Psychiatrists, Psychologists, Psychotherapists: Are You Referring to the Right People?

In 2014, Lifeway Research and Focus on the Family partnered on a project called “Study of Acute Mental Illness and Christian Faith.” This research project yielded many interesting and important insights into the current response to mental illness within churches, and some of their findings confirmed the results of my own (far less formal) research, whose findings I reported in my book Troubled Minds.

Among the results was this interesting discrepancy: When asked whether their churches “maintain lists of experts to refer people to” for mental health care, 68 percent of Protestant pastors said yes. But among family members of people living with acute mental illness, only 28 percent said yes. This suggests many churches have lists their congregations (or at least the people within their congregations who most need them) don’t know about. This is a problem.

But there’s another problem with some of those lists. In conversations with various church leaders and people in congregations, it’s become clear to me that many people create these lists haphazardly, without a real understanding of the differences between various types of mental health professionals. To some, the Christian counselor in the congregation looks the same as the psychologist across town or the psychiatrist at the hospital. But these are very different professionals with dramatically different qualifications and specialties. Furthermore, individual practitioners tend to specialize within their areas of expertise, so, for example, a therapist who focuses on generalized depression and anxiety would not necessarily be the best referral for someone with an eating disorder.

These professionals know how they differ from each other, and most are willing to acknowledge their limitations, make new referrals, and encourage people to find the right kind of care. But it’s much more helpful if churches who make referrals can send most people to the right place from the beginning.

Mental health care is the kind of thing most people don’t know much about until they need it–for themselves or someone they love. And in that time of crisis, churches are the first place many people go for help–in fact, clergy are the number-one place people have gone for help with mental illness. Unfortunately, churches aren’t always providing the referrals to professional care that many people need–but many do. And if churches are serving in this role as front-line triage centers for mental health care, we really ought to take this responsibility seriously. One way to do so is to understand the differences between professionals.

I encourage you to get more (and better) information somewhere else, but here’s a starting primer:

Social workers have masters degrees. They are qualified to provide counseling and care for emotional difficulties and problem-solving. They also often serve as case workers or case managers, addressing circumstances that threaten people’s well-being, especially helping establish healthier and safer environments for vulnerable people.

Qualified counselors also have masters degrees. They help clients work through difficulties of various kinds, and they typically focus on addressing a specific area of life that needs a solution or a new approach. They help people with emotional difficulties, coping strategies, and finding new ways to look at life.

Psychotherapists can have masters or doctoral degrees. Many counselors provide psychotherapy in addition to counseling, simply employing different techniques. Some are trained in specific methods and focus on providing therapy for certain issues, such as trauma, grief, diagnosable mental disorders, and self-destructive patterns. Therapy focuses more deeply on the root causes of dysfunction and strives to help clients find healing and build healthy and productive lives.

Psychologists have doctorate degrees in psychology. Some psychologists don’t do therapeutic work at all, focusing instead on research and study or on improving workplaces or other organizations. Some work with clients in clinical settings, and they are qualified to do psychotherapy and to diagnose and treat all forms of mental health problems. However, they cannot prescribe medication.

Psychiatrists also have doctorate degrees, specifically in medicine. They are licensed medical doctors who specialize in psychiatric medicine. Psychiatrists, like other medical doctors, can prescribe and manage medications for their patients. They might choose specialties, such as child psychiatry or forensic psychiatry.

This list doesn’t cover every possible specialty or profession, and these categories all contain subsets (such as neuropsychiatrists and neuropsychologists). But this basic list provides a starting point for the main distinctions every church should understand.

Churches who want to be equipped with referrals for people who need them must do more than simply write down a list of names they’ve heard or people who happen to attend their church. They really need to do more homework and include a variety of people who can provide mental health care, including people in different professions and with a variety of specialties. Some communities have more available than others, and we face a serious shortage of mental health care professionals, particularly psychiatrists. But I don’t think we can justify a failure to do our best on behalf of people who come to our churches for hope and help. A few hours of research could make a huge difference to someone in crisis.









