A psychiatrist’s thoughts on pastors and suicide

The most encouraging ministry development I’ve witnessed in 2019 is the way God is calling so many of his people to transform ministry with individuals and families struggling with mental illness. I’m probably aware of five times as many leaders serving in mental health ministry compared to this time last year. The interest is reflected in the volume of requests our ministry team receives for training, resources and support.

One organization I hadn’t been aware of until this past week is Anthem of Hope, a faith-based non-profit “dedicated to amplifying hope for those battling brokenness, depression, anxiety, self-harm, addiction and suicide.” I suspect many in the church discovered Anthem of Hope in the same way I did – through the media coverage of the suicide of Jarrid Wilson, a young, influential pastor from Southern California who co-founded the organization with his wife, Juli.

While the suicides of other pastors have received considerable media coverage in recent years (here, here and here), the reaction to Jarrid’s death throughout the church has been qualitatively different. Perhaps the church where he served and the influence he gathered through his speaking and writing gave him a higher profile than other pastors who have died from suicide. The tragedy of his death is magnified by he and his wife having created an organization to provide hope and encouragement to people who suffered as Jarrid did. Anthem of Hope operates a 24 hour help line, and lists the National Suicide Crisis Line – (800) 273-8255 – at the top of their home page. In describing the purposes of their ministry, Jarrid and Juli state the following on their website

Through unique content creation, hope journals, workbooks and online courses, Anthem of Hope will provide the tools needed for every individual to discover that life is worth living, and that everyone has a purpose in this world.

The suddenness of Jarrid’s death and the extent to which he was able to carry out his ministry without others appreciating the intensity of mental anguish and distress he experienced at the end of his life is very unsettling. It feels like it could happen at any time to anyone wrestling with hopelessness or suicidal thinking. On the day of his death, Jarrid was officiating at the funeral of another church member who had committed suicide. Below is a photo of Jarrid posted by Greg Laurie, the senior pastor of Harvest Fellowship (the church where Jarrid served on staff) from a baptism service he took part in one week ago Saturday.

Just about everything I’ve read on Jarrid’s death has been written from from the perspective of other pastors. Ed Stetzer and Russell Moore shared excellent blog posts this past week. I thought a psychiatrist’s perspective of the struggles that contribute to suicide risk among pastors might help the leaders the church and the people of the church to better understand the care for and support needs of those who are called to shepherd us. Here are a few of my observations…

Lots of pastors have no idea where to go for help if they find themselves struggling with suicidal thoughts. Less than 30% of Christians with a family member affected by major mental illness report their churches maintain a current list of mental health professionals to share with attendees in crisis, according to a study by LifeWay Research. If pastors turn to a trusted physician within their churches for advice, they’re significantly less likely to be referred to a psychiatrist than if they approached a non-Christian physician.

Pastors in need of mental health care are all too often unable to afford it. Congregations owe it to their pastors to provide them with health insurance necessary to access care without having to worry about how they might feed and clothe their families. Pastors are less likely to have insurance to offset the cost of their mental health care. Check out this survey from LifeWay reporting nearly half of Southern Baptist pastors of churches with weekly attendance of > 100 receive no health insurance. Pastors who obtain less expensive coverage through cost-sharing ministries typically receive no mental health benefits through such ministries. One such organization, Christian Healthcare Ministries (CHC) serves as a sponsor for the American Association of Christian Counselors, despite refusing to pay for services offered by any of their members. Here’s an article from CHC’s blog pertaining to mental illness written by an OB/GYN.

When facing challenges like fear, bitterness, poor self-image, lust, money troubles, grief, worry, marriage conflict or any other issue, delving into what the Bible has to say about a specific struggle will change you. Soak in God’s word. Spend time reading and contemplating it. Let the power of Scripture penetrate your soul, wash out the junk and fill you to overflowing with God’s truth and grace.

Not that I would disagree with any of that, but it appears they believe (as 48% of evangelical Christians reported in the Lifeway study) that serious mental illness may be overcome by Bible study and prayer alone.

A pastor may know where to go for help and have the resources to pay for help, but they’re sufficiently worried about the stigma of seeking help that they may go to great lengths to avoid being seen seeking help by someone from their church . In the early days of my practice, I’d occasionally see a few adults. I regularly saw one pastor on Saturday mornings at 7:00 AM because there was NOBODY in our office building at that time on Saturdays. I’ve had other ministry families come in at 7:00 PM on Sunday nights so their kids wouldn’t run into other kids from the church.

For many of the pastors I’ve come across in my professional life and ministry life, working in the church depletes their emotional resources. One explanation for research showing churchgoers experience better mental health is that they have larger social networks. That’s a good thing unless most of your social network is either demanding something from you or complaining about their experience at your workplace.

I’ve had a taste of this experience at church as a result of my day job. Because attending our home church involves a 37 mile, one way trip, our family regularly worshiped at a church down the road from my office while our girls were growing up. At one point I had about forty kids from that church as patients. I began to dread church because I’d struggle to get in and out without being bombarded by questions from families in our practice. I found having to be “on” professionally for maybe 5-10% of the families at church exhausting. Imagine having to be on for ALL of them! I wonder if pastors and their families might be healthier if they were to attend a different church than the one where they serve.

Like doctors, pastors often feel trapped in their careers. Lots of parallels exist between the medical profession (notable for the highest suicide rate of any profession) and the ministry. Both pastors and doctors are vulnerable to burnout, deal with constant criticism (patient satisfaction ratings for employed physicians, anonymous letters and e-mails for pastors), struggle to maintain excellence during a time of diminished resources and both lack the ability to leave their jobs when depleted or burdened without catastrophic consequences to their standard of living.

