Category: mental health

healthmember caremental healthmissiology

Why don’t we talk about missionaries and mental health?

Traditionally, depression and anxiety have been seen as hard topics to talk about for missionaries and others involved in full-time ministry.

Actually, they are hard topics for any Christian. If a person believes that they have a loving God who is with them all the time, and who has a wonderful future for them in heaven, how can they be depressed, or anxious? And aren’t missionaries those who have even more faith and courage than other Christians? (er…not really!) And surely missionaries and ministers must know the added joy of living out their calling in their everyday lives? (Well yes… but this can actually add extra nasty layers of guilt and self-doubt…)

Because of these kinds of expectations, it has been easier for missionaries to avoid mentioning doubts and leanings towards depression in their prayer letters. How can it be that if a missionary expresses their negative feelings in a supporter update they can be criticised rather than sympathised with? (If you find this surprising, read some of the comments underneath a recent article in which Matt Redman admitted to his inner struggles.)

In the secular world, mental health issues are beginning to be talked about more openly and the traditional stigma is being challenged, not before time. The same needs to happen in the world of mission and ministry.

I was prompted to think about this having just finished an excellent book called Reasons to Stay Alive by Matt Haig. Funny, sad, revealing, and ultimately positive about human life, it contains vivid descriptions of what depression and anxiety felt like to the author. I would recommend it to anyone who wants to understand them better. One endorsement on the cover says, “This book could save lives.” That struck me, though, because Haig is not a Christian. He doesn’t talk about any kind of religious faith. I understand that the phrase on the cover was intended to mean, “This book could prevent someone from killing themselves.” And it could, I suppose. But to me, with years of Christian life behind me, language about saving lives has another layer of meaning – it is what the gospel does, and it leads to eternal life, not just a few more years of earthly life in our mortal bodies. Jesus saves lives.

But what are Christians saying to those suffering depression and anxiety? We seem to be saying, “You shouldn’t be depressed, and if you are, you certainly shouldn’t admit to it.” And all the more so if someone is in any kind of leadership or ministry role.

But the truth is that missionaries and those in ministry are just as vulnerable to depression and anxiety as anyone else – and further, there may be particular factors in these kinds of work that cause or exacerbate them. Prevention is obviously the best option; but if they do begin to appear, recognising and responding to them as early as possible is essential  – and this means talking about them.

Some writing has been done about missionaries and depression. Marjorie Foyle’s book Honourably Wounded (Monarch, most recent edition 2009) is a well-known resource for missionaries dealing with such issues, and is very helpful. Foyle’s PhD, written in 1999, was entitled Expatriate Mental Health (PhD Thesis, University of London, 1999). She found that whilst some people who suffered on the field had pre-existing factors, others developed depression due to factors on the field.  Her findings included recommendations for better selection and also better care on the field. But it seems as though the time is ripe for a more current study in this area.

The practice of and research into Member Care (pastoral care for missionaries) has grown a great deal over the twenty or so years since Foyle’s 1999 thesis. Much recent thinking has been done in the area of resilience (commonly defined as the ability to overcome and bounce back from adversity). A part of resilience is the ability to recognise early symptoms of stress or anxiety in oneself, and knowing the steps to take to maintain or restore wellbeing, before a plunge into depression happens. Member Care research has shown that whilst you might think of resilience as an inborn trait, it is also a learned skill. Recent Redcliffe graduate Duncan Watts urged in his dissertation the responsibility of the mission agency to help build resilience in their workers, saying

Mission organisations can no longer ignore the physical, emotional and psychological needs of their staff and trust that all will be well.

Alongside this, there has been a growing realisation of the importance of self-care for missionaries, and Member Care providers see part of their role as making sure their people are practising it. Self-care includes eating healthily, exercising, getting sufficient sleep, knowing how to relax, and taking holidays (again, there may be barriers of expectation in place: as in the old-fashioned view that missionaries shouldn’t need to take costly holidays or regular time off).

Another related area of recent exploration has been into the key role lamentation can play in aiding people to process and express grief, disappointment, or frustration. A healthy outpouring to God of negative emotions (as we see for example in some of the Psalms) is a valid part of prayer.

Finally, when a missionary or person in ministry is experiencing depression or anxiety, there should be avenues for expressing this without any judgment, and a ready willingness among supporters and the mission agency to help, support, and love them, and to provide the means for treatment, rest and recovery. Member Care providers have an important part to play in normalising this.


Former missionary, minister and writer Mark Meynell, has written a book about this topic which promises to be excellent: When Darkness Seems My Closest Friend: reflections on life and ministry with depression, IVP, available May 2018.

Duncan Watts’ MA Thesis Defining, assessing and enhancing resilience in cross-cultural mission workers: lessons member care providers can learn from the wider field of resilience research, Redcliffe College (2016), will also shortly be published: look out for publicity on the Redcliffe social media sites.


Rosie is the Course Facilitator of Redcliffe’s MA in Member Care. This course is designed for you if you’re involved in any way in caring for and supporting mission workers and those in ministry. It is the only course of its kind, helping students develop organisational support structures that help their people to thrive, wherever they are.