Inside Out: A Mental Health Theology Big Enough to Hold the Dark

Mental health in the church is one of the most underprepared gaps in the Christian community, and for families in crisis, that gap has real consequences.

This episode is personal. Kristen reads a piece of writing kept private for years, a story about her son, suicidal ideation, and a 5150. After reading it aloud, she pauses to name what her body still carries: not just memory, but PTSD. The hypervigilance doesn't turn off when the crisis passes.

From there: a direct theological reckoning with what the church typically offers families in mental health crisis, and why it causes harm even when it means well. The anti-medication strain in evangelical culture has cost people their lives. The brain is an organ. Bipolar disorder is not a faith failure.

The church's silence around suicide compounds the harm, isolating families, layering shame on the unbearable, leaving the bereaved without a community equipped to hold their grief.

Scripture offers more. Psalm 88 closes in darkness without turning toward hope, and that's canon. Jesus was on his way to perform his first resurrection miracle when he stopped for the woman with the issue of blood. Turned. Made her visible. Called her daughter. The resurrection could wait. She could not.

Mental health in the church is also a justice issue; kids from trauma backgrounds, BIPOC families, and lower-income communities bear the highest cost of the church's unpreparedness.

The close lands in Ezekiel 37. God doesn't ask the dry bones to reassemble before entering the valley. God enters first.

Mental Health Awareness Month is not a secular intrusion into sacred space. It is an invitation to recover something the church was always supposed to be.

Content note: This episode discusses suicide and mental health crises. The 988 Lifeline is available by call or text, anytime.

RELATED EPISODES

• Season 1 Episode 14, Beyond the System: A Journey of Love, Loss, Healing and Faith (ACEs and childhood trauma)
• Season 1 Episode 16, Bearing Witness: Navigating Mental Health and Miracles (original telling of this story)
• Season 3 Episode 5, The Cost of Staying Awake: How Long, O Lord? (lament theology and Psalm 88)
• Season 3 Episode 14 Everyday Prophets: You Can't Heal What You Won't Name with Conscious Coore(trauma-informed spiritual care)
• Season 3 Episode 8, Starting in the Rubble: Reconciliation That Holds (repair before reconciliation)

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Transcript

Inside Out: a mental health theology big enough to hold the dark

HOOK

At 4:30 in the morning, I swept my son's hair off the garage floor and knew we were headed to the hospital, again. What I needed was a theology big enough to hold the dark, and a church that knew what a 5150 was. This is Mental Health Awareness Month, and this one is personal.

OPEN

Before we go any further, this episode deals with suicide, suicidal ideation, and mental health crises. If you're in a vulnerable place today, please take care of yourself. The 988 Suicide and Crisis Lifeline is available by call or text, anytime.

Today I'm going to do something a little different.

A few years ago, I wrote a story. It won a small award at a writers' conference and has sat in my computer since then, because I wasn't sure where it belonged or whether the world was ready for it. Or maybe whether I was ready for it.

I think it's been waiting for such a time as this.

So I'm going to read it to you. It's about my youngest son. He knows I share our story, and he's allowed me to do that. But I've made a choice not to have him read this particular piece, because he has already lived it once, and it is not fair to ask him to carry the weight I carry on top of processing his own.

I say that because one of the cruelties of the system is that kids are often required to tell their story over and over again, as therapists cycle through faster than the seasons, especially if your insurance only covers Medi-Cal, or whatever your state calls its public health coverage, which is how most kids from the foster system are covered.

But that's another reason this conversation can’t wait.

After I read it, we're going to talk about the church, about mental health, about what's at stake when faith communities get this wrong. And about what it looks like when we get it right. Here goes. 

May 2024 

His light was on. At 4:30 am, this wasn’t entirely unusual. After all, my youngest, the last one to potentially leave the nest, is still a teenager.  But this early morning, when the sun had not even thought about appearing, something seemed off. It seemed to have been brewing for a week, but that often happens, and it fizzles as the week lingers.  As most parents, past and present, know, the emotional lives of teens tend toward uncertainty.  But when you have a teen who battles the inner demons of his mental health for as long as he can remember, sometimes those feelings that grip our hearts need to be taken more seriously.  

