“His Main Problem Was Not Being in a Relationship With God”: Perceptions of Depression, Help-Seeking, and Treatment in Evangelical Christianity

Abstract

Some Christian communities may understand mental illness as the result of spiritual causes, such as sin, demons, or a lack of faith. Such perceptions are likely to influence how Christian individuals conceptualise and experience their mental health and enact help-seeking behaviours. This study explores perceptions of depression and mental health help-seeking in evangelical Christianity by using a novel qualitative story completion task. A convenience sample of 110 Christian participants from the United Kingdom completed a third-person, fictional story stem featuring a male with depression who entered his local church. A contextualist-informed thematic analysis illustrated how the disclosure of depression was represented as eliciting negative social reactions, potentially rendering individuals with depression as socially dislocated. Stories suggested that, increasingly, evangelical Christians may perceive a spiritualisation of mental illness, which negates reference to psychological, social, and biomedical representations, as unhelpful. Findings reveal the risks of a solely spiritual aetiology of depression and highlight how existing mental ill-health can be exacerbated if fundamentalist beliefs and approaches to therapeutic care are prioritised over holistic models of care. Methodologically, this study demonstrates the value of a rarely-used tool in psychology—the story completion task—for examining socio-cultural discourses and dominant meanings surrounding stigmatised topics or populations.

The experiences of faith and church community among Christian adults with mental illness: A qualitative metasynthesis.

“…The church acted as a space that provided vital congregational support. The participants described feeling welcomed and accepted in churches and religious spaces (Keefe et al, 2016; Lloyd et al, 2022; Whitley, 2012); they noted they were treated with respect and without judgment (Baker, 2010; Lloyd et al, 2022). Engagement in church and religious communities, participants reported, allowed for the development of meaningful and positive social relationships with congregation members who shared common interests and spiritual strivings (De Castella & Simmonds, 2013; Lloyd et al, 2022; Pivarunas, 2016).…”

“…The participants described feeling welcomed and accepted in churches and religious spaces (Keefe et al, 2016; Lloyd et al, 2022; Whitley, 2012); they noted they were treated with respect and without judgment (Baker, 2010; Lloyd et al, 2022). Engagement in church and religious communities, participants reported, allowed for the development of meaningful and positive social relationships with congregation members who shared common interests and spiritual strivings (De Castella & Simmonds, 2013; Lloyd et al, 2022; Pivarunas, 2016). Some participants noted the social relationships they developed through their religious community were especially beneficial in the absence of strong, familial support networks (Baker, 2010; Wittink et al, 2009).…”

“…The positive social bonds the participants made with congregation members offered opportunity for pastoral support. Congregation members reportedly offered practical help and advice (e.g., listening with care; Lloyd et al, 2022; Lloyd & Panagopoulos, 2022), as well as emotional support throughout the participants’ experience of mental illness (De Castella & Simmonds, 2013; Lloyd et al, 2022; Lloyd & Hutchinson, 2022; Lloyd & Panagopoulos, 2022; Virdee et al, 2016). In addition to its social aspects, congregational support was described as providing vital spiritual support for the difficulties associated with mental illness.…”

“…That being said, an existing body of research has also suggested that religious individuals are possibly less likely to come forward for mental health help when facing psychological difficulties (Lloyd et al, 2021; Lloyd & Kotera, 2021). It has been suggested that religious individuals with fundamentalist beliefs are more likely to see mental illness as the outcome of a poorer relationship with God, sinful living, or demonic activity (Lloyd et al, 2022; Lloyd & Panagopoulos, 2023). Thus, within the context of such a conceptualization of mental illness, there is also evidence of religious stigma toward mental illness, despite the fact that mental illness is found to be reported less prevalently within religious communities.…”

Accounting for the demonic: Helpful and unhelpful factors associated with belief in demonic etiologies of mental illness among evangelical christians.

“…More recently, the prevalence of stigmatized perceptions of mental illness in Christian settings has been supported (Lloyd, 2021, 2023a; Lloyd & Hutchinson, 2022). As such, religious individuals experiencing mental ill-health can be misunderstood, ignored, and isolated (Lloyd et al, 2023) which may impact help-seeking behaviors (Lloyd et al, 2022). Recognizing these conflicting accounts, the experience of mental ill-health among Christian individuals is complex, incorporating religious social systems and frameworks of meaning that can work to both benefit and disadvantage the mental well-being of the individual.…”