“No pastor escapes the necessity of dealing with person who have suffered with mental or emotional illness”. The problem of mental illness often comes to him late. This happens because the family members of the mental illness seem to be embarrassed and they may like to keep such information from him. 

Many people do not often like to associate with mental illness persons because it damages the personality and so they will keep it from the society and try to face the situation alone. Before the pastor will know of it, he may visit the patient in a mental hospital. It is good for the pastor to get himself acquainted with the hospital management or workers and get some information to ascertain how to approach mental illness. To approach mental illness, the minister must know the procedure and be familiar with the law that governs the status of mental illness. 

Pastor Care

Pastoral care refers to the traditional prerogative of ministers to take initiative towards persons in response to need. Traditionally, it encompasses home and hospital visits for purposes of education, nurture, care, evangelism, organization and discipline. 

Mental Illness:

There is no answer that everyone would accept, but in general, this term describes a broad variety of symptoms that could fall into several overlapping categories, some distress which include anxiety, depression, anger, other emotional or psychological effects more than it is physical [1].

The pastor should be informed on time whenever this type of situation arises from any family. The pastor can provide solution and follow-up in constant visits and prayers for the mentally ill persons. The church should also be involved in prayer, financially and otherwise be involved as brother of the same parish. More people are afflicted with mental and emotional disturbances than with strictly physical maladies [2]. As fewer patients are admitted to hospital and more maintained in some kind of community setting churches may find that they have a group home or other community facilities within their neighbourhood. In this paper, the writer will be focusing on pastoral care for mental illness.  

Causes of Mental Illness 

The causes of mental illness are varied and it also depends on where one lives. The rates vary from place to place. Some mental illness start from adolescents, while others from age forty-five. The following could be seen as the causes of mental illness:

• Present Stress

Present stress refers to the situation of an individual or state of life that could lead to mental illness. This could also be referred to as “psychological and physiological product of reaction to change”. There are four categories of stress: biological, social and spiritual stress. “Stress is the term used to describe the physiological process whereby the human body internally activates itself to adapt to either physical or psychological tressors in its immediate internal or external environment” [3]. Stress is whatever stimulus or irritation is followed by nervous ans mental disturbance” [4]

• Biological Stress: This can be influenced by disease, drugs, toxins or pollutants in the air, brain damage. This type of biological stress can lead to mental illness; they are more common through birth from the parent of disorder, because his/her parent is with this problem. Some also can still be traced as generational problem that flows in the bloodstream which is easily transmitted to the unborn child. This type of stress is disease inherited from the parents. Drug is another biological cause of mental illness. This is often caused by mothers who are involved in alcoholics, smoking etc during and before pregnancy that also causes disorder after the birth of the child. This starts from adolescent age. All these facts can cause mental problem

Psychological stress includes frustrations, feelings of insecurity, inner conflicts, fears, or even the pressure to get things done when we have too much to do” [1]. This is another kind of stress that causes mental illness; when a person is psychologically unbalanced, which could take place from birth. 

• Social Stress: This has to do with the economic uncertainty, unemployment, political instability, or threat from terrorist attacks. It can be very difficult for some people to handle the tension and uncertainties [1]. Social stress normally causes mental illness when one is socially down, looking at the problem around him/her. This often starts after childhood and adolescence

• Spiritual Stress: This is when humans are subject to the strategic tricks of the devil and align with rules and authorities of the unseen world and wicked spirits in the heavenly realms that put us under pressure. Spiritual stress is in stages of lives either before or after birth, which drags one into a serious mental problem that can also be cured through the scripture and the help of the pastor. This type of mental illness is caused by present stress which could lead to death if adequate care is not taken. 

Predisposing Influence

This type of illness can be caused by different ways, either biological, psychological or sociological predisposing. Predisposing is to influence somebody so that he/she is likely to think or believe in a particular way. Predisposing also causes mental illness through depression, worry or anxiety, unconsciousness, pre-consciousness or sub-consciousness, conscience relation and avoidance. 

Depression is an emotional disorder caused by psychological or physiological situations. It can manifest in various ways with different people and in varying degrees. It may start with a low spirit or a low state of strength or a feeling of slight sadness and mature or utter misery, dullness and dejection [5]. Depression covers a wide variety of symptoms that differ in severity, frequency, duration and origin” [1]. “Depression is an affective disorder with a retardation of mental, physical and social activities characterized by loss of interest, lack of energy and pessimism”.

