In April 2013, 27-year-old Matthew Warren tragically took his own life, after a lifelong struggle with mental illness. While such incidences may seem unremarkable due to their sad frequency, Warren was the much-loved son of Rick and Kay Warren, the pastors of Saddleback Church in California.

Along with the wave of inevitable grief, the untimely passing of Matthew Warren triggered a long overdue conversation in American Evangelical circles, around the crucial question: how does the church best support those who live with mental illness?

Various responses have been given, arising from theological reflections on the nature and role of suffering, healing, personhood and community.

For Kay Warren, this conversation has led to the creation of a "place of refuge, love and compassion for those who need it most."

This week, Saddleback Church is hosting the Gathering on Mental Health and the Church, a two-day conference that brings together clergy and mental health professionals, with the aim of providing practical support and training to Christians around the area of mental illness.

Such responses are heartening, for several reasons. Firstly, as Stanford and McAllister argue, "clergy, not psychologists or other mental health professionals, are the most common source of help sought in times of psychological distress." Hence, while clergy often claim that their role is predominantly one of spiritual support, the statistical reality of mental illness suggests that they cannot afford to forgo training in this area. This is not only a matter of providing good pastoral care - but also often of meeting their duty of care obligations.

Secondly, such conferences are encouraging because they demonstrate that many clergy are no longer separating spiritual wellbeing from other aspects of health. Recognition of the inter-relatedness of wellbeing demonstrates that many American Evangelicals legitimise the complex and nuanced nature of mental illness - and that ministry should involve a holistic understanding of the person.

One of the obvious implications is that while there is an increasing adoption of holism, there is still a breadth of theological interpretation across the ecumenical Christian community, resulting in varied responses to mental illness. Too often, the issue is that our theology has not led to an integrated understanding of the person, leading to several problematic outcomes.

One major outcome is that clergy simply refer congregants to external services without further support when mental illness becomes apparent. Sadly, this is in line with Matthew Stanford's finding that 60% of people who had a negative experience with the church during a period of mental illness simply experienced a lack of support or abandonment. However, of the remaining 40% that had a negative experience, Stanford states that 21% were told by their church that they were demonised, whereas 19% were told that their situation resulted from a lack of faith.

This highlights another problematic outcome: when clergy lack an integrated understanding of the person, they are more likely to misinterpret mental illness solely through the lens of spirituality and thus "treat" the person themselves with spiritual tools such as prayer, scripture and confession. The result, of course, is that the biological and psychological causes of mental illness are not addressed - and clergy themselves often experience burnout in trying to manage situations they have minimal training for.

In identifying the Christian communities that are more susceptible to these outcomes, Robert Taylor et al. suggest that theologically progressive clergy are more likely to refer to professional assistance, while those with more conservative convictions are likely to keep responses "in house." There is, however, an obvious issue here: "conservative" is not clearly defined. Within the Australian context, for instance, the label of "theologically conservative" might apply equally to the Catholic community, as well as Evangelicals, or Pentecostals - but a variance in theological beliefs and practices between and within these three movements surely nuances pastoral responses to mental illness.

In a focused study that further clarifies the issue, Jennifer Shepherd Payne delineates a distinct difference between the attitudes of mainline Protestants and the Pentecostal community when it comes to mental illness. Specifically:

"Mainline Protestants were more likely to view depression in line with mental health professionals; they were more likely to see depression as having a biological component, and more likely to see it as being separate from a religious issue. Pentecostals in particular were more likely to view depression as an issue that depends on the situation and felt depression was strongly influenced by spiritual causes."

Such perspectives are not particularly unique. When it comes to Pentecostals, Shepherd Payne's assertions corroborate the findings of other studies. In particular, Stanford and McAllister suggest that Christians in "Spirit-filled" churches - that is, conservative congregations with Pentecostal and Charismatic leanings - are more likely to view mental illness as a predominantly spiritual issue, resulting in a dismissal of medical diagnoses that a person may have received.

Theologically, it could be argued that this response reflects a dualistic soul/body rendering of personhood (where the mind is perhaps considered part of the "soul"). This may be compounded by a central belief in these settings that the Holy Spirit is present and active, and expected to bring miraculous healing that defies medical explanation - and that, in fact, miraculous interventions are superior to medical interventions, because they provide an evangelistic opportunity.

In truth, however, contemporary expressions of Pentecostal-Charismatic spirituality are not as straightforward - and never have been. In elucidating this, James K.A. Smith argues that rather than looking for doctrinal definitions that underpin practices, we are better to use the lens of the "Pentecostal worldview," which challenges modern epistemologies separating reason and experience - that one's knowledge and experience of God are inseparably integrated, through the ongoing, tangible presence and work of the Spirit. This shift away from doctrinal definition leaves a lot of room for theological variations, and it recognises that Charismatic expressions over time have also been incorporated in different ways within more traditional Evangelical and Catholic settings.

