A nationwide study in the United States reveals that pastors are counseling less, have fewer referral resources, and often feel isolated with personal struggles. Lifeway Research surveyed more than 1,500 evangelical and Black Protestant pastors, illustrating a shift in how faith leaders contribute to mental health care. The findings offer lessons for faith communities worldwide, including Thailand.
In Thailand, Buddhist monks and temple communities frequently serve as the first line of spiritual and emotional support, especially in rural areas where formal mental health care is limited. The American findings prompt Thai religious and community leaders to strengthen collaborations with professional services as demand for counseling grows and stigma around mental health persists.
The study shows that today’s pastors are less likely to have formal counseling training, less likely to refer congregants to mental health professionals, and less likely to nurture lay counseling programs inside churches than a decade ago. In 2015, about two-thirds of pastors reported having a trusted list of counselors; by 2025, this dropped to roughly half. Training patterns reflect a broader trend: fewer pastors hold graduate degrees in counseling, and fewer engage with conferences or relevant literature. Informal training has also declined; reading counseling books or articles fell from about 90% in 2015 to 81% in 2025.
A notable finding is the decline in referrals to mental health professionals. In 2015, 76% would refer after a few counseling sessions; by 2025, that figure stood at 72%. Smaller congregations show the steepest declines, while larger churches are more likely to offer referral lists and lay counseling programs. In churches with more than 250 attendees, 80% maintain referral lists, compared with 38% in the smallest congregations.
Reasons for these declines remain unclear. A Lifeway executive notes it is uncertain whether reduced professional development in counseling reflects intentional retreat or other competing priorities. Nevertheless, the trend leaves many pastors less prepared to address complex mental health needs within their communities.
Although the research centers on the United States, its implications resonate in Thailand. Thai authorities have started promoting collaboration between healthcare systems and Buddhist temples to bolster mental health support, particularly as depression and suicide rates rise. Training and willingness to refer individuals to professional care remain critical issues for temple communities and lay volunteers alike.
The study also highlights gender and generational differences. Male pastors are more likely than female pastors to have staff present when counseling someone of the opposite sex, reflecting institutional or cultural sensitivities. Age and regional patterns also influence these practices, paralleling dynamics seen in Thai Buddhist contexts, where guidelines often restrict private counseling of women by monks.
Despite declining referral and training rates, pastors value personal support networks. Most still meet monthly with someone to share their struggles—usually a spouse, another pastor, or a close friend. Yet these conversations are less frequent than in the past. Only about 9% meet with a counselor monthly. The executive director cautions that fewer pastors engaging in supportive relationships raises concerns for their well-being and service capacity.
For Thai readers, the emphasis on peer and personal support may echo concerns about isolation among religious leaders, amplified by disruptions to temple life during the pandemic. Without strong peer networks and access to professional guidance, both American and Thai faith leaders risk burnout and reduced ability to meet community mental health needs.
Cultural hesitation to refer outsiders for mental health care is not unique to the United States. In Thailand, stigma, trust in traditional spiritual solutions, and unfamiliarity with professional resources can hinder help-seeking. The overarching takeaway is clear: bridging spiritual and professional care through joint training and ongoing dialogue is essential.
Looking ahead, the report advocates renewed focus on counseling education and referral networks to equip religious leaders for increasingly complex social and personal challenges. This is especially important as modern life intensifies mental health pressures within faith communities.
Thai authorities, healthcare providers, and temple administrators can draw practical lessons from these findings. Expanding accessible counseling training for monks and temple volunteers, strengthening ties with mental health professionals, and encouraging leaders to acknowledge their own vulnerabilities will be crucial. Enabling appropriate referrals while maintaining spiritual guidance helps destigmatize mental health care and improves access, particularly in rural areas where temples may be the primary source of support.
For readers in Thailand, the message is universal: mental health issues require a broad network of support. Whether approaching a monk, a community leader, or a professional counselor, building bridges between traditional spiritual care and modern mental health services strengthens individuals and communities.