This title caught my eye because I am painfully aware through personal and family experience that churches have too often contributed to the suffering of people with mental illness, rather than relieving it. Christians have suggested that people with mental illness are complicit with demons, do not deserve burial within Christian cemeteries, lack faith to be healed, and many other subtle and overt forms of blaming the wounded for their own anguish and excluding them from the community they need.
The book’s introduction offers a concise description of the failings of Protestant Christianity to respond with compassion to people with mental illness. In the main section of the book, however, Heather Vacek focuses on exceptional individuals who reflected on the mental suffering they witnessed and took positive public action to alleviate it, motivated by their Christian faith. Her portraits of these individuals take care to place the person within the historical context of the day. Through these biographies, she portrays changing societal attitudes toward mental illness and evolving approaches to treatment throughout the course of American history, from colonial times to the present.
The final chapter “Conclusion: Suffering, Stigma, and Hospitality,” struck me as the heart of what the book has to offer to contemporary Christian communities. Here Vacek turns to consider how Christian congregations today can continue the legacy of the exemplary leaders she has described. She notes that although these influential individuals have truly had a lasting impact on mental health treatment in public life, “their dedicated efforts failed to refashion congregational practice” (172).
Offering a way forward, Vacek calls congregations to practice Christian hospitality, a hospitality that “draws together guests and hosts into relationships of mutuality with one another and with God in Christ” (173). She outlines the role of stigma in intensifying suffering, noting that “in the face of being stigmatized by association, congregations prove reluctant to risk care for those suffering from mental illness (168)”. When they withdraw from those who suffer, they lose coherence between a belief in Christian mercy and practice marked, instead, by indifference.
Yet, Vacek asserts, “Christians possess the resources and the power not only to reshape their practices but also to alter views of those around in their midst” (169). Cognizant of the risks and consequences of resisting societal norms, Vacek outlines four acts that hospitality requires: welcome, compassion, incorporation, patience. With each of these acts, Vacek gives concrete examples and a theological vision for what these practices can accomplish.
I recommend this book, and especially its final chapter, to pastors and church leaders who are seeking to reflect on and develop a congregation’s ministry among people with mental illnesses, whether they be church members or strangers. It will also appeal to readers with an interest in the history of American mental health attitudes and practices, or, more generally, the history of Christian influences on American society.
Purchase from the publisher.

Christine Guth is Program Director for Anabaptist Disabilities Network.