Why Do Missionaries Leave the Field? It’s Hard to Say

Read very many reports of people who out of the blue quit their prestigious, well-paying jobs (for example, company CEO, NBA coach, speaker of the house), and you’ll quickly see that one of the main reasons they claim is “to spend more time with family.” Of course, we understand that in most cases, that’s a boilerplate answer used to sidestep what’s really going on. The truth is much more difficult to discern.

When it comes to missionary attrition, the situation is not much different.

After finishing our first term on the mission field in Taiwan, I and my family made our first trip back to the States. During that visit I heard a representative from our sending agency talk about the many reasons why missionaries leave the field. What she said went something like this:

There’s the reason you tell your supporters.
There’s the reason you tell your church.
There’s the reason you tell your agency.
There’s the reason you tell your teammates.
There’s the reason you tell your family.
There’s the reason you tell yourself.
And there’s the reason you tell God.

Detlef Bloecher, in Worth Keeping: Global Perspectives on Good Practices in Missionary Retention, has a similar list, citing

stated reasons (written in the missionary’s prayer letter)
personal reasons (told to close friends or family)
secret reasons (not shared but believed deep in the missionary’s heart)
leader’s reasons (identified by the team or field leader)
recorded reasons (added to the missionary’s file)
believed reasons (accepted by the director of the sending base)
socially accepted reasons (published in the mission journal)
further reasons identified by the missionary’s professional counsellor, and
true reasons (a combination of the above or something completely different)

Bloecher’s listing is part of his discussion of the challenges faced by the Mission Commission of the World Evangelical Fellowship (WEF) when, in 1994, they set out to examine why missionaries leave their work. Their study, surveying 551 mission organizations and sending churches from 14 countries, was called ReMAP (Reducing Missionary Attrition Project), and their findings were reported and discussed in Too Valuable to Lose: Exploring the Causes and Cures of Missionary Attrition.

Why do missionaries leave the field? It seems that it’s hard to say.

Attrition Happens

In Chapter 6 of Too Valuable to Lose, Peter Brierley writes that one of the key findings of ReMAP is that each year the on-field mission force loses 5.1% of its workers. Of these, 71% leave for what are called “preventable reasons.” These reasons are in contrast to non-preventable reasons, “such as normal retirement, a political crisis, death of a spouse, marriage outside the mission, or a change of job.”

To clarify, this number of “leaving” missionaries includes those who resign from one agency and then join another, thus returning to the field, but it does not include those who leave the field to take a home-based position with their agency.

When grouped in categories, the reasons that ReMAP found for missionary attrition are as follows, ranked by weight/importance:

Unpreventable
Personal
Marriage/Family
Society
Work-Related
Team
Cultural
Other

Broken down further, the complete list includes 26 reasons, arranged by perceived significance, from greatest to least:

Normal retirement
Child(ren)
Change of job
Health problems
Lack of home support
Problems with peers
Personal concerns
Disagreement with agency
Inadequate commitment
Lack of call
Outside marriage
Immature spiritual life
Marriage/family conflict
Poor cultural adaptation
Problems with local leaders
Elderly parents
Inappropriate training
Lack of job satisfaction
Political crisis
Inadequate supervision
Death in service
Dismissal by agency
Immoral lifestyle
Language problems
Theological reasons
Other

Where Should the Data Come From?

It is important to note, and fully acknowledged by ReMAP researchers, that the reasons above are not necessarily those given by the missionaries themselves. Rather, they are the ones perceived to be true by their sending agency or church. This is because, writes Jonathan Lewis in Too Valuable to Lose, interviewing all 4,400 missionaries who left the field during the study period, from 1992-1994, would have been nearly impossible. And by choosing to get data from organization “decision makers,” the researchers were involving the people who would have the power to later make the changes necessary to reduce attrition.

This method of gathering data on attrition is not uncommon in the missionary community. Mark Wingfield, writing in the Baptist Standard, reports that the Southern Baptist Convention’s International Mission Board (IMB) carries out a study each year on personnel attrition, with regional supervisors filling out the survey forms.

In 2000, several IMB trustees had questions about the reported numbers. They wondered if IMB’s recent movement of missionaries to new fields had caused an increase in missionary attrition.

