More important is how we handle mental health issues in our office, specifically when dealing with parishioners who come in for counseling. In most of my pastoral counseling appointments, I ask about medication history and current medications as a routine part of the intake process.

This may seem intrusive, but most people are very comfortable with this line of questioning these days. If they aren’t, I simply move on. Some folks still feel guilty about taking medication for what they perceive to be “a spiritual issue,” but at least they know I’m open to discussing medications in the future. Because I raised the issue initially, they may feel free to bring it up later.

If they answer the medical questions, I take the time to research the condition on the Internet, learning what each medication does and its side effects. Sometimes I call mental health professionals to ask how to deal appropriately with someone using that kind of medication. I don’t reveal names or specifics, just ask for some basic guidelines.

Once I know more, I follow up by giving the counselee tools for better self-awareness and accountability. And I encourage the counselee to reveal the condition to at least one other trusted person in the congregation. The pastor should not be the only one who knows.

I give the counselee a copy of the information I gathered. If appropriate, I will challenge him or her to get involved with a small group that deals with such issues—whether that is available at our church or another church in town. In Tammy’s case accountability has proven to be life altering. Although she now lives in a different city, she stopped by last week to visit. She is doing much better, she says, and her mood and behavior have stabilized. It was good to see her smile and to hear her laugh. It was encouraging to know that she has received help and that she is seeing her counselor and doctor as prescribed.

Wait a minute … I have a phone call. It’s one of Tammy’s accountability partners. Tammy’s counselor just called and said Tammy skipped her appointment again. The partner wanted me to know she would be confronting Tammy. It’s good to know that the system we worked hard to get in place is helping us care for one of God’s children.


  1. Think of a time you had an experience similar to the one Anderson had with Tammy. How did you handle the situation? What did you do right? What do you wish you’d done differently?
  2. What warning signs can you look for to clue you in to congregants who might need to seek medical attention for mental illness?
  3. What resources and support does your church offer for those who are suffering from mental illness? How are you actively helping to plug people into these programs? Focusing on the insights found in this article, what changes might you need to make to more effectively help the mentally ill?

—Elliott Anderson is senior pastor of Elgin Evangelical Free Church in Elgin, Illinois; adapted from our sister publication Leadership Journal, © 2007 Christianity Today. For more articles like this, visit


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