of better resources, we can do much better. I have known folks with the right med who became married and raised kids. The meds sometimes (not always) take away the voices.

Thank you.


Yes, it is, and it’s also heartbreaking.

Yes, I’ve posted before about mental illness in poor countries where no treatment is available. It is treated as a spiritual problem, and the mentally ill are literally chained up in prayer camps.

Ghana: Dealing with the Mentally Ill

People with these problems should be very, very careful about where they go for help. If a minister thinks you have a spiritual problem you should run!


In the Bible they drank wine all the time. And consider the first miracle at the wedding in Cana.

Medical school???
Do you take your religious theology from medical school or from the bible? This is a christian forum…not a medical school!

Also, the new testament is not a Jewish print…its nothing of the sort so im not sure where that part of your claim came from?

It seems to me that many individuals have a lot of trouble recognising the difference between Jewish tradition and the gospel.

Whilst on that point…the creation of this world, the fall of Adam and Eve into sin, Noahs flood, the tower of babel, the destruction of Sodom and Gomorah…these are not exclusively Jewish traditions. They predate Judaism. Its absurd to say “oh but they are part of Jewish history”…given we all came from a single creation event, we can all lay claim to that.

The gospel is that Christ came to reverse the destruction of sin (from the fall of Adam and Eve). Thats exactly the point…not just to save Jews 4 thousand years later

Btw…i dont give a crap about secular ideas on these things. The bible clearly tells us, the sins of the fathers will cause subsequent generations to suffer and this very definately includes physical defects and mental health issues.

As an example…i have two cousins with birth defects both attributable to substance use/abuse during pregnancy. We know for a fact that consuming alcohol and smoking during pregnancy are very likely to cause defects, add drugs into the mix…enough said.

No relevance…read Solomons poems on the effects of alcohol. SDAs dont believe the wine Christ created was alcoholic.

We do not believe God creates evil or is responsible for making sin…that is the opposite of what God is.

The first person to sin was Lucifer (who became satan) when he rebelled in heaven. He transgressed Gods law and was judged accordingly and cast out of heaven. The angels who followed him were the second group to sin, then the serpent and finally, Eve then Adam…the rest is history.

Thats an example of a lack of knowledge about the role of ministers and their professional training. It also suggests to me that your minister has no academic qualifications at all!

Having said that, i do agree that a ministers job is not to be a medical doctor…however it is also not a.medical doctors role to be a counsellor either. So each has their own professional skills to contribute to the equation and its a certainty that spiritual guidance forms part of the mental health debate just as medical health does, physical fitness, employment, personal grooming, social interractions and relationships…its a wholistic problem that i believe needs wholistic solutions…not just “chill pills”.

One thing that shits me with doctors is how quickly they want to prescribe anti depresents…often these make the problem worse. Sure they are an important tool that goes without saying, however good health isnt something you buy with a pill.

I know that in some cases its simply too late or the damage (if you like) is too great and we have few options…i accept that but i dont like the idea of shutting these people away or placing them in barrels.

Adam, this shows I have not communicated well. I am sorry. There was a comment above about schizophrenia.

Schizophrenia is very, very different from alcoholism, substance abuse, or depression. It is a severe brain disorder that causes delusions, paranoia, hallucinations, and withdrawal. It is awful.

This does not criticize our faith at all. The medical school doc emphasized that schizophrenia is not the result of a Judeo Christian worldview. This is not depression, nor drug dependence. It is different from the drug dependence. Your message seemed to say that schizophrenia came from moral choices. I wanted to explain what the difference was. Maybe I did it badly. I apologize, if so.

Maybe this will help with understanding Phil’s message.

Thank you for the wonderful description of your father. It sounds like your dad is terrific. He reminds me of mine. He also gave me frequent hugs. He was a graduate of a Christian college (Hope, in Holland, Michigan), but not a pastor. He was a very devout, Christlike missionary doctor, who gave up a potentially large salary to serve people he really cared for.

We likely have more in common with each other. I am from a very conservative background–mainly fundamentalist, or Baptist. I have never drunk alcohol, and despite Jesus’ having drunk alcohol, I have no intention of trying it. I don’t need any more trouble! I have a family history of alcoholism in 2-3 generations back (not now), but that’s likely why my grandma told me to stay away from it–because we likely have a gene for dependence. So, I understand some of where you come from, and appreciate it.

Genes likely affect our tendency to eating more (many of our ancestors likely survived famines because of tendency to be more hungry or retain calories; I struggle more in this way than many others, I think!), and also many other things, including bipolar. It’s amazing how things work, and we can be grateful for lots of things.

Please let me know your questions. You know a lot more than I do about many things, as well, so we can learn from each other.

Again, I am very grateful for my own parents and grandparents. I am not perfect, but so glad for their wonderful humility and example. In fact, I told my parents at one time that I should set up a fund to pay for their counseling, after all I had put them through!

I hope you have a good morning.

Thank you.


Your quote mining is a form of dishonesty. Our clergy do have excellent educations. They are kind, and cultured people. On the other hand, your minister’s mother wears combat boots.

Health care professionals do screen patients for mental health problems. I think it’s pretty routine at a good hospital to ask patients if they have ever felt like hurting themselves or if they have experienced depression.

Got any stats on that? I have a wonderful friend who suffers from depression and has even been hospitalized for it. Her doctor adjusts her medication as necessary. She wouldn’t be alive without such treatment. At the end of the day, this isn’t amateur hour.

btw, your foul language is interesting. If I had used such language I would have been shut down. But then again, BioLogos has a double standard.

Then it wasn’t real wine, was it? There was wine at the Last Supper.

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There seems to be a concern among some that saying that a personal problem, for example dependence on drugs or alcohol, has a partly biological cause excuses the alcoholic or drug addict from taking responsibility for poor life choices. It is clear that these are not mutually exclusive. Someone may have a genetic tendency towards alcohol dependence but that doesn’t absolve them of personal responsibility for making poor choices as an alcoholic. On the other hand, the fact that their alcoholism is related to poor life choices doesn’t mean that they don’t need help, both psychiatric and spiritual, getting out of their alcoholism or that they are undeserving of compassion.


Adam, you remind me here of something that happened to me when I was at university.

In Cambridge, it was common for students to hit a low point round about the fifth week of term. You were just far enough into term that the workload was getting on top of you, but just far enough away from the end of term that it seemed like ages until the start of the holidays. We used to talk about this low point as “fifth week blues.”

When I was in my fifth term—halfway through my second year—I had what was probably the worst mental health crisis I have ever experienced in my entire life. I couldn’t sleep, I couldn’t focus, and I was hit by a level of depression, confusion and anxiety unlike anything I’ve ever encountered before or since. This wasn’t just fifth week blues, it was a full-blown nervous breakdown.

There was one person who I spoke to about this, whose judgment as a pastor and Christian leader I really, really respected. This particular person responded to me simply by saying sharply, “Christians don’t get fifth week blues.”

Did that solve my problem? No. It just made things worse. It heaped condemnation on me.

I am really, really thankful that in the years since then, many churches (including my own) have started to treat mental health issues in a much more informed and compassionate way than they used to. Yes, there are some mental health issues that are spiritual in nature, but there are others whose origins and treatment can be well explained and treated using the principles of evidence-based medicine. I really should have sought professional help at the time. Pastors should view science and Scripture as complementary in these issues, not setting the two up in opposition to each other. Because when physical, chemical or biological problems are treated as if they were purely spiritual in nature, people just end up getting hurt.