8 MINUTE READ

From Luke’s Journal Nov 2024 | Vol.29 No.3 | Mental Health II

Initially I set out to write a book review of Steve Midgley and Helen Thorne’s book “Mental Health and Your Church” but as I began to write, I immediately thought of how this was being lived out in my own local church and, personally, in my community group. This is my hope for this review, that it is a handbook that can be applied in your own local church.

I had the opportunity to hear directly from Steve Midgley when he visited Australia when invited by Biblical Counselling Australia¹ to lead workshops and discussions around this book. As in the book, he opened with a quick sketch of the global picture of mental illness: 1 in 8 people worldwide are affected by mental illness, and 1 in 5 people in Australia are affected by mental illness in the past 12 months.² In view of such a global reality, he first asks: What do people in your church believe? Is mental illness a spiritual issue where the solution is repentance and faith, or is it purely a biological and brain issue where the solution is medication.

A helpful feature of this book is the use of case studies which are composites of real people in the authors’ churches. Here is where I want to introduce M – a lady in her early 50s who was working as a general practitioner (GP) at the practice where I was working. A compassionate curiosity drew me towards M, learning that she couldn’t drive because of the strength of the analgesia she was on for chronic pain. Her pathway to being recognised as a vocationally-registered GP had become siderailed by a head injury; then followed the diagnosis and treatment for breast cancer; whilst also being entangled by untrustworthy family members; and the financial strain of costly specialist reviews and treatments.

When I meet a person like this in my GP clinic, I have a bio-psycho-social-cultural-spiritual approach to helping them as an individual. But there is a richness that being part of a local church allows, in inviting someone like M to be cared for in that community. In the opening chapter, the authors put forth a vision of a church with the following metaphors: a family of brothers and sisters, a body whose members suffer and rejoice alongside its other members, a flock cared for by their Shepherd King, a place where all can use their gifts, a fellowship of shared resources, a supportive community and congregation with gentle boundaries in place for the good of all, and a countercultural gathering.

In the first section of the book, Thorne and Midgley invite us to consider that:

• We are part of the continuum of our church family’s experiences – thus, the “us and them” attitude that can be so easy to adopt as a healthcare professional is unhelpful, and I would argue unbiblical.
• Thus, we can find points of connection with everyone with mental illness, and we can offer help, starting with the gift of time and attention.
• Finally, there can be a helpful shift in thinking of psychiatric illness as being alien to us by considering that God speaks powerfully and repeatedly to address us in the frailty of our fallen state and has deep compassion for us. Thus we can speak God’s words to others.

The next chapter provides a helpful and simple Biblical model of a person: that a person is both embodied and embedded. An important point I want to highlight is that the current bio-psycho-social-cultural model of the person has “a strange omission of the heart”. Biblical counsellors will also be aware that the human’s heart is active and is always responding as a moral agent, to choose between right and wrong, good and ill – and as such, wisdom calls for boundaries. This section also includes helpful summaries of current treatments including medication and talking therapies, within a Christian worldview

The second section, titled “What can we do?”, asks us to consider two perspectives that are simultaneously true: 

Doing nothing is not an option; but that doing everything isn’t an option either. At the workshop I participated in, Steve encouraged us to brainstorm barriers that prevent the local church from engaging well with those struggling with their mental health. This list included:

• A conceptual divide between spiritual and psychological needs, reflected in the statement “It’s not the church’s business”
• This is for the pastors and experts, not the layperson
• Lack of skills
• Lack of leadership for pastoral care
• That the church program is too full already, and it is too time-consuming
• Fear of doing harm
• Mental illness remains a stigma and taboo area to step into

Midgeley calls for the local church to have the following ambitions in pastoral care:

• to be eager, not reluctant;
• compassionate, not critical;
• Gospel-shaped, not worldly;
• wise, and not reckless.

To that end, he calls the church to do the following:

1. Raise awareness in the church of the lived experiences of people within their own congregation, not just for the sake of awareness, but so that what they are experiencing is within the bounds of normal human experience, they are not alone, and that there is hope and help in God and others.
2. Relate to others, and do so wisely, remembering that trust builds slowly, but also to help sufferers relate to God, encouraging them to turn to God in the midst of difficulty. Different ways include: praise, lament, intercession for self and others, Bible-reading and corporate worship.
3. Remember who God is, as taught theology can differ from functional theology which are defined in the book as “beliefs that drive their actual behaviour”. Here he addresses the problem of spiritual abuse and being careful to prayerfully consult a trauma specialist and ask the person how best the church can help. The authors encourage us to prepare Bible studies with these experiences in mind by considering such questions as: How do they see God? How did this view of God develop? What would make it safe for them to consider changing their views? Are there realistic expectations of change?
4. Refine, by which the authors mean refining what change can look like. Helpfully they point out the balance between not expecting any change in a entrenched mental illness, to trusting that God is able to do immeasurably more than we can imagine, without an “over-realised eschatology” of promising complete transformation on this side of eternity before Christ returns.
5. Resource its members practically, including holding information nights with invited speakers who have experience in treating mental illness.

