Mental health has become a major focus in our post-COVID world, as rates of depression, suicide, and anxiety are climbing at alarming rates. Within the missions community, books and white papers urging sending and training organizations to pay more attention to the mental health of candidates and missionaries have been around for decades. Pre-field psychological assessment of missionary candidates is a widely used way both to: (1) proactively evaluate emotional and relational strengths and risk factors, and (2) make spiritually sensitive and clinically informed recommendations for ways to remediate areas of concern.
At the November 2022 “Mental Health & Missions” International Conference, held in Dallas, Texas, psychological assessment of missionary candidates got a huge endorsement. The directors of five of the largest, most respected international missionary mental health centers (from four continents) were on the stage together. At the end of the session, the facilitator of this panel discussion asked them a final question: “What can we, as stateside mental health professionals, do better? How can we partner with you in more effective ways?” Every single panelist responded with some version of this answer: “Do a more thorough and clinically informed job of screening missionary candidates, and require them to work on remediating their deficits before you send them overseas!” In other words, take a more proactive, preventive approach to helping candidates with their mental health issues.
Cross-cultural mission work is so very important, and it can be fulfilling, enriching work for individuals and families. It is also extremely stressful work, and people who do missions well must be flexible, adaptable, resilient, and stable.
Paying more attention to the mental health of missionary candidates just makes sense. We have always encouraged, if not required, missionaries to get physical exams, because we are aware that medical problems could interfere with their abilities to function effectively. Nearly every sending organization has some minimal standards for biblical and missional knowledge, as well as ways to evaluate theological soundness. Educational needs of children are typically discussed and overseas resources for ongoing academic training are explored. BUT … sending organizations have sometimes overlooked and/or been inconsistent in establishing protocols for evaluating the mental, emotional, and relational strengths and vulnerabilities of candidates and missionaries, even though deficiencies in these areas are common reasons for disunity on a team, struggles for the missionary, and an early return from the field. Mental health is an area we must take note of in sending missionaries overseas well.
Cross-cultural mission work is so very important, and it can be fulfilling, enriching work for individuals and families. It is also extremely stressful work, and people who do missions well must be flexible, adaptable, resilient, and stable. Missionaries need to be “hardy” people who: (1) are deeply committed to God, Kingdom work, self-care, and their primary human relationships; (2) have a firm sense of internal ability to control, with the guidance of the Holy Spirit, so they trust their judgment, function independently (and interdependently with team members), make good, rational decisions, are free of debilitating habits and addictions, and have an overall positive view of themselves; and (3) view change as an opportunity for growth and a challenge that can be overcome (rather than change being something that is anxiety-provoking and fearful).
Psychological testing is a valid and reliable way to surface individual, marital, and familial strengths and deficits. When done early in the pre-field process, there is time for remedial interventions (readings, spiritual mentoring, professional counseling, skills acquisitions) to take place. Of the thousands of psychological assessments that I have done, I have rarely recommended that a candidate never go to the mission field. By far, my most common recommendation is that the candidate work on improving an area of personal vulnerability or relational weakness before being sent overseas. Making specific recommendations for improvement and sharing resources for help are also aspects of the assessment process.
Psychological testing is a valid and reliable way to surface individual, marital, and familial strengths and deficits.
Sometimes, doing a good job of “becoming more emotionally stable and/or relationally mature” requires delaying departure. The old saying that “an ounce of prevention is worth a pound of cure” certainly holds true in mission work. The spiritual, financial, emotional, and relational fallout that results from pulling someone off the mission field due to mental health problems (that could have been addressed pre-field and remediated stateside, where resources are plentiful) is costly, tragic, and oftentimes avoidable. I petition you to join me in being the best stewards of our knowledge and resources about mental health that we can possibly be. Doing so requires us to invest proactively in our missionary candidates.
A note from the Upstream Team: Ask your missions organization if they utilize psychological testing. If they do not, look for an organization that will do this. Dr. Steve’s organization is a great place to start. Through the process the potential Sent One will take some psychological tests, do a life history assessment, and have a meeting with a counselor to go over the results. You can email firstname.lastname@example.org for more information.
Healthy, Resilient, and Effective in Cross-Cultural Ministry by Laura Mae Gardner
Too Valuable to Lose, edited by William Taylor
Worth Keeping: Global Perspectives on Best Practices in Missionary Retention by Rob Hay, Valeria Lim, Detlef Blocher, and Jaap Ketelaa
Enhancing Missionary Vitality, edited by John Powell and Joyce Bowen
Doing Member Care Well: Perspectives and Practices from Around the World, edited by Kelly O’Donnell
Global Member Care: The Pearls and Perils of Good Practice by Kelly O’Donnell
Steve Allison, PhD, is the President of International Missions Personnel Consultants, a ministry that does psychological pre-field assessments of missionary candidates and consulting with missions agencies. Dr. Allison holds the MA in Theology and PhD in Clinical Psychology from Fuller Theological Seminary. He has been in clinical practice and taught at the college level for over forty years. He has been the Robert & Mary Ann Hall Endowed Professor of Psychology and Intercultural Studies at Abilene Christian University since 2002. Dr. Allison has been involved in member care, doing consulting, conflict mediation, team-building, and counseling with many missions organizations and churches, in over sixty countries on six continents.