David Garrison, then the associate vice president for strategy coordination and mobilization, assured them that that was not the case.

IMB’s figures showed that in 1999, only 9.56% of those who left their work left with “disagreement with IMB philosophy, policies, staff or structure as a contributing reason.” The largest proportion, 25%, left because of a “change in understanding of God’s call.”

Winfield writes that Garrison “admitted some who resigned could have failed to cite their true feelings about IMB philosophy changes but expressed confidence that was not likely to have been true in many cases.”

Drilling Deeper

When Worth Keeping was published in 2007, it was ten years after Too Valuable to Lose. The second book uses the results of the ReMAP II (Retaining Missionaries: Agency Practices) study to followup on ReMAP, this time focusing on what organizations can do to keep their missionaries. ReMAP II called on agency leaders to evaluate their practices, and then their responses were used to find correlations between methods and retention.

Two months ago, the mission research organization Global Mapping International (GMI) published a post on their blog commenting on ReMAP II, calling it “one of the more famous mission research studies since the turn of the millennium.” But GMI reports that when Jim Van Meter, the leader of the US analysis, looked at the correlations, he found that the practices and retention rates didn’t match up as expected. So he asked GMI for its input. Were the questions flawed?

No, said GMI. “The problem isn’t the questions. It’s the person answering them!” They explain further:

Administrators can reliably answer factual questions about their agency’s practices, but they cannot reliably answer evaluative questions related to their support of field staff.

GMI cites the following example: In ReMAP II, administrators were asked to rate their agencies’ practices in relation to the statement “Missionaries are included in major decisions related to the field.” While the responses showed that this is something that agencies do well, the findings did not correlate with retention rates.

When GMI did their own survey of over 1,700 workers in the field, the phrase “My organization involves employees in decisions that affect them” was rated in the bottom 10 of 68 items. And unlike in ReMAP II, this finding did correlate with retention.

The solution, says GMI, is a third-party collector of data, and in what they call a “shameless plug,” they offer Engage, “a customized Field Missionary-Friendly employee survey,” implemented by GMI and Best Christian Workplaces. By using Engage, they say, “Everyone wins. Leadership teams get to celebrate successes and identify priorities. Boards receive meaningful measures and see how leaders are taking initiative. Field staff gets a chance to be heard and offer ideas.”

Getting the Full Picture

To better know why missionaries leave the field, it makes sense to me to start with what the missionaries themselves have to say, reported by them, unfiltered through others. We all have our natural, inherent biases, along with fears that come with speaking and hearing the unvarnished truth, and the less we add these to the equation, the closer we will get to that truth.

This won’t be easy, and we should consider utilizing GMI and Best Christian Workplaces, and other groups like them, for their objectivity and for their experience in conducting and analyzing surveys. At best, surveys should be repeated consistently (as is done by the IMB), and they should be shared with, and owned by, everyone in the organization, not just those in leadership.

While I highly value the responses of missionaries, I also realize that their views alone aren’t guaranteed to represent the whole picture on the causes of attrition. Missionaries don’t always completely understand their own situations, and even when they do, they’re too often inclined to voice safe or respectable explanations. Getting to the truth will take patient listening and will need to seek anecdotal input that goes beyond numerical responses to a standardized list of questions.

Groups and individuals who offer member care and debriefing can help in this area. They often hear what others do not, because of their willingness to listen and because of the safe outlets they provide. But care needs to be taken to ensure that any reporting they do does not compromise the very trust they have fostered that encourages missionaries to share openly.

Writing in Too Valuable to Lose, Brierley suggests that future research on attrition goes beyond the statistics of quantitative research and move to the explanations of qualitative research. One example he gives of how this would be helpful would be to look more deeply at the differences between responses collected from different sources. How and why do the reasons given by missionaries and those written in the missionary’s personnel file and those believed to be true by mission leaders differ?

The Truth Is Out There

We need to recognize that though the truth on why missionaries leave the field may be elusive, it can be found. The differences in viewpoints can cause confusion, but they can also bring clarity. Recognizing how we see things differently can help us get closer to the truth and can also point out areas where more communication is necessary.