It could be the years of practice at hypervigilance. The kind of hypervigilance that is more than just the constant evaluation of the sounds in our home. More than just the senses. It is the kind where I dread falling asleep, and when I do, I awaken to every slight noise that might mean something is just not right. The kind of hypervigilance that means you are confined to your home for fear that something may go awry if you leave them unsupervised, even for an hour. Maybe this one was momma’s intuition.  Or perhaps it was the presence of God and our surrounding angels who nudged me just when I needed it. Just enough to know that I needed to pay attention.

Nonetheless, 4:30 am was what I saw as I squinted to see the numbers on my watch face. 4:30 am when I woke to see that his light was still on, and I heard rustling in his room, just a few feet away from mine. At the risk of disturbing the myriad of pets that believe my bed is more theirs than mine, I crawl out of bed. Sitting in a chair, rolling dice on the floor, he told me to go away when I asked if he was ok. I returned to my room, desperately trying to listen to any slight sound that would give me a clue. The familiar sounds that might mean something more than what they appear, more than a night of insomnia. 

Fifteen minutes pass, and I hear him grab something from the hall closet and head to the garage.  The garage has been his respite in a small house and a room with no door. He broke it down in a fit of rage in his earlier years of processing his childhood trauma. I don’t know how long he has been awake, but I suspect he has yet to sleep. After a few minutes, waiting as long as I think I can stand it without appearing bothersome, I head down the hallway to the garage and am surprised to see that he is shaving off his hair with the clippers. The clippers I have used to cut every one of my three boys’ hair since they were little.  But this is different. This is the hair that he loves and has been growing for years. He prides himself on this hair, his crown of glory. This hair, now in a pile on our garage floor. 

I breathe deeply and consider my words as he struggles with the back of his head. “Do you want some help, buddy?” I tentatively ask. He is unresponsive, without even looking my way as he spurns yet another one of my attempts to connect. I grab the broom and begin to sweep the dark, curly locks as an excuse to stay in the space with him because now I know this is not a normal night.

This kid has always been able to ask for help right at the edge of a crisis. And I mean, at the edge.  He moved to the bathroom. I heard the shower running and listened intently for any curious sound, anything that might mean something more than teen angst and a bald head. Quietly, he moved to his room. I knocked on the door frame and peeked in, and he flatly said, “5150.” The only way he knows how to ask for real help when it is beyond what his mind, his body, and his spirit can handle. That moment just before he inches past the point of no return.

For this, I have always been thankful. He gets ready with clothes he knows he will need.  Sweats and sweatshirts without drawstrings. Shoes without laces. There is no need for socks as he knows they will give him a pair. But as he got ready this time, I knew it was different. He is 18 now, so I won’t have any say legally. We drive silently to the closest hospital that takes his insurance; the night is still dark as sunrise is nearly an hour away.  Twenty minutes in silence. We park and walk into the emergency room, where he tells the receptionist he wants to admit himself. She appears confused, and when the nurse arrives and listens to him, she quickly says, “Bring him back.”

Thankfully, he still wants me there while he is being assessed. Listening to him talk causes my heart to shatter…again. His suicidal ideation is intense. Strong enough that he had a plan. Strong enough that he started to go through with that plan.  Strong enough that they check him in.  We wait, with a guard at the door—a mini prison sentence. After a few hours, he eats a hospital sandwich. His mood has lightened, but we both know the darkness has only shifted. It isn’t gone.  It is never entirely gone. We wait. After several hours, he gets accepted for a 72-hour mental health hold in a facility that is two hours away—more waiting. By 2 pm, an ambulance has arrived to take him on the two-hour drive. He knows the drill. We have been here before. We hug and I relax ever so slightly because I know, for at least a couple of days, he is safe.

