The Biblical response to autism, and other mental health issues

Note: The following article primarily focuses on autism, also known as Autistic Spectrum Disorder, or Asperger's Syndrome. However, the principles discussed apply more broadly to other mental conditions, which will receive a passing glance.

As a species, we tend to understand the importance of progress, yet we are also highly resistant to change. We fondly remember the past, even forgetting the complaints we had even then, all because we are spending so much time complaining about the modern world. A noteworthy example is the observation that autism diagnoses are increasing in frequency. And indeed, this is true. One study found a 787% increase in diagnoses over a 20 year period (1). Some people, failing to understand that medical science develops over time, suggest this increase is because autism is "trendy", not because it's a real thing.

Sadly, this mass ignorance is already inside the Church. In fact, even some influential figures hold it. One prominent example is John MacArthur, a world famous, widely revered pastor from California. MacArthur's popularity is not entirely unjustified. While there isn't much he can offer that you shouldn't be able to get from your own pastor, MacArthur is, overall, a very sound and edifying teacher. However, when it comes to mental health, he falls significantly short of the Biblical standard.

Appearing on a Q&A panel in 2024, MacArthur sat before a crowd and confidently declared “There’s no such thing as PTSD, OCD, or ADHD. Those are noble lies to basically give the excuse in the end of the day to medicate people.” (2). He continued to explain his view that "We try to make clear to parents that behavior essentially is the result of choices that kids make and if you parent them properly they’ll make right choices.", adding that parents who "blame it on something other than their choices and you identify them as having something they can't do anything about but medicate it, you literally are turning your child into not only a potential drug addict, but maybe a potential criminal because they never learn how to navigate life in a socially acceptable way."

Now, although he is the example I am springboarding from, I don't want to single out MacArthur. This is certainly not designed as a hit piece against an otherwise respectable pastor. In fact, his views are part of a broader misunderstanding of mental health, which he perpetuates, but he is certainly not unique in doing so.

When we look back at history, we see the tragic reality. It is not the modern world that is cruel to the neurodivergent by identifying and treating their conditions, but the ancient world that was cruel to them by failing to do so.

Ultimately, the "increase" in neurodivergence is entirely illusory. More people are being diagnosed with things like autism because less people are being diagnosed with "lunacy". The term "lunatic" comes from an outdated belief that a person's mental state could be affected by the phases of the moon (3). This explanation is obviously flawed, but its existence shows that mental illness was both present and prominent even as far back as the 14th century. In the modern day, common solutions include therapy, and occasionally medication designed to correct chemical imbalances in the brain. In the past, however, the solution was to fill the asylums.

Incidentally, one of the victims of the notoriously cruel asylums was Ignaz Semmelweis, a Hungarian physician who died as a result of an infection he likely received when the asylum guards beat him (4). The irony of this example is that Semmelweis is widely credited with the advancement of medical science.

See, in Semmelweis' day, germ theory existed only in primitive form. By contrast, humoral theory and miasma theory were the prevailing consensus. At this time, the technology by which we detect microbes was still underdeveloped, and connecting these organisms to disease was still an obscure idea. Semmelweis himself did not directly deal with germ theory, but he is well known for connecting unwashed hands to maternal death rates. This was a common problem in his time, with mortality rates reaching as high as 30% in some hospitals.

There were many theories as to why the death rate was so high, but Semmelweis noted that doctors would often handle dead bodies, then subsequently head off to deliver a baby. Thus, he introduced the practice of washing hands in a solution of chlorinated lime. This saw in instant and dramatic reduction in the unacceptably high death rates.

In spite of Semmelweis' observable success, medical pride prevented the practice of handwashing from becoming widespread. Using consensus as a defence mechanism, medical professionals took great offense at Semmelweis' research, being unable to accept the implication that - even through simple ignorance - they had inadvertently been killing their patients for decades. Rather than accept that they had been in error, the scientific community forcibly and violently institutionalised Semmelweis, directly resulting in his death from the very diseases he had fought to prevent.

In the modern day, ignorance of germ theory is rare, and denial even more so. In spite of the initial 40 years of resistance to handwashing practice, and a further 100 years for the practice to become a legal requirement, Semmelweis was eventually vindicated. We are now fully aware that microbial organisms cause disease, and that hygiene practices designed to control them - such as handwashing - prevent it.

When we look back at the history of germ theory, we see that the initial ignorance was unintentional. With neither divine revelation, nor relevant study, how could Victorian era physicians be expected to know about these tiny, invisible creatures, which would travel from corpse to patient on the hands of an unsuspecting doctor? It wasn't their fault. But as evidence mounted, this lack of awareness ultimately became negligence.

This is the case with autism. Historically, ignorance was unintentional. Whether it was blamed on the moon, demon possession, or even just poor breeding, people did not understand autism, and they couldn't be expected to. However, in the 20th century, patterns were identified, evidence was collected, and finally, autism was given its own classification as a distinct mental condition.

Just as with any other condition, knowledge of autism has increased since its initial identification. This means we now have a reasonable understanding of both the causes, effects, and ideal treatments, for autism. It also means views like John MacArthur's, linking these conditions to parental techniques, have been thoroughly debunked. Autism is neither a result of poor parenting, nor can it be "trained out" of a child by "parenting them properly". Rather, it is a neurodevelopmental condition with clear, observable features. Further study has also shown effective treatments and methods of support. However, there is a lot of room for improvement.