I think of how we prepare for the classic interview question, “What is your greatest weakness?” Knowing that the question is coming, we try to prepare an answer that at least seems honest but also doesn’t reveal an actual grievous problem. In one interview, I was asked to tell what my coworkers would say my greatest weakness was. Though I can’t remember what I said, I know it was more revealing. Just looking at myself through others’ eyes helps me see myself more clearly.

I hope that we will be able to trust each other more and become more open to listening to different perspectives. This goes both ways in the relationships between mission leaders and field workers—and should also include researchers, trainers, and member-care workers. We’re all on the same team, and while we sometimes don’t see eye to eye, we all are working toward the same goals.

So back to the question: Why do missionaries leave the field?

It is hard to say. But if we commit ourselves to opening our hearts and our ears, it’s far from impossible.

[Update: Global Mapping International closed in June of 2017, and the Engage survey is no longer available. For more on this and for a deeper look at the ReMAP results, see my post at A Life Overseas.]

(Detlef Bloecher, “ReMAP 1: What It Said, What It Did, and What It Achieved,” Worth Keeping: Global Perspectives on Good Practices in Missionary Retention, edited by Rob Hay, William Carey Library, 2006; Peter W. Brierley, “Missionary Attrition: The ReMAP Research Report,” Too Valuable to Lose: Exploring the Causes and Cures of Missionary Attrition, edited by William D. Taylor, William Carey Library, 1997; Jonathan Lewis, “Designing the ReMAP Research Project,” Too Valuable to Lose; Mark Winfield, “Disagreements Discounted as Source of Missionary Attrition,” Baptist Standard, April 24, 2000; “Listening Well . . . and Why It Matters,” Global Mapping International, September 22, 2014 [cached at Google])

[photo: “Walk Away,” by Nikos, used under a Creative Commons license]

Repost from Stephen W. Smith: The Greenhouse Effect

When Steve and Gwen Smith founded Potter’s Inn, they had their hearts set on helping, as Stephen calls them, “men and women who are caught in the whitewater of life.” Some of those men and women are church leaders, some are leaders in business, some are missionaries. The Smiths, who have served in churches in Kentucky, North Carolina, and The Netherlands, now lead others in soul care and spiritual formation, with much of their ministry taking place at their retreat center, Potter’s Inn at Aspen Ridge, in Colorado.

My wife and I met Steve and Gwen when they were facilitators at the week of Debriefing and Renewal we attended (DAR is a program of Mission Training International) after we came back to the States following 10 years in Taiwan. We so appreciate the wisdom, comfort, and encouragement they shared with us and with the others in our group.

Steve, the author of The Lazarus Life: Spiritual Transformation for Ordinary People and Soul Custody: Choosing to Care for the One and Only You, recently posted the following on his blog.

The Greenhouse Effect
(reposted with permission from www.pottersinn.com)

People build green houses to help plants and vegetables to flourish. When the weather conditions are less than ideal, greenhouses are constructed to help plants thrive. Too much cold; too much wind; too many predators and nothing will grow.

In many ways, the ministry of Potter’s Inn is creating a Greenhouse Effect for people. People come to our retreat; read one of our books, experience soul care and something deep within happens. They begin to flourish in many ways they could never do without coming to the retreat or reading a book. Sometimes, the harshness of life—the predators and conditions—make life more difficult, almost unbearable. We need a new, safe and spiritual environment to grow and thrive.

We all need the right conditions to grow, don’t we? Jesus used this metaphor in helping his followers understand the spiritual life. We need the right soil—the right environment and conditions—to truly thrive.

This past weekend I personally experienced the Greenhouse Effect. We hosted a “Coming Home” retreat based on the teaching of the life-changing book, Return of the Prodigal by Henri Nouwen. It was a moving weekend to be sure. One business executive flew in from Atlanta to attend. When he arrived, he showed me his worn, tattered shoes that were literally falling apart. He asked where the closest store would be so he could go buy new shoes. I said, “Here, take my shoes and wear them for the weekend. You’ve come with your ‘soul’ falling apart. God must really want you here.” He smiled and graciously took my shoes and wore them. On Sunday, I said, “Wear these shoes all the way ‘home’ cause God is doing a new thing in your life.” He cried and wept in my arms.

