I’ve written before about my own brush with anxiety and depression. You can read my story here, here and in the book, The Pastor with a thorn in his side (ed. Steve Kneale). I wanted to say a bit more about how churches can look after the mental health of their pastors and other leaders (elders, staff workers, women workers, youth workers etc). Prevention is better than cure and so in fact, you want to do what you can to avoid a situation where a leader breaks down. However, whilst a lot of what I describe here is meant to be preventative, there is a lot of relevance to reactive measures as well.
Responsibility starts with a leader to keep a watch on their own health
It is helpful for leaders to know themselves, to know where the primary stress points in their life are and to know how they respond to particular forms of stress. Knowing what normal health is like, will also give you a sense of where and when you are being stress tested, where your weak points are and when there are significant warning signs.
It also means making sure that you are observing healthy rhythms of life. This is an application of Scripture’s requirement for leaders to show self control. Do you have a healthy diet? Do you take time for exercise? Are you resting as well as working? Are you creating space for your family? What is your personal walk with the Lord like? Who can you talk to?
This also means that we need to think about strategies for responding to warning signs. What would you do if you became aware that you were showing signs of stress and anxiety or if your moods seemed to be dropping and not picking up? Who would you talk to? Are the ways that you can helpfully adjust your life patterns temporarily -a sabbatical, a holiday, a drop in your hours?
Other leaders also need to be looking out for each other
We can’t just leave the responsibility with each individual though. We have a duty of care to bear one another’s burdens. So as well as the worker keeping a watch on their own life, others should be looking out for them. This means asking one another the questions I suggested above.
It also means listening out for what a fellow leader is saying. Are they talking in ways that suggest they are struggling. Listen out particularly for words and phrases such as “this work will be the death of me”, “it’s killing me”, “I feel overwhelmed”, “I’m drowning”. You don’t need to automatically treat such statements as expression of suicidal intent but nor should you treat them as joking or exaggeration.
Watch for warning signs too. Do they seem tired, more emotional, more irritable, less engaged? And just as we asked the leader whether they personally have a plan for what to do, have you as a church got one for when the warning signs first show.
Have a healthy theology of mental health -and make sure the church shares it
This means that the church family don’t treat mental health as a taboo subject. This is of course important for members as well as pastors too. We want people to be able to talk openly about their struggles with anxiety, depression and other aspects of mental health without fear or shame. Their shouldn’t be suspicion, judgement or gossip circulating around those who are struggling.
Look after the pastor/leader’s family
Often the greatest burden, fear, regret of a pastor is the experience his wife and children have to go through because he is up front. This includes the sense that the pastor is often busy and the challenge of them having time with him. It includes when they experience attack because others choose to get at the pastor through them. It also includes when they see their husband or father suffering and so they hurt with him and for him
So I would encourage churches to think carefully about how they look after pastor’s wives and children so that they are not caused unnecessary pain.
Make use of other help
This is particularly important when you reach crisis point. I would encourage leaders to go and see their doctor if they experience depression or anxiety. Don’t believe they lie that it’s trivial, embarrassing or that you are taking up their time. If sick leave is advised, take it -and churches should make sure that they follow the recommendations of a GP on return to work. Also make use of medication if and when prescribed.
Similarly, counselling may be helpful in many cases. I recommend that a Christian counsellor away from the church should be sought as far as is possible because a leader may feel restricted in talking about their experience to an unbeliever, especially if it seems to reflect badly on the ministry or the local church. However, I would not say that the counsellor should necessarily be a “Biblical Counsellor” in the narrow sense of the word. This is because the term “Biblical Counselling” has been applied to a very specific approach which isn’t always Biblical or counselling nor helpful.
A quick word on return to work for paid workers. This may include a psychologists or counsellor’s report about fitness to return. However, such a report may be deeply personal and detailed. My advise is that fellow leaders may do well not to read the detailed reports. Instead it would be better that either the report goes back to the GP first who provides a summary of the return to work requirements or alternatively that the church looks to an outside organisation to effectively function as an outsourced occupational health for them. This leaves the person in control of what is shared with others for pastoral reasons.
Pray
Remember that your leaders are engaged in spiritual warfare and often under attack. Commit to praying for them regularly.
Faithroots 
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