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Warren Kinghorn on Mental Health and Christian Worship

It is far more common to hear about physical ailments than mental ones in congregational prayers and worship. Psychiatrist Warren Kinghorn explains why mental health issues and people with mental illness should be acknowledged in Christian worship.

Warren Kinghorn teaches pastoral and moral theology at Duke University Medical Center and Duke Divinity School in Durham, North Carolina. He codirects the Theology, Medicine, and Culture Initiative at Duke Divinity School and is a staff psychiatrist at the Durham VA Medical Center. In this edited conversation, Kinghorn talks about how congregations can faithfully include people with mental illness in Christian worship.

What’s a good first step for churches that want to include people with mental illness in worship?

I’d recommend talking more about mental illness. It is more prevalent than people realize. Trauma is all around us all the time. Statistics tell us that one in five people in any congregation or community will have experienced sexual trauma, including harassment, abuse, and assault. One in fifteen people live with serious mental health challenges.

What else do churches need to know about mental illness?

Your identity is not defined by your experience or your diagnosis. As a psychiatrist at a veterans hospital, I see people who meet the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for post-traumatic stress disorder (PTSD). But like many disorders, the diagnosis for PTSD is very broad. Treatment depends on the person’s context. It matters a lot whether your PTSD results from an isolated incident, such as an auto accident, or a whole series of traumas over a lifetime, such as child sexual abuse.

Combat-related trauma can emerge from things you have received, resulting in anxiety and fear, or from what you did or witnessed or felt complicit in, resulting in something more like shame. We describe the latter situations as moral injury. But your identity is not defined by any set of experiences, whether something done to you or something you did. Your identity is held in God.

What church setting is appropriate for talking about mental illness?

Christians with mental illness say that talking about mental illness, especially in sermons, is helpful and destigmatizing. I’d advise engaging story as much as possible in worship. Stories have a way of getting us out of analytic positions that we either agree or disagree with. Stories can remind us that we are more than minds that inhabit bodies, more than people with broken minds and broken bodies that doctors need to fix.

The Christian story is about coming from God and going home to God. In between, like Thomas Aquinas said, we are fellow humans and wayfarers on a journey.

How should a preacher tell someone’s story of mental illness?

I find it best when people tell their own stories, whether of struggles with or recovery from depression, an eating disorder, or addiction to alcohol. As we hear their experiences, we grow to see the person as a human we know and love, not just a diagnosis. People can tell their stories in Sunday School, as part of a sermon, or during the testimony time in worship. Of course, this depends on whether testimony is actually part of a congregation’s life and worship.

Preachers can pay more attention to engaging the hard parts of scripture, like Job, Lamentations, lament psalms, and texts that tell stories of social and sexual trauma. Psalm 13 is helpful for people in depression. How long, God? Why are you taking so long to come to me? Yet Psalm 13 sets this story of lament within the people of God. They are calling to a God who seems absent but has pledged presence.

Engaging tough biblical stories has to be done well, though. The preacher must never say or imply that mental illness or lack of healing is due to lack of faith. Instead preachers can remind us that, as wayfarers on our journey home to God, we all experience things wanted and unwanted.

How else might worship planners include mental health concerns in Christian public worship?

You can choose songs about healing and wholeness. You can make sure that you talk about mental illness in a way that’s hopeful, not shaming. The goal is to strike a balance. On the one hand, Christ is with us in brokenness, suffering, and mental illness. On the other hand, we want to acknowledge that there’s hope for healing. We can thank Christ for the grace he’s given, while praying for the grace we still need.

Also, getting to know and love people with mental illness should call us to advocacy and action, like working for parity in health care access. These kinds of topics belong in our pastoral and congregational prayers too.


Download two free resources from the American Psychiatric Association on mental health and faith leaders.