The weekend was so very powerful for all of us. Healing. Restorative and Transforming. For me, it was a moment of truly giving someone shoes who had come as the Prodigal—someone who had lost so much on their journey home. We sat in silence for our final breakfast and ate breakfast together without one word. As I sat there with my fruit and yogurt, I wept. I was flooded with emotion and compassion. It was a moment of sheer highlight for me to truly feel God’s love for me and so many others who had come with their Prodigal hearts only to truly come home to God again.

Everyone needs a greenhouse to flourish. Churches help us flourish. Friends help us flourish and as you know, Inns help us to flourish. Jesus told another story to help us understand this in the story of the Good Samaritan. After the man was beat up and left stranded, someone took this man to an “Inn” where he would experience the Greenhouse Effect.

That is who we are. This is what we do.

[photo: “Antique Greenhouse Interior,” by Jaydot, used under a Creative Commons license]

Listening and the Spirit of Unhurried Leisure

“Get busy.”

That’s the mantra of many a boss.

“Look busy.”

That’s what coworkers say when the boss is coming.

Busyness isn’t always a synonym for work. In fact, busyness can get in the way of productivity.

Eugene Peterson, best known for his translation of the Bible, The Message, also served as a pastor of Christ Our King Presbyterian Church in Bel Air, Maryland, for 30 years. One of the consistent themes in his teaching and writing is that pastors should not fall into the seductive trap of busyness. Instead, as he writes in “The Unbusy Pastor,” his goal in his role as a church leader was to do three things, things that are too easily pushed aside by a busy life: to pray, to preach, and to listen.

Listening, he says, needs “unhurried leisure.” This leisure is the opposite of busyness. And just as busyness does not equal work, neither is leisure the same thing as laziness. Instead, leisure is having time at one’s disposal, and when one chooses to use that time for listening to what someone else has to say, it is a very valuable gift.

The passage below was written by Peterson in 1981. It is about and for pastors, but it can help any of us listen better, unless, of course, listening is something else we’ve ceded over to the professionals.

I want to be a pastor who listens. A lot of people approach me through the week to tell me what is going on in their lives. I want to have the energy and time to really listen to them so when they are through, they know at least one other person has some inkling of what they’re feeling and thinking.

Listening is in short supply in the world today; people aren’t used to being listened to. I know how easy it is to avoid the tough, intense work of listening by being busy (letting the hospital patient know there are ten more persons I have to see). Have to? But I’m not indispensable to any of them, and I am here with this one. Too much of pastoral visitation is punching the clock, assuring people we’re on the job, being busy, earning our pay.

Pastoral listening requires unhurried leisure, even if it’s for only five minutes. Leisure is a quality of spirit, not a quantity of time. Only in that ambience of leisure do persons know they are listened to with absolute seriousness, treated with dignity and importance. Speaking to people does not have the same personal intensity as listening to people. The question I put to myself is not “How many people have you spoken to about Christ this week?” but “How many people have you listened to in Christ this week?” The number of persons listened to must necessarily be less than the number spoken to. Listening to a story always takes more time than delivering a message, so I must discard my compulsion to count, to compile the statistics that will justify my existence.

(Eugene Peterson, “The Unbusy Pastor,” Leadership, Summer, 1981, also in The Contemplative Pastor: Returning to the Art of Spiritual Direction, reprint edition, Eerdmans, 1993)

[photo: “Railway Chit Chat,” by Brett Davies, used under a Creative Commons license]

The Faith of a Bicycle

When we first moved to Taipei, we lived across the street from a park. One day, in that park, I was approached by three college-age students who asked me in English, “Do you know Jesus?”

“Yes,” I said.

“OK,” they replied. “But do you really know him?” This was a logical question, because while English has the one word for knowing someone, Chinese has two. The first would be the one in “I know who he is,” while the second means “I know him personally.”

I had the perfect response. Not only was I a Christian, but I was a missionary . . . and I’d been studying Chinese, too. So, I told them, somewhat smugly, in their language, “Yes, I know him. I’m a . . . bicycle.”