An important first step in making these improvements is to thoroughly eradicate the idea that autism, and similar conditions, are somehow a "noble lie" designed to push medication. We need to recognise that medical science - like all science - progresses with further research. When we remove petty obstructions such as pride, consensus, and a heavy reliance on antiquated beliefs, we are able to kill germs, close wounds, and even understand the inner workings of the body without cutting it open. And that, to me, is key.

See, if you look at someone like Nick Vujicic, his condition is fairly obvious. You might not understand exactly why, but only a blind man would miss the fact that he has no arms or legs. So, you're obviously going to forgive him if he won't stand to sing hymns with the rest of the congregation. Even if a man with both his legs rolls into church one Sunday, you'd have to be rather callous to deny his condition. He can't choose to stand up or walk, and you're committing a grave sin if you say otherwise.

But the thing about the body is it has an inside, as well. Not every condition will be immediately visible. You won't see if a man has a faulty valve in his heart. You won't perceive if another has lung cancer. You can't detect diabetes with your eyes. These are all genuine illnesses which, while they have noticeable effects for the patient, are not immediately visible.

Now, all of these conditions affect different organs. The heart can be diseased, the lungs can be diseased, the pancreas can be diseased. We must therefore realise that the brain is not uniquely immune to the effects of our fallen world. It can develop incorrectly, it can be injured, and it can be affected by disease.

Now, as Christians, even before we get to the issue of disease, we know how important the brain is. We are constantly called to be sober minded, being warned about intoxicants like alcohol. Why? Because when we consume these intoxicants, our minds are affected. Here's the difference: We can reduce the effects of alcohol on our minds by reducing our intake of alcohol. But mental conditions are not a choice. There are no foods, drinks, or drugs, that we can just stop consuming in order to become less autistic.

And believe me, most of us would. Autism is not a pleasant thing to have in a neurotypical world. Try though we may, we just don't understand "normal" people, nor do we feel understood. This is especially the case when they are explicitly opposed to us, dismissing our condition as a choice we make. Tell me, "pastor", how will we seek your counsel when we fear your scorn? Do you expect us to seek your help, knowing either we, or our parents, will first receive your blame? And if you are so ignorant of our problem, what kind of solution can you really offer? Such an attitude is wholly inappropriate for anyone in the Church, be it the pastor in the pulpit, or the pupil in the pew.

Of course, it would be unreasonable to ask for the other extreme. No one can be expected to know everything about every possible condition that may affect everyone who walks through the church door. Human beings are limited and fallible, and so we should let a pastor be a pastor, and a doctor be a doctor.

But what does that look like? Well, first, it looks like simply admitting what we do not know. It is ok to not understand autism, and it is ok to admit you do not understand autism. It's also ok to let us admit that actually, we don't either. The entire concept of mental health is relatively new, and at the time this article was written, the first person diagnosed with autism - Donald Triplett - hasn't even been dead for two years. The solution to this is not to just give up and attribute autism to bad parenting, but to get out of the way of further research.

In short, the correct response to autism, or indeed any mental condition, is the same as with any other issue of health. First, we don't blame sin, either the sin of the individual, or the sin of the parents. This is the mistake the disciples made in John 9, when they encountered a man born blind, and they asked Jesus "Rabbi, who sinned, this man or his parents, that he was born blind?" And Jesus said "Neither this man nor his parents sinned, but that the works of God should be revealed in him."

We need not imagine this man is the sole exception to a hard and fast rule. While Jesus isn't in the regular habit of miraculously healing anyone who comes to Him, He is also not assigning blame for whatever conditions we may have, whether we were born with them, or contracted them later on. "But God has chosen the foolish things of the world to put to shame the wise, and God has chosen the weak things of the world to put to shame the things which are mighty; and the base things of the world and the things which are despised God has chosen, and the things which are not, to bring to nothing the things that are, that no flesh should glory in His presence." (1 Corinthians 1:27-29).

Make no mistake: If God has seen fit to give any man a weakness, it is for a good purpose. That purpose may be to humble the individual, as Paul's famous "thorn in the flesh", which he was given "...to buffet me, lest I be exalted above measure." (2 Corinthians 12:7). But it may also be for His own glory, because it is more impressive when God uses the weak than the strong. We're talking about a God who used His own death to defeat sin. I can say this much: Bible Brain likely would not exist had it not been for my own infirmities, including my autism.

Only God knows all things. Beyond Him, no one can be expected to understand every intricate detail of every possible condition. But no one has the right to use that ignorance to deny, or belittle, another person's condition. Mental health is as real as physical health, and indeed it is physical, because the brain is a physical organ. When it is affected, so are we, and so mental health is physical health, and but for divine intervention, it cannot be wished away. Therefore, let us be Godly in our response. Let us seek to understand, let us have compassion, and let us do all this for the glory of God.

References

1. Russel, Ginny et al. - "Time trends in autism diagnosis over 20 years: a UK population-based cohort study", The Association for Child and Adolescent Mental Health, August 19th 2021 (link)

2. MacArthur, John - "Q & A Panel - For the Valley • Jonny Ardavanis, Costi Hinn, John MacArthur, Scott Ardavanis", Grace Church of the Valley, April 25th 2024 (link)

3. Lunatic Etymology - Etymology online (link)

4. Zoltán, I - Ignaz Semmelweis, Encyclopedia Britannica, February 18th 2025 (link)