• Worry or Anxiety: This is uneasiness or concern of a mind that is expecting some even to happen, leading to fretting or a trouble. Anxiety causes mental illness in attempt to achieve one’s desire or to satisfy one’s need, whereby the mind will now become unstable, it leads to mental illness. “More people are afflicted with mental and emotional disturbances than with strictly physical maladies. Worry which is often needless causes peptic ulcers and wrong thinking has a definite relation to hypertension, colds and tuberculosis [2].This group of people could either be adults or adolescents, but it mostly affects aged people. “The aged among us need more attention than ordinarily they receive. They too have problems of health, security, relations, doubts and most often of sheer or loneliness” [2]

Unconsciousness is another predisposition that causes mental illness. Unconsciousness is the opposite of consciousness. It is a process like sleep caused by injury or illness when one is unable to use his/her sense as normal. Many are in this stage that their sense is unable to work normally as a result of injury, either on the brain or nervous system or injury from birth that causes such mental illness. 

Pre-consciousness or subconscious is a feeling that connects you and your influence, your behaviour, even though you are not aware of this feeling. It is a feeling that influences your behaviour and can cause mental disorder, because it tampers with your emotions or ideas, this has the ability to change one’s level of understanding about matters of life. “These are thought processes (ideas, emotions, etc) which slip in and out of consciousness. They are capable of being remembered or reproduced” [5].

Conscience is derived from ‘conscious.’ It is the feeling of right or wrong; a person may be described as having good, clear, bad or guilty conscience [5].Awareness of right and wrong is different from feeling that one is doing what is right or wrong. Everybody has the awareness, but is not everybody that has feeling when they are doing evil. Evil conscience is predisposition that also leads to mental illness which many evil doers are not aware of. This causes people to lament in pain and sorrow. Such will never pray a prayer of peace for whoever that is the cause of their problems. The worldviews of the African says, “Whatever happens there is an enemy who are involved in this act.”

Rationalizationis the tendency to make excuses [1]. When we assign logical motives to what we do so that we present ourselves to have acted properly, we are rationalizing. Often the explanations or arguments are misleading yet we still want to prove to be right [5].

Avoidance – a person seeks to avoid a difficult situation or problem by running away from the scene or immediate environment and pretending as if the undesirable situation never existed [5].Such a problem could be of spiritual than physical. Wherever you may have run to, the problem is still there. Such disturbance is predisposition that causes mental illness. Spiritual predisposing factors could include the person’s past experiences with such harmful predisposing issues as abusive church experiences involvements with satanic rituals or a history of sinful behaviour that have scars even in believers who have been forgiven by God. 

Locus of Control

The influence of these present stresses and prior predisposing issues can depend on how much control the person feels he or she has over the circumstances and directions of life [1]. The inability to control one’s present feelings crate a different atmosphere to ascertain if the present condition will escalate or not. Few mental patients out of hundred can control themselves while some go behind their control capacity. These are the ones that mental illness has overgrown them due to lack of proper care by their family members.

Sin and Responsibility 

A number of Christian counsellors hold the view that mental illness results mostly from personal sin in the life of the person with the ailment [1]. This view is mostly correct because the psychologist fails to view mental illness from this perspective from which the Christian counsellors see it. Sin against God and against man can affect one’s life to get mental illness. Example can be seen from Genesis 4 of the story of Cain and Abel about the sacrifice offered to God that led to the killing of his blood brother. Such can affect one’s life through which he/she can be mentally ill. 

Counseling therefore, involves urging people to confess their sins and change behaviour. This viewpoint fails to appreciate both the complexity of mental disorders and the deeply penetrating influence of sin [1]. Non confession of one’s sins leads to stress or emotional imbalance whether conscious deliberate sins that an individual commits knowingly, or the innate sinfulness that is part of human nature. Such sin should be confessed to God so that healing can come. Without confession of sin, there is no forgiveness. Christian counsellors hold this view that with confession of sin to God healing can come through that process. 

Other biological factors that may be involved in the development of mental illness include:

• Genetics (Heredity): Many mental illnesses run in families, suggesting that people who have a family member with a mental illness are more susceptible (have a greater likelihood of being affected) to develop mental illness. Mental illness is linked to abnormalities in many genes, not just one. That is why a person inherits a susceptibility to a mental illness and does not necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors such as stress abuse or traumatic event, which can influence or trigger an illness in a person who has an inherited susceptibility to it

• Infections: Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as paediatric autoimmune neuropsychiatric disorder (PANDA) associated with the streptococcus bacteria has been linked to the development of obsessive compulsive disorder and other mental illness in children.

