When Should a Pastor Recommend a Psychiatrist?

Three Guidelines


Sometimes no matter how loving and supportive a pastor may be, the people who come to him need professional counseling. Dr. Mike Emlet, counselor and faculty member at Christian Counseling and Educational Foundation (CCEF), shares three general guidelines to help pastors determine if they should recommend a psychiatrist.


Mike practiced as a family physician for 12 years before joining the CCEF. He holds an M.D. from the University of Pennsylvania as well as a Master of Divinity degree from Westminster Theological Seminary. He has authored Asperger Syndrome, Help for the Caregiver, OCD, and Angry Children, and CrossTalk: Where Life & Scripture Meet.  



Mike said he typically sees two responses from pastors regarding psychiatric referrals: 
  1. They rarely, if ever, refer church members to psychiatrists.
  2. They dismiss people to a psychiatrist too quickly when their pastoral care and care from the church body could have sufficed. 
Mike recommends a middle, wiser, way.  

If you’re a pastor, have you ever wrestled with how to best care for someone who came to you for guidance? If so, what were the circumstances? What questions did you ask yourself?
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Mike offers three possible guidelines for when to refer a church member to a psychiatrist:

  • If he/she has bizarre, erratic behavior. This could be a sign of some kind of psychosis.
  • If the church member is suicidal.   
  • If he/she has been fairly receptive to biblical counsel and the church community but still shows signs of severe depression or various obsessions or compulsions.
Any of the above might be in need of medication or a professional psychiatrist for guidance. 

Have you ever referred someone to a psychiatrist who fit one of Dr. Emlet’s guidelines? How did that referral go?
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What benefits do you see, or have you experienced, in referring people to a psychiatrist?
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Do you know anyone who fits one of these descriptions now? If so, who are they? What are some conversations you can begin having to ultimately lead them to a psychiatrist?
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Pastors have a wonderful call on their lives. God calls them to shepherd people, share the gospel, and lead the church, amongst other things. This call is very different that that of a psychiatrist, though. God calls psychiatrists to use their education and training to help mentally ill people in a way that is more appropriate and helpful to them. As the body of Christ, both pastors and psychiatrists should feel free to work together to care for God’s people uniquely so that they can fulfill their callings and help the best they can. 


This video is a publication of the Christian Counseling & Educational Foundation (CCEF). All content is protected by copyright and may not be reproduced in any manner without written permission from CCEF. For more information on classes, materials, speaking events, distance education and other services, please visit www.ccef.org