A new nationwide study reveals that pastors, traditionally seen as frontline counselors in their communities, are now providing less counseling than a decade ago, have fewer resources for referrals, and are increasingly isolated with their own struggles. The Lifeway Research survey, involving over 1,500 evangelical and Black Protestant pastors across the United States, underscores an important shift in how spiritual leaders participate in mental health care—a development with broad implications for faith communities worldwide, including Thailand.
This trend is particularly significant for Thai readers interested in the intersection of faith and mental health. In Thailand, Buddhist monks and temple communities often play a comparable role in spiritual and psychological support, especially in rural areas where mental health resources can be limited. Examining how American pastors navigate these challenges may provide valuable insights for Thai religious and community leaders as demand for qualified counseling grows and mental health stigma lingers.
According to the study, today’s pastors are less likely to be trained in counseling, less likely to refer congregation members to professional mental health providers, and less likely to foster lay counseling ministries within their churches than they were just ten years ago. In 2015, two-thirds (67%) of pastors had a list of trusted counselors on hand for referrals. By 2025, that number had fallen sharply to almost half (52%). This downward trend was echoed in other areas: fewer churches maintain lay counseling ministries, and fewer pastors are attending counseling conferences or keeping up with literature on counseling. Only 9% of pastors have a graduate degree in counseling, a rate that has not grown over the past decade, and fewer pastors are supplementing formal training with conferences or books—down from 64% attending in 2015 to under half (48%) in 2025. Even informal training is slipping: nearly 90% of pastors read counseling books or articles in 2015, but that has dropped to 81% in 2025.
One of the most striking findings is pastors’ growing hesitancy to refer church members to mental health professionals. In 2015, 76% of pastors would refer a person to a specialist after a couple of counseling sessions; by 2025, that number is down to 72%. The decrease is most stark among pastors leading smaller congregations, where only a minority maintain referral lists or robust lay counseling programs. Larger churches remain more likely to offer these supports—80% of pastors at churches with more than 250 attendees have referral lists, compared to just 38% among the smallest congregations.
The reasons behind these declines, according to Lifeway Research executive director, are not entirely clear: “It is unclear if the lower rates of professional development in the area of counseling among pastors have been an intentional retreat or the unintentional distraction of other priorities.” However, the impact is clear—pastors are less prepared to handle the complex mental health needs presented by their congregations.
While the study focused on the US context, its findings reverberate in Thai society, where temples often form the heart of both spiritual and emotional care in villages and cities alike. Recent years have seen Thai authorities encourage collaboration between healthcare systems and Buddhist temples to expand mental health support, particularly as the country faces rising rates of depression and suicide (World Health Organization, 2022). As in the US, training and willingness to refer community members to professional mental health care remain pressing issues for the monastic community and lay volunteers.
The American research also highlights important gender and generational differences. Male pastors are considerably more likely than female pastors to have a staff member present when counseling someone of the opposite sex (79% vs 47%), perhaps reflecting differing institutional guidelines or cultural sensitivities. Pastors aged 45–54, as well as those serving in the southern US, were among the most likely to follow this practice. This echoes broader distrust or discomfort with cross-gender counseling that may exist across faith traditions, including in Thai Buddhist settings, where guidelines restrict monks from private counseling of women.
Despite the decreasing rates of referral and training, pastors still express the importance of personal support networks. Most report meeting with someone to share their struggles each month—most often their spouse, another pastor, or a close friend. Yet, these interactions are becoming less common. The percentage of pastors confiding in their spouse fell from 90% in 2015 to 74% in 2025; those sharing with a close friend dropped from 74% to 60%, and sharing with another pastor from 71% to 60%. Only 9% meet with a counselor monthly. As the Lifeway Research executive director notes, “It is concerning to see fewer and fewer pastors engaging in relationships that help them with their struggles.”
For Thai readers, this decline in collegial and personal support may resonate with growing concerns about isolation among Thai religious leaders, particularly in the wake of the COVID-19 pandemic, when monasteries and spiritual gatherings faced disruption (Bangkok Post, 2023). Without sufficient peer and professional support, both American and Thai religious leaders risk greater burnout and diminished capacity to serve their communities’ mental health needs.
From a cultural standpoint, the reluctance to refer congregants to outside professionals is not unique to the US. In Thailand, there can be reluctance to seek help outside the temple for psychological issues due to stigma, trust in traditional spiritual solutions, or unfamiliarity with professional mental health resources. Both contexts demonstrate the need for bridges between spiritual and professional care—whether through joint training, partnerships, or ongoing dialogue between religious and medical institutions.
Looking ahead, the report suggests that without renewed emphasis on counseling education and referral resources, pastors (and by extension, religious leaders elsewhere) will be less equipped to effectively support their communities through increasingly complicated personal and social challenges. The situation is exacerbated as more complex mental health issues, exacerbated by modern life pressures, reach the doors of faith communities.
Thai authorities, healthcare providers, and temple administrators could learn from these findings. Proactive steps might include expanding accessible counseling training for monks and temple volunteers, building stronger networks with mental health professionals, and encouraging leaders to acknowledge their own vulnerabilities. Ensuring religious leaders can refer individuals to qualified professionals—while still offering spiritual support—will be crucial in destigmatizing mental health care and closing gaps in services, especially in rural areas where temples may be the only source of help.
For ordinary Thai readers, the lesson is equally relevant: Mental health struggles are complex and require a network of support. Whether seeking help from a monk, community leader, or professional counselor, openness to building bridges between traditional spiritual support and modern mental health services will strengthen both individuals and communities.
For further insights, the complete study and its methodology are available at Lifeway Research, with additional context from recent Bangkok Post and World Health Organization in Thailand reports underscoring global trends in religious responses to mental health.
Thai communities—and faith leaders—are encouraged to support ongoing education and collaboration across spiritual and medical domains, to better prepare for the rising tide of mental health needs.