Driving home alone in the late afternoon I am exhausted from multiple nights with little sleep. My brain is fuzzy enough that I can just manage to get myself home. I pull into the driveway, knowing that I will need to talk to my family. Tell them what is going on so they can pray. But this first part of the story isn’t about me. Or at least it is not solely about me. This part of the story belongs to my son, so I want to be careful in the telling to honor his pieces, not mine. Time and mistakes have taught me that it is important that my kids’ stories are theirs to share. 

As I drove back to a home with another empty bedroom, my head reminded me that this is a familiar story, just a different year.  A story that will seemingly never end.  We have been here before. But it has been almost five years since we were in this place. 

I am thankful he is alive.  I am grateful to have friends and family ready to pray earnestly and check on me – even when I don’t know what I need.  I am thankful that when my faith is clinging to the smallest patch of land in a sea of despair, they are there to say, we’ve got this. We will pray. We are here if you need us. 

But there is more in this story. It is more than the face value of our experiences. Yes, this is a story about living with and parenting a boy profoundly affected by childhood trauma. But it is also about foster care and mental health. It is about race and systems. As unrelated as those topics may seem, they are all part of our story, and the threads are intricately knit together through systems of pain and injustice. Systems that have allowed generational trauma to persist. Systems that go back centuries and are sadly often rooted in the Church. It is a story of learning, letting go of control, and finding purpose. 

This story is deeply personal. Not just because it is the life we live but because within it lies the story of my unbelief and my faith. It is a story about searching for God when the pain prevails and wondering if he is even listening. It is about asking God where He lives in our story when we have prayed for miracles and healing for over a decade.  It is about learning to relinquish my need for control and remembering that God loves my kids more than I do. It is about honestly and authentically finding Him without the veils I hid behind. It is about my mistakes and my evolving awareness that God and the Bible are rooted in social justice, a topic that becomes more meaningful to me as I raise two bi-racial boys. And it is about where the church can be a safe haven for the most marginalized of people.

This story is also about faith and the Church. Not the building but the body of believers who aim to chase Jesus in our lives and actions. Because the Church is full of people like my son. On the outside, for the most part, he looks like a normal teen. Nothing immediately belies what goes on in our home or in his heart. But if you pay attention, there are things that give hints to his pain. You have to look carefully because he has learned that hiding it is easier. And, because of that secret facade that he believes he needs to move through the world, I encourage all of us to consider how we care for those who may look or behave differently. How do we encircle the families who don’t subscribe to what a family is supposed to look like?  

Within this story are lessons about how we honor behaviors that look like defiance but are just trauma showing itself in the only way it knows how. It is about getting to know people enough that they feel safe to tell their stories. It is about how being well-intentioned but uninformed causes hurt to our sisters and brothers and ensures that many of us will walk away to hide in our houses and in our heads, where it is much safer because the church and its people don’t seem to understand. It is about places that are often hard for us to enter as white evangelicals who feel safest when things are more homogenous. Because the stories aren’t always pretty, and the systems aren’t set up to care for those who need it most. 

In the end, I always ask, "Are we truly doing right by the least of these?” This slice of our story asks us all to bear witness to the pain of the hurting and marginalized in our midst. Whether you know it or not, they are here. Whether you make an assumption about someone’s life because of how they show up, the pain is there. And as believers, God calls us to respond. 

My son is home now. It has been five more months, and we still await miracles, but I know God is present in our story. I can’t always pretend to understand everything and what He is doing, but for now, the lights in our house are not on at 4:30 am.

End of story, although not really the end of the story. I want to pause for a moment here because even reading that back to myself, my heart is racing. My body remembers. That's not a metaphor. That's PTSD. And I think it's worth naming that, because parents like me don't just carry the cognitive memory of these moments. We carry them in our nervous systems. The hypervigilance I described in that story, that doesn't turn off when the crisis passes. It becomes the baseline. There are places I drive by that bring a story up. There are certain things that happen that have me on edge, and I want to let you know that if that is you, if you feel the physical emotions of your story, you are ok, and I am here with you. 

