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Some Christian communities may understand mental illness as the result of spiritual causes, such as sin, demons, or a lack of faith. Such perceptions are likely to influence how Christian individuals conceptualise and experience their mental health and enact help-seeking behaviours. This study explores perceptions of depression and mental health help-seeking in evangelical Christianity by using a novel qualitative story completion task. A convenience sample of 110 Christian participants from the United Kingdom completed a third-person, fictional story stem featuring a male with depression who entered his local church. A contextualist-informed thematic analysis illustrated how the disclosure of depression was represented as eliciting negative social reactions, potentially rendering individuals with depression as socially dislocated. Stories suggested that, increasingly, evangelical Christians may perceive a spiritualisation of mental illness, which negates reference to psychological, social, and biomedical representations, as unhelpful. Findings reveal the risks of a solely spiritual aetiology of depression and highlight how existing mental ill-health can be exacerbated if fundamentalist beliefs and approaches to therapeutic care are prioritised over holistic models of care. Methodologically, this study demonstrates the value of a rarely-used tool in psychology—the story completion task—for examining socio-cultural discourses and dominant meanings surrounding stigmatised topics or populations.

Seeking professional help for psychological distress is generally associated with improved outcomes and lower levels of distress. Given the saliency of religious teachings, it has been shown that aspects of Christian belief may influence adherents’ attitudes towards mental health help-seeking. Based on existing research on American Evangelicals, it was hypothesised that religious social support would positively predict attitudes towards mental health help-seeking, whilst fundamentalism, mental distress, and the belief that psychopathology is caused by immoral or sinful living would negatively predict participants’ attitudes. On a convenience sample of 252 British Evangelicals, our hypotheses were supported and these variables significantly predicted participants’ attitudes towards seeking mental health help, F(7,243) = 9.64, p < 0.001, R2 = 0.195. These findings together suggest that whilst religious support positively predicts help-seeking attitudes, Evangelical fundamentalism, in addition to beliefs that mental illness has a spiritual cause, as well as experiences of mental distress may be associated with more negative attitudes towards psychotherapeutic intervention. Thus, mental health practitioners should be aware of clients’ religious worldviews and tailor interventions appropriately, acknowledging that working with religious organisations may yield the most positive outcomes for patients.

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