May 25, 2020

Mental Health and Ministry Among the Poor

As to mental maladies, is any man altogether sane? Are we not all a little off the balance? – Charles Spurgeon

One cannot talk about ministry among the poor and hard neighborhoods of the world and neglect issues related to mental health. I currently teach at-risk students in a local high school and daily interact with students that have severe anxiety, trauma, and/or outbursts of uncontrollable anger. Some cannot stay focused on one task for more than two minutes (literally) and others hear voices.

Although these issues are also common in more well-to-do communities, they are especially pervasive in poor communities. Consistent financial struggles, relational turmoil, and environments plagued with crime and abuse cause even the best of us to wear down and become ill.

So when it comes to pastoring in hard places, we need to be prepared to address the vast array of mental health issues found therein. In this article, I hope to provide biblical language concerning mental illness and also a few suggestions for addressing the mental illness in ourselves and also in those we serve.

Use Biblical Definitions to Describe Mental Illness

I have spent nine years as a pastor, and one of the primary ways I serve my community is through teaching. This has provided me an opportunity to participate in both formal and informal conversations concerning mental health. In these conversations, I’ve seen two extremes emerge.

One extreme blames everything on mental illness. This often leads to excusing sinful behavior, wherein the person who battles with mental illness is given a free pass time and again. The other extreme, however, doesn’t take mental health seriously enough. This often compounds the suffering of the person struggling because they are not treated with the care and compassion they deserve.

But these two extremes ought not be characteristic of a Christian response to mental illness. As followers of Christ, we can give thanks that the Scriptures give us accurate definitions of mental health. Here are a few truths to help us.

1. Mental illness is a result of the Fall.

The Scriptures teach that the wages of sin is death (Rom. 6:23). From the day we’re born, our bodies begin the journey towards death. This is true for our mind just as much as it is for our heart, lungs, and other vital organs. Our minds do not function fully to begin with, and the effects of the Fall around us can wear the mind down to the point of exhaustion. This truth reminds us that no one ‘has it all together’ mentally.

As the Spurgeon quote at the beginning noted, we are all ‘a little off the balance’ mentally, in one form or another. This ought to produce humility and compassion—to avoid creating too much distinction between ‘us’ (the sane ones) and ‘them’ (the mentally ill)—and to look to our Savior for redemption. With the Psalmist, we ought to exclaim: “My flesh and my heart may fail, but God is the strength of my heart and my portion forever.” (Ps. 73:26)

2. Mental illness is affected by sin, fatigue, and spiritual warfare.

Even in our best state, we are not perfectly well. We must be aware that the Scriptures show us how sin can affect our mental well-being. Psalm 32 describes the mental and physical condition of one who is hiding his sins.

For when I kept silent, my bones wasted away through my groaning all day long. For day and night your hand was heavy upon me; my strength was dried up as by the heat of summer.

(Ps. 32:3–4)

Fatigue and exhaustion can also affect our mental well-being. In 2 Corinthians 1:8, Paul describes his near breakdown due to the mental and physical pressures of ministry. He was feeling discouraged and cast down as a result of obedience to his calling. In other words, not all mental illness is directly attributed to someone’s sin.

We must also be aware of spiritual warfare in the battle against mental illness. Ephesians 6 commands the believer to be on guard against the lies and attacks of the evil one. Many mental health issues are compounded when we don’t take up the armor of God, and instead give into ungodly and unbiblical thinking about ourselves, our circumstances, and other people. Many times, the mental funk that we find ourselves in is the result of a combination of the three.

In his classic book Spiritual Depression: Its Causes and Cures, Dr. Martyn Lloyd Jones writes:

You cannot isolate the spiritual from the physical for we are body, mind and spirit. The greatest and the best Christians when they are physically weak are more prone to an attack of spiritual depression than at any other time and there are great illustrations of this in the Scriptures.

3. Combine biblical compassion with biblical admonition when discipling the mentally ill.

The book of Galatians is very instructive for us here:

Brothers, if anyone is caught in any transgression, you who are spiritual should restore him in a spirit of gentleness. Keep watch on yourself, lest you too be tempted. Bear one another’s burdens, and so fulfill the law of Christ. For if anyone thinks he is something, when he is nothing, he deceives himself. But let each one test his own work, and then his reason to boast will be in himself alone and not in his neighbor. For each will have to bear his own load.

(Gal. 6:1–5)

It can be easy for those who are mentally and emotionally strong to become impatient or lack understanding when discipling those struggling with mental illness. On the other hand, those who are sympathetic can allow strugglers to lean on them too much.

But God gives us His perfect wisdom in Galatians 6. He tells us to bear one another’s burdens and to consider our own weakness. But He also tells us that each must bear his own load. We must walk alongside and support the mental strugglers, but we cannot walk for them.

Use Biblical Wisdom When Dealing with Mental Illness

Despite what some (Christians) might say, there is not one single cause for mental illness. Neither is there one single cure. It’s not simply a matter of ‘having more faith’. Christ Himself is the ultimate cure. One day, we will be fully redeemed from the effects of sin and enjoy Him in complete perfection (1 Cor. 13:12). In the meantime, Christ has given us common and spiritual means of grace by which He brings relief and healing to strugglers here on earth.

With some, we need to help navigate unhealthy and/or unbalanced lifestyles that are contributing to mental health problems. We need to come alongside others and help them walk in repentance (Gal. 6). We need to call together the elders to pray over and lay hands on others (James 5:13–16).

We must also be careful to not contradict a doctor’s directives regarding prescriptions that people are already using. Pastor, you are (likely) not a medical health professional, so don’t try to be one. To be clear, I’m not saying that all medicinal treatments for mental health are right or godly. There may be times when it’s necessary to counsel someone away from the use of certain medicines. No matter what, it’s crucial that we regularly teach and model godly stewardship of our time and bodies.

One thing that I think sadly often gets neglected in the fight against mental illness—even by pastors—is the absolute necessity of biblical church membership and community. We must encourage strugglers toward these things. Isolation accelerates mental illness. We all need others to speak truth into our lives when we struggle to remember it or believe it. We need others to pray with and for us. We need the consistent healing from the very words of God as they are preached faithfully.

Above all, we need the saving gospel of Jesus Christ, the One who came to bear our griefs and carry our sorrows (Is. 53:4).

If you’d like further resources on mental health, here are a few.

  • Mike Watt

    Mike Watt currently serves as the Worship Pastor at Hillside Community Church in Minneola, FL and teaches at-risk high school students in Orlando, FL. He's an apprentice with Church In Hard Places, an Acts 29 initiative. Mike is married to Jennifer, and together, they are raising five awesome sons. Learn more about Mike by visiting

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