When Someone in Your Pew Is Struggling

Why this matters

Depression and anxiety are common, including in church. Many people sitting in our pews are struggling quietly, and many will go to a pastor or church friend before they ever see a doctor or counselor. How the church responds can open the door to help, or close it.

The goal isn’t to turn leaders into therapists. It’s to make church a place where people can say “I’m not okay” without shame, and then get connected to real help.

Say this, not that

Well-meaning words can wound. Here’s what helps.

When someone opens up

1. Listen first. Put your phone away. Don’t rush to fix, quote a verse or share your own story. Job’s friends got one thing right: they sat with him in silence for seven days.
2. Thank them. “Thank you for trusting me with this.” Telling someone took courage.
3. Ask directly about safety. If they seem hopeless, ask: “Are you thinking about suicide?” Research shows asking directly does not plant the idea. It often brings relief.
4. Connect them to help. Encourage a doctor or licensed counselor. Offer to help them make the call, or sit with them while they do. Share the help card below.
5. Follow up. A text in two days matters more than a perfect speech today. Keep showing up.

Know your limits, and your referrals

Pastors and leaders are not expected to be therapists. Your role is spiritual care, presence and connection. Build your referral list before someone needs it.

Your church’s referral list

• Two or three licensed counselors you trust (ideally including at least one who welcomes faith in sessions), with phone numbers
• A low-cost or sliding-scale option (community mental health center, university clinic)
• Local doctors or clinics
• Crisis lines: 988, and local emergency services
• Addiction recovery groups that meet nearby
• Your church’s benevolence fund process, if counseling costs are a barrier

Need a place to start? Finding a Counselor explains the options in plain English.

A Mental Health Sunday outline

Use all of it, or borrow a piece for any Sunday.

• Call to worship: Psalm 34:18, “Yahweh is near to those who have a broken heart.”
• Readings: 1 Kings 19:1–18, Psalm 42 and Matthew 11:28–30.
• Sermon: “Under the Juniper Tree.” 1. Even prophets crash (Elijah after Mount Carmel). 2. God cares for the body first: sleep and food. 3. God speaks in a still small voice, not the earthquake. 4. You are not alone: God had 7,000 more. 5. God gives a next step and a friend (Elisha).
• Testimony: invite someone (with their permission and preparation) to share briefly about getting help, including counseling or medication.
• Prayer: for those who are struggling, for families, for counselors and doctors, and for those we’ve lost.
• Practical step: put the help card in the bulletin, and have trained people available after service.

For small groups

• Agree on confidentiality at the start: what’s shared here stays here, except when someone’s safety is at risk.
• Make check-ins honest: “On a scale of 1–10, how are you really doing?”
• Respond with presence, not fixes. “Thank you for sharing. How can we support you this week?”
• Get practical: meal trains, rides to appointments, childcare, a text chain.
• Know when to refer: a small group is not a substitute for professional care. Encourage it, and help make it happen.

For prayer teams

• Pray with people, not at them. Ask what they’d like prayer for, and keep it gentle.
• Don’t diagnose spiritually. Avoid telling someone their depression or anxiety is a demon, a lack of faith or a result of sin. It can cause deep harm.
• Never discourage treatment. Pray for healing and for wisdom for their doctors and counselors.
• Keep it confidential. Prayer requests about mental health should never be shared on a prayer chain without permission.
• Know when to step in: if someone mentions thoughts of suicide, follow the steps above and connect them to help today.