by Elizabeth Joy Redekop
Leaders on the mission field have been given one of the highest honors. We are entrusted to make decisions for, care for, and shepherd God’s children, all to make God’s name known to all people! It’s a role of great influence. How are you influencing your team? How can you care well for the people under your leadership?
The reality is missionaries are not superhuman and mental health does not discriminate. Due to the nature of a life in missions (high number of transitions, increased risk of exposure to trauma and crisis, visa difficulties, etc), it is important that we understand how to cultivate health and resilience in ourselves and our teams. Stressors on the field look different for everyone and so can the signs of burnout, depression, anxiety, cross-cultural stress, etc. However, there are signs that are commonly seen in individuals struggling with their mental health. If we pay attention, we may be able to offer care and support to these individuals before they hit a crisis point. To help us in this endeavor, we’ll look at three of the most common mental health challenges for missionaries on the field: cross-cultural stress, depression, and burnout.
Cross-Cultural Stress
Cross-cultural stress (CCS) is the stress we experience when changing from one way of life to a new culture with an unfamiliar way of life (new customs, new language, etc). Often, your “common sense” does not work anymore and you must create a new grid for functioning in this new society. Clashes of values and communication styles also contribute to CCS. Additionally, many missionaries must straddle two cultures simultaneously – the culture of the host country and the culture of the YWAM community. When working on an international team, there are many layers to CCS as everyone brings their own cultural framework.
CCS is felt at different times for different people and often comes in waves. The first wave may hit immediately upon arrival in a new culture, or maybe you experience excitement about this new adventure, and then a month in, when you’ve been reprimanded a few times for your cultural faux pas, the first wave hits. CCS, unlike culture shock, can last for years with spikes in severity during the first 1-2 years. It commonly presents as anxiety (especially over tasks that you would generally find easy), confusion, insecurity, helplessness, tiredness, and a lack of joy and/or motivation. It also can lead to feelings of hostility towards God or the host country, anger, irritability, impatience, lack of creativity, and loss of capacity.
So how do we support our staff when they experience CCS? A good first step is to educate your YWAM community about CCS and how to manage it – this is especially helpful for staff in their first year on the field. Staff will be better equipped to recognise CCS and give vocabulary to identify and name what they are feeling. Remind them that it is a normal and inevitable experience and will get easier to manage with time. Regularly check in to see how staff are doing, create a safe space for them to share the hard or confusing experiences they are having. Encourage staff to not neglect the activities they love, like watching a favorite movie, going for a hike, running, sewing, reading, making a meal from their home country, planning a special Sabbath activity, etc. Call out their strengths and affirm them in what they are doing well and how they are adapting. Remind them that it takes time to adapt and it can’t be rushed. However, if someone’s symptoms of CCS consistently and significantly impair their quality of life for more than six months, then more steps (i.e. involving a member care provider or therapist) should be taken to provide extra support and care.
Depression
According to 2015 research, nearly one-third of missionaries report experiencing depression. Depression involves on-going loss of motivation, interest or pleasure in activities for a long period of time, and generally affects all aspects of life. We must be careful not to confuse depression with symptoms of other mental health challenges such as stress, anxiety and cross cultural stress. Depression stands out by showing many symptoms, over a long period of time, with regularity (meaning nearly everyday for most of the day) for at least a two week period.
Symptoms look like the following: negative self-talk; irregular sleep patterns; feeling sad, depressed, or empty; drastic changes in eating; fatigue; feelings of worthlessness; decreased ability to think clearly and make decisions; increased irritability or short-temperedness; thoughts of death and/or suicide. There are many reasons why someone may fall into depression including a slow and steady increase of environmental stressors, lack of social support, major life transitions, unfulfilled expectations, a major traumatic event, events that trigger past negative events, etc.
As missionaries working in cross-cultural settings, we are often experiencing a myriad of stressors like CCS, as discussed above, loss of social support, unfulfilled expectations by our new ministry or team not going as expected.
If you see signs of depression in yourself or your staff there are ways you can offer support by rehearsing positive self-talk, affirmations, journaling, going into nature, listening to relaxing music, speaking with a trusted friend or leader, setting realistic goals, or changing one’s routine. By reaching out to the YWAM Europe Member Care Resource Team (MCRT) you can access depression assessment inventories and connect with a professional about recommended action steps based on the needs of the individual. While some self-help approaches may be helpful for some mild cases, depression is best treated by speaking with a professional for a varying range of time and sometimes requires medical treatment.
