Matthew Warren, the son of Pastor Rick Warren. (Uncredited/Associated Press)

In the days after the suicide of California megachurch pastor Rick Warren’s son, evangelical Christian leaders have begun a national conversation about how their beliefs might sometimes stigmatize those who struggle with mental illness.

Well-known evangelical figures called for an end to the shame and secrecy that still surrounds mental illness throughout U.S. society and a greater embrace of medical treatment, particularly among evangelicals.

“Part of our belief system is that God ­changes everything, and that because Christ lives in us, everything in our hearts and minds should be fixed,” said Ed Stetzer, a prominent pastor and writer who advises evangelical ­churches. “But that doesn’t mean we don’t sometimes need medical help and community help to do those things.”

The death of Matthew Warren, 27, who shot himself Friday, stunned evangelical Christians. Most were unaware that Rick Warren, the best-selling author of “The Purpose Driven Life” and a pastor known for frank talk on subjects including politics, marriage and sex, was struggling with such a serious family problem. Rick Warren wrote to his congregation at Saddleback Church in Lake Forest, Calif., that “only those closest” knew that his son had long been suicidal, despite receiving the best of spiritual and medical care.

Rebekah Lyons, a blogger and wife of the popular pastor Gabe Lyons, wrote this week that “anxiety and panic are my nemesis” and urged Christians not to link mental illness with spiritual weakness.

The Post’s Sally Quinn talks with Saddleback Church co-founder Kay Warren on doubting God’s existence, the HIV/Aids epidemic and why God allows suffering. (From the archives: August, 7, 2012) (The Washington Post)

“As Christians, we believe this side of heaven all disease, sickness and pain is rooted in a world broken by sin. But there are real consequences to living amidst the mess. To oversimplify these complexities would be naive at best, negligent at worst,” she wrote.

The revelation has spurred discussion within church communities about how a fervent belief among evangelicals in the power of prayer and dependence on God and Jesus for healing might stifle congregants from talking about mental illness or seeking help for themselves or family members.

For Christians who believe in turning to a divine source for emotional help, even defining a prayerful request can be fraught, some leaders and congregants pointed out. For example, is depression the result of sinful behavior for which one should seek forgiveness? And if prayer does not bring relief, what might God be saying?

When people suffer despite prayer and consider therapy, “people think: ‘Is this a knock against my faith? Am I not believing in God enough? Now I have to resort to this?’ ”said Henry Davis, leader of the evangelical First Baptist Church of Highland Park. “I believe God is in therapy. I believe God can be in medicine. If someone says, ‘I’m just going to pray,’ you have to do more.”

Calling suicide “a dark secret people don’t want to talk about,” Davis decided to raise the issue of Matthew Warren’s suicide on Sunday, encouraging his Landover congregation to pray for the Warren family. In private conversations after the service, one congregant confided in Davis that he had nearly killed himself a year or two before. Then Davis learned that another congregant who died a few days earlier had hanged himself.

“I think talking about suicide that day opened up some people to be free enough to approach me,” he said.

William and Naomi Powell lead a support group at First Baptist for people who have lost loved ones to suicide. Their son, William Jr., killed himself in 2003, although they think he was mentally healthy and don’t know why he decided to end his life.

But they know that his death forced them to reconsider their beliefs.

The Mitchellville couple wrestled with the belief held by many evangelicals — and people of other faith traditions — that those who end their own lives are going to hell. Only God can give or take life, some believe. Several people told them that after their son’s death.

“We had that question, too,” William Powell said. But after some research and conversations with others, they found solace in the note their son left behind. “At the end, he said: ‘Lord have mercy on my soul.’ I know just by that request, that appeal, that my son was ushered into heaven.”

Stigma, discomfort and disagreement about mental health issues are hardly confined to religious communities or evangelical Christians.

Traditional Catholicism and Judaism teach that suicide is immoral and may impact one’s existence after death. For centuries people of those faiths who ended their own lives were commonly refused burial in official cemeteries, although that is no longer the case.

Protestantism doesn’t teach that committing suicide affects someone’s standing with God after death. But while evangelical Christians vary in their approaches to the topic, many conflate mental illness and spiritual struggle and look first to God for healing.

When Michelle Freeman’s husband came to her a decade ago, struggling with depression, her advice was clear: There’s no such thing as depression. He was battling internally because he was resisting God, Freeman remembers telling her now ex-husband.

“He didn’t want to bend the knee. God was drawing on his heart, and he was refusing it,” she said this week, paraphrasing a talk that now makes her cringe.

Raised in a traditional Methodist home, she had joined a small fundamentalist church in Loudoun County for a time in which the pastor taught that all healing rested with God. She has since left that church and today considers herself a devout, if churchless, Christian. Her own struggle with depression a few years later led her to believe that psychological struggles don’t signal a lack of faith in God.

The desire to unify beliefs in psychology and those in God have produced a recent boom in faith-based counseling. This includes counselors who meld prayer, medication and secular concepts as well as those who focus primarily on prayer. Some evangelicals, including Stetzer, said it can be dangerous for people to confuse “spiritual struggles” with mental illness. “It’s exceedingly important that we get the difference.”

The topic of mental illness and church silence has gained steam lately because of the school shootings in Newtown, Conn. Rick Warren and his wife, Kay, were among the major leaders previously scheduled to attend a meeting in a few weeks to help form a clearer Christian approach to mental health. Another participant is Southern Baptist Convention President Frank Page, whose daughter Melissa killed herself in 2009 at the age of 32.

This week, Page said that the problem of stigma is a societal one but that “most churches aren’t stepping up to the plate to talk about the elephant in the room.” He said the “niceties in Christian society” are a roadblock, but theology can appear to be one too.

Mike Fewster, a pastor at Chantilly’s New Life Christian Church, can relate to Matthew Warren’s struggles. Fewster, 44, fought various addictions and considered killing himself before he was hospitalized and diagnosed with bipolar disease. His problems led him to found a weekly support group to encourage others to open up, but about half of the group’s members come from churches where they don’t feel comfortable sharing their struggles.

“For a lot of people, church is just a place they go, a building, they put on their suit and tie, stand up when they’re told to and check a box, but that’s not supposed to be church,” he said. “There is this false idea that church people are perfect. I try to say: ‘Until you break that, you’ll never get healing.’ ”