I am approached by a gifted young Christian leader at a conference that I am speaking at. It is a conversation I have had hundreds of times in the 13 years since we started The Mind and Soul Foundation. Here is another passionate leader and brilliant communicator of the gospel who is becoming aware of the juxtaposition between their mental state and the message that they are delivering to others.
My empathy is rooted, in part, in the fact that I can see something of myself in the struggles of this young preacher. Having experienced a sudden and terrifying descent into Generalized Anxiety Disorder more than a decade ago, I know the sense of disbelief Christian leaders encounter when they realise they are not immune to the 1:4 statistic. (The prevalence of mental health issues among church leaders is at the higher end of the national average.)
While the UK is often described as experiencing an 'epidemic' of mental health problems, the reality is a little less dramatic. The fact is, due to some exceptional public awareness campaigns by Time to Change, Mind and Rethink Mental Illness, the general population is more aware of their mental wellbeing than they have ever been. The reduction in stigma means that more people are seeking treatment and this has led to a surge in medication prescriptions, particularly for mixed anxiety/depression which is the UK's most prevalent mental health issue.
While much of what is called the Mental Health Awakening is to do with awareness, some issues are a rising concern. As the population lives longer, we are seeing older people experiencing mental illness, some related to loneliness. Young people are also increasingly vulnerable in our society and the UK has seen a rising trend of self-harm both inside and outside of the church. Manchester was recently dubbed ' the self-harm capital of Europe'. Male suicide is also an issue of vast concern in the UK and is the biggest killer of men under 45 years of age.
Wellness versus illness?
I am loath to simply quote statistics (of which there is an infinite supply) largely because it has been this binary view of wellness versus illness which continues to plague the mental health arena. The 1:4 statistic has given us a realistic idea of scale but it falsely suggests that three in four people don't need to be concerned with their mental health. The reverse is true: mental wellness is a health priority for everybody and a part of our God-given responsibility for good stewardship.
Christian silence on mental health has undoubtedly had a detrimental impact upon the Christian community's motivation for mental self-care, but it has also inhibited our social mission. While the church has pioneered ministry in child education, poverty, homelessness, social equality, physical health and disability, we have largely abdicated any responsibility for mental wellbeing.
Our absence in the mental health space only generates even more stigma and suspicion over the origins of clinical mental health problems. It has also meant that initiatives to promote mental wellness have not been taken up. When we launched Mind and Soul, I was initially warned off the idea by several Christian leaders who felt that psychological and theological perspectives on mental health were completely incompatible. This is despite the fact that many celebrated Christian leaders have openly wrestled with the impact of mental illness in their own lives.
From a preacher's perspective it would be remiss not to mention Charles Spurgeon or Charles Wesley's lifelong battles with depression, or Martin Luther's wresting with OCD and anxiety. There are many others who appear to have had serious and enduring mental health issues, including Florence Nightingale (bipolar), William Cowper (depression) and John Bunyan (OCD).
The church has a mixed record, historically, of engaging with those who had mental health problems. Juan Luis Vives, born in Valencia in 1492 was respected by Erasmus, Henry VIII and Thomas More. His words are perhaps a helpful reminder to us all that in our reflections on mental health, clinical or theological, distressed people are involved:
'There is nothing in the world more excellent than man, nor in man than his mind, particular attention should be given to the welfare of the mind; and it should be considered a highest service if we either restore the minds of others to sanity or keep them sane and rational... One ought to feel great compassion for so great a disaster to the health of the human mind, and it is of utmost importance that the treatment be such that insanity be not nourished and increased.'
If we accelerate forward to recent years, the culture is changing again in a positive way. Mental health is an issue of huge public interest and over the last five years we have noticed a significant shift in Christian leaders' willingness to engage in psycho-education, emotional health training and mental health conversation. The impact of more informed leadership is being felt in congregations as a reduction in stigma, more informed preaching, referral activity and adapted prayer models.
Mental health in leaders
A key part of improving the culture for Christians suffering from mental health issues is addressing the emotional and mental health of Christian leaders directly. Typically, leaders set the culture in their churches, and they also tend to preach with passion and authority on issues that they have experienced and understood for themselves. Seminaries and theological colleges could consider mandatory training in mental health and self-care. Church leaders are vulnerable to stress, depression and burnout: 'I had to quit the ministry so we wouldn't end up quitting the church,' a former executive pastor said.
Mental health stigma has improved but it remains a real blockage to us realising our ambition for the church to treat mental health issues with parity to physical health issues. This is because many leaders have generally retained a view that mental health issues have a stronger spiritual orientation than physical health problems. In the most troubling examples this has led to individuals suffering from psychotic illness undergoing humiliating public 'exorcisms' or being advised against taking effective medications. It has also been the experience of many sufferers that the implicit message in church is that depression is 'laziness', anxiety is a 'lack of trust' and that mental health problems can be resolved by greater 'obedience to Christ'.