I wish I could say that the Chinese words for missionary and bicycle sound just alike, but they don’t. The first is chuan jiao shi, and the second is jiao ta che. I think I must have learned them on the same day, because they are forever confused in my mind. The young people in the park laughed with me and let me correct myself. “Chinese is hard,” they said. I didn’t argue.

Over the years, that encounter became a symbol to me for the good and bad times in Taiwan: Some days I was a missionary. Some days I was just a bicycle.

Flat Tires and Slipped Chains

In an article published by Christianity Today this month, John Wilson interviews British author Francis Spufford about defending the Christian faith in a post-Christian culture. Spufford talks about a chapter in his latest book, Unapologetic: Why, Despite Everything, Christianity Can Still Make Surprising Emotional Sense, that gives a summary of the New Testament:

[T]he reason why I have Yeshua, my de-familiarized Christ, saying, “Far more can be mended than you know,” which I think is actually true to the New Testament, is that I want mending. Not flying free, not transformation, but humble, ordinary, everyday, get-you-back-on-your-feet mending, to be at the center of the Christian story.

When the book was being translated into Dutch, the translator sent me an email: “This word mend, I’ve looked it up in the dictionary, and it seems to be the same word you use for repairing bicycles. You must mean something else.”

I wrote back, “No. No. No. I want the bicycle-repair word.” What I absolutely want is to suggest that before it’s anything else, redemption is God mending the bicycle of our souls; God bringing out the puncture repair kit, re-inflating the tires, taking off the rust, making us roadworthy once more. Not so that we can take flight into ecstasy, but so that we can do the next needful mile of our lives.

We all need that kind of mending from God. I guess being a bicycle isn’t so far from being a Christian—and a missionary—after all.

(John Wilson, “Faith for the Post-Christian Heart: A Conversation with Francis Spufford,” Christianity Today, April 3, 2014)

[photo: “Bicycle,” by Marcella, used under a Creative Commons license]

Repost: Are You Listening? Really Listening?

[My family is moving across town this week, so I haven’t been able to work on the blog much lately. So here’s a repost from about a year and a half ago. This transition thing can feel like Frost’s “miles to go before I sleep.” But until that rest comes, I’ll look for a park bench along the way.]

Finding good listeners is very important to missionaries. In fact, when member-care trainer Brenda Bosch surveyed missionaries about what they wanted from their mission agency, the top answer was “someone to listen to me.”

German theologian Dietrich Bonhoeffer writes that listening is necessary in Christian community. He calls it the “first service” that Christians owe each other:

Just as our love for God begins with listening to God’s Word, the beginning of love for other Christians is learning to listen to them. God’s love for us is shown by the fact that God not only gives us God’s Word, but also lends us God’s ear. We do God’s work for our brothers and sisters when we learn to listen to them. So often Christians, especially preachers, think that their only service is always to have to “offer” something when they are together with other people. They forget that listening can be a greater service than speaking. Many people seek a sympathetic ear and do not find it among Christians, because these Christians are talking even when they should be listening. But Christians who can no longer listen to one another will soon no longer be listening to God either; they will always be talking even in the presence of God. The death of the spiritual life starts here, and in the end there is nothing left but empty spiritual chatter and clerical condescension which chokes on pious words. Those who cannot listen long and patiently will always be talking past others, and finally no longer will even notice it. Those who think their time is too precious to spend listening will never really have time for God and others, but only for themselves and for their own words and plans.

For Christians, pastoral care differs essentially from preaching in that here the task of listening is joined to the task of speaking the Word. There is also a kind of listening with half an ear that presumes already to know what the other person has to say. This impatient, inattentive listening really despises the other Christian and finally is only waiting to get a chance to speak and thus to get rid of the other. This sort of listening is no fulfillment of our task. And it is certain that here, too, in our attitude toward other Christians we simply see reflected our own relationship to God.

In the latter paragraph, Bonhoeffer describes a false, inadequate kind of listening. In reading what is lacking there, we can see the qualities required of a good listener. Are you someone who listens in that way?

Do you listen with a “whole” ear?
Do you presume that you will hear something unique and valuable?
Are you patient?
Are you attentive?
Do you love the speaker?
Do you waive your right to speak?
Do you hope to keep the other person in your presence, sharing with you?
Are you fulfilling your task, to your neighbors and to God?

