We face unprecedented demands upon mental health as humanity continues into an unknown and unpredictable future rocked by a pandemic. As another school year begins, it’s time to consider thoughtfully how we address the care of children, teens, parents, teachers, and health care providers. How can the church offer a non-judgmental space for grace that offers peace, light, and assurance?  In The Caring Congregation Implementation Guide and the Care Minister’s Manual, you will find encouragement and ideas about mental health ministry. Here is a brief excerpt from the Implementation Guide to help pastors and lay volunteers think through how churches of all sizes might address the mental health needs of their communities.                                                                                                                          

Mental health ministry 

“Whenever the evil spirit from God affected Saul, David would take the lyre and play it. Then Saul would relax and feel better, and the evil spirit would leave him alone.”  —1 Samuel 16:23 CEB

The scriptures make clear that biblical characters suffered with depression and anxiety. And although they called them “[evil] spirits . . . from God,” it's clear they were trying to find ways to relieve their suffering. Other scriptures include the laments of the psalmist along with the despair and depression of Job, Hagar, Naomi, and Judas. Sleepless anxiety is noted as Jacob in the scriptures wrestled with God night and day (one example is located Gen 32:22-32). 

As we do our part to help struggling people with their mental health, the faith community can be key to eliminating stigmas and misunderstandings wrapped around mental health. We must help our congregations understand that this is not brought on by God or by evil spirits nor is it a character flaw or spiritual weakness. Rather anxiety and depression are a disease process. If we get a physical wound or injury, we quickly go to an urgent care clinic. That same kind of urgency to seek professional help must be encouraged when people need a counselor, psychiatrist, or both. Breaking the stigma can best be done through classes, sermons, and one-on-one care where shame and denial are identified.

What we know about mental illness

• In almost all cases, mental illness is a function of chemical imbalance plus genetic predisposition combined with environmental factors.
• MRI studies increasingly demonstrate that mental illness is best accounted for as differences in neurological functioning.
• One in five American adults experience a mental illness in a given year. 
• Major mental illness reduced life expectancy by up to thirty years.
• Sixty percent of people with mental illness don't receive treatment, usually because of stigma.

During the years of the Great Recession, suicide peaked in the rural area where I was raised because of the unspoken shame and fear. The mental health struggles were many times dealt with by the guns or ropes in the closets of the farm or ranch families. 

In the grip of a world pandemic, suicide increases out of despair, exhaustion, and PTSD.

As pastors and congregational care ministers (CCMs), we want to be of help with these situations. We may not be able to offer a menu of mental health classes, but any size church can begin by creating connections with the mental health caregivers in your region, who can brainstorm with you about how best to encourage care. No matter where you live, it can be challenging to find resources where you do not need to wait a week or more. Yet it is essential for a church to create a list of resources ready to hand to congregants that will give them a starting point. This list of resources identifies trusted counseling and mental health services, local Alcoholics Anonymous/Narcotics Anonymous, safe shelters for abuse victims, national mental health hotlines, and food pantries, to name a few. 

As faithful CCMs and pastors offering spiritual guidance, our role is important. We offer hope and encouragement through scriptures and prayer that God is with the suffering and loves them during this challenging time. Again, we should be convinced that our theology reflects grace without judgment. 

Key scriptures to consider:

Psalms 27; 31; 69; 71; 91; 138; 139; 143

Lamentations 3:21-24

Matthew 11:28-30

John 14:27

Philippians 3:13-15; 4:4-7, 13

Ways to address the stigma regarding mental health

• Talk about mental illness, whenever you can and wherever you can.
• Regularly host groups, panels, and classes focused on mental health.
• Avoid using shaming words, such as crazy, psycho, insane, and so on.
• Don’t discriminate on the basis of mental illness for volunteer roles.
• Talk about the value of counseling and medicinal interventions.
• Collaborate with area clinicians on programming.
• Give staff and volunteers access to “mental health first aid” training.
• Find a mental health professional who can review your church’s worship experience.
• Take away guesswork by making as much of your ministry accessible online as possible.  

As pastors and CCMs, it is helpful to know the differences among the mental health clinicians.

• Psychiatrists are medical doctors specializing in mental illness. In most contexts these providers focus on medicinal interventions. 
• Psychologists are doctoral-level clinicians using primarily traditional talk (insight) therapy to treat clients. They may also administer advanced testing (ADHD, IQ, personality, etc.).
• Counselors/Therapists are masters-level clinicians who usually use traditional talk therapy to treat clients. They may also offer tools like EMDR, neurofeedback, TMS, and hypnotherapy. 
• Substance Abuse Counselors are, in many states, able to obtain licensure without an advanced degree, though most states require a licensure exam. They use talk therapy and support to assist those in recovery. 