Six Conversations: the power of our words
As leaders absorb more psychologically-friendly language, we have seen the appearance of a subtle hybrid of the same stigma appearing in preaching and we have broken these down into six general topic areas:
1. The Trust Conversation: 'As you learn to trust God more you will find that your anxiety will gradually fade away.'
What the mental health sufferer hears: 'My mental health problem is a result of my lack of trust in God, and it will disappear as I go deeper in my faith.'
Anxiety disorders impact people with a deep trust in God and are not related to the strength of a person's faith. Anxiety issues also fluctuate over time and need long term management. They tend not to improve on their own but through awareness, medication, talking therapy and self-help strategies.
2. The Self-Indulgent Conversation: 'Lots of biblical greats such as Job and Elijah were depressed. The key thing to remember is that they didn't pander to their depression, but got on with the ministry God had called them to.'
What the mental health sufferer hears: 'It's not OK to be self-indulgent and be impacted by my mental health problems. I need to ignore my pain and get on with what God's calling me to.'
God never criticises people suffering with depression in the Bible, indeed he does the opposite; he comforts them and meets their needs. Dealing with emotional pain is not self-indulgent, any more than dealing with physical pain is. We all need to offer and receive the comfort of God without qualification: that's grace!
3. The Personal Cross Conversation: 'We all have our own cross to bear, for you it may be your mental health issues. The good news is that in heaven there will no more weeping or gnashing of teeth.'
What the mental health sufferer hears: 'I am never getting any better this side of heaven. God is responsible for me carrying this cross. Life is hopeless this side of eternity.'
We can identify with the suffering of Christ in our sufferings, but these are not fixed God-ordained things. Mental health issues, like physical disabilities, provoke suffering but also creativity and gifting. They do not define our identity or reflect the sum of our struggles. We can live life well this side of heaven with mental health problems.
4. The Undermining Mission Conversation: 'The enemy is using mental health issues to make the church inward-looking. As long as we are being introspective, we are losing our effectiveness in mission.'
What the mental health sufferer hears: 'Mental health issues are a weapon of Satan to stop people meeting Jesus. As long as I am talking about mental health, I am undermining the gospel.'
Jesus was the ultimate pastoral leader who loved the hurting and broken like no other. He calls us to 'take care of the sheep' with the same care and love that he demonstrated. Supporting people with mental health problems in the church is fulfilling the spirit of the Beatitudes and the Great Commission. It is the very thing that will make our message heard in a sceptical world.
5. The Already Healed Conversation: 'You have already been healed of your mental health problem, now you just need to agree with the healing that you have received.'
What a mental health sufferer hears: 'Your disobedience is keeping you ill.'
Sometimes we need to choose the behaviours that we have decided for in our minds. However, this is not the same as choosing a healing. Mental health recovery is not about disobedience, but it is sometimes about courage. No one with the 'flu is being disobedient by feeling unwell, equally no one with depression is disobedient by feeling low. Let's not confuse healing steps with the healing itself.
6. The Medication Conversation: 'Medication is OK, but you haven't been called to rely on it forever. You need to step forward in your faith journey so that this crutch is no longer needed.'
What the mental health sufferer hears: 'Medication is a weak alternative to real recovery. I should get off it as quickly as possible so that I can do this recovery right.'
Medication is a valid, necessary and often essential part in mental health recovery. It is neither less virtuous nor effective than other sorts of treatments, in most cases. Just as with conditions like diabetes in physical health, many psychotic illnesses will require a life-long medication regime. This is wholly good and right and should be actively supported by the Christian community.
As preachers and leaders, we carry a huge responsibility to use our words and actions to heal and not hurt. While we may in some instances carry genuine disagreements over some aspects of this topic, we can no longer allow ignorance to inform us.
For the sake of our congregations as well as ourselves, I would encourage us all to become as educated and informed as we can possibly be over mental health, from both a secular and a Christian perspective. There is no doubt that our society needs it, our churches are impacted by it and our families will encounter it. Jesus is still the healer, and powerful biblical preaching that is psychologically informed has a key role to play in the mental health recovery of hurting people within our churches today.
Rev Will Van Der Hart is pastoral chaplain of Holy Trinity Brompton, London. He is a director of The Mind and Soul Foundation and works to support people with emotional and mental health issues within the Church. He is co-author, with Dr Rob Waller, of a number of books including 'The Worry Book', 'The Guilt Book' and 'The Perfectionism Book'. www.mindandsoulfoundation.org @mindandsouluk
This article first appeared in the October edition of Preach magazine, which focuses on mental health, and is reproduced with permission. World Mental Health Day 2018 is on October 10.