• Brain Defects or Injury: Defects in or injury to certain areas of the brain have also been linked to some mental illness brain chemistry is known as biochemical mode and other aspects of mental health. Naturally occurring brain chemicals called neutrotransmitters play a role in some mental illness. In some cases, hormonal imbalances affect mental health. It’s thought that inherited traits, life, experience and biological factors can all affect brain chemistry linked to mental illness

• Biological Factors: In addition to inherited traits, outside forces can sometimes be linked to mental illness. For example, traumatic brain injury or exposure to viruses of toxins while in the womb. Parental damage also shows some evidence, suggests that a disruption of early facta brain development or trauma that occurs at the time of birth, for example loss of oxygen to the brain, may be a factor in the development of certain conditions, such as autism

Effects of Mental Illness 

Mental illness is a major problem that consumes money and wastage of life and future which could be affected at different dimensions. And at the same time, the stigma and focus on the idea that mental illnesses are real illnesses from which people can recover. [1]. stated two effects of mental illness and how their families suffer or struggle to cope; the effect on individuals and collectively. He further classified the effects on individuals into three as follows:

• Emotion: Painful emotions are so common that counsellors often refer to mental illness as affective or emotional disorders. These emotions can differ in a variety of ways. Emotional variability refers to sometimes unpredictable emotional ups and downs [1]. Emotional illness that reacts as mental illness can be caused by the following:

• Lack of love by parents and mates: If a child is the result of an unwanted pregnancy, he is likely to miss the necessary parental care and love. You must have heard cases of unfortunate babies picked up in dustbins or gutters who are eventually taken to foster homes. Research findings show that children who miss the early mother attachment grow up to develop emotional problems. Similarly, a child born to maladjusted parents of who are inconsistent in their discipline like using harsh corporal punishment or arguing hotly with each other is very likely to develop emotional problems by becoming aggressive or violent

• Physical Defects: Some physical disabilities like blindness, speech defects and lameness can cause a child or any person to be irritating. This is particularly possible when the society shows little or no sympathy for such unfortunate children or persons. All these factors are responsible for the development of emotions that metamorphose into mental illness which many of our parents, guardians or people are interested to note and carefully observe in our people’s lives as the days go by either of adult or children. Other effects include:

• Sensation and Perception: It is difficult to function well if we fail to receive and respond appropriately to stimulations from the world around us [1]. This type of individual effect is called “sensations and perceptions.” Some mental patients find it difficult to differentiate their formal world of life and the present condition because it has affected their entire being. Some can see clearly or watch television because they can watch the screen and listen at the same time, some are unable to relax or concentrate because of their situation

• Thinking: Some mental health professionals suggest that through disorders are the most obvious indications of mental illness often. For example, there is the faulty thought content in which the person does not think clearly, logically, or consistently [1]. The ability to think or reason well and relate effectively makes one a normal person. Mental illness affects mostly their thinking fault and subdues them to unreasonable person. In addition, some people appear to be confused, uncertain when and where they are, unable to appreciate the consequences of their behaviour, unable to remember or easily distract. All these can show that the person is out of contact with reality [1]

• Behaviour: It is not surprising that the person with faulty sensation, perception, emotions and thinking is also likely to act in ways that are odd or socially inappropriate. This is so common that mental illness is frequently known as behaviour disorders, ritualistic compulsive activity, hyperactivity, withdrawal, childlike behaviour, lack of self-control, religious or political fanaticism, and other unusual behaviours can indicate that something is wrong  [1]. Behaviour is a way of identifying a mentally ill person which shows through the five senses of the human organs

Effects on Families 

Most people are not able to think logically because of their experience, emotional problems and are coping with life’s stress more or less effectively. But when another person lacks these abilities, especially a person in one’s family, communication and interaction become extremely difficult. When this happens to children, everybody believes that they are children as they grow older and mature, they will change with time. 

When immature and inappropriate behaviours are seen in one’s spouse, parents or grown children, it is much more difficult for family members to cope and be patient with. Unlike mental illness where the families are left alone to face the uncertainty, confusion, mental stigma, guilt, financial pressures, self-blame and tensions that may follow a relative who has a mental illness. Some people may conclude that mental illness runs through the family that in a way complicates the matter and affect the family greatly. 

