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What Pastors Need to Know About Mental Health, Ministry, and Liability
What Pastors Need to Know About Mental Health, Ministry, and Liability
How both legal experts and ministry leaders approach mental health issues in the church.
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“Yeah, there’s risk. There’s always risk on this side of heaven,” says Hoefs. “But isn’t there a greater risk of not having to reach people for Jesus?”

The church, as a whole, is becoming more aware of the great need and opportunity for ministering to those suffering from mental illness.

The church, as a whole, is becoming more aware of the great need and opportunity for ministering to those suffering from mental illness, in addition to their family and friends. With the rise of nationally recognized mental health ministry events, such as Saddleback Church’s “The Gathering on Mental Health and the Church,” it’s clear that at least some churches and ministers are waking up to the reality of mental health issues that already exist among churchgoers. Whether church leaders wish to minister to mental health needs or not, that one in five Americans have a mental health issue each year means people with mental health issues are likely already in their pews. “What is big, dark, and horrible,” says Hoefs, is “if you don’t do anything and you lose somebody to suicide.” Hoefs is speaking from experience: he lost his own mother to suicide some 30 years ago. He says the fear of helping people with mental health issues is “more of a stigma than a risk factor.”

It’s an important distinction, too, that not all church ministries to those with mental illness have to look like traditional pastoral counseling. In addition to referrals to licensed medical professionals, churches can offer space and support through other means.

One way of doing that is to host peer group programs that don’t purport to be professional help. Hoefs’s ministry, Fresh Hope, offers an effective example. As peer-to-peer support groups, they likely sidestep the major concerns for liability. “There’s no more risk in doing mental health stuff than doing a nursery ministry or celebrating recovery,” Hoefs says.

Stanford agrees and admonishes churches to not stigmatize mental health ministry as untouchable: “The majority of AA meetings happen in churches. AA [groups] are just autonomous groups that just use church buildings. I’ve never heard a church go, ‘Oh, I don’t know if we want those alcoholics in here with liability issues.’ Forty-three percent of people with substance abuse problems also have a serious mental illness.” Stanford suspects that concerns about liability issues are often “just an excuse to try to keep ‘those people’ out of our places.”

At least for peer-to-peer groups like Fresh Hope, Cole says that although she’s not aware of prior legal cases that test their liability, those groups likely avoid the main liability issues of counseling. She explains:

Presuming it is a group where everyone is on the same level and simply comes together to share their personal experiences, it is likely to not rise to the level of counseling. As such, I can see that there could be the potential for real good there. . . . Just from a base human perspective, we appreciate when others can relate, and that itself provides a high level of support. I don’t know that such a program could take the place of actual [licensed] counseling, but if an individual were to utilize that system and find it to be helpful, I imagine that would be of benefit to the individual and pose less potential for legal liability because it is peer-to-peer.

What church leaders should know about mental health first aid

Regardless of the policy a church chooses to adopt in the area of pastoral counseling for mental health issues, anyone could benefit from taking what is called “mental health first aid.”

Mental health first aid operates on the same principle as something like CPR: most people can’t become licensed medical professionals, but the average person can learn some basic, yet vital, skills for recognizing and responding to medical crises.

Judy Smith teaches mental health first aid in the western suburbs of Chicago. “Across the board, mental health literacy is pretty low,” she says. A key solution she advocates for—especially for pastors—is the basic training provided by mental health first aid.

These courses cover the basics: understanding what mental illnesses are and understanding what help a person might need until a professional steps in. It’s important to note that this basic training does not elevate pastors to the realm of mental health professionals. Instead, the training gives pastors objective ways to recognize the difference between what is mental illness and what is not.

Pastors and church leaders can learn from mental health first aid the basics of recognizing and/or responding to issues such as:

  • Panic attacks
  • Depression
  • Anxiety
  • Psychosis
  • Substance use disorder (SUD)
  • Suicide

On the issue of suicide, for example, the class teaches individuals how to ask if the person is thinking about taking his or her own life. For individuals who are thinking about it, they’re likely to be honest and relieved. “We’re not going to trigger anything,” says Smith, hoping to allay any fears that asking about suicidal thoughts would somehow be detrimental.

Likewise, in Smith’s class, she gives a five-point guide for pastors who do encounter someone dealing with mental health issues:

Posted:
May 30, 2017

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