Joe Boyd is a former megachurch pastor who left the ministry to start his own business. He posted around this time last year on Facebook about his experience – and the experience of many of his colleagues – on being a pastor with depression and anxiety.

Some pastors (not all, but most) have no training or experience in anything other than ministry. They know that they are burnt out (or were never really a good fit) and they want to do something else, but they stay in for economic reasons. They have a family to support. When and if this fact is discovered they are shamed for it by their congregation. They also feel deep shame that they couldn’t just be faithful and make it work.

If denominations, seminaries or church boards were interested in what I had to say about pastors and suicide, here’s what I’d want them to think about…

  • Every time a prominent pastor or church leader publicly speaks about their own experience with mental illness or suicidal thoughts, it makes it easier for a struggling colleague to reach out for help.
  • Elders and church board members should ensure that pastors and their families have healthcare benefits that allow them to access counseling, medication and a continuum of mental health care without having to worry about putting food on the table.
  • Seminaries and denominations would develop services to help pastors who are unable to bear the burdens of full-time ministry to develop the skills necessary to find other means of employment.
  • In lieu of building another building, some very wealthy Christian might make a sizable gift to the establishment of a world-class mental health treatment facility for pastors and ministry families.
  • Finally…I’d want the people of the church to love, care for and support their pastors in the same way that we want them to demonstrate the love of Christ to us.

That would be a nice way to honor Jarrid’s memory.

Are you a pastor or ministry leader searching for resources to better understand how to support children, adults or families affected by mental illness in your church or in your community? Check out Key Ministry’s Mental Health Resources page, containing links to video, articles and topical blog series designed to help you minister with persons with common mental health conditions. Also available through the website are a free, downloadable mental health ministry planning tool designed to accompany Mental Health and the Church, along with links to recommended books, like-minded mental health ministry organizations, relevant research, sermons addressing mental illness, social media resources and a compilation of stories from families affected by mental illness.

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What Derek and his mom can teach the church about inclusion

Numerous friends had been badgering me to check out a restaurant located near my office with a national reputation for preparing young adults with developmental disabilities to enter the workplace. I didn’t get to visit the Two Cafe and Boutique until our daughter from med school was in town and she and my wife were in search of something healthy for lunch. I’d been told by folks involved with our ministry that I needed to meet Shari Hunter, the founder of the Two Cafe and Foundation. I had some time this past week to hang out with Shari at the Cafe. She has lots of very relevant ideas and experience to share with the disability ministry community.

I didn’t know about Shari’s connections with the church until our recent conversation. She’s a graduate of Cedarville University. Her husband (Nate) served as a pastor at several churches in our immediate area. Her current mission began when their youngest child (Derek) was identified at birth with Down Syndrome.

The cafe and foundation derive their names from Ecclesiastes 4:9-10 (ESV).

Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up his fellow. But woe to him who is alone when he falls and has not another to lift him up!

Shari discussed her parenting approach with Derek when the Today Show sent a crew to do a feature on the cafe.

“I was so concerned for Derek and for his future,” Hunter said. “And mostly because I was afraid of what society thought, and I felt society didn’t really provide equal opportunities and acceptance.”

She made a promise to herself then: “I will never label him and I will never limit him,” she recalled. “I’m going to raise him just like I’m raising (my other children) Christian and Tiffany. We’re just going to see what happens. We’re going to see what he can do.”

Her approach to parenting ultimately led to a vision for a different employment model for young adults with what she describes as “exceptionalities.”

Hunter is particularly interested in hiring individuals who recently graduated from high school or from sheltered workshops, government-run programs in which people with disabilities (or exceptionalities, as she calls them) work, often for less than minimum wage.

“It’s so important because right now, individuals that are transitioning out really don’t have a lot of good options,” Hunter said. “And so they are sitting at home. They’re bored. They’re depressed.”

But she doesn’t believe segregated work sites are the solution. The world needs community-based employment. In other words, more places like Two Cafe.

“We have to have higher expectations, not lower,” Hunter said. “We need to provide more opportunities, not less. We need to have clearer, firmer discipline with love, not less. And I want young parents to know those things.”

Even if, as Hunter has learned, that means letting them figure some things out on their own.

“I tell parents all the time, ‘Yeah, we love to put them in a bubble and protect them,'” she said. “But that is the worst thing we can do. Just let them go and make their choices and sometimes make their own mistakes. That’s what it’s about. That’s life. That’s parenting.”

The Today Show segment captures Shari’s vision of the Two Cafe.

I got to meet Derek when I came by to visit. He’s far more optimistic than I am about the Browns this season. He’s “launched” from his home more successfully than most young adults I know. Derek is married to Lauren (who he met through work). They have their own home in a nearby community. Lauren owns her own gift basket business. Derek and Lauren both drive. They also go to a different church than the one Derek’s parents attend.

The Two Cafe approach is based upon a peer buddy model. They train employees to assume the role of a job coach and provide support to students working in the cafe. The principles of their training don’t necessarily need to be applied in a food service business. Two Cafe has relationships with approximately 20 businesses in the greater Cleveland area that provide permanent employment to individuals who train in the restaurant.

Shari and I got into a conversation about how the values that shape Two Cafe might be applied in the church. These are some thoughts on what a “Two Cafe” approach to ministry  might look like with kids and adults with exceptionalities.

Names, not labels. We would look at each person as an image bearer with unique gifts and talents to contribute to the church. No one would be described as having “special needs.”

Excellence in all we do. We would expect them to serve, and to do so with the same standard of excellence as everyone else representing the church in an area of ministry.

