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Missionary Care: Triage or Wellness Checks?

Author: Jeremy Harrison
Published: February 2015

MD 6.1

Article Type: Text Article

Missionaries need ongoing care and counsel as they face the myriad of challenges posed by living in a cross-cultural context. Reactionary models of care have proven insufficient. How then do we care for those who serve overseas? What methods and means are most effective? This article explores these issues and presents alternative ways to provide holistic care to missionaries.

“I am done.” John uttered these three words over the phone resignedly, his voice thick with emotion. In the middle of his first term overseas, John’s world was coming apart around him. He felt hopeless, exhausted, and burned out. These three words run through every missionary’s mind at some point. These three words can break a person, fragment a team, divide a marriage, stymie a church-planting movement, or cause a family to leave the field completely. The silence that hung between us over the phone was palpable. Was it too late for John? How should I respond? Could his situation be salvaged?

Missionary care is an area of increasing concern among churches and sending agencies. The prevalence of burnout, depression, culture stress, feelings of isolation, and chronic anxiety among missionaries is a disturbing trend—one that demands our attention. While many churches and agencies require the missionaries they send to the field to undergo extensive screening, training, and education prior to departure, these issues continue to be a perennial element of the missionary experience. Why? Are our efforts to prepare missionaries inadequate? Are we failing to maintain sufficient support and care while they are on the field? When these issues surface, do we not respond in an expedient and effective manner? Are these issues unavoidable, something every missionary must endure with clenched fists and gritted teeth?

This article explores the adequacy, accessibility, and timing of missionary care services that churches and sending agencies provide. The methodological framework for this conversation will be the description of two specific case studies, including the engagement of these cases through critical reflection. It is my hope that this article facilitate discussion of these issues among those on the front lines of missionary care in churches and sending agencies.

In preparation for this article, I interviewed Jeff Holland, who has served as Missionary Care Counselor for Pioneer Bible Translators since 2008. He has a positive appraisal of the recent trends he sees in the area of missionary care: “In recent years, far fewer people are coming [to me] in a state of crisis, but because they have a safe place to come.” Jeff attributes this trend to more intentional efforts to maintain regular communication with missionaries on the field. Of course, those crisis moments still come. When I asked Jeff what his usual response was to people who come to him in a state of crisis in their first term, he said: “I help them understand that this is common. I tell them that everything they are feeling is valid but likely to change given time.” Jeff sees the role of the counselor or missionary care provider as walking alongside people, listening, praying, giving advice, and providing helpful resources.

The following cases provide examples of two missionary families. These examples are adapted from real-life situations, with names changed for confidentiality.

Case #1: Internal Bleeding

The Jones family’s first term on the field was disastrous. After years of prayer, planning, fundraising, team training, language learning, and other preparations, they departed for the field excited but daunted at the prospect of joining a team already in place in this particular field. The day after they arrived, they had their first team meeting, in which they learned of a deep, underlying conflict with missionaries from a partner agency who were working in the same area. This conflict had been kept from them intentionally in order to shield them from additional stress as they made preparations to enter the mission field. The nature of this conflict had become so severe that the partnership between these teams was in serious jeopardy. This wasn’t quite how they imagined their first day on the field.

The ensuing months were replete with struggles, trials, and disappointments. Tensions continued to escalate with the missionaries from the sister agency, resulting in the eventual dissolution of the partnership. Friction arose from within their own team over various issues: methodology, division of labor, how to proceed in light of the failed partnership, and so forth. The nationals seemed to resent their presence and, when they did express interest in them, it was for financial assistance, food, or some other form of tangible help. Their children were struggling with their educational needs. Relational drift began to creep into their marriage. They began to feel homesick.

The convergence of these factors led to a crisis moment on their journey. They questioned their call to missions, their sense of purpose, and God’s activity in their lives. They felt their commitment to this work slipping away. They began to despise the host country and resent the persistent requests of the nationals. In light of this, they decided it was time to call it quits. They contacted the staff person assigned to them in their agency’s missionary care department for a Skype call. They weren’t reaching out to ask for help or to seek advice—they were notifying their agency of their intent to resign. They were ready to come home. They were done.

That Skype session was two years ago. This family no longer serves in missions. They now have jobs in the marketplace and no longer attend church. They do not maintain any contact with their sending agency or former teammates.

Case #2: Bandaged Wounds

The Smith family enjoyed the first several months of their initial term overseas. Their entry into the host culture went relatively smoothly. Their relationship with their teammates was strong and their engagement with the nationals was beginning to show signs of increased trust and credibility. There were certainly the usual bumps and adjustments, but they were pleased with the way things were proceeding.