The New Testament records Jesus saying several times, “He who has ears to hear, let him hear.” In The Message, this is translated, “Are you listening to this? Really listening?”

Thanks to Brian Stankich at FULFILL for drawing my attention to the survey in his post “11 Types of Care Missionaries Want from Their Sending Agencies and Co-Workers.”

(Brenda Bosch, “Summary of Missionary Survey Outcomes,” Global Member Care Network Conference, April 2012; Dietrich Bonhoeffer, Life Together, Dietrich Bonhoeffer Works, Volume 5, Augsburg Fortress, 2004, 98-99)

[photo: “Listen carefully,” by Justin Lynham, used under a Creative Commons license]

Park-Bench Conversations

[I’ve written a new “page” to point readers to posts in this blog that are the most meaningful to me. It’s called “park bench,” and it’s linked in the banner above. And to save you a click, here it is below.]

The posts on this blog, while all under the umbrella of cross-cultural issues, cover an array of topics. All of these are interesting to me, but some of the most important to me are on the subject of transitioning between cultures.

It’s often a difficult process and lasts well beyond the plane ride. Though there are many voices telling us about the challenges of redefining “home,” many of the stories are not shared eagerly or in public. Rather, they come out in safe places and only in response to careful and gentle prodding.

There are several images that conjure up thoughts of those conversations: a kitchen table, side-by-side cups of coffee, the corner booth in a cafe, a front porch.

For me, it’s a park bench.

I’m not always comfortable with talking face-to-face. It’s easier for me to sit next to someone, with the option of staring into the distance or getting up for a walk. Some of my deepest conversations, with people and with God, have taken place on park benches—at the edge of a mountain trail, in a park, next to a playground, in the courtyard of an apartment complex, at a bus stop on a busy street.

At Clearing Customs, the park-bench talks center on the difficulties of transition, on the grief that comes from losses associated with moves, on finding confidants who are able to listen without judgment. If those topics are relevant to you, too, please follow the category links below.

All of the topics in this blog are interesting to me, but these are some of the most important to me.

[photo: “City Park in Fall,” by Michael Williams, used under a Creative Commons license]

Fear of Heights: Pastors, Missionaries, and the Dangers of Pedestals

143527358_30cf8a796b — The statures of thirteen saints adorn the roof of Montreal’s Cathédrale Marie-Reine-du-Monde.

According to the 1917 Catholic Encyclopedia, Simeon Stylites was the first “pillar hermit,” spending much of his life perched atop a column (stylos is Greek for pillar). Simeon began this practice to escape the constant crowds of pilgrims who sought his prayers, disrupting his personal devotions. His original pedestal held him around nine feet off the ground, but over time it was replaced by ever-taller versions, until it was some 50 feet high. Simeon remained on his pillar for 36 years, until his death.

While Simeon seems to have thrived living above the masses, most church leaders today find life atop a pedestal difficult at best. But that doesn’t stop many Christians from elevating them to greater and greater heights, and sometimes those leaders get quite comfortable with the view from above.

This is one of the topics addressed in this month’s issue of Christianity Today. The headline on the front cover is “New Life after the Fall,” referring to the seven-year recovery of Colorado Springs’ New Life Church following the scandals and resignation of its founder and pastor, Ted Haggard.

In a companion article, “Letting Pastors Be Real,” Mark Galli interviews Dale Pyne, president of Peacemakers Ministries, on how churches can help keep their leaders from falling. While Pyne’s advice is focused on pastors, I believe that it applies to missionaries, as well—not only concerning their pastoral role overseas, but also in their relationships with sending churches and supporters. Here is some of what he has to say:

Putting pastors up on pedestals, says Pyne, creates “minigods in our minds and hearts.”
We don’t hold pastors or missionaries accountable when we think we don’t know enough to address their adherence to “fundamental issues.” Pyne says he’s lost track of how many times he’s heard elders say, ‘I wanted to say something, but I thought, Who am I?'” If a pastor wants to “address or confess [a sin], his place on the pedestal sometimes facilitates pride and fear of man. So they die in silence and pain.”
When it comes to attendance, there is pressure on church leaders to “inflate or puff the numbers.” But Pyne says that “if we start managing shepherding by the numbers, we’re going to lose shepherding, and we’re going to focus on the numbers.”
“Jesus was perfect,” says Pyne, “pastors are not.” This is, of course, true for missionaries, as well. If either aren’t humble and honest, they “create distance and discourage connection.”
Pastors—and missionaries—need “a high-integrity accountability relationship with one or several spiritually mature individuals” to address personal issues. “And they must trust that the relationship is a confidential one.”