I also used the word suicidal in that story. I want to stay there for a moment because the church almost never does. Suicidal ideation is not a topic most pastors have been trained to address. It is not something most small groups have language for. And so families like mine learn to use clinical words, 5150, ideation, 72 hour hold, because the church words ran out a long time ago. The silence around suicide in our faith communities is not neutral. Some of you listening have lost someone. A family member, a child, someone at your child’s school. And the church didn't know what to do with your grief any more than it knew what to do with the crisis that preceded it. The shame around suicide has gone on long enough. The church should be the last place it lives, and right now it's often the first.

Shame thrives in silence. And the church has been silent long enough.

I know, because I have lived it. 

The story I shared is now a couple of years old. And I want to be honest with you, the story has continued. There have been more hard nights since then. We are still in it, though it has morphed a bit.

Some of you who have been with me since Season 1 may remember Episode 16. I recorded a version of this story live while I was still in the middle of it. Raw and unprocessed. What I read today is what I wrote after, with a little distance. Same story. Different vantage point. And I think that's worth naming, because coming back to something this hard from a different place is itself a form of healing.

But I'm sharing it today because it's not just our story. It's the story of thousands of families sitting in church pews every Sunday, carrying something the church doesn't have language for. Families who have learned to hide because they've already felt the church flinch.

This is Mental Health Awareness Month. And most churches are largely missing it, or worse, making it harder for the people who need it most.

So let's talk about that.

What the Church Typically Offers

When mental health enters the conversation in most church contexts, the pastoral toolkit is pretty small and often predictable.

Pray more. Have more faith. God won't give you more than you can handle.

That last one, by the way, is not in the Bible. It's a misreading of 1 Corinthians 10:13, which is about temptation, not suffering. But it gets deployed constantly, and what it communicates to a family in crisis is: if this is too much for you, that's a “you” problem.

What I have actually found is the opposite. Life in a broken world often gives me more than I can handle, and in those moments, the invitation is to relinquish the control I was never meant to carry in the first place. Not because God engineered the hardship, but because He meets me in it. Every time.

We do this with other Scripture too. James 1:2-4, 'consider it pure joy when you face trials', was written to Jewish Christians who had been scattered and were facing genuine persecution. It's a word of solidarity to people who had already lost everything, not a prescription for cheerful suffering. But when it gets handed to a parent who just drove their child to the emergency room, it functions as a bypass, not a balm Same thing with Romans 8:28, all things work together for good. That's an eschatological promise, meaning it's about the final, ultimate redemption of all things, made to a community groaning under empire. Not a pastoral bandage for individual pain. True. And devastating when used to rush someone past suffering they haven't been allowed to name yet. The church is deeply uncomfortable with anything that doesn't resolve cleanly. We are a resurrection people, which is good, but we skip too fast from Friday to Sunday and miss what happens in the valley in between. We want tidy testimonies, not ongoing darkness. We want healing stories, not chronic conditions. And mental health often falls into the latter.

I've lived inside that gap long enough to know exactly where it shows up most, and one of the clearest places is the church's relationship with medication and science. This is the anti-science, anti-medication strain that runs through so much of evangelical culture. The implication, sometimes stated, sometimes just hanging in the air, that medication is a lack of trust in God. That if you were really surrendered, you wouldn't need an antidepressant. That prayer should be sufficient.

I want to be direct about this: that theology has cost people their lives.

The brain is an organ. Bipolar disorder is not a faith failure. Depression is not a spiritual deficiency. Chemical imbalance is physiological, and a God who created neuroscience is not threatened by pharmacology. We would never tell a diabetic that insulin means they don't trust God enough. We need to stop saying the equivalent to people with mental illness.

Because the difference between those two responses is sometimes a matter of life and death.

I actually said something close to this in Season 1, back in that Episode 16 I just mentioned, when I was sitting in the middle of that crisis: 'Maybe right now our miracle is finding the right medication to help heal and stabilize a brain that needs it.' I believed it then. I believe it more now.

Here is what Scripture actually holds. I talked about this Psalm in a previous episode, but it earns repeating here. Psalm 88 is the only psalm in the entire psalter that does not turn toward hope at the end. It closes in darkness. "Darkness is my closest friend." That's the inspired Word of God, making space for suffering that doesn't lift on cue, grief that doesn't resolve by the final verse. The church that has never fully sat with Psalm 88 is not equipped for your family.