Celebrate strengths and diversity. We would spend more time identifying what our attendees can do and building upon their strengths as opposed to conceptualizing them by what they can’t do.

We are all better when we do life together. We wouldn’t have “siloed” ministries for persons with disabilities. We’d be looking to include them in worship services and all the other ministries and activities charged with making disciples.

Shari’s goal is to launch 100 sites around the country offering the type of work experience currently provided in the cafe in Chagrin Falls. Could there possibly be a better place to host this type of job training than a church, a Christian school or university or a Christian-owned business?

Interested in bringing Two Cafe to your community? Click here if you’re interested in learning more from Shari’s team.





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A different way of looking at “Christian Privilege”

While checking my social media accounts upon returning home from an evening with my lovely wife, I saw that #ChristianPrivilege was trending on Twitter. If you click the link, you’ll find a number of comments that are somewhat less than complimentary about the teachings and practitioners of our faith.

Not being a recent college graduate or someone who might be considered a social justice warrior, my first instinct was to think of the incredible privileges we enjoy as Christians. I was studying Romans 8 earlier this week. Just within that one chapter of the Bible, we’re reminded of the following privileges:

  • Freedom from condemnation (verse 1)
  • The presence of the Holy Spirit within us (verse 9)
  • Eternal life (verse 11)
  • Status as the adopted sons and daughters of God (verses 14-16)
  • Justified before God (verse 33)
  • Conquerors (verse 37)
  • United forever with Jesus (verse 39)

In the social justice sense, privilege is often defined as

Unearned access to resources (social power) that are only readily available to some people because of their social group membership; an advantage, or immunity granted to or enjoyed by one societal group above and beyond the common advantage of all other groups. Privilege is often invisible to those who have it.

The concept of privilege is frequently associated with the theory of intersectionality that seeks to describe culture in terms of oppression resulting from inequalities in power or social influence associated with identification with a particular group identity.

Intersectional theory asserts that people are often disadvantaged by multiple sources of oppression: their race, class, gender identity, sexual orientation, religion, and other identity markers. Intersectionality recognizes that identity markers (e.g. “female” and “black”) do not exist independently of each other, and that each informs the others, often creating a complex convergence of oppression.

In some ways, the Christian life represents the ultimate demonstration of “unearned access to resources.” As a result of Jesus’ death and resurrection, all who are recipients of God’s unmerited favor (otherwise known as “grace”) are justified by faith and gain access to the very throne of God.

Where it doesn’t fit is the “only readily available to some people” part of the definition. Scripture is clear that adoption into God’s family and membership in the church is available to all.

For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.

John 3:16 (ESV)

Jesus said to her, “I am the resurrection and the life. Whoever believes in me, though he die, yet shall he live, and everyone who lives and believes in me shall never die. Do you believe this?”

John 11:25-26 (ESV)

Because, if you confess with your mouth that Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved. For with the heart one believes and is justified, and with the mouth one confesses and is saved. For the Scripture says, “Everyone who believes in him will not be put to shame.”

Romans 10:9-11 (ESV)

From a Christian anthropology, the ultimate “oppression” might be seen as any barrier or impediment that gets in the way of people coming to faith in Jesus. We as individuals do that when we act in a manner that compromises our witness. The institutional church does so whenever it acts in a way that drives people away from the Gospel. The church does so when it tolerates the systematic abuse of women and children, when persons in position of leadership place too much importance upon seeking access to political power, and when it twists and distorts the gospel to the point at which it becomes devoid of all meaning and power.

What might fit into the concept of “Christian Privilege” is the way in which the leadership of churches from every theological orientation often fail to recognize and act upon the many barriers (physical, cultural and programmatic) that become impediments to persons with physical, intellectual, developmental and mental health disabilities to full participation in the life of the church. Here are some questions church leaders might consider in examining the ways we disadvantage children and adults with disabilities:

Do we hide behind our exemption from the Americans With Disabilities Act to justify our reluctance to eliminate the physical barriers to the spaces in which worship and other ministry activities take place?

Does your church not only welcome persons with disabilities, but give them meaningful opportunities to serve?

Does your church shame individuals with mental health conditions by making blanket assumptions that their condition is a result of personal sin or some other spiritual failure?

I would think that the idea of privilege as it pertains to status and persons with disabilities in the church is one area both theologically liberal and conservative churches might consider without the divisiveness often associated with intersectionality theory. With that said, I’d like to issue a little challenge.

In our experience, it’s VERY unusual to encounter requests for assistance in launching or growing ministries to persons with disabilities from the types of churches that embrace the concepts of privilege and intersectionality. Prove me wrong. Feel free to fill the comments section below with links to the ministry initiatives your churches have launched to elevate the status of persons with disabilities in your church. Here’s a link if you’d like free resources or support from our staff to help you launch or grow your disability ministry.

Our true Christian privilege is the privilege to serve. One of the best ways for Christians to change the ways in which our faith is perceived by secular culture is through serving and elevating the status of the most vulnerable in society.
Are you a pastor or ministry leader searching for resources to better understand how to support children, adults or families affected by mental illness in your church or in your community? Check out Key Ministry’s Mental Health Resources page, containing links to video, articles and topical blog series designed to help you minister with persons with common mental health conditions. Also available through the website are a free, downloadable mental health ministry planning tool designed to accompany Mental Health and the Church, along with links to recommended books, like-minded mental health ministry organizations, relevant research, sermons addressing mental illness, social media resources and a compilation of stories from families affected by mental illness.

