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Episcopal inkblots: Does the Church need mental health screenings for bishops?

When priests gathered this week for the installation of a new bishop in northwestern Minnesota, some conversations turned to the last bishop to lead the region: Bishop Michael Hoeppner, who resigned earlier this year after a Vatican investigation into serious lapses of leadership.

Several Crookston priests told The Pillar their “war stories” about dealing with a bishop they said was a difficult personality. And some asked a question which advocates for victims of clerical sexual abuse have also raised in recent years: Why don’t potential candidates for the episcopacy undergo psychiatric or psychological evaluations before they get the job?

It is possible to imagine that, in light of recent experiences, some in the Holy See might be asking the very same question.

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Some of those who dealt with Hoeppner in Crookston describe the man as a narcissist — and many say that his personality impeded his ability to make sound judgments, to be a father to his priests, to lead the diocese as it needed to be led.

Priests describing other bishops under investigation have used the same language.

Of course, those who recount such things are not qualified psychologists; they speak from personal experience, not clinical expertise.  

But qualified experts have made the same point. Psychotherapist Richard Sipe railed for years about the relationship between clinical narcissism and clerical sexual abuse. Psychologist Peter Kleponis has made the same point, arguing that “basic narcissism” has led to clerics leading double lives.

In fact, Kleponis, Sipe, and other experts have said consistently that narcissism and other personality disorders are often correlated with spiritual or physical abuse, or even just bad leadership.

“It’s my seminary rector. And I’m late for Morning Prayer.” Inkblot. public domain.

Psychological evaluations have become commonplace in the Church before admission to seminary or ordination to the presbyterate. Men seeking to become even permanent deacons undergo a battery of psychological tests. But when the Church considers a priest for appointment to the episcopate, it might be decades since he last had a psychological evaluation.

In the years since priestly ordination, new psychological issues might have developed, once-latent problems might have become severe, or simple cognitive decline, caused by any number of physical or psychological issues, might have begun to impact judgment and discretion.

And those personality issues sometimes go undetected by those most directly involved in evaluating clerics for leadership positions — namely other bishops, who suggest the names of qualified candidates to the apostolic nuncio.


In recent years, the Holy See has shown new awareness of the mental health needs of bishops. U.S. apostolic nuncio Archbishop Christophe Pierre is widely known, for example, to have supported Bishop James Conley’s 2019 request for a leave of absence to seek treatment after the bishop was diagnosed with major depressive disorder. Pierre also approved Conley’s decision to return after the bishop got treatment.

Indeed, not all mental health diagnoses are considered invalidating for the episcopate, or should be. 

But priests who have suffered under bishops with serious, enduring, unrecognized and untreated psychological maladies have begun to ask why the Holy See doesn’t add a mental health component to the list of qualities required for episcopal leadership.

Could it happen? It’s hard to say.

Asking a man to undergo a mental health evaluation, and maybe even a physical, before accepting an episcopal appointment would not be outside the Church’s standard practice for ordination to sacred orders. And pragmatists in the Holy See would likely argue that such evaluations could save the Vatican the kind of buyer’s remorse it has seemed to experience with some recent appointments.

Further, media reports indicate that priests are turning down episcopal appointments more frequently in recent years — as bishops look further down the bench to find candidates they can put in the game, there might be an awareness in Rome that some of those priests are likely to have issues which have gone unseen.

But there is also the possibility that psychological testing would be seen as beneath the dignity of the office, or an insult to a potential episcopal candidate. 

During November’s meeting of the U.S. bishops’ conference, bishops had near uniformly positive things to say about Fr. Michael Fuller, newly elected general secretary of the USCCB. But even among those who most vigorously praised both Fuller and his election, some bishops told The Pillar they were surprised to see no change to the conference process of screening and evaluating candidates for the secretary general position, after Fuller’s predecessor, Msgr. Jeff Burrill resigned less than a year into the job when it was reported that he was consistently engaged in behavior inappropriate for a cleric.

An aversion to rock “the way we do things” remains strong in some elements of ecclesial culture.

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At the same time, both Vos estis investigations and media attention to episcopal misconduct since the McCarrick scandal have made clear that among the Church’s bishops, some men are struggling mightily. Some could use the help that might come from therapeutic interventions. Some could use more support from the pope’s representatives, or even their metropolitans. And some, according to the priests who suffered their leadership, never should have been made bishops in the first place.

Would it hurt the Church if a man were asked to see a shrink before accepting his call to episcopal ordination? Not nearly as much, some priests argue, as it hurts the Church to see bishops ordained lacking sound minds to accompany stout hearts.

Will the Holy See address the issue? To ignore it, some priests have told The Pillar, you’d have to be crazy.

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