What the Church Is Unprepared For

I want to be careful here, because I don't think most of this is malice. I think it's unpreparedness. And that distinction matters, not to let the church off the hook, but because unpreparedness can be addressed. It can be changed.

Most pastors receive minimal, if any, mental health training in seminary. Most churches have no crisis protocol. No one knows what a 5150 is. No one has thought through what to do when someone discloses suicidal ideation in a small group, or what language to use with a family navigating a psychiatric hospitalization, or how to support a child whose trauma shows up as rage and defiance rather than tears.

So families learn quickly. We read the room. We sense the church has no container for our reality, and we get quiet. We come on Sunday, and we smile, and we answer "fine" when someone asks how we're doing, because the honest answer would make them uncomfortable, and we don't have the energy to manage their discomfort on top of everything else.

The shame that gets layered on top of an already unbearable situation is one of the church's most specific and underacknowledged harms.

Scripture gives us a perfect image for this in Job. Job's friends, when they first arrive, actually do something right. They sit with him in silence for seven days. No words. No explanations. No theological frameworks. Just presence. That was the right instinct. But then they start talking, and everything they say makes it worse. A good reminder for me tucked right into Job. Job’s friends’ theology is too small for what he is living. They keep trying to explain his suffering in ways that fit their categories, but none of them are adequate.

The church often becomes Job's friends. Well-meaning people with theological frameworks that cannot hold the complexity of what you're living. This isn't about pointing fingers. We've all been formed into ways of entering hard spaces that aren't actually helpful, trained to fix, to explain, to resolve. Nobody taught us to just stay. And that formation is what needs to change

There's another image in Mark 5 that I keep coming back to. The woman with the issue of blood. Twelve years of a condition that the religious system had no category for. Ceremonially unclean and isolated. She had spent every resource she had on systems that couldn't help her. She had to fight through a crowd just to get near Jesus.

And when she reaches him, Jesus stops. In the middle of a crowd, on his way to heal the daughter of a synagogue leader, someone with a name, with status, with access. In fact, he's on his way to perform his first resurrection miracle. And he stops. For her. The unnamed one. The unclean one. The one who had spent everything she had on systems that couldn't help her. He turns around. He makes her visible when the entire system had made her invisible. He calls her daughter.

That's not a healing formula. That's a posture. Stop. Turn. See. Name.

The resurrection can wait. She cannot.

That is what the church is called to practice with families like mine. Not fix. Not explain. Not resolve. Just stop long enough to see us.

The Justice Layer

There is something else we need to understand in this conversation: this is not just a pastoral care issue. It's a justice issue.

The families who bear the highest cost of the church's unpreparedness are not random. Kids from foster care and trauma backgrounds have disproportionate mental health needs and disproportionate barriers to getting help. My kids are not the exception. They are the pattern, a pattern created by systems of harm that the church often helped build and has rarely helped dismantle. If you want to go deeper on the neurological and developmental impact of childhood trauma, go back to Season 1 Episode 14. I did a full breakdown of ACEs there and what it does to a child's developing brain. That foundation lives there, if you want it.

But the weight of the church's unpreparedness doesn't fall equally. BIPOC communities, Black, Indigenous, and people of color, face compounded layers of stigma, both cultural and within predominantly white church spaces. The mental health conversation in most evangelical contexts is already coded toward white middle-class experiences of anxiety and burnout. The trauma of racial violence, generational poverty, and systemic oppression doesn't fit neatly into that framework.

Lower-income families often have no alternatives when the church fails them. The church is sometimes the only community infrastructure available. When it fails to show up, there is nothing behind it.

I also want to say something that might be uncomfortable for some of you. The church has often held up adoption as the heroic, happy answer to unwanted pregnancies and vulnerable children. We've made it a cause, a calling, a photo opportunity. And in doing so we've obscured some real and important questions, about what it costs children to be separated from biological family and culture, about transracial adoption and identity, about whose needs are actually being centered in that narrative.