Pyne ends with a call for transparency. Here again, as in most of his responses in the article, pastor can be replaced with missionary. It’s a lesson that needs to be learned by everyone in Christian leadership and service:

If we’re too busy denying and protecting and putting on a church face, then the congregation perceives that the pastor has it all together. We say to ourselves, Wow, I am so far from that pastor. I am unworthy. Why isn’t God working in me the way God’s working in him? The people start to elevate them. It’s not all about the pastor, but that transparency releases the congregation. It helps the pastor be real. And releases the congregant to accept who they are and pursue hope in Christ.

(“St. Simeon Stylites the Elder,” Catholic Encyclopedia, 1917 edition, New Advent; Mark Galli, “Letting Pastors Be Real,” Christianity Today, December 2013)

[photo: “Don’t Jump!!” by Sue Richards, used under a Creative Commons license]

The Psychological Health of Missionaries—Adding to the Research

Here’s a quick question:

What percentage of returned missionaries and aid workers report psychological disorders during their time overseas or shortly after their return? What do you think? About a quarter, a third, half, two thirds, three quarters?

According to a 1997 study conducted by Debbie Lovell-Hawker of Oxford University, the answer is “about half.” More precisely, Lovell-Hawker’s findings show that among the returned missionaries and aid workers she studied,

46% reported that they had experienced a clinically diagnosed psychological disorder either while working overseas or shortly after returning to the United Kingdom.

Before I went overseas, I would have guessed much lower than half, but after I first heard this statistic referenced in a debriefing I attended, in my mind, the number began to grow much higher than 46%. Statistics have a way of doing that.

Lovell-Hawker’s research included 145 aid and development workers and missionaries from 62 organizations. Though not definitive, the findings are significant as a wake-up call to cross-cultural workers, sending agencies, NGOs, churches, and member-care givers. And they also can assure those repats who are struggling that they are not alone.

Other findings include

• 18% reported that their problems developed while they were overseas—82% said they began after returning to their home country
• Depression was the most frequently reported problem, occuring in 87% of the cases
• Those who reported having psychological problems had spent significantly longer time overseas than those who reported having none

(Debbie Lovell-Hawker, “Specialist Care: Psychological Input,” Global Connections Member Care Conference, February 18, 2002)

Moving forward from this study, there are some things I’d still like to know: Has anything changed in the 26 years since the findings were published? What would the numbers be for all missionaries and aid workers, not just those who’ve returned? What would the breakdown be among those working in relief and development vs other settings, such as teaching or church planting in developed areas? Are the numbers consistent for workers returning to countries other than the UK? And what about TCKs?

The good news is that there are researchers who are working on these and similar questions.

The Research Continues

One of those researchers is Lynette H. Bikos. Lynette served as a guest editor (along with M. Elizabeth Lewis Hall) of a special issue of Mental Health, Religion & Culture in 2009, titled “Missionaries.” Lynette is director of research and professor of clinical psychology in the School of Psychology, Family, and Community at Seattle Pacific University—and she also happens to be a friend who lived next to me, on an adjoining farm, as we grew up in northeast Missouri. We’ve kept in touch over the years, and she corresponded with my family and me as she worked on her research.

The special issue includes 10 articles dealing with several aspects of cross-cultural adjustment among those whom the editors call “religiously motivated sojourners.” I’d like to highlight four of those articles:

“Social Support, Organisational Support, and Religious Support in Relation to Burnout in Expatriate Humanitarian Aid Workers”
(Cynthia B. Eriksson et al., Mental Health, Religion, & Culture, November 2009)

This assessment found that 40% of expat middle managers in an international faith-based agency were at “high risk” of burnout in one of three areas—lack of personal accomplishment, emotional exhaustion, and disconnection or distance from those being cared for—but less than 4% reported high levels of burnout in all three.