The ultimate consequence of this, of course, is that Pentecostal-Charismatic responses to mental illness cannot be generalised. While there are many instances of Pentecostals causing harm due to narrowly viewing mental illness as a spiritual issue, there are also many who recognise the role of medical and psychological assistance and actively work with appropriate external services to ensure the proper care of their congregants.

Indeed, where resources are available, many Australian Pentecostal congregations have set up spaces to facilitate medical and psychological services within their congregations and local communities. These may not be as extensive or as well known as the excellent work of the Salvation Army or Uniting Care, but this may be because Pentecostal and Charismatic denominational structures tend to be more autonomous and decentralised. Nevertheless, the existence of such spaces reinforces the observation of Donald Miller and Tetsunao Yamamori that in the last decade, there has been an emerging social conscience among many Pentecostals, resulting in targeted ministries to meet practical needs.

This does not negate the still present need for ongoing pastoral and lay training, however. It could be assumed that a "Pentecostal worldview" should lead to a balanced, integrated understanding of intellect and affections when it comes to pastoral ministry - particularly with issues like mental illness. Yet, because Pentecostals and Charismatics highly value the empowerment of the Spirit as the main means of ministry and witness, the role of training and education can sometimes be downplayed as stifling the work of the Spirit.

Most obviously, this is reflected in the ordination education requirements for many Australian Pentecostal denominations, which are comparatively less than Evangelical circles. This is compounded by an understanding that ordination serves as a means of affirming one's established ministry - and so, it is often acceptable for pastoral care to be undertaken by those not recognised denominationally in a position of authority. Consequently, while attitudes regarding mental illness may be shifting in Pentecostal and Charismatic congregations to include medical and psychological factors, many pastors and lay leaders are entering roles of ministry ill-equipped to care appropriately for those with mental illness.

That said, Pentecostals cannot be singled out as the only Christians lacking adequate training. While Evangelical contexts often require three-to-four years of degree level study to obtain ordination, the focus of study is often centred on an intense program of biblical study, languages, doctrine and systematic theology, which reflects an understanding of the minister's role to predominantly lead the congregation through sound teaching. While many denominational structures often provide policies on how to address mental health concerns, foundational training in the area of mental illness - as well as other pastoral skills - may still be lacking, leading to ministers being underprepared when they engage in parish ministry.

Overall, there is a dire need for all church communities and theological institutions to address this issue more closely. In the process of ordination, denominations need to ensure that educational requirements include appropriate pastoral training to deal with complex issues like mental illness. Furthermore, theological colleges responsible for training pastors need to ensure that their programs provide ample space for foundational training in this area. Yet, this alone is not enough, as it only captures those who are currently preparing for ordination.

For the many who are already engaged in ministry - whether ordained or not - opportunities for ongoing professional development certainly need to be provided, and in a format that is accessible. With many theological institutions utilising online learning platforms, there is a potential opportunity for them to further serve denominations by developing short courses on holistic mental health ministry that could be made available, regardless of location or time availability. This also ensures that courses are contextually appropriate for different denominational settings.

However, because training is not as much of a priority within many settings, denominations also need to ensure appropriate incentives are provided for those who engage in training. In many cases, theological institutions across Australia provide vocational training in basic chaplaincy skills that may complement a more rigorous theological training - and the incentive of adding a Certificate IV or Diploma to one's resume may be attractive. But when such courses are not logistically possible due to time restraints or location, shorter programs like Mental Health First Aid can also be beneficial, as they can work with the schedule of pastors, while still providing some recognition for training undertaken.

Still, there is a long way to go. While mental health training is readily available, much needs to be done to address the unbalanced theological underpinnings within congregations that may shape unhelpful attitudes and responses to those with mental illness. What is needed is a well-rounded understanding that God works through both the spiritual and the medical and psychological.

This calls us to reflect afresh upon our understanding of personhood, healing, and care. In doing so, we will find ourselves more open to collaboration with those in the community who can assist us in caring for others - and as a result, will find that St. Paul's charge to the Romans might become a lived reality: "be transformed by the renewing of your mind."

Greta Wells is an Associate Lecturer in Pastoral Ministry at Alphacrucis College, the national training college for Australian Christian Churches (formerly Assemblies of God in Australia). Her Masters of Theology research focused upon the attitudes of Australian Pentecostal pastors, regarding anxiety disorders.