Congregational Mental Health Interventions

The Problem

After ten years in an abusive marriage, Amanda sought help. “So what if your husband smacks you around a little? That’s normal, right? Until I admitted it wasn’t.” Depressed and anxious, Amanda turned to her seminary-trained pastor for guidance. The pastor asked if she wanted to give God a chance to save the marriage. When she said yes, he suggested performing oral sex on her husband and praying together as the first steps. Amanda stayed in the marriage two more years before filing for divorce, believing it sinful but necessary. When the pastor found out, he removed her as a children’s Sunday school teacher to prevent her from “negatively influencing the kids.”

Amanda’s experience is one of several eerily similarly stories shared during The NorthHaven Church Mental Health Study. Fortunately, there are simple interventions that positively affect the mental health outcomes of NorthHaven church members.

This project examines the role of pastoral leadership and small group ministries in reducing the stigma surrounding mental health within NorthHaven Church. Through an ethnographic study, it demonstrates how pastors who publicly exhibit compassion toward mental health concerns can challenge congregants’ assumptions of stigmatization,[1] and how fostering supportive small group ministries empowers individuals to seek help, share their struggles, and develop resilience in faith-based communities.[2] By integrating pastoral care with social support, NorthHaven Church provides a model for faith communities to cultivate a more inclusive and healing environment for individuals navigating mental health challenges.

Context

NorthHaven Church is a small, 20-year-old congregation in Oklahoma that identifies as moderate to progressive Baptist with an average worship attendance of 75. NorthHaven mainly partners with the Cooperative Baptist Fellowship, a moderate Baptist community. However, since NorthHaven Church affirms women and LGBTQ+ persons in all levels of church membership and leadership, NHC is on the leftmost wing of the CBF. For this reason, we also align with the Alliance of Baptists, a smaller, more progressive denomination. Both the CBF and the Alliance broke away from the Southern Baptist Convention over 25 years ago, and likewise, most of the founding members of NorthHaven have Southern Baptists roots. Today, the church is a more ecumenical community, bound together more by progressive Christian ideals than denominational loyalty.

Method

Research at NorthHaven Church followed Mary Clark Moschella’s ethnographic approach put forward in the book Ethnography as Pastoral Practice: An Introduction.[3] This qualitative research method argues that a theoretical narrative will emerge from the accumulated insights of group study, one-on-one interviews, and the participant observations of the researcher.

Narrative

Every member of NorthHaven Church who participated in the study once believed that if they were to experience a mental health concern, then they needed to keep it to themselves to avoid being stigmatized and humiliated by their church and/or pastor. [4]   This perception was especially true in divorced women and LGBTQIA+ persons. Fortunately, many participants came to believe that their pastor and their small group were safe avenues with whom to share honestly and to find support.

For most participants, the perception of stigmatization began to change when they heard their pastor say or do something that showed compassion toward mental health challenges, affirmed LGBTQ+ personhood, or acknowledged the necessity of divorce in some cases. Hosting special mental health focused events and inviting professional mental health workers to educate the congregation did little to change the assumption of stigmatization at NorthHaven. What was significant in changing the assumption was seeing their pastor engage mental health concerns with compassion. This didn’t need to be a sermon series or even an entire sermon. Just a sermon illustration, a bible study reference, or a personal anecdote was enough to challenge the assumption of stigmatization in many cases. However, no one could do this on behalf of the pastor. Churches with mental health professionals on staff still weren’t perceived as safe places nor were their pastors automatically assumed to be compassionate toward mental health concerns. Neither did the compassion of a Sunday school teacher suffice as a substitute. Until the pastor was able to signal that they were compassionate toward mental health concerns, the assumption of stigmatization wasn’t significantly challenged in the community. Some members discovered that when they witnessed their pastor’s compassion, it empowered them to begin challenging their own internal stigma and begin sharing openly in their small group. Others also needed to see their small group mirror this same compassion before their perceptions shifted.[5]

Once the silence was broken and the perception of stigmatization was challenged by the pastor’s compassion and further deconstructed in small groups, NorthHaven Church members began to minister to each other in meaningful ways. They offered social support in post-traumatic circumstances, resources for those in need, and invaluable affirmation for those who had already experienced significant stigmatization such as divorced[6] and LGBTQ+ persons. Almost all study participants who attended a small group said it was a significant source of strength when trying to live their lives as a Christian and simultaneously care for their mental health.

NorthHaven Church’s pastor didn’t need to be a mental health expert or implement extravagant programs to positively affect the mental health outcomes of their congregants. The pastor needed to be a compassionate person toward mental health concerns and find ways to explicitly show it, and then they needed to promote and support healthy small groups within the church community.

[1] One study in Kenya mirrors this finding, suggesting that since pastors are often the “first line of support,” their compassion plays an essential role in destigmatize mental health. Richard Ondicho Bundi, The Intersection of Faith and Mental Health: Promoting Holistic Well-Being in Evangelical Christian Communities, Impact: Journal of Transformation 7, no. 2 (2024).

[2] Amanda G. Carnes, Healing Inside Out: The Church and Mental Health (PhD diss., Fuller Theological Seminary, School of Psychology, 2024), ProQuest Dissertations & Theses (31234845), 13.

[3] Mary Clark Moschella, Ethnography as Pastoral Practice: An Introduction (Cleveland, OH: Pilgrim Press, 2008).

[4] In this study, it was discovered that the belief in stigmatization prevents many from seeking professional help. Perez LG, Cardenas C, Blagg T, et al: Partnerships between faith communities and the mental health sector: a scoping review. Psychiatric Services 2025; 76: 61–8.

[5] For further study on this see Bia Fiamo, An Integrated Outpatient Program: Fostering Community Support Group for Mental Health at Church (Master’s thesis, Northwest University, 2022).

[6] MM Saunders, DC Curtis, and JL Alexander, “Can Christian Divorce Support Groups Influence Forgiveness and Health Outcomes in Black Divorcees? A Phenomenological Investigation,” Journal of Divorce & Remarriage 54, no. 2 (2013): 107-123, https://www.tandfonline.com/doi/abs/10.1080/10502556.2013.828985.