Advent brings out crowds to local churches for respite, festivity and brushes with the holy. But for many church workers, facilitating such experiences for others requires navigating an invisible storm within themselves: mood-related mental health problems.
Disorders rooted in anxiety and depression are showing up among church workers at rates several times higher than the national average. What the data show has denominations working to understand potential causes. They’re also rolling out initiatives, from a new Episcopal Church webinar on compassion fatigue to a Lutheran online mental health tool that goes live January 1.
Insurance claims suggest church workers are lining up for help. Through October, 40 percent of the 11,000 church workers in the Evangelical Lutheran Church in America had filed claims in 2019 for treatment of mood disorders, according to the ELCA’s Portico Benefit Services. That number is expected to climb in the fourth quarter, which brings a spike in mood disorder claims every year, according to Portico President and CEO Jeff Thiemann.
“Mood disorder is the number one claim in our population,” Thiemann said. “We believe that they are higher than average users [of mental health benefits] because of the nature of their work as caregivers and counselors. They’re under stress. They also appreciate the value of therapy and are more likely to use it than the average person would be.”
In the general population, mood disorders are far less common than among church workers. They afflict about 9.7 percent of American adults, according to the National Institute of Mental Health. Only 19 percent of Americans experienced any type of mental illness in 2018, according to the Substance Abuse and Mental Health Services Administration.
ELCA workers aren’t alone in facing these types of struggles. A 2019 Wespath Benefits survey of 1,240 active United Methodist clergy in the U.S. found that 60 percent report feeling emotional distress; 29 percent report feeling down or hopeless; and clinical depression afflicts eight percent. Depression rates among clergy run about 50 percent higher than the national average, according to Duke University’s Clergy Health Initiative.
A wider context brightens the picture. The Clergy Health Initiative finds a larger percentage of clergy (68 percent) enjoys positive mental health than U.S. adults writ large (58 percent). And clergy job satisfaction exceeds that of many other professionals, including physical therapists, teachers, and artists.
But clergy are also at greater risk of depression, which suggests church work is particularly fraught with both mental health perils and opportunities to thrive.
Roman Catholic researchers see the tension play out in satisfaction versus morale. Surveys in multiple dioceses find that about 90 percent of U.S. priests are satisfied with their vocations, according to Fr. Thomas Gaunt, S.J., executive director of the Center for Applied Research in the Apostolate at Georgetown University. But only about 55 percent report good morale.
“They’ll say, ‘I’m very happy to be a priest. I can’t stand my bishop’ or ‘I think the parishioners are unrealistic.’ But when you go back to asking about being a priest or minister, they’ll say, ‘No, I’m very satisfied’,” Gaunt said. “Our explanation would be that people are very happy with their vocational call but kind of dissatisfied with the practical dimensions or structures — the parish or diocese.”
Managing mood-related issues becomes especially important at this time of year. Seasonal affective disorder tends to kick in now when days are short and sunlight proves elusive. Difficult and demanding parishioners can exacerbate mood-related troubles. But denominations vary in how much they know and are willing to disclose about mental health challenges their workers face.
The Pension Boards of the United Church of Christ did not respond to queries from The Living Church. The Church Medical Trust, which administers health benefits for 35,000 Episcopal Church workers and their dependents, declined to provide data on anxiety and depression disorder claims filed with its insurer, Cigna Behavioral Health (CBH).
However, CMT spokesperson Curt Ritter said in an email that Episcopal Church workers are experiencing more problems in at least one mental health area: post-traumatic stress disorder. PTSD claims from a pool of 35,000 Episcopal Church workers and dependents are up 20 percent since 2016, according to CMT.
PTSD is not classified as a mood disorder because it traces to a traumatic experience rather than a chemical imbalance in the brain, according to Dr. Lilly Friedland, a Los Angeles psychologist who helps clients with PTSD and mood disorders. But those who suffer from PTSD routinely also experience depression, anxiety or both, she said.
Ritter said CMT does not understand what’s causing the increase in PTSD claims. He did not say how many workers are affected, despite multiple requests from The Living Church to get the figures that were used in calculating the 20-percent increase. He passed along general context from CBH.
CBH indicates “that the lack of a good social support system, childhood trauma and exposure to traumatic events often increases the risk for PTSD,” Ritter said in an email.
That church workers would be suffering more PTSD comes as no surprise to Fr. David Peters, an Iraq War veteran and vicar of Saint Joan of Arc Episcopal Church, a new congregation that launched last January in Pflugerville, Texas. He helps veterans suffering from PTSD through the Episcopal Veterans Fellowship. He writes about the disorder — how it takes root, generates numbness and stirs feelings of doom and constant threat — in his book, Post-Traumatic God: How the Church Cares for People Who Have Been to Hell and Back.
