With much fanfare, the folks from Lifeway Research and Focus on the Family released a report yesterday containing data collected from three separate surveys of Protestant pastors, Protestant adults identified with mental illness, and family members of Protestants with mental illness in what’s been titled the Study of Acute Mental Illness and Christian Faith.

I spent the last two evenings pouring through their report. Given the emphasis that our ministry places upon supporting churches as they minister to families impacted by mental illness and the prominence the studies are likely to receive throughout the evangelical church as a result of the people and organizations behind them, the release of the report is something we need to speak into. Nevertheless, I found the design of two of the surveys to be profoundly disappointing and the results of the survey not nearly as useful as they could’ve been.

We’re going to examine the results of each of the three surveys

The most useful of the three surveys was a telephone survey of 1,000 U.S. senior pastors in Protestant churches conducted last May. Responses were weighted to reflect size and geographic distribution of the churches surveyed. Here are some key findings…

• 74% of pastors personally know one or more people diagnosed with depression.

• 76% know one or more people diagnosed with bipolar disorder.

• 50% don’t know anyone who has been diagnosed with schizophrenia.

• 59% have counseled one or more people eventually diagnosed with an “acute” mental illness…defined here as schizophrenia, “clinical depression” or bipolar disorder, but only 13% had counseled more than ten. 31% answered “none.” Pastors were more likely to answer “none” as the size of the church they serve became smaller. Pastors in the South were significantly more likely to answer “none.” Note: Schizophrenia is not an “acute mental illness,” nor is depression in many instances.

• 38% of pastors reported feeling equipped to identify a person dealing with acute mental illness that may require referral to a medical professional.

• 23% indicate they have personally struggled with mental illness of some kind, but only 12% of pastors surveyed were ever formally diagnosed. Pastors in the Midwest were significantly more likely to report undiagnosed mental illness.

• Only 35% strongly agreed with the statement that a Christian with an acute mental illness can thrive spiritually, regardless of whether or not the illness has been stabilized, although 41% answered they “somewhat agree” with that statement.

• 40% agreed with the statement that medications should be used anytime they can ease symptoms of an acute mental illness.

• 51% agreed with the statement that psychological therapy should be used before sharing spiritual principles, while 20% agreed that psychological therapy should be used before sharing spiritual principles.

• 56% strongly agree that local churches have a responsibility to provide resources and support to individuals with mental illness and their families.

• 68% of pastors indicate their church provides care for the mentally ill or their families by maintaining lists of experts to refer people to…but only 28% of family members of persons with mental illness reported such lists were available.

• 49% of pastors rarely or never speak to their church in sermons or large group messages about acute mental illness.

So…what to make of all this?

After my first read through the survey, my initial reaction was to question the extent to which the folks who designed this project understand the concept of mental illness. Were they hoping to study the impact of severe mental illness and stumbled onto the concept of “acute” mental illness? How or why did the survey authors decide to ask specifically about schizophrenia, depression and bipolar disorder? 90% of patients with bipolar disorder experience recurrent mood episodes resulting in most instances in a need for lifelong treatment. Schizophrenia is certainly not an acute illness. Here’s the first sentence in the National Institute of Mental Health’s (NIMH) information page describing schizophrenia…

Schizophrenia is a chronic, severe, and disabling brain disorder that has affected people throughout history.

The diagnosis doesn’t matter as much as the severity of functional impairment the person experiences from symptoms related to the diagnosis. Want to know what mental health condition results in severe impairment to the greatest number of adults according to NIMH? It’s anxiety! The authors never asked about it in the survey.

Here’s my most significant criticism of this survey…they didn’t ask the right questions!

If I had access to 1,000 pastors, here are some of the questions I’d ask…

To what extent do you believe mental illness is indicative of an individual lacking sufficient faith in Christ?

What percentage of the time do you believe that mental illness is a direct result of habitual sin in the life of the affected person?

How often is prayer likely to lead to remission/cure of the following conditions?

• Depression?
• Anxiety?
• Autism?
• Schizophrenia?
• PTSD?
• ADHD?

In the last year, have you referred a person attending your church who appears to be experiencing symptoms of mental illness to…

• A fellow pastor (inside or outside your church) for counseling
• A Nouthetic, Biblical or Christian counselor
• Their primary care physician
• A secular psychologist or counselor
• A psychiatrist (MD/DO)

What challenges would you anticipate a person with mental illness or a family member with mental illness might experience if they sought to regularly attend worship services at your church and participate in other activities your leadership views as essential for spiritual growth (small groups, Christian education, missions/service, etc.)

Here are a few thoughts on this survey of pastors…

Why weren’t questions like those I suggested included in the survey, especially after Ed Stetzer from Lifeway noted in an earlier blog post that a high percentage of Americans views prayer and Bible Study alone as sufficient for overcoming serious mental illness. Where do those attitudes originate? I wonder if the folks at Focus on the Family didn’t want to ask tough questions that might embarrass some of their longtime friends and supporters?  Are they even aware of the experiences of shame or blame reported by faithful Christians when seeking comfort and support during episodes of mental illness? Are they so isolated from Christians with outstanding reputations for doing quality academic research on disability-related topics that they didn’t know where to go for help in tackling a project like this one?

It’s interesting that while nearly a quarter of pastors identify themselves as having personally experienced mental illness, roughly half never sought help. Why not? Is the stigma against seeking help that great among senior pastors? Do they have difficulty finding high quality mental health care that’s affordable under their health care benefit packages? Is it a lack of trust of mental health professionals? Somebody should’ve asked.

Last…and this is one area where this data is consistent with surveys looking at other areas of disability…there’s an enormous disconnect between what pastors believe their church is offering in the way of supports and what families in the church experience in describing the availability of supports when it comes to mental illness. The graphic on the right illustrates this point nicely…the church may have resources to help support persons with mental illness and their families, but if we never talk about mental illness at church, how would those who might benefit know that the resources even exist?

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Key Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!