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"You need to do something about this,” the pastor pleaded. I was walking back to my room while attending the annual governance meeting of my denomination, the Christian Reformed Church (CRC), when this pastor approached me. He urged, “I won’t tell you the details, but you need to do something to address the mental health challenges pastors face.”

Disability Concerns helps churches minister with people who have various disabling conditions, including mental health challenges. Though the pastor’s request caught me off guard, it did not surprise me. I know several pastors who live with mental illness, and I had seen statistics.

When I brought the pastor’s request to the Mental Health Task Force of Disability Concerns, we assembled a team that included chaplains, pastors, people who minister to pastors, and people will lived experience of mental illness. Among them was Rev. Rick Nanninga, who lived through a period of agoraphobia early in his professional ministry.

At our first meeting, we told stories. We recalled a CRC pastor who lived with depression and was missing. (His body was found years later; he had completed suicide.) We heard from a pastor who went through a time of severe depression. We heard about congregations struggling with how to minister with and to their pastors who had acute mental illness.

Although most congregations and pastors do not want to face it, our research revealed that many ministry leaders live with mental illness.

  • The number of pastors diagnosed with clinical depression was double the national average.
  • Forty five percent sought advice from their family doctor regarding stress and anxiety issues.
  • Nearly one-fourth of all pastors (23 percent) acknowledge having “personally struggled with mental illness,” and half of those pastors say the illness has been diagnosed. (LifeWay Research)

Not surprisingly, pastors accede to their own and to their congregations’ demands to perform, neglecting time for self-care and for their own faith nurture.

  • On average, pastors surveyed are working 50 hours. A quarter of them work more than 55 hours.
  • Nearly 40 percent take fewer than three days off per month.
  • Many ministers neglect regular exercise, personal devotions, and relaxation to find more time for serving or to avoid feeling guilty.
  • Ninety four percent of pastors said that although they read Scripture to prepare sermons, it rarely nourishes them personally. (Centre for Clergy Care)

Our team found many resources related to clergy mental health, but we did not find guidelines for pastors and congregations to navigate the rough waters when the pastor has acute mental illness.

Our team created two versions of a Guide for Clergy Leave of Absence for Mental Health Reasons. The two versions conform to the policy and structure of the two denominations represented on our team, the CRC and the Reformed Church in America. They could be used as templates for American Baptists or people from other denominations to create their own.

The Guide recommends things like:

  • (for the pastor) Seek professional help in processing and reflecting on your situation so that you can gain insight and make healing and healthy changes. Be patient with yourself. Healing takes time.
  • (for the council or consistory) Pastoral care is important. Let the pastor and the pastor’s loved ones guide you as to what they need. The need for emotional space varies and must be respected. It may be tempting to prescribe what should be done and when, but the details for an arrangement need to be worked out with the pastor and the pastor’s health care providers.

In order to introduce this document, we have created slide presentations of varying lengths, discussion questions, sample case studies, and a leader’s guide. The materials are not copyrighted, and may be modified as users see fit.

I hope and pray that the resources our team created give at least one helpful answer to the plea of the pastor who approached me several years ago. More importantly, our team hopes and prays that this resource will provide a map for pastors and congregations to deal with a difficult situation in a healthy way, and that they can honor God and love one another as they journey through it together.


Thanks very much, Mark. This is one of those issues that church councils need to be aware of at least as much as pastors. Our efforts as pastors to try to be all things to all people is not what St. Paul meant, though we and councils out-guilt ourselves with that mis-interpreted verse selected out of context by adapting it to our idolatrous service to overwork disguised as work ethic. 

Clergy mental illness is widespread across the denominational spectrum. My first bout with depression came through a complete awareness of unrealized expectations for  ministry, aka burnout, as a young ordained Pentecostal church planter. Through a prolonged leave of absence, I was able to come to a complete understanding of the cause and finally cures for situational depression (dysthymia). Self-care is of primary importance for long-haul success in ministry. As I result of my mental illness, I lost years of potentially productive pastoral ministry. I am thankful to God and to those who provided the loving care I received for restoration back to health and eventually productive ministry after a 14-year absence due to depression.

The best piece of advice and take-away from that awful dark period was, " why work 55-70 hours per week for 10 years when you can work with health and effectiveness 35-40 hours per week for 40 years.

Self-care is what makes me currently effective in ministry for the long run. Talk to your leadership about the need for self-care. Form a covenant with them to preserve your mental health, so you can run the race with the endurance needed for a full, rewarding career in ministry.

I agree, thank you, Mark, for raising the subject and giving another nudge to the discussion. Response to mental health crisis is vital, as well as mental health maintenance and prevention of crisis. A quote from Ed Friedman's "Generation to Generation" has stuck with me, that "Stress is less the result of some quantitative notion such as 'overwork' and more the effect of our position in the triangle of our families." I know I've found this helpful when I begin to feel the burdens of ministry, that maybe those burdens are not necessary. Could we create a denominational context where it's normal for pastors to consult with mental health care providers, where pastors continue to explore our own areas of risk? 


 Guilt is a bad motivation to do things.  I know.  as someone in recovery from schizophrenia, depression was my main negative symptom and guilt the main one of that.  Before I was treated for this illness I felt guilty for breathing, let alone failing to do stuff.  It nearly drove me to suicide, and even after I'd decided not to throw myself into a river I still had suicidal thoughts.  GET HELP.   It's the only way.

Michele, yes, getting help is so important. It's a huge step, and I would guess for many people it feels like failure. Of course, as you well know, getting help is a step back toward health. I hope that our society, and people in churches especially, will start to view getting help for a mental illness as the same wise decision as getting help for heart trouble or knee pain or vision problems. 

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