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The trial of Dr. Josephson

Allan Josephson is one of the most highly regarded child and adolescent psychiatrists in America. He headed up the child psychiatry division at the University of Louisville for the past fifteen years. He is the principal author of the practice parameter on assessment of the family from the American Academy of Child and Adolescent Psychiatry (AACAP). He would be considered one of the world’s leading experts on the role of family in treating kids with common mental health issues, including trauma. If one were to compile a list of academics  in our field who might be considered unassailable, I would have thought Dr. Josephson would have been on that list. I would have been wrong.

From the Louisville Courier Journal:

A University of Louisville medical professor sued U of L President Neeli Bendapudi and other school officials this week, claiming he was demoted and will be effectively fired over comments he made about how to treat transgender children during an off-campus panel.

In a new federal lawsuit, Dr. Allan Josephson, a university employee, claims he was retaliated against for exercising his First Amendment rights.

What exactly was Dr. Josephson accused of?

Josephson was chief of the U of L medical school’s Division of Child and Adolescent Psychiatry and Psychology for nearly 15 years but was demoted soon after speaking in late 2017 at an event for the Heritage Foundation, a conservative, nonprofit public policy think tank, according to his lawsuit.

During that event, he discussed his professional opinions on the treatment of children who experience gender dysphoria — views similar to those he had expressed as an expert witness in various legal cases.

Specifically, Josephson’s lawsuit says the professor generally made the following comments, among others, during his Heritage Foundation appearance:

  • He noted that the “notion that gender identity should trump chromosomes, hormones, internal reproductive organs, external genitalia, and secondary sex characteristics when classifying individuals is counter to medical science.”
  • He noted that “transgender ideology neglects the child’s need for developing coping and problem-solving skills necessary to meet developmental challenges.”
  • He indicated parents should empathetically listen to their kids and then “use their collective wisdom in guiding their child to align with his or her biological sex.”

Dr. Josephson was interviewed last week by National Review. I definitely encourage our followers to read the entire article. Here are a couple of highlights:

MK: The other thing you mentioned is that — to those outside this world — it can seem as though there are only a handful of doctors expressing your view, which makes them much easier to dismiss as crackpots or whatever.

AJ: I think it takes a certain academic perspective and knowledge of the field to say something. It can be lonely. For me, it was really three things.

First, it was a conviction that I had been wronged. It was just this moral sense. You don’t do this to someone who had worked this hard for university and in a few weeks get rid of them for expressing a view, which is really part of your job description. So there was a kind of a righteous indignation.

Second, I saw parents and children being hurt by this. These kids are, for the most part, very vulnerable people. You can see that when you spend time with them. Certainly, the teenagers have multiple problems. Most of the time, 60 or 70 percent of the time, depression, anxiety, substance abuse, they’re hurting people. And parents are confused because they’re basically getting one message from medical and mental-health professionals and that is “Affirm people.” And so I have encouraged people to explore before prescribing treatment, specifically to consider other developmental factors, family factors, that have gone into the insecurities that are associated with this.

And, and then finally, I spoke up because I’m at the end of my career. I have accomplished a lot professionally and had an established reputation. If someone like me can be demoted, harassed, and then effectively fired for expressing my views, think of what an intimidating effect this has on younger professionals, who are not yet established in their careers. And that should not be how academics proceeds or how science proceeds. We think together, we reason together, we talk together. My colleagues couldn’t do that. And I think we see that nationally as well.

Why are we talking about this?

Treatment of gender discordance is becoming a hot button topic in the autism and special needs communities. Some question the apparent overrepresentation of kids with autism among minors who are undergoing hormonal transitioning with hormones. In this news report out of the U.K. from last year, 35% of all child and adolescent patients served by the only gender clinic offering puberty-blocking drugs to youth were identified with autism spectrum disorders. I’m planning to explore this issue in a future post.

I have serious concerns regarding the objectivity of the evaluations and clinical recommendations given to families of kids who present to gender clinics. One interesting revelation from a high profile court case involving custody of a teen with gender discordance was the “concern” expressed by the judge that the Transgender Program at the Cincinnati Children’s Hospital deemed “100% of the patients…who present for care” to be “appropriate candidates for continued gender treatment.” The program had 965 active patients at the time of this case. In another study from the U.K., the number of referrals to the nation’s gender identity development service increased by approximately 1,000% between April 2011 and April 2017.

I’m very concerned about the ability of adolescent patients to provide truly informed consent to treatments associated with a substantial risk of sterility.

My biggest concern is whether sufficient evidence exists to demonstrate that the treatments offered to kids with gender discordance (puberty blockers, gender-affirming hormones) are safe and effective in reducing the levels of comorbid mental illness and suicidal thinking/behavior common in this population. For an excellent summary of the research, check out this article in the British Medical Journal’s Evidence-Based Medicine blog, most recently updated on April 13, 2019. Here are their conclusions:

There are significant problems with how the evidence for Gender-affirming cross-sex hormone has been collected and analysed that prevents definitive conclusions to be drawn. Similar to puberty blockers, the evidence is limited by small sample sizes; retrospective methods, and loss of considerable numbers of patients in the follow-up period. The majority of studies also lack a control group (only two studies used controls). Interventions have heterogeneous treatment regimes complicating comparisons between studies. Also, adherence to the interventions is either not reported or inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding.

An Archive of Diseases in Childhood letter referred to GnRHa treatment as a momentous step in the dark. It set out three main concerns: 1) young people are left in a state of ‘developmental limbo’ without secondary sexual characteristics that might consolidate gender identity; 2) use is likely to threaten the maturation of the adolescent mind, and 3) puberty blockers are being used in the context of profound scientific ignorance.

