Ministers who take care of everyone’s needs but their own often end up needing ministering themselves.

Or as psychologist Darcy Ing might say to a pastor suffering from burnout, "The Bible tells us to love each other as ourselves, not better than ourselves."

Clergy of all faiths in emotional turmoil can find direction and support at the Counseling & Spiritual Care Center of Hawai‘i, which celebrated its 24th year in the state this spring. Ing said a large part of the center’s mission is to offer programs designed specifically for clergy, including personality evaluations and support groups, in addition to continuing-education workshops for religious leaders and their congregations.

What distinguishes the center, formerly called the Samaritan Counseling Center of Hawai‘i, from other counseling groups is that it combines science with an understanding of the spiritual. It also helps people with no religious ties.

"The unique perspective we bring is that we understand the domain of the spirit and how sacred traditions enhance our lives," the center says on its website, www.cscch.org.

Mental Health America has designated May as Mental Health Month, but people often take clergy members for granted as spiritual caregivers, not those in need of care, Ing said in an interview.

"The pastor, whether Buddhist or Christian or Jewish, is a human being first. People tend to believe that they’re superhuman in some ways, which is why we tend to be more horrified when we find out, oh my god, pedophilia! or whatever, because we have all these perfect expectations of them," said Ing, a psychologist at the Counseling and Spiritual Care Center.

"Ministry is extremely rigorous, with a lot of demands," but religious leaders are notorious for not taking the time for taking care of themselves, said Ing, who is also a minister of the nondenominational Johrei Foundation faith. "Being a minister can be a lonely business because you’re up at all hours. People will call you at 2 a.m. — oh my god, somebody just died, can you come right now? You’re on call a lot," she said.

Ministers who come in for counseling are asked such questions as, "‘How do you take care of you? Does your family get to see you ever? Do you have your own personal prayer practice? Do you take vacations when you need it?’ Because a lot of them don’t," Ing said. "It’s like a pitcher of water. If you end up pouring yourself out for everybody all the time without pouring something in once in a while, you end up empty."

Gary Augustin, a therapist at the doctoral level who has been at the center since 1997, recommended regular evaluations for ministers to avoid burning out and becoming more vulnerable to "slippery slopes" that end disastrously.

"A trend occurring in Christian churches is that people over the last 20 years, I would say, have been moving away from a service delivery model to an executive model. A lot of churches put pressure on their clergy to produce like a CEO in a company when they’ve been trained all their lives to provide service to others. And so this frequently creates dilemmas in churches," he said.

Pastors get burned out and angry over demands to increase the budget, the number of parishioners and the like, and they might leave the ministry or get fired, Augustin said.

Sometimes clergy are given a personality evaluation test to detect "red flags" as part of their therapy, he said. Testing can uncover elevated levels of anger, suspicion, confusion, anxiety, depression, physical body pain or the tendency to overreact, or "certain combinations that would raise concerns," he said.

A large proportion of the center’s clients are Christian — including members of the United Church of Christ, Methodists, Episcopalians and Lutherans — though the Honpa Hongwanji Mission of Hawaii recently asked for workshops on bereavement and marriage counseling, and other subjects. There has been an increase in requests for training clergy and educational support overall, as surveys reveal that most people go to their ministers first for mental health concerns, Augustin said.

An ordained Christian minister, Augustin does individual as well as pastoral counseling. He tries to match clients with a counselor of their own faith if they request it, but he and other staff have worked with people who belong to different religious groups.

"My training is to focus on where their spiritual concern is and not really try to convince them of my frame of reference or what my perspective is, but to really be sensitive and thoughtful to their religious needs and concerns," he said.