On several fronts, local groups are working to provide mental-health information and training to clergy. Since late 2001, the Utah chapter of the National Alliance for the Mentally Ill (NAMI) has been holding training sessions for bishops, Relief Society leaders and other members of the LDS lay clergy. Some of these regional meetings, says NAMI Utah executive director Vicki Cottrell, have drawn as many as 1,000 people. NAMI Utah has also contacted other denominations, she says, but "they haven't gotten back to us."

But all clergy could benefit from more training, she says. "Even if you have a master's in social work, do you really have a connection with what a person is living with? What we're trying to do is open up empathy for people living with this, and their families."

The group began holding the sessions, she says, "because so many people were saying, 'My bishop doesn't understand what I'm going through.' " As evidence of a lingering confusion about mental illness, she points to questions asked at the sessions, particularly those that equate depression and the "dark behavior" of sinfulness.

The Mental Health Resource Foundation, whose board members are largely LDS but who hope to provide assistance to all religious faiths, has a Web site with links and resources about mental illness and is putting together a checklist for clergy. This list, says Elder John Lasater, LDS general authority emeritus, would help clergy evaluate whether a particular problem requires immediate medical attention, spiritual counseling alone, or a referral to a mental-health professional after the problem is "stabilized."

Salt Lake psychiatrist Dr. Gregory Ellis suggests that a good role of thumb for clergy, when a parishioner confides about emotional problems, is to "listen to what the past 10 days or two weeks has been like." Has the person "been in that malady for most of the hours of those past 10 or 14 days?" Is he doing something potentially dangerous to himself or others? If so, he says, that's when a referral to a mental-health professional is in order.

Sometimes, notes Ellis, a bishop or pastor or rabbi might need to sort out whether a person who is consumed by guilt has a mental condition such as obsessive compulsive disorder or clinical depression, or whether the depression is caused by a disconnect between a person's actions (engaging in premarital sex, for example) and his belief system (which might teach that premarital sex is a sin).

This is where things can get problematic, since moral values can color a diagnosis and a prescription for treatment. When the questions revolve around a patient's doubt about his religious upbringing or his faith in God, things get even touchier. While a religious leader, and some therapists, might see the issue as getting a doubter back on the right spiritual track, others might prefer to let a client explore that doubt.