The development of these interventions should, therefore, occur in the context of research, and treatments for under 18 gender dysphoric children and adolescents remain largely experimental. There are a large number of unanswered questions that include the age at start, reversibility; adverse events, long term effects on mental health, quality of life, bone mineral density, osteoporosis in later life and cognition. We wonder whether off label use is appropriate and justified for drugs such as spironolactone which can cause substantial harms and even death. We are also ignorant of the long-term safety profiles of the different GAH regimens. The current evidence base does not support informed decision making and safe practice in children.

The University of Louisville just fired a highly regarded, full professor of child and adolescent psychiatry for questioning the use of hormonal treatments for which there is little evidence of effectiveness and lots of unanswered questions regarding short and long-term safety in a youth population at very high risk of mental illness and suicidal thoughts and behavior. What message does this send to any clinicians who might question the wisdom of “gender-affirming treatment?”

From what I’ve been able to gather from a variety of online sources, Dr. Josephson’s arguments are based upon what had been accepted wisdom in the care of kids with gender discordance until about five years ago and aren’t based upon any specific religious concerns or objections, although there are those who hold such objections.

There’s one more thing folks need to know about Dr. Josephson. He is (was) probably the most prominent Christian in academic child psychiatry. He’s the past-President of the psychiatry section of the Christian Medical Dental Association. He wrote a book used in many training programs to help young psychiatrists to understand the impacts of spirituality and worldview in clinical practice. I’ve previously met him at several dinners he organized for Christians attending the AACAP meeting. He’s a very impressive man and a credit to the practice of medicine.

It’s ironic that at a time when Christians are becoming more open and accepting of welcoming and including persons with mental illness, the mental health field (and academic medicine, in particular) seems to be growing less and less tolerant of colleagues with a Christian anthropology or worldview.
Are you a pastor or ministry leader searching for resources to better understand how to support children, adults or families affected by mental illness in your church or in your community? Check out Key Ministry’s Mental Health Resources page, containing links to video, articles and topical blog series designed to help you minister with persons with common mental health conditions. Also available through the website are a free, downloadable mental health ministry planning tool designed to accompany Mental Health and the Church, along with links to recommended books, like-minded mental health ministry organizations, relevant research, sermons addressing mental illness, social media resources and a compilation of stories from families affected by mental illness.

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How any church can “Make ‘M Smile”

I’ve wanted for many years to attend Make’ M Smile, an annual community festival held in Downtown Orlando every year on the first Saturday of June to celebrate children and adults with special needs and their families by Nathaniel’s Hope, a wonderful Christian organization that has helped churches from all across the country to launch respite ministries serving special needs families. The Orlando celebration his grown to involve tens of thousands of people with dozens of sponsors, including corporations not normally associated with Christian events. The entire undertaking seemed so overwhelming that it was hard for me to imagine that many other churches would be capable of hosting something so large.

I was delighted to learn several months ago that Make ‘M Smile was coming to Ohio. I was more surprised to hear it would take place in Hartville, a small town about equidistant between Akron and Canton, and hosted by Harvestime Apostolic Temple, a church committed to serving families of kids with special needs but considerably smaller than several in the area with well-known disability ministries.

The folks from Harvestime put together a wonderful event together with the leadership team of Nathaniel’s Hope. There were a wide variety of activities and stations located around the park and lots of happy people to welcome and hang out with the VIP guests.

The therapy dogs were certainly a big hit!

The staff from Cleveland’s contemporary Christian music station (95.5 The Fish) were there to do a live broadcast.

Quite a few organizations serving families with special needs were in attendance including this group from Pegasus Farms, a facility offering equine-assisted therapy.

There were plenty of activities over the course of the day. It got pretty hot as the day went on, so there were no shortage of volunteers to sit in the dunking booth or visitors to the snow cone cart. The Stark County Department of Developmental Disabilities brought a large contingent with them to help connect families with available services in the area. Free lunch was provided. Of course, Nathaniel put in a special appearance.

New friendships were made…

Given that the event was called Make ‘M Smile, the evidence suggests the day was a rousing success! Smiles were had by all!

My biggest takeaway from the event is that Make ‘M Smile represents a great model for a summertime special event to share God’s love with kids and adults with a broad range of disabilities. Marie Kuck and her team have developed a model for a celebration that churches of all sizes might easily replicate, with each event taking on its own unique flavor from the sponsor, the event venue and the mix of participating disability-related organizations.

Make ‘M Smile would be most impactful for churches with an established disability ministry. It wouldn’t make a lot of sense for a church to host the event if they aren’t prepared to invite and welcome their VIP guests and their families to a weekend worship service. Hosting an event might serve as a great catalyst for relationship building between church leaders and disability organizations in the communities they serve. While this  event serves as evidence that a large church isn’t necessary for success, the ability to recruit volunteers and to execute a good publicity plan would be essential.

Wouldn’t it be wonderful if Make ‘M Smile events were available in as many cities as the Night to Shine proms hosted by hundreds of churches every winter?

Interested in hosting Make ‘M Smile in your community? Reach out to Marie and her team  at Nathaniel’s Hope to learn more about making it happen!

In Mental Health and the Church: A Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions, Dr. Stephen Grcevich presents a simple and flexible model for mental health inclusion ministry for implementation by churches of all sizes, denominations, and organizational styles. The book is also designed to be a useful resource for parents, grandparents and spouses seeking to promote the spiritual growth of loved ones with mental illness. Available now at Amazon, Barnes and Noble, ChristianBook and other fine retailers everywhere.

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Are kids from devoutly Christian families with same-sex attraction at higher risk of suicide?