Pastoral Care and Counselling In Mental Illness 

A pastor is nearly always allowed to visit a patient in a mental hospital. At times, he is the only outsider allowed frequent, the family of the patient are deeply involved in the dynamics of his illness and this limits or eliminates a good deal of their usefulness as visitors. It is the minister who has the greatest opportunity to be of real help to them. As such, his pastoral care and counselling should pursue the following goals. 

• Healing: These are in different dimensions. It may be physical, emotional or spiritual [6].Through the help of the pastor as a caregiver, the mental ill patient can receive healing through consistent visits and prayer of the pastor; the patient will gradually recover of either physical or spiritual mental illness. The pastor and the church can help to provide healing to the mentally ill patient by praying for them. Prayer is a means of direct communication with God. The mentally ill patient believes in prayer for healing. The pastor/church can also assist a patient by paying the medical bills and constantly visiting the patient at the hospital

• Sustaining: This involves helping someone to keep alive by comforting, consoling and advising when they have extreme distress. The presence of the minister can help to calm mental situation by counselling the patient that all hope is not lost, that such can still be useful to him and to the society and sustaining the patient through the drugs and other medical care. The minister in driving his point home, can cite examples of people who had gone through this problem and are still moving on with their normal lives in order to sustain the healing of the mentally ill patient. 

The pastor and the body of Christ should also remind the patients of hope that despite their physical challenges, God still values and loves them. Encouraging them always keeps them strong and alive even though they are mentally ill. Generally, people who experience stress or emotional problems need somebody who will identify with them despite the fact that they are cut out from the reality. They need people to live with them, it is the duty of the pastor and the church to visit such patients with God’s word to sustain them

• Guidance: This involves giving educative advice and spiritual directive. In educative guidance, the counsellor will provide room for explorations of different options out of which a person will choose [6]. In guidance and counselling, a patient is not forced to choose; in the counsellor options rooms are given; it is the duty of the counsellor to guide not to force any option on the counselee; while making these options available to the patients, prayer and the word of God should be the guiding rule. The minister guides the mentally retarded patients in decision making which in turn will bring joy, healing and sustaining to the patient. 

People of this capacity need the ministry of presence, either from the pastor or the church to guide them even though they are mentally ill and to see themselves as human beings and as people created by God for purpose. Guiding them, the pastor who is the caregiver needs to lead them to take certain decisions that will lead to the recovery from their sickness. The pastor or the church must not force them to take decisions, but create room for different options out of which they will choose 

• Reconciliation: This can involve reconciling a person or persons with God, others and self. A person must have good relationship with God, others and self to live a peaceful life. Many emotional problems arise from the problem of interpersonal relationship [6]. 

The patient through the minister will be assisted to make reconciliation to God by confession of sin and asking God for forgiveness and at the same time interpersonal reconciliation. It is mostly believed that metal illness often comes through sin committed either by personal self or the enemy. Such, the minister will lead the patient for reconciliation

• Nurture: Nurture means helping one to grow and to control self. It could come in form of religious education, training or guidance, preaching, prayer and Bible study help [6]. Most ministers believe that when a patient gets to this stage, it is over. But this is not so, because the work of counselling is not yet over because for the healing, sustaining, guidance and reconciliation to be effective, the minister has to continue nurturing the patient which is a way of follow up. This could be a long term nurturing or short-term in the patient’s life. 

The pastor/church is to assist the patient by nurturing and the family of the patient should be notified that despite the fact that the patient is partially healed, he/she still needs nurturing for total wholeness to manifest. This process is the last of all the functions needed by the pastor/church which is the caregiver to apply to ascertain the position if the patient is responding to treatment or not

The researcher has made known the meaning, causes, effects and pastoral care for mental illness. Mental illness is a stigma to the family of the affected patient, which could have been caused by different things as discussed in the paper. It is also a stigma to the patient because after recovering, the shame of ever being a mentally ill person affects him/her psychologically. The pastor can help the patient recover from such feelings prayerfully, physically and financially to put the situation under control.

1. Collins G R. "Christian counselling." Third edition. A comparative guide. Nashville: Beijin Publishers. 2007.

2. Anderson E S. "Every pastor a counsellor." Wheaton, Illinois: Van Kampen Press. 1949.

3. Ogieriakhi O. "Mastering stress and anxiety." True Love House. 2009.

4. Adegboyega D A. "Managing stress, anxiety and burnout." Africa Christian Textbooks (ACTS). 2006.

5. Adebayo J A. "You’re guide to effective Christian counselling." Ehindero (Nig) Ltd. 2004.

6. Ayandokun E E. "Counselling made easy." Lagos: Gloryline Christian Publications. 2010.