Mental Health and Missions

That evening she was having trouble breathing. The doctor and hospital was several miles away. She died in her living room as her family watched helplessly. Later the autopsy revealed she died of a blood clot. Not yet forty years old, she left a husband and four children.

I thought of that event in Kenya, which took place 25 years ago, while reading an article in the July 2010 issue of Evangelical Missions Quarterly entitled, “Trauma and Traumatic Stress in Cross-Cultural Missions.” The authors did a survey among missionaries in West Africa and Europe and found that 71% of men and 64% of women serving in West Africa; 47% of men and 30% of women in Europe, had experienced trauma on the field (serious illness; car, train or plane accidents; unexpected death of family members; immediate exposure to fighting, civil unrest, or war; burglary; serious threat or harm to family members or close friend, immediate; evacuation). Of that number 20% of men, 16% of women in West Africa; 19% of men, 0% of women in Europe suffered from Post Traumatic Stress Disorder (PTSD) or Post Traumatic Stress Syndrome (PTSS).

In my time on the field I knew missionaries terrorized by robbers, two friends who accidently ran over and killed kids and people who went through coups and coup attempts. In addition to these stresses in the life of a missionary there is the added pressure of homesickness, loneliness and everyday tension of living in a different culture.

As one who disciples missionaries I spend a great deal of time on the “effective” aspects of cross-cultural ministry. I don’t spend as much time on the “affective” dimension of mental and emotional health, yet, I realize that one of the chief reasons people leave the field is due to the affective tensions on families.

We are often encouraged to pray for missionaries. Without question prayer is the number one thing we can do for our brothers and sisters working overseas. But there are other things the church and sending organizations can do for the emotional and spiritual health of our cross-cultural colleagues.

1. Provide better training for missionaries before they leave for the field. The approval process for missionaries should include good screening on psychological and emotional stability. Even the healthiest of missionaries will crack under the weight of trauma on the field, but a mission organization is derelict in their duties if they ignore personalities that may be most vulnerable to stress environments.

2. Make sure there is a well qualified mental health provider for those on the field. It could be a pastor or someone in the sending organization that is trained to help people in trauma situations.

3. Sending churches and mission organizations should be aware of what their missionaries are facing on the field and help them in coping with stress, whether that be encouraging missionaries to find professional help on the field or making sure that missionaries “take a break,” through vacations or trips outside their countries. By all means one should be careful not to criticize missionaries who seek ways to cope with trauma or stress.

I am not a mental health expert, but in my time as a coach visiting missionaries on the field, invariably the issues of culture fatigue, manifested in everything from family discord to cultural bitterness, become a part of our discussion. The life of missionary is rich and rewarding, but it’s also a career that places people in tough and difficult situations. I am praying for my colleagues today and I hope you are as well.