Clergy can get what’s called “secondary PTSD” in parish work, Peters said, simply by compassionately listening to trauma victims. To identify ensuing emotional troubles in clergy as PTSD likely would not have happened 15 years ago, but now people are more aware of the problem and how to treat it.
“The nature of the job — dealing with death and dying and crises — I do think that produces PTSD in a lot of people” in congregational ministry, Peters said. “I don’t know that [the 20-percent increase in claims] means more people are getting traumatized. It might just mean that more people are getting help for it.”
Peters notes that trauma leading to PTSD, even for military personnel, usually stems from early life experiences (e.g., abuse) that then get triggered by intense episodes later. Dynamics in parish life can cause a previously traumatized person to revert to feeling unsafe or under threat, even if no realistic threat exists, he said.
“There’s tons of back channel communication in parish life where people come to you and say: ‘you know, some of us were talking, people are talking, people are saying they don’t like this or they don’t like that’,” Peters said. “Those types of things are going to trigger people who have lived in abusive situations because some of that stuff can either feel like abuse or just be abusive.”
Getting treatment for PTSD can enable church workers to function well, Peters said, whereas untreated PTSD can be debilitating. The cognitive dissonance alone can be disruptive.
“On a spiritual level, PTSD is an inability to trust,” Peters said. “In a job where you’re supposed to be teaching trust and helping people trust, [to] discover that it’s really hard for you [to trust] would be, I would think, really upending. It has been for me at times.”
Multiple factors could be causing or exacerbating mood disorders among church workers, Thiemann and others said. Among them:
- Political tensions are playing out more intensely in congregations and local communities since 2016;
- Declining participation in local church life can lead to blaming church leaders and heightening stress;
- Negative perceptions of church in wake of clergy sexual abuse and other scandals foster low morale;
- Social support for church-related careers is lacking as confused peers wonder: Why choose ministry?
- Perennial challenges, such as feeling isolated as clergy, and financial stress.
“A lot of folks are really frustrated that their kids are not in church and their grandkids are not in church as we’ve seen the de-churching of America,” Thiemann said. “One way to [respond] would be to say: ‘What did I do wrong?’ But it’s much more likely people will say: ‘What did the system do wrong? What did the leader do wrong and why don’t you fix that?’ And then point to the pastor.”
Friedland said mood disorders among church workers aren’t surprising in part because clergy have what she calls “one of the toughest jobs in the world.” She notes they’re expected to always be in a good mood, have time for every congregant, show up for major moments such as births and deaths, yet accept being away from their own families at special occasions. If they’re idealists, reality can deal some hard blows too.
“Most people go into nonprofits because they want to do good, and part of this [mental health struggle] is realizing: ‘Oh my God, I can’t make that big of a difference’,” Friedland said. “It’s very humbling. The pay isn’t often great. The expectations others have are very high. So, I think it’s just a hard time.”
Denominations are taking a proactive approach. They’re encouraging church workers to use employee assistance programs and manage stress by taking sabbath days of rest, eating well and getting enough exercise. They’re also rolling out new resources.
For Episcopalians, Church Pension Group produced new webinars this year. Topics include stress reduction through mindfulness practices, overcoming compassion fatigue and resilience when disaster strikes. See the resources here: bit.ly/34OMAg6.
United Methodists have released a resiliency toolkit that encourages workers to use their Employee Assistance Program and their Live and Work Well benefits: bit.ly/2K8vL7W
The ELCA meanwhile is planning a Jan. 1, 2020 launch of Learn to Live, a new online mental health program. It’s designed to help members strengthen their minds and improve emotional resilience through principles of cognitive behavioral therapy.
Learn to Live is part of a “wellness reformation” that the ELCA has touted since 2016. That’s when Portico Benefit Services took the unorthodox step of reaching out beyond its membership to engage congregational leaders. Among the central goals: to raise awareness of how congregants are impacting church workers’ mental health. Every church council president received a “conversation guide” to open the dialogue.
“We hope you’ll play a part in the wellness reformation, too!” says Thiemann’s letter introducing the guide. “We encourage congregation leaders to engage in a conversation about how your church culture is (or isn’t) supporting healthy lifestyles. This conversation is meant to affirm positive practices already in place and shine light on new ways your church can support the health of your leaders and be a place of wellness.”