The featured article in this month’s Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is titled LGBT Youth, Mental Health, and Spiritual Care: Psychiatric Collaboration With Health Care Chaplains. As one of a very small number of Academy members in a position to comment on the cultural competency necessary in working with Christian families who adhere to traditional church teaching regarding sexual expression, I’ve been wrestling with how to best respond to the authors.

One reason this is such a big issue is that the authors are making statements in one of the most influential and prestigious journals in our field about what constitutes ethical care of youth with same-sex attraction not just for child and adolescent psychiatrists and other mental health professionals, but for chaplains providing spiritual care and support with children and teens in hospitals and other healthcare facilities.

After describing the two to fourfold greater risk of suicide among students who self-identify as members of a sexual minority, the authors make the following statement:

The religious/spiritual beliefs and traditions of LGBT youth, their families, and communities could be important related issues. Different religious and spiritual traditions hold various beliefs and attitudes about LGBT people, whose sexual orientation, gender expression, or identity might differ from family and social expectations and norms. Struggles over self-acceptance and whether to come out to others are typical, sometimes anguishing, challenges unique to these youths’ development. Health care chaplains might be uniquely positioned to help clinicians address mental health issues related to whether a patient’s spiritual/religious tradition is affirming or non-accepting of being LGBT—for culturally competent, humanistic care and to support positive clinical outcomes. This article discusses principles of health care chaplaincy for LGBT youth and families, opportunities for collaboration, and a framework for coordinating ethical chaplaincy and medical practice when religiously based stigma causes mental health risk.

In the paper, the authors present and discuss two case vignettes – one involved a college age student who had undergone male to female hormonal transitioning and struggled with body image issues upon following hair loss as a side effect of treatment for leukemia. The other vignette described a 15 year-old Latino boy from a devoutly Catholic family who verbalized to his father that the cardiac arrest that led to his hospitalization was a warning sign from God to “stop liking boys” – an interpretation his father agreed with.

Before making specific suggestions or criticisms of the approach they took in each case, I thought it important to seek to understand the thoughts and assumptions guiding their treatment. From the paper’s abstract:

Lesbian, gay, bisexual, and transgender (LGBT) youth have unique medical and mental health needs. Exposure to stigma such as family non-acceptance is associated with adverse mental health outcomes that are important sources of morbidity and mortality in this population. These include depression, anxiety, substance abuse, suicidality, and risk behaviors that mediate exposure to human immunodeficiency virus and sexually transmitted infections. Different religious and/or spiritual traditions hold various beliefs and attitudes about LGBT people. These can be a factor influencing a youth’s risk of experiencing stigma. Other unique developmental challenges of LGBT youth, such as conflicts over identity integration and disclosure, also can be influenced by religious/spiritual factors. Health care chaplains could collaborate with clinicians to support mental health by helping LGBT youth and families integrate religious with other aspects of identity, decreasing religiously based stigma, and supporting family connectedness.

This statement from the discussion section of the paper jumped off the page at me.

To serve widely diverse patient populations, chaplains take a nonjudgmental approach to the content of individuals’ beliefs and practices. However, chaplains can encounter stigmatizing attitudes among patients, families, or health care systems that increase risk for morbidity and mortality in LGBT youth. In providing spiritual care, chaplains can empathize with family concerns without validating stigma and preserve paths to novel solutions. They might discuss the meaning of LGBT identities or fears of non-acceptance in the context of a given faith tradition and explore awareness of accepting traditions. Chaplains can collaborate with psychiatrists to ensure that parents with non-accepting attitudes are aware of their risks and appropriate resources and help these parents process their religious commitments in light of evidence-based clinical recommendations(Emphasis mine.)

To summarize the thinking of the paper’s authors…

  • Stigma related to family non-acceptance of a student’s sexual minority status increases risk of suicide.
  • Youth from spiritual traditions that are non-affirming of sexual contact between members of the same sex are at a higher risk of religiously-based stigma and hence, suicide.
  • Ethical approaches to reducing suicide risk in sexual minority youth might include directing the youth to places of worship within their family’s broad spiritual tradition that affirm sexual expression in the context of same-sex relationships or encouraging families to “process their religious commitments in light of evidence-based clinical recommendations.”

If the flagship journal of the child psychiatry academy is suggesting that clinicians and chaplains act ethically by urging youth with same-sex attraction to explore more “affirming” houses of worship than those in which they have been raised and families to “process religious commitments in light of evidence-based clinical recommendations,” is there evidence to support their assumption that teens from “non-affirming” families and churches at greater risk of suicide? Let’s look at the data.

It’s generally accepted that suicide rates among kids from families with higher levels of religious commitment and worship attendance (predominantly Christian churches in studies conducted in the U.S.) are lower than those of kids from less religious families. In a three-generation study from Columbia University of families at high risk of mood disorders, parent belief in the high importance of religion was associated with an approximately 80% decrease in risk in suicidal ideation/attempts in their offspring compared with parents who reported religion as unimportant. The association of parental belief was independent of the offspring’s own belief in the importance of religion and other parental risk factors and was statistically significant. 85% of subjects in this study identified as Christian (59% Roman Catholic, 26% Protestant), and the mean age of subjects was 12.5 years.

Results of this longitudinal study of 9412 respondents from four waves of National Longitudinal Study of Adolescent Health indicate that religious activity participation is associated with reduced suicidal behaviors among adolescents but this effect declines as they approach adulthood. In adjusted models, weekly church attendance at baseline was associated with a 42% reduction in suicide ideation by Wave III. This study by the same author suggests protective effects of religiosity in reducing suicidal behavior were prominent in adolescence but not in young adulthood. Analysis showed the early adolescent period represented an important window of opportunity for preventing escalation of suicidal thinking and behavior. Another study of suicidality among predominantly Roman Catholic youth in Mexico demonstrated internal religiosity (personal convictions and beliefs) did not appear to protect against suicidal ideation, but external religiosity (frequency of church attendance) did exert a significant protective influence.