When helping a congregant or guest choose a “Christian” counselor, it is important to be aware of their theology, training methods, and values. Trained, trusted counselors should respect the diversity of clients, the goals of the client, and avoid imposing their own values, attitudes, and beliefs. It is extremely important for you as a pastor or CCM to know the counselor has been vetted and know that the therapist's values align with your congregation's commitment to do no harm. Try to eliminate barriers that would prevent people from getting counseling such as:

• cost,
• location, and
• too many/too few options.

Prayer and meditation can be a very helpful practice for the struggling person. Daily meditation has been scientifically proven to increase the capacity of the brain to process at higher levels of reasoning. As you begin to care for someone, create a space of grace where they can feel accepted and heard. When they are ready, offer meditation tools such as the “Breath Prayer.”  Another excellent practice is prayer through journaling. Encourage them to acknowledge their pain followed by an acceptance of God’s love and light readily available to them. Breathing deep and releasing their pain eases physiological stress. The importance of daily prayer rituals cannot be overstated. As a pastor or CCM our task is to model, encourage, and provide tools to develop these disciplines of prayer. 

As you sit with and care for those who are struggling mentally, the pastor or CCM must be clear (yet compassionate) about their own boundaries. For instance, be definite about when, where, and how long you will meet with this person. Do not overcommit or give contact details about your personal information too quickly. Be cautious and wise about the use of touch: it can be healing and comforting or confusing, hurtful, and unwelcome. These basic guidelines set an example for the person in how to set their own healthy boundaries. 

One recommended resource you might have on your shelf is a book, The Depression Cure: The Six-Step Program to Beat Depression without Drugs by Stephen Ilardi (Da Capo Press). It highlights Therapeutic Lifestyle Changes (TLC) that include diet, exercise, light (sunshine or otherwise), socialization, sleep, and finding healthy activities to counter rumination patterns. 

Even as we teach the TLC method and offer encouragement through spiritual methods, we must always be aware that a care plan for mental health should include mental health professionals. The church is most effective in mental health ministry when we promote the fullness of care.  

Anxiety

Anxiety is just as dangerous as depression, and often the two illnesses occur at the same time. Thus be aware of a few of the symptoms: 

• Excessive worrying
• Panic, fear, and restlessness
• Sleep problems
• Not being able to stay calm or still
• Cold, sweaty, numb, or tingling hands or feet
• Shortness of breath
• Heart palpitations
• Dry mouth
• Nausea

If you note these symptoms, don't assume that you can help a person without more professional help. Address the possibility of seeking more help with the person. Also, remember these points:

• Anxiety can be contagious and can hijack your ability to provide good care. Manage your own anxiety by taking a deep breath and controlling your tone of speech, pace, response, and follow-up questions or comments.
• Stop to pray. This can break the cycle of anger, self-pity, or indecision that may be getting in the way of progress. Remember, you cannot control the other person’s response or the outcome.
• You are in control of the session’s length. Generally, at the onset, tell the person that you have set aside a certain amount of time, perhaps an hour. The greater clarity you can give, the better it usually is. Setting boundaries in space (a quiet, safe place) and time (decided ahead of time) gives people a sense of structure and will help them manage their own anxiety better.
• Allow yourself grace when dealing with complex or emotionally challenging situations. Remember, when we get down in the dirt with people as Jesus did with the woman in John 8, we can find ourselves in difficult circumstances. Do not be discouraged. Find a pastor, colleague, supervisor, or counselor to help you process your feelings.

Offer Comfort

The scriptures tell us, “Comfort, comfort my people!” (Isa 40:1). Always offer a next step for those who come to see you, even if it is just seeing them in worship next week.

Offer weekly check-ins with good boundaries. Who else on your team would offer helpful compassionate support? Are there courses that would help them find healthy socialization or greater understanding of their situation? Are there ways that they can serve others to find a renewed sense of purpose? 

They have come to you, spilled their story, and offered you a part of their life that perhaps no one else has ever heard. You are acting on behalf of Christ and the church. What would Christ do for this lamb?

Helpful scriptures include: 

• Proverbs 12:25
• Psalm 46:10
• Psalm 91
• Isaiah 43:1-5
• 1 Peter 5:7

A simple ABC Prayer is a practice you can share:

• “A” is acknowledge how you are feeling, without judgment.
• “B” is being aware of your breath. Breathing in peace, exhale your pain.
• “C” is choosing to be full of love, light, grace, peace, and joy.