Burnout
Burnout is so important to understand as it has become a catchall for a number of mental health complaints due to its signs and symptoms being similar to those of compassion fatigue, depression, unprocessed grief, CCS, and fatigue from overwork. Burnout actually has little to do with how much we work and more to do with how we work. Dr. Alessandra Pigni, author of The Idealist’s Survival Kit describes it as “a state of exhaustion in which one is cynical about the value of one’s occupation and doubtful of one’s capacity to perform.” That cynicism is often a mask we use in burnout to cover our disappointment, pain, helplessness, disillusionment and despair.
Burnout is a common occurrence among those in helping professions because the needs of those around us never stop. In addition to that, as missionaries, there is often an expectation to sacrifice our own needs and desires for the sake of the team/community and in order for the Gospel to go forth. There is so much care and dedication to the mission and the needs of the other that personal health and needs are often neglected. With all good intentions, we risk preaching and living self-sacrifice to the extreme and ignore the model of work, rest and recovery that Jesus lived.
There are a number of contributing factors to burnout, some personal and some structural (ie how the community functions). Personal factors include perfectionism, 24/7 availability, self-worth tied to what we do, unrealistic expectations, fear of showing weakness, and a romanticized view of missions and ministry. Structural factors include a culture or idolatry of busyness, unclear role descriptions, little to no training for your role, lack of control in your own work or home, micromanagement from leaders, little to no value for certain giftings, lack of trust or support from leaders and peers, and if there is no room for mistakes, questions or grief. Ultimately, a team that lacks trust, care, incentives, fun, and mutual respect is guaranteed to cultivate a culture of burnout.
The good news is that burnout is not inevitable! We don’t have to burn out to learn how to live in a healthy way. In fact, if your community experiences a high number of staff leaving before the end of their commitment due to exhaustion, depression or burnout, then that is a great opportunity to examine and reflect on how your team operates and identify what are some structural factors that may be contributing to a frequent turnover in your staff. Other ways to cultivate resilience is to take sabbaticals, get regular, personal debriefs, allow yourself to grieve what needs to be grieved, and prayerfully maintain healthy boundaries.
While burnout is avoidable, there is still a high number of us that have experienced it. If you or someone in your team is experiencing signs of burnout, then it should be taken seriously. Warning signs can look like an imbalance of relationships where you give and not receive support; distancing yourself emotionally from those you serve; feelings of apathy or cynicism about the effectiveness of your work or organization; persistent fatigue; confusion; inability to make decisions; sleep disturbances; feeling trapped; etc. Burnout can lead to serious consequences such as medical intervention and even hospitalization. The YWAM Europe MCRT has burnout inventories, assessments and other resources that can help identify burnout (or the potential of it) and help implement changes to reverse burnout as well as help you find counselors or therapists trained in burnout recovery.
In conclusion, mental health challenges are not a sign of spiritual immaturity, it is not a metric for closeness to God, and it is not something to be shamed or ashamed of. It is simply another symptom of the fallen world we live in, and until we experience God’s kingdom on earth as it is in Heaven, we will wrestle with these challenges.
Let’s not shy away from the uncomfortable topics, but rather get used to talking about them, because mental health is relevant to missionaries and to those we are serving – in our teams, schools, ministries, and on the streets. If we really want to see God’s kingdom come quickly, we need holistically healthy missionaries on the field.
Sources
Koteskey, R. L. (2017). What missionaries ought to know: A handbook for life and service. New Hope International Ministries.
Pigni, Alessandra (2016). The Idealist’s Survival Kit: 75 Simple Ways to Avoid Burnout. Parallax Press.
Schaefer, C. A., Schaefer F. C. (2012). Trauma and Resilience, a Handbook: Effectively Serving Those Who Serve God. Frauke C. Shaefer, MD, Inc.
Strand, M. A., Pinkston, L. M., Chen, A. I., & Richardson, J. W. (2015). “Mental Health of Cross-Cultural Healthcare Missionaries”. Journal of Psychology and Theology, 43(4), 283-293. https://doi.org/10.1177/009164711504300406
Elizabeth “Joy” Redekop earned a bachelor’s degree in Psychology and a Master’s in Clinical Social Work where she received training on trauma informed care, one-on-one counseling, case management, and mental health services, specializing in children and families. Joy’s professional work experience includes case management for homeless families and battered women and children seeking emergency shelter and counseling, as well as house supervisor for woman with histories of drug abuse and homelessness. Joy also has experience writing curriculum for after school programs for low-income and homeless children, teaching practical skills as well as proving psycho-social support. Joining YWAM in 2020, Joy has served with YWAM in Greece, the Middle East, Ukraine, and Germany. Through this, Joy has worked with YWAM in several refugee camps in Europe and the Middle East, utilizing her Social Work training while working with refugees of war and violence. Joy has trained others in trauma informed care, managing stress, caring for children in crisis, and processing trauma. Currently Joy is serving with YWAM Berlin in Germany as well as with the YWAM Europe MCRT.