In all of these studies, religiosity had a greater impact upon suicidal behavior in female adolescents, and in no study was data broken out by sexual orientation.

The authors cited this article from 2011 in Pediatrics on the relationship between social environment and suicide attempts among self-identified LGB youth. In this study of over 31,000 eleventh grade students in Oregon, the 4.4% who self-identified as lesbian, gay, or bisexual youth were significantly more likely to attempt suicide in the previous 12 months, compared with heterosexuals (21.5% vs 4.2%). The risk of attempting suicide was 20% greater in “unsupportive” environments compared to supportive environments. A more supportive social environment was significantly associated with fewer suicide attempts, controlling for sociodemographic variables and multiple risk factors for suicide attempts, including depressive symptoms, binge drinking, peer victimization, and physical abuse by an adult. A problem with this study is there is no direct evidence that suicidal behavior was correlated with internalized religiosity, church attendance or involvement with religious traditions that prohibit same-sex sexual relations. The authors used the following assumptions to develop a composite index of the “supportiveness” LGBT students were likely to experience across 34 different counties in Oregon. Supportive counties were defined by:

  • The proportion of same-sex couples
  • The proportion of registered Democrats
  • The presence of gay-straight alliances in schools
  • School policies (nondiscrimination and anti-bullying) specifically protecting lesbian, gay, and bisexual students.

This study from Archives of Suicide Research examined the relationship between religious conflict, sexual identity, and suicidal behaviors among a self-selected sample of LGBT young adults (ages 18-24) who completed an online survey nearly twenty years ago. Subjects with parents holding anti-homosexual religious beliefs experienced a 1.565 x greater risk of suicidal thoughts in the last month and were more than twice as likely report a suicide attempt in the last year compared to other participants. The same study revealed leaving one’s religion of origin due to religious conflict was associated with a 1.335x  greater risk of suicidal thoughts and a two-fold greater risk of a suicide attempt in the past year.

Another study drawing from a University of Texas research database of over 21,000 18-30 year-old students demonstrated that increased importance of religion was associated with higher odds of recent suicide ideation for both gay/lesbian and questioning students. For bisexual students, the importance of religion was not associated with suicidal behavior, while religiosity was protective against thoughts of suicide and suicidal attempts among heterosexuals. Lesbians and gays who reported that religion was important to them were 38 percent more likely to have had recent suicidal thoughts (52% more likely among lesbians). The study was limited by a lack of detail about whether a participant’s specific religion had stigmatizing views of sexual minorities.

In summary, here’s what the available research suggests:

  • Religiosity appears to play an important protective role in protecting against suicidal behavior in adolescents. The protective effects of church attendance and religiosity appear to have a greater impact upon females than males, and may diminish during the transition to adulthood.
  • There is no data I could identify demonstrating increased risk of suicidal thinking or behavior in kids under the age of 18 resulting from parents or churches prohibiting homosexual contact.  
  • There is data in studies of young adults with same-sex attraction reporting higher rates of suicidal thoughts and attempts among participants for whom religion has greater importance and higher rates of suicidal behavior among those who leave the religion in which they were raised.

In the absence of any data supporting an association between traditional religious beliefs and increases in suicidal thinking or behavior in children and adolescents, suggesting an ethical mandate exists to influence kids with same-sex attraction to leave their places of worship for more “affirming” congregations or suggesting parents need to “process their religious commitments in light of evidence-based recommendations” is extremely premature at best, demonstrates an extraordinary lack of cultural sensitivity and ignores the ways in which spiritual formation and church attendance may help mitigate the increased risk of suicidal behavior among sexual minority youth.

How might church attendance benefit sexual minority youth? What if the higher rates of suicide described in this population are related to earlier onset of sexual exploration?

We know family religiosity is negatively associated with lower rates of adolescent sexual activity, fewer sexual partners and delayed onset of sexual activity in teens. Here’s a study suggesting the younger the age at which young men with same sex attraction begin to progress through developmental milestones of sexual identity – awareness, identification, sexual experience, and disclosure – the greater their difficulties with emotional dysregulation, sexual compulsivity, anxiety and depression in adulthood.

This study reported sexual minority youth, in comparison to heterosexual peers are twice as likely to have sexual intercourse prior to the age of 13, more likely to be sexually active and more likely to have had four or more sexual partners.

Let’s look at some of the findings from this study out of the U.S. Centers for Disease Control on the relationship between sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12.

How is sexual orientation related to self-reported prevalence of “serious” suicidal ideation?

Serious suicidal thoughts

18% of U.S. high schoolers expressed “serious” suicidal thoughts in the past year – 15% among heterosexual students, 43% among LGB students, and 32% among youth identifying as “not sure” of their sexual orientation. Rates are clearly higher among females as opposed to males, consistent with what we know about sex ratios of suicidal ideation in teens. Two observations…

  • The frequency with which high schoolers across the board endorse the presence of serious suicidal thoughts is unacceptably high for kids of all sexual orientations.
  • The statistics describing rates of suicidal ideation among LGBQ teens are especially  alarming and public health interventions targeted at reducing suicidal ideation and behavior among sexual minority youth are clearly indicated.

One approach the government has taken in response to the very high rates of reported suicidal ideation among sexual minority youth has been to implement anti-bullying strategies in schools across the country. The CDC made very specific support recommendations to schools for supporting youth from sexual minorities. LGBQ kids report more victimization from bullying than heterosexual peers.