With my friend M, the way in which individuals in our community group have heard her story, allowed her to cry, organised a roster for her to be picked up for weekly community groups, and if possible, attend church, has been nothing short of God’s answers to my unspoken and spoken prayers when I first met her. Through M, our community group has also been equipped with more awareness to the mix of troubles that are often found together: neglectful parents, trauma, complex chronic illness, and poverty throughout which God remains sovereign and gracious to save. Also, through M’s own spiritual search for truth, she brings her questions where taught theology conflicts with her functional theology into our Bible study.  This often led us into messy places of “Why?” that could not be answered neatly.  As a result, I have seen our community group members grow in wrestling with their own understanding of the character of God and  their own suffering, and developing patience as a result of her transparency and sincerity when asking questions.

“The authors Steve and Helen also address confidentiality, stigma, and feeling out of our depth when encountering chronic complexity in the lives of those we meet in our local churches.”

The authors Steve and Helen also address confidentiality, stigma, and feeling out of our depth when encountering chronic complexity in the lives of those we meet in our local churches. I will only speak of confidentiality as this gets complex very quickly in the church context, particularly in the area of sharing prayer requests. I was grateful to read the authors’ advice to speak directly to the person about how they want their information shared – in M’s case, initially, she was happy for details of her life to be shared amongst the females in the community group, as our community group has decided to split into female and male prayer groups after the study finishes. However, over the past eighteen months, M has expressed wanting to allow the men’s prayer group to know her struggles, enabling them to pray for her as well, with the implied assumption of trust in their confidentiality.

Having a team of brothers and sisters involved in a pastoral care team is wise (Prov 15:22) and it is important to think carefully about how information is shared within this team. Importantly, this leads to the related topic of safeguarding.  It is important not to over promise confidentiality in instances where self-harm and suicidality are present. The topic of domestic abuse is not specifically addressed in this book, so I would refer you to other books on this vital topic.³

The final section goes into detail with case studies on anxiety, depression, addiction, psychosis and finally, and very importantly, caring for the carers.

To me, this book serves as a call to personally work to create a culture of safety to care for the vulnerable in the local flock by doing so as a community. It was an encouragement to involve all members of the flock in the life and ministries of the church, within their capacity. After attending Dr Midgeley’s seminar, I was prompted to email the senior GP in my clinic, Dr Paul Mercer, for a list of local churches in the area that housed op shops or community pantries to whom I could refer patients.⁴ I was also delighted that our practice pharmacist found and ordered a handbook of local services for women in crisis, since the local church is just one place of help amongst many.

This book reminded me that the kingdom of God has upside-down values in contrast with our world’s culture. The gospel is for the needy, and the constant trajectory of the way of Jesus is that weakness is the way of demonstrating the strength of Christ in us (2 Cor 12:7-10). I highly commend this book to everyone, because we are all part of a local expression of the body of Christ. Did you also know that one of the objects of the constitution of CMDFA is to pastorally care for our members?⁵

This book is a very helpful resource for each of us, serving its intended purpose as a concise manual of practical theology.  It is grounded in sound pastoral theology, written by experienced pastoral care leaders who understand that we are all fellow strugglers in Christ.

Mental Health and Your Church: A Handbook for Biblical Care (A Ministry Guide to Mental Illness, Anxiety, Depression, Trauma and Addiction)
by Steve Midgeley and Helen Thorne
ISBN‏: ‎ 978-1784987787
2023 The Good Book Company

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References

1. Biblical Counselling Australia (BCA) is an Australian network of over 1500 Christian pastors, chaplains, counsellors, university staff workers, women’s workers, kids workers, psychologists, doctors and more, pursuing biblical counselling and discipleship. These people come from 300 churches from multiple denominations. Their mission statement is “Connecting, encouraging, and equipping Australian believers, leaders, pastors and parachurch counsellors who are committed to seeing lives changed by the Lord through the personal ministry of the Word, Spirit, and prayer.” To find out more, go to their website at: www.biblicalcounselling.org.au
2. Australian Bureau of Statistics, 2020-21
3. Darby Strickland, “Is It Abuse?: A Biblical Guide to Identifying Domestic Abuse and Helping Victims”, P&R Publishing, 2020; Diane Langberg, “Redeeming Power: Understanding Authority and Abuse in the Church”, BrazosPress, 2020.
4. The Christian Health Professionals Network chpn.com.au is a secure closed nationwide directory for Christian Health Professionals, available free for pastors and pastoral carers to access on behalf of their congregations, as well as to list their churches and the community services available.
5. Please contact the National Office if you would like a copy of the Constitution of the Christian Medical and Dental Fellowship of Australia.