Practical Insights for Leading Worship

How to Be Inclusive of Persons with Mental Illnesses

The language we use to speak about mental illnesses and persons with mental illnesses needs to be respectful and non-stigmatizing, and it must honor the dignity of persons as image-bearers of God. Dr. Charlotte vanOyen Witvliet’s article in this issue includes a discussion of the use of language when talking about mental illnesses (p. 13). This article provides even more specific examples. The language we use in worship should be pastoral and minister to the concerns of people with mental illnesses and others who live with distress. Pastoral language ministers broadly to people in different circumstances.

During a long period of depression, I found worship to be both difficult and healing. I wrestled with whether I had to hide my depression so I looked like a cheerful Christian, or whether there was space for my brokenness. People would often ask empathetically, “How are you doing?” A brief encounter at worship is not an easy time to answer that question. People often respond with the obligatory “fine.” A brief hug or hand squeeze with “I’m thinking of you and praying for you” removes the pressure of deciding how honest one should be.

Worship can also be healing. The creative, healing power of God in worship is a mystery. The Holy Spirit might use a phrase from a song, Scripture, or sermon to touch the pain or to give hope. We can’t orchestrate how the Holy Spirit will work, but sensitive worship planning can cooperate with the work of the Spirit.

Here are practical ideas for different elements of worship that can stimulate your own creative planning.

Welcome/Call to Worship

Usually we think of opening the service with robust praise. But it is helpful at times to recognize the different ways people approach worship. Perhaps try beginning worship with the following: “As we gather to worship this morning, we come from various places and situations. We come with our anxieties, our doubts, and our fears. And God meets us where we are. God comes to us—offering us rest, hope, and peace. Let us come to him.”

The creative, healing power of God in worship is a mystery.

Confession and Renewal

During times of distress, people often have negative ways of perceiving themselves. Honest confession gives voice to our broken perceptions. For example: “Forgive us, O God, when we see ourselves with little value, when we wonder why you created us or what you see in us. Remind us that we are fearfully and wonderfully made, that your love for us is long and wide, deep and high, and that you will never let us go.”

The assurance of pardon can emphasize the extent of God’s great love for us and how Christ makes us new creations.


Music with accompanying words can minister to us at a deep level, and a phrase or a tune can stay with us for days. Include songs that recognize difficulties and brokenness, that speak of God’s healing power, and that minister to our brokenness. The hymn “We Cannot Measure How You Heal” Bell, LUYH 446, SNC 69, WR 628 is a powerful prayer for healing.

Pastoral Prayer

It’s appropriate to mention mental illnesses along with physical illnesses. Broad mention of anxiety, depression, and other concerns will apply to people with specific diagnoses and those who live with general mental health concerns. For example: “Give patience and strength to all who live with physical and mental illnesses. Give hope to family and loved ones who walk alongside them.” And “Loving God, you are always near to us, especially when we are weak, suffering, and vulnerable. Reach out to those who experience mental illnesses. Lift their burdens, calm their anxiety, and quiet their fears. Surround them with your healing presence. Bless them with skills and strengths as they recover.”

(Portions of this prayer were taken from the Catholic Health Association of the United States. Used by permission.)

Prayer for Suicide Prevention

Every time we gather there will likely be one or more persons contemplating or feeling the effects of suicide. While this prayer is always appropriate, you might want to consider its use during Suicide Prevention Week (second week in September in the U.S.), Mental Health Awareness Month (May, U.S.), Mental Health Awareness Week (first week in October, Canada), Mental Health Week (second week of May, Canada), or World Suicide Prevention Day (September 10, 2018):

God, we celebrate the gift of life for each person.
We commit to nurturing the well-being of each person here.

We know for some, life is a burden filled with suffering.
Help us to talk about our fears, our anger, and our despair with someone we trust.

We celebrate that life has purpose and meaning.
For some, purpose and meaning are like dry bones, dead and lifeless.
Remind us that You know us by name.
You know our place and purpose in this world.
We belong to you.

We are created to live in community.
Some feel alone, unloved, and disconnected.
Give us courage to reach out with love to someone who needs us.
May we be Your presence with them.
Teach us to be gentle and non-judgmental.

We remember those who ended their life before it was time.
Comfort those who grieve and bring healing.

In the name of Jesus, who gives life and who heals. Amen.

—Cindy Holtrop, “Prayer for Suicide Prevention.” Used with permission.


Preaching the psalms of lament gives expression to the range of emotions people experience, including despair and hopelessness. Be careful not to assign specific diagnoses to people in Scripture. We don’t have enough information or the qualification to diagnose. General descriptions of anxiety and depression are appropriate.


Worship services are filled with words and “noise.” And sometimes we use silence so we can privately fill the space with more words. Meaningful space for silence gives people time to listen, to wait, and to absorb what is happening at a particular moment in worship.

Litany: God of Life, Hold Us

God our Creator, Redeemer, and Sustainer,
you give breath to each person you made.
You treasure the gifts of each unique person.
But when life becomes a burden rather than a gift,
God of life, hold us.

When darkness strangles the will to live,
when days become endless nights,
God of light, shine on us.

When no one seems to understand,
when we walk and wait alone,
God of love, embrace us with your presence.

Where there is despair, bring hope;
where there is shame, give value and worth;
where there is emptiness, bring fulfillment;
where there is suffering in mind or body, bring healing.
God of hope, hear our prayer for life.

—C. Holtrop. Used with permission.


For people who have little energy during times of deep depression, the act of rising for a song is too much. It took enormous energy for them just to come to worship. Inviting people to “Please rise in body or in spirit” gives people the option to remain seated when they are emotionally and/or physically weary.

Yet movement can also give opportunity for people to express themselves without words. Movements such as extending one’s hands to receive the greeting or blessing from God, shaking hands during mutual greetings, holding the bread and the cup in your hands, or using motions with a song can make a theological truth a tangible reality. Experiencing a liturgical dance, or perhaps the assurance of pardon done with movement and no words, can touch people in deep and profound ways.

There is no one-size-fits-all pastoral care so be in dialogue with those you know who are living with mental illnesses. The more aware and pastorally sensitive you are as a worship leader, the fewer barriers will be in the way of the full, conscious, and active participation of all members in the worship of God. But in all things, remember that the Holy Spirit transcends our wordless groans and our feeble efforts.

Cindy K. Holtrop is author of several Christmas dramas and So You've Been Asked to Greet or Usher--all available from CRC Publications, 1-800-333-8300.


Reformed Worship 128 © June 2018 Worship Ministries of the Christian Reformed Church. Used by permission.