According to the authors of the study, “This suggests that despite intense work and chaotic environments a majority of workers find ways to identify accomplishments, stay connected to others in their work, and rejuvenate. Team relationships, friendships, and positive organisational support may contribute to the resilience for these workers.”

The findings also indicate that younger workers are at a greater risk of burnout, as they register greater negatives in all three burnout areas. But while age was a factor, the number of years serving with the agency was not.

“Resilience in Re-Entering Missionaries: Why Do Some Do Well?”
(Susan P. Selby et al., Mental Health, Religion, & Culture, November 2009)

The authors posed the question ‘‘Why do some re-entering missionaries do well while others do not?’’ and interviewed 15 Australian cross-cultural missionary workers to help find the answer.

All the participants were over 25 years old and had spent at least 2 out of the previous 3 years in a non-Western country. Based on their responses, the researchers divided the missionaries into two categories: “resilient” and “fragile.”

In the interviews, the eight resilient missionaries described having

• flexibility
• higher expectancy and self-determination
• denial in the form of minimization to deal with their distress
• good mental health
• more social support
• a positive reintegration
• a personal spiritual connection to God

In contrast, the seven who were considered fragile described

• less flexibility
• lower expectancy and self-determination
• less use of denial with minimization
• poorer mental health
• less social support
• difficulty reintegrating
• a decreased or fluctuating personal spiritual connection to God

It is interesting that while the results of a questionnaire measuring depression, anxiety, and stress (DASS 21) showed higher levels for the fragile group, the scale showed that only one out of the entire group (including resilient and fragile) had an actual perception of being “personally stressed.”

“Psychological Well-Being and Sociocultural Adaptation in College-Aged, Repatriated, Missionary Kids”
(Michael J. Klemens and Lynette H. Bikos, Mental Health, Religion, & Culture, November 2009)

When the researchers compared a group of MKs to non-MKs at a Christian university, they found that while both groups scored in the healthy range of psychological well-being (PWB), the missionary kids’ scores were significantly lower.

The missionary kids’ MK status accounted for only 4% of the variance in psychological well-being but was responsible for nearly a quarter (23%) of the difference in sociocultural adaptation (SCA). In this latter area, the MKs reported the most difficulty in “taking a US’ perspective on the culture; seeing things from an American’s point of view; understanding the US’ worldview; understanding the US’ value system; and making yourself understood.”

“Curiously,” report Klemens and Bikos, “neither the age of the participant, nor the number of years abroad, nor the number of years since repatriation was related to PWB or SCA for the MKs.”

“Reduction in Burnout May Be a Benefit for Short-Term Medical Mission Volunteers”
(Clark Campbell et al., Mental Health, Religion, & Culture, November 2009)

This assessment looked at how international short-term mission trips affect burnout among volunteers.

The participants in the study, most of whom were physicians and nurses, travelled to South America for two weeks to provide medical care in a non-disaster-relief setting. Prior to their departure, the group members’ responses to questionnaires showed that they were experiencing moderate burnout. Their burnout levels were again assessed one month and six months after the trip.

“The major finding of this study,” report the researches, “is counter-intuitive: that medical personnel who are emotionally exhausted, have an impersonal response towards their patients, and lack a sense of [personal accomplishments] (moderately burned out) benefit by working hard with numerous patients in an international context.”

They found that levels of emotional exhaustion and perceived personal accomplishments showed significant improvements following the short-term trip and continued in a positive direction in the 6-month followup.

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All good research builds about what has been learned before and leads to questions for new studies in the future. I join with Lynette and her co-editor in hoping that the information in their special issue of Mental Health, Religion & Culture encourages others to join in the “exploration” of the psychological health of missionaries. There is so much more to be discovered.

(Lynette H. Bikos and M. Elizabeth Lewis Hall, “Psychological Functioning of International Missionaries: Introduction to the Special Issue,” Mental Health, Religion, & Culture, November 2009)

This special journal issue also includes several articles specific to the experiences of female missionaries. I hope to discuss these in a future post.

[photo: “Confused,” by Mary T Moore, used under a Creative Commons license]

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