About seven months into their term, John’s parents (who had been opposed to their decision to move overseas from the outset) began to put pressure on them to return to the United States. Phrases like “We need you here” and “We don’t want to miss our grandchildren growing up” became common in their conversations. Coupled with this, Mary had begun to struggle with depression, which had plagued her in previous seasons of her life. She felt her capability to homeschool the children diminishing and she withdrew into herself, becoming increasingly isolated and emotionally unavailable to her family. Then, their sole teammates found out that their home congregation would no longer be funding their ministry beyond the end of the year. John felt that things were unraveling around him.

The next few months continued the downward spiral. John’s parents were furious that they would not be seeing their grandchildren for Christmas and had virtually issued an ultimatum for them to return for the holidays. Mary’s depression became more severe, leaving John to pick up more of the domestic duties and homeschooling. Their teammates were consumed with their impending exit plans and strategy for procuring new funding or an entirely different job. As a result of these developments, the work itself had begun to suffer. Relationships with the nationals were starting to become distant due to lack of engagement.

The recent months had taken their toll on John’s emotional health. He felt hopeless. He was in a state of despair regarding the future of their work. John and Mary had been talking about these issues to some degree with their staff counselor during their regular monthly phone calls, but during this particular session things reached critical mass. When the counselor’s voice came over the line, they laid it all out for her—their frustration, their disappointment, their anxiety. Through tearful and painful moments, they peeled back the tender layers of ache surrounding their hearts. They confessed that they wanted to quit—to return home and leave all this behind. They were done.

After listening intently, the counselor urged them not to make any decisions about their future while in this state of mind. She prayed with them and gave them the name of a book she thought would be helpful. She suggested to them that some more focused care and counsel could do wonders, so she scheduled them for weekly phone calls for the indefinite future. As a last resort, she mentioned that the agency could purchase plane tickets home for their entire family out of an emergency fund from the missionary care budget. However, the counselor offered an admonition that research shows that those who leave the field early in their work to manage a crisis are less likely to return than those who complete their term while working through these issues. Taking her words to heart, the Smiths invested themselves fully into the additional counseling and were able to persevere through the healing process.

That phone call was six years ago. This family is still on the mission field, serving in the same country with the same teammates (who eventually found new sources of funding). Not only did this family persevere through these trials and “make it,” they are now active in mentoring and helping new, young missionaries through similar seasons in their own journeys. They are serving today as “wounded healers” who tend to the hurts of others out of their own experiences.

Teaching Exercise

For those involved in an academic or other professional context related to missions, I am including the following exercise as a way to facilitate further discussion of this topic. It is my hope that these cases be instructive and create evaluative dialogue within churches and sending agencies related to their missionary care strategies and protocols.


  • Students will analyze the nature of missionary care.
  • Students will discuss the effectiveness of various missionary care practices.
  • Students will consider the benefits and challenges of missionary care.
  • Students will reflect on how issues raised in these cases intersect with their own experiences.


Read both cases carefully. In groups of 4–6, have students filter each case separately through the following reflection questions.

Reflection Questions

  • What stands out to you most about the Jones/Smith family’s situation?
  • Were certain aspects of this situation preventable? If so, how?
  • How do you characterize the behavior of the Jones/Smith family? What could they have done differently?
  • How do you characterize the response of the sending agency? What organizational values does their response indicate?
  • What lessons in missionary care does this case illuminate?
  • What elements of this case connect with you and your current situation?


Stress, problems, tension, and disappointment should be expected parts of missionary life. How one deals with such issues is paramount to one’s success and longevity on the mission field. Reactionary models of missionary care are doomed to fail because, when problems are allowed to fester, help is usually sought after it is too late. When both missionaries and those who have sent them engage in a proactive process of preventive care involving regular communication, field visits, spiritual retreats, and other creative strategies, the ability to navigate the turbulence of missionary life is increased significantly. May all involved in the task and privilege of missions take stock of both their own self-care and the missionary care model of their agency or church. These issues are critical and warrant our careful reflection.

Recommended Resources

Emotionally Healthy Spirituality: Unleash a Revolution in Your Life in Christ, by Peter Scazzero.

Doing Member Care Well: Perspectives and Practices from around the World, edited by Kelly O’Donnell.

The Reentry Team: Caring for Your Returning Missionaries, by Neal Pirolo.

Jeremy Harrison has served with Pioneer Bible Translators since 2013, coordinating translation projects among immigrants and projects involving a digital platform. His overseas travels have taken him to 10 countries, including Thailand, Hungary, Kenya, and Tanzania. He holds degrees from Abilene Christian University. He and his wife, Holly, live in Dallas and have two children. He can be contacted at

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