Co-Sojourners on a Difficult Journey
A Review of David Finnegan-Hosey's Christ on the Psych Ward
Brent Schnipke

I decided to become a psychiatrist for many reasons: an interest in the diagnoses; longer time for patient care; opportunities to pursue teaching and writing; and a desire to help people. When I think of that last point, I think about Christ’s charge to care for “the least of these.” Patients with mental illness and/or substance abuse frequently qualify as “the least of these,” and at least part of my motivation to become a psychiatrist is to participate in the ministry of reconciliation, to help heal the sick and make the broken places whole. Accompanying individuals in their rock-bottom moments, offering them hope, is what I imagine Christ would do.

This image aligns with the central idea in Christ on the Psych Ward by David Finnegan-Hosey. The author, now a chaplain-in-residence at Georgetown University, was a seminary student when he was first admitted to a psychiatric inpatient unit, the “psych ward,” with a diagnosis of bipolar disorder. He writes from this joint perspective, as a chaplain and a patient.

Early in the book, Finnegan-Hosey shares a personal story from that initial inpatient experience, about a nurse who offered him encouragement after asking him about his habit of reading his Bible. But this book is not primarily a memoir, detailing specific experiences and then considering their broader significance. Instead, the book is mostly commentary. Finnegan-Hosey returns to the central image of Christ on the psych ward—an image that, for him, inspires hope. He imagines Christ the servant, who meets hurting people and sits with them, listens to them, loves them. He uses this image to put forth several tangible ideas for how the church could model its treatment of individuals with mental health struggles. Some of these ideas include starting the conversation about mental health in small groups and worship services; checking in on people who may be isolated or lonely; holding mental health training sessions; and advocating for just and equitable access to mental healthcare.

The idea that Christ would get involved with people at their messiest moments, showing up in surprising and unexpected places—for example, on the psych ward—is an image I also carry, and I appreciated Finnegan-Hosey giving voice to this. When he does write about his own specific experiences, he discusses how nurses, social workers, and doctors have embodied Christ to him. During his time in the psych ward, he was comforted with the understanding that Christ was present with him. He advocates “physical presence” over “intellectual arguments” as ways of supporting people in crisis in a manner of Christ-likeness.

Books like this one, which exist at the intersection of disparate fields, sometimes do not have a clear-cut audience, and that seems to be the case with Christ on the Psych Ward. Finnegan-Hosey writes in an academic style, and his seminary education informs much of his writing; there are long paragraphs about biblical interpretations and theological terms. He uses this knowledge to share his insights and recommendations with church leaders, but this material doesn’t always blend easily with the narrative elements that seem addressed to a broader audience. In some places he writes directly to individuals with mental illness, asking forgiveness for poor treatment by the church and encouraging these readers to contemplate and find solace in the idea of Christ accompanying them.

One audience for which the book did not seem to be written is mental health professionals. I had hoped this book would offer fresh insights into how psychiatrists or other mental health workers could function in a pastoral role. Christ on the Psych Ward scratches the surface of the connection between faith and mental illness, but it contains very little about the psychiatrist’s role in bridging the gap. The author mentions a few key interactions (both good and bad) he personally had with mental health workers, but his message is aimed, for the most part, toward people outside the psych ward: friends and family members of people with mental illness (“co-strugglers, co-sojourners on a difficult journey,” as he says in the introduction), and churches and ministers trying to discern “how to be in ministry with people struggling with mental health problems.”

Even if the author didn’t write this book for people in my line of work, I found numerous points of value as I think about my future as a psychiatrist. First, all patient narratives offer insight of some kind. Finnegan-Hosey provides an important reminder of the significance of each interaction between patient and caregiver. A patient’s understanding of his or her illness and self-image can be rooted in a few simple sentences spoken by a doctor. If those sentences are careless, they can cause damage. Finnegan-Hosey seems to have a clear understanding of himself and his illness—and, like every individual patient, he has a perspective shaped by his background and worldview.

A second lesson this book drives home is the importance of the connection between theology and psychiatry. I am fascinated by this connection, and I appreciate that psychiatrists must consider the spiritual background of each patient. An individual’s spirituality and religion can deeply affect his or her mental health, and this book provides a great example of that connection. Not every patient is a seminary student, but we are all spiritual just by nature of being human.

Christ on the Psych Ward contributes an important voice to the ongoing conversation about how people and churches should address mental illness. I would have liked more of Finnegan-Hosey’s personal story because it was, for me, the most captivating aspect of the book. And while his critiques of the church’s responses to mental illness do not break new ground (nor do his ideas for their improvement), he nonetheless offers a perspective that may enlighten readers. His image of Christ serving the most vulnerable individuals is the crucial takeaway. For those who want to begin thinking and reading about the complex interplay of religion and mental health, Christ on the Psych Ward is a fine place to start.


Brent Schnipke is a writer, doctor, and psychiatry resident based in Dayton, Ohio. His professional interests include medical humanities, mental health, and medical education. Brent can be found on social media

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