I've been sitting with this for a while. Those of you who caught the 2025 Summer Snippets episode on adoption heard me say it plainly, I was part of the breakup of a family. I'm still reckoning with what that means. My sons' biological parents were unable to care for them, and I am grateful every day that they call me mom. And. I also have to sit with the complexity of what it meant for them to lose their first family, their culture, their origin story. Those two things are both true and I don't get to resolve the tension between them just because my intentions were good. I am still learning what it means to sit honestly with that.

Still, the hard reality comes. It almost always does.

Because the church doesn't know what to do with a child who doesn't behave the way a blessed family is supposed to look. We have no framework for rage that is actually grief, for defiance that is actually fear, for a child whose nervous system was shaped by experiences we don't have categories for. The child who doesn't fit our image of redemption makes us deeply uncomfortable, and so we go quiet or we blame the parents.

Jeremiah 8:11 names this: "They dress the wound of my people as though it were not serious. 'Peace, peace,' they say, when there is no peace." The prophetic tradition has always had language for the gap between shallow comfort and actual healing. 

Micah 6:8 asks what God requires of us: justice, mercy, and humility. What does doing justice look like when we're talking about mental health access? It looks like advocacy. It looks like funding. It looks like trained pastoral staff and church protocols, and not cutting the programs that serve the most vulnerable.

What We've Actually Needed

I'll speak personally for a moment.

What my family has needed from the church is not a formula. It's not a program, though better programs would help. It's people who are willing to stay. Who don't flinch when the answer to "how are you doing" is actually honest. Who can sit in the garage at 4:30 am without trying to fix it, and who will still be there six days later when it's hard again.

The loneliness of being the strong one is everpresent. I lead a podcast. I speak on stages. I teach on justice and faith. And I have sat in church spaces carrying things no one in the room knew about, because I learned, like my son learned, that hiding is safer. I am incredibly grateful to be a part of a church right now that gets it. A church with a pastor who is living a similar experience to mine. Sometimes the most healing place is to be able to tell someone the unspeakable thoughts that race through my brain and have someone say, “I get it.”

But we don’t all get that. If any of this is you today, you are not alone. And your struggle is not a failure of faith.

If you're a faith leader listening, the people in your congregation are doing the same thing. They are present and smiling and quietly drowning. If your theology has no room for Psalm 88, it has no room for families like mine. Your pastoral training needs to include crisis protocols. Your church culture needs to make it safe to tell the truth.

CLOSE

I want to close with an image from Ezekiel 37.

The valley of dry bones. Scattered. Disconnected. Lifeless. Unable to reconstitute themselves. And God asks the prophet: "Can these bones live?"

And then God re-members them. Sinew. Flesh. Breath.

That word, re-member, is doing something this season. To re-member is to put back together what has been scattered. What trauma scattered. What stigma scattered. What silence and shame and a church that didn't know what to do scattered.

God doesn’t ask the bones to pull themselves together before He enters the valley. God enters the valley first.

That is what a healing community is called to be. Not a place that fixes people before they're welcome. Not a place that hands out Bible verses and moves on. A community that enters the valley. That sweeps the hair off the garage floor and stays.

Mental Health Awareness Month is not a secular intrusion into sacred space. It is an invitation to recover something the church was always supposed to be.

Next week we close the season with Pentecost. The Spirit poured out on all flesh, all of it, including the parts that are still healing. I hope you don’t miss it.

And after that, this summer I'm doing something a little different. Researching, writing, and editing a podcast is a lot of work, especially when it is not a full-time job, so despite loving what I get to do, I am going to honor a little burnout. I'm doing something called Theology Unleashed, which will be short, fun, under-ten-minute episodes doing Greek and Hebrew word studies with my very theologically gifted and incredibly photogenic dogs. Justice-rooted, seminary-informed, and considerably less scripted than usual. It's going to be a fun summer.

And then this fall, The Reckoning Season. Season 4. We're going there. Just not yet. Some seasons need a little breathing room before you can reckon well. This summer is that space.

Until then, Jesus. Justice. No apologies.