Suicidal Ideation Among Students at a United States Seminary: The "Wounded Healer" and Implications for Clergy Mental Health.

Analogous to other "helping professions," clergy often experience a higher prevalence of adverse mental health outcomes than the general population. However, it remains unclear whether this elevated risk can be attributed to work-related factors (e.g., high emotional demand and burnout) or experiences prior to entry into ministry. This study compares suicidal ideation (SI) among seminarians at matriculation to a weighted national sample and examines SI at multiple points during their degree program using repeated cross-sectional samples (n = 463 at matriculation, n = 421 at mid-program, and n = 277 at graduation). As pastors-in-training, seminarians offer insight into selection effects, including mental health factors, that shape entry into the clergy profession. Results demonstrated higher SI among seminarians at matriculation compared to a weighted national sample asked a separate SI measure (OR = 1.79; 95% CI [1.33, 2.40]; p < 0.001), with particularly elevated odds among those planning to enter congregational ministry (OR = 2.70; 95% CI [1.84, 3.87]; p < 0.001). Among seminarians, sexual minority status was positively associated with SI. Though the study did not measure within-person change, mid-program estimates demonstrated a lower prevalence of SI compared to matriculation. These differences were no longer significant once accounting for vulnerability to other mental health factors. Past experience with depression was the strongest predictor of SI. Results are consistent with the "wounded healer" hypothesis, suggesting that clergy may enter ministry at elevated SI risk prior to exposure to work-related stressors. Results underscore the need to provide tailored mental health support to seminarians before, during, and after seminary training.