From preacher’s daughter to mental health advocate

Dorothea Dix (1802 – 1887) was an American educator, author and reformer. She was also a mental health advocate whose efforts led to significant improvements in treatment for the mentally ill. According to historians, both of her parents suffered from depression. Her father was described as a volatile man who also suffered from alcoholism. He also happened to be an itinerant preacher.

Pastors are not immune to mental illness

Spiritual leaders, like members of other caring professions, are at risk of burnout and depression. The statistics are very sobering. Nearly one in five US pastors say they have contemplated self-harm or suicide within the past year. Furthermore, the same study showed that:

52% of pastors are not receiving any care for their mental health. In this group,

37% state they do not need it and

13% say they do not have time to take care of themselves.

Although concerning, it is not particularly surprising that a significant number of pastors report not receiving care for their mental health. Although some churches and other religious organizations are acknowledging the importance of mental health, there is still a lot of stigma related to mental illness and in some cases, outright denial.

Stigma and denial are significant barriers

A study published in 2024 found that 18% of pastors are not able to speak openly about their mental health, 15% do not feel mental health affects their pastoral role and 38% experience guilt with regards to their mental health. Additionally, 26% believe their mental health is only to be between them and God. These findings are very concerning, especially given the fact that many people look up to their pastors for guidance and direction.

A prominent Christian leader recently announced that there was no such thing as mental illness. He said there’s no such thing as PTSD (post-traumatic stress disorder), ADHD (attention deficit- hyperactivity disorder) and OCD (obsessive-compulsive disorder), describing them as “noble lies,” and simply an excuse to medicate people. A more detailed discussion is available in this essay.

Such misleading statements and attitudes highlight the need for education, specifically among clergy. If a pastor believes that mental illness is not real, or that it is a result of some moral failing, how can they get the professional help they need when they experience anxiety, depression or other mental illnesses? The problems of overdiagnosis and overmedication do not negate the reality of these disorders, and not all conditions need medication. Sometimes the solution may be as simple as engaging in talk therapy, lifestyle modifications or adjustments to a work schedule.

The biological basis of psychiatry is an evolving field

The Christian leader mentioned above referenced a book by a psychiatrist, Thomas Szasz, published in 1961, to defend his statements. Szasz seems to have believed that mental illnesses shouldn’t be classified as diseases because we can’t consistently demonstrate pathological findings in the nervous system in patients who are mentally ill.

A lot of progress has been made since Szasz published his first book and significant strides have been made in understanding the biological basis of psychiatry. There is still so much we don’t know about mental illness, but our limited knowledge should drive us to learn more, rather than deny the existence of these diseases.

With advances in imaging, changes in the brain can actually be demonstrated in patients with certain mental illnesses, but even if this wasn’t the case, their existence cannot be denied.

Spiritual healers need to be healthy

People, including clergy, need to be free to ask for help when they need it. It starts with acknowledging that mental illness is real and it’s OK to ask for help. Their jobs are stressful enough and if they don’t take care of their own mental health, they can’t be expected to attend to the spiritual needs of those who look up to them.

To the pastors and other spiritual leaders who deny mental illness, I suggest that they consider all the spiritual concepts that they teach their followers that need to be accepted by faith: the existence of God, the Virgin Birth, the Resurrection, to name a few. Within any faith, there are things we accept regardless of whether we can see them, even if they sound absurd to people outside the faith.

I really don’t think you need faith to acknowledge the reality of mental illness. The point is that we can’t always see things that matter. Our inability to see them doesn’t make them any less real.

Considering all that Dorothea Dix, the daughter of a preacher who suffered from mental illness, accomplished in terms of advocating for the mentally ill as far back as the 1800s, it is sobering that in 2025, we still have to convince people that mental illness is real. We must do better.

For more information about my work and my forthcoming book, “Girls Become Doctors and Much More,” check out my website.

May is Mental Health Awareness Month… let’s all do what we can to raise awareness. If you are experiencing a mental health crisis, help is available.

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “NAMI” to 62640, or chat online. In a crisis, call or text 988 (24/7).

The Mental Health Hotline at 866-903-3787 can answer your questions confidentially and free of charge.