The current "secular" and "religious" models of end-of-life care (and I focus on the Christian tradition) usually presuppose a patient who has the intellectual capacity to rationally complete a series of emotional tasks in order to achieve a "good death". Most of these tasks relate to healing past relational hurts, and traumas and reconciling one's relationship to God. In my experience as a hospice chaplain, I find these models are useful for most patients. However, in my hospice chaplaincy work, I am also called to care for patients who are not able to complete such tasks in a rational order because they suffer from conditions such as depression, generalized anxiety disorder, PTSD, and schizophrenia. As Clinical Pastoral Education migrated from the mental health care facilities in which it was originally conducted to hospital based settings, hospice chaplains are increasingly ill-prepared to skillfully provide spiritual care to patients with mental health challenges. This project seeks to explore how the presence of mental health challenges might require re-thinking common end-of-life care models prevalent in chaplaincy training. It also seeks to explore ways of thinking about God's presence to patients with mental health challenges, and the practical techniques of pastoral assessment, care, and support hospice chaplains need to develop to provide quality support to patients with mental health challenges at the end-of-life. While there are non-theological accounts of the virtue that medical clinicians need to develop to work with such patients, (ie Raden and Sadler's The Virtuous Psychiatrist Oxford UP 20