A few years before Craig Sanders lost his father to suicide, a music pastor in their South Carolina town took his life.

“I remember the superficial and judgmental anger I had toward him,” Sanders said. “How could you do that to your daughters? What a selfish act.”

When his own father, Larry, a pastor plagued by depression and insecurity, died, Sanders was also angry at him. But it wasn’t the same; this time, he sought to understand the complexities of mental health and other issues behind his dad's decision to take his life. Sanders felt hurt at being left behind and frustrated with a pastorate that doesn’t make it easy to get help.

“I remember the last conversation with him on the phone. He said, ‘Craig, I’m a failure.’ And I couldn’t believe what I was hearing. I said, ‘Dad, you’re my hero. Do you understand that all my life I’ve tried to measure up to you? I’m at seminary because I want to be like you.’”

Larry’s depression, which was in part biological, had likely worsened from diabetes medication, church conflicts, and unhealthy comparison with other ministers, Sanders said. “He really got stuck in the comparison game. . . . He was doing a doctor of ministry degree and reading books on church growth, looking at models of how to make your church grow. He was like, ‘If I’m doing these things and my church isn’t growing, what does that say about me?’”

National Trend

The number of suicides in the United States increased 24 percent from 1999 to 2014, gaining momentum after 2006 when the increase each year jumped between 1 and 2 percent, according to the Centers for Disease Control. The biggest jump was among adolescent girls and men aged 45 to 64.

It’s no surprise that more than half of Americans believe suicide is an epidemic (56 percent), according to a 2015 LifeWay Research study. Most said they didn’t think those who take their own lives are selfish (55 percent disagree that it’s selfish, 9 percent aren’t sure) or necessarily going to hell (62 percent disagree, 16 percent aren’t sure).

Among evangelicals, however, 44 percent said committing suicide was selfish (compared to 36 percent nationally), and 32 percent said those who commit suicide are going to hell (compared to 23 percent).

Pastors, Too

Pastors aren’t immune to the rising suicide rates. More than half of pastors have counseled people who were later diagnosed with a mental illness (59 percent), and about a quarter say they’ve experienced some type of mental illness themselves (23 percent). According to LifeWay, 12 percent have been diagnosed with a mental health condition.

Chuck Hannaford, a clinical psychologist who consults for the Southern Baptist Convention (SBC), said he believes the rate of pastor suicides has increased during his 30 years of practice. And he expects the number will continue to rise.

“Being a pastor is a dangerous job,” he said. “Especially in certain evangelical circles, where you have more of a fundamentalist orientation theologically, you find pastors who will reduce their depression or their negative thought processes to strictly spiritual problems.”

Indeed, a 2013 LifeWay survey found that 48 percent of self-identified evangelical, fundamentalist, or born-again Christians believe prayer and Bible study alone can overcome mental illness.

Pastors are hard on themselves, often judging themselves for sins of omission and commission, Hannaford said. But they fail to take the Fall’s effects on the world into account: “The Fall disrupted everything, including the brain.”

And pastors, who are role models for their flock, are often too isolated by life on a pedestal to talk honestly with others.

“My dad had no one to talk to,” Sanders said. “Everyone talked to my dad. He was the only pastor in the church.” In addition, Larry’s role of mentoring other pastors made it difficult to open up with them about his struggles, which further isolated him.

More than half of evangelical and Reformed pastors told the Schaeffer Institute in 2015 and 2016 that although they’re happier (79 percent), they don’t have any good and true friends (58 percent). About the same number reported they can’t meet their church’s unrealistic expectations (52 percent).

And close to a third battle discouragement (34 percent) or depression/the fear of inadequacy (35 percent) on a regular basis.

“Anybody will say all the disciples were screwed up but Jesus used them,” Hannaford said. “And look at all the Old Testament heroes—they were a mess. And yet somehow, we subtly think that only applied to them, not us.”

Part of the trouble is that the church has separated the care of the body, soul, and spirit, Hannaford said. In the days of the Reformation or the later Puritans, a pastor would be consulted for any malady and be somewhat knowledgeable about all areas. Today, a physician treats the body, a psychologist treats the mind, and a pastor treats the spirit. But that separation can lead to trouble, since the spiritual, emotional, and physical affect each other.

Learning from the Puritans

Pastor Tony Rose fell into a “deep hole of depression with obsessive thinking” when he was 31. It got so bad he couldn’t physically lift himself off the floor.

“I began begging God for somebody who could speak a vocabulary that preached to my soul, and I couldn’t find anybody in the contemporary Christian world,” said Rose, who now pastors in Kentucky. “Then I stumbled onto the Puritans. And they’re known for a lot of things, but very few people actually read their writing on pastoral care.”

The Puritan pastors, because they lived in and among their flock, were able to describe a spectrum of emotions, he said. “My hope started to build while reading John Bunyan’s account in Grace Abounding to the Chief of Sinners.”

“That guy was obsessive to the hilt,” Rose said. “If he were alive today, there’s not one evangelical church that would call him to be their pastor.”

Bunyan was both deeply spiritual and “at times had a crazed wit,” Rose said. “However, Bunyan’s unimaginable torments of mind and soul are what gave him the ability to speak with such creative clarity to the human experience of the Christian.”

Bunyan’s “earthiness”—and that of his contemporaries—is the opposite of the Facebook-perfect image both pastors and congregants are now expected to project, Rose said. But “if the church wants to go forward, she has to go backward. A depressed person is convinced no one has felt what they feel, [so they] benefit when someone speaks the language who has been there.”

That lack of awareness almost certainly stems from the silence churches maintain around the issues of suicide and mental illness more broadly. According to LifeWay, only a quarter of churches have a plan to assist families affected by mental illness (27 percent), and even fewer have trained leaders how to recognize mental illness (13 percent).

Meanwhile, those with a mental illness (59 percent) and their families (65 percent) want pastors to talk openly about these subjects. But most seminaries offer little training in mental illness or pastoral care, Rose said.

Opening the Conversation

Rose recently chaired the SBC’s mental health advisory council. He was appointed around the same time SBC Executive Committee president and CEO Frank Page released his book Melissa: A Father’s Lessons from a Daughter’s Suicide.

Rose and his colleagues recommended the SBC produce materials to educate churches about mental illness. The approach was threefold: develop a website with specific resources, appoint someone to champion mental health issues in the SBC, and work with SBC seminaries for a minimum standard of mental illness education.

They also advised pastors to reach out to local Christian psychologists. Not only will that person be able to help when a congregant is troubled, but the pastor himself is also much more likely to reach out for help to someone he knows and trusts, Rose said.

Coming Out of Hiding

Knowing someone to reach out to is vital, since most pastors feel they can’t tell their congregations about their mental health struggles. They’re afraid of losing their jobs, not being a good role model, or being inappropriately transparent.

“When I went to get counseling, I was almost ducking behind bushes, looking around to ensure nobody saw me,” Rose said. “We’d go in camouflage if we could.”

Instead, Rose recommends taking a tip from those who do in fact wear camouflage. Doug Carver, a retired military chaplain who now serves as the executive director of chaplaincy at the SBC’s North American Mission Board (NAMB), sat on Rose’s mental health committee.

“He said the Army uses an ace of hearts as an acronym for Act Compassionate and Escort,” Rose said. If soldiers notice anyone suffering from mental or emotional troubles, they’re to be kind and bring them to someone who can help.

“If I could do that for the church,” Rose said, “that would be the win of a lifetime.”