‘Mad, bad, or possessed’? Perceptions of Self-Harm and Mental Illness in Evangelical Christian Communities

Mental illness within evangelical Christian communities is frequently stigmatised, with many attributing it exclusively to demonic possession, lack of faith, personal sin, or other negative spiritual influences. This study explores perceptions of self-harm in the context of evangelical Christian faith communities using the novel qualitative story completion task. A convenience sample of 101 UK-based evangelical Christians completed a third-person fictional story stem featuring a devout female Christian who self-harms. A contextualist informed thematic analysis was carried out focusing on perceptions of cause, cure, and treatment. Most stories positioned spiritual causes of mental illness (that is, demonic possession or personal sin) as harmful to the individual by rendering individuals as stigmatised objects or as socially displaced. The stories also provided insight into negative perceptions of females experiencing mental illness within evangelical communities. The stories suggested that these views often led to stigma and shame, which ultimately exacerbated illness and led to reduced help-seeking. Conversely, stories depicting the integration of relational care alongside spiritual resources frequently led to recovery. That the stories represented the need for relational support, within a spiritually syntonic framework, for recovery from mental illness highlights the limitations of a dichotomised approach to pastoral care. Methodologically, the study demonstrates the usefulness of a seldom-used tool within the pastoral psychology context – the story completion task – for accessing sociocultural discourses and wider representations surrounding stigmatised topics or populations.