Bullying at school

In the sample, 20.2% of all students; 18.8% of heterosexual students; 34.2% of LGB students; and 24.9% of “not sure” students had been bullied at school during the twelve months prior to the survey. Put differently, LGB students are about 80% more likely and “Q” students are about 30% more likely to be bullied compared to “straight” peers.

Let’s examine the impact of sexual contact on suicidal ideation in teens.

Suicidal ideation by sexual contact

  • Overall, students who experienced sexual contact with the same or both sexes were approximately 225% more likely to experience serious suicidal thoughts than students who had sexual contact with the opposite sex only and 370% more likely to experience serious suicidal thoughts than students with no sexual contact.
  • Boys who experienced sexual contact with the opposite sex only were twice as likely to report serious suicidal ideation than those with no sexual contact.
  • Girls who experienced sexual contact with the opposite sex only were nearly 60% more likely to report serious suicidal ideation than those with no sexual contact.

Let’s look at the data on high schoolers who developed a suicide plan

Suicide plan

  • Overall, students who experienced sexual contact with the same or both sexes are approximately 250% more likely to report having developed a suicide plan than students who had sexual contact with the opposite sex only and 390% more likely to report having developed a suicide plan than students with no sexual contact.
  • Boys who experienced sexual contact with the opposite sex only were 78% more likely to report having developed a suicide plan than those with no sexual contact.
  • Girls who experienced sexual contact with the opposite sex only were 55% more likely to report serious suicidal ideation than those with no sexual contact.

Here’s the data on suicide attempts and sexual contact

Suicide attempts

  • Overall, students who experienced sexual contact with the same or both sexes are approximately 285% more likely to report having attempted suicide compared to students who had sexual contact with the opposite sex only and 650% more likely to report having attempted suicide than students with no sexual contact.
  • Boys who experienced sexual contact with the opposite sex only were 215% more likely to report having attempted suicide compared to those with no sexual contact.
  • Girls who experienced sexual contact with the opposite sex only were 300% more likely to report having attempted suicide than those with no sexual contact.

Next, let’s look at kids who received medical intervention as a result of a suicide attempt

Suicide and medical intervention

  • Overall, students who experienced sexual contact with the same or both sexes are approximately over three times more likely to have been seen by a doctor or nurse following a suicide attempt compared to students who had sexual contact with the opposite sex only and over twelve times more likely to have been seen by a doctor or nurse following a suicide attempt than students with no sexual contact.
  • Boys who experienced sexual contact with the opposite sex only were seven times more likely to have been seen by a doctor or nurse following a suicide attempt compared to those with no sexual contact.
  • Girls who experienced sexual contact with the opposite sex only were over three times more likely to have been seen by a doctor or nurse following a suicide attempt than those with no sexual contact.

The data suggesting a relationship between early onset of sexual behavior and suicide is overwhelming – yet we never hear about interventions to delay the onset of sexual activity as a strategy for reducing suicide rates in youth – especially sexual minority youth!

In conclusion… There is no clear evidence growing up in a family with traditional religious beliefs related to sexual expression or attending a church espousing traditional beliefs makes kids any more likely to attempt or commit suicide and overwhelming evidence that teens who delay the onset of sexual activity – gay as well as straight – are much less likely to struggle with suicidal thoughts or behavior.

Editor’s note: One area in which I’m in agreement with the authors is in asserting there is no evidence that sexual orientation can be altered through therapy, and attempts to do so could be harmful

Are you a pastor or ministry leader searching for resources to better understand how to support children, adults or families affected by mental illness in your church or in your community? Check out Key Ministry’s Mental Health Resources page, containing links to video, articles and topical blog series designed to help you minister with persons with common mental health conditions. Also available through the website are a free, downloadable mental health ministry planning tool designed to accompany Mental Health and the Church, along with links to recommended books, like-minded mental health ministry organizations, relevant research, sermons addressing mental illness, social media resources and a compilation of stories from families affected by mental illness.

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Are we “pro-family” to families from the church?

I spent parts of three days in Colorado Springs this past week at a meeting for Christian leaders convened by the Center for Public Justice and sponsored by the Flying Horse Foundation on providing paid leave to parents and caregivers who are eligible to take unpaid time off under provisions of the Family Medical Leave Act (FMLA) but are unable to do so for economic reasons.

I discovered during my time in Colorado that considerable bipartisan support exists in Washington for legislation to provide paid leave to parents around the birth or adoption of a child. I also discovered that many churches and parachurch organizations are far less supportive of families dealing with a birth, an adoption, a disability or acute care needs than secular organizations.

I saw data presented at the meeting from a Seattle Pacific University study of family- supportive employment practices in the “sacred sector” – churches, schools, charities and healthcare facilities associated with a broad range of Christian denominations. Here is one slide that caught my attention…

According to the American Academy of Family Physicians, the minimum time required for mothers to recover from childbirth is 6-8 weeks. The typical length of paid leave for new mothers working for Christian organizations from all sources (vacation, sick leave, short-term disability) is six weeks.

I’ve become aware of two situations* involving ministry families through my practice that illustrate ways Christian organizations failed to demonstrate integrity with their professed ministry values. In one instance, a parent resigned because their employer refused them the necessary scheduling flexibility to get multiple children to regularly scheduled mental health appointments. In the other, a parent from an adoption ministry needed to leave their job when evening and weekend work demands threatened their ability to bond with a newly adopted child.

I have no reason to believe after the meeting that any legislation likely to become law will help address the day-to-day challenges of parents of children with chronic disabilities. But surely the church can do more to support the caregivers in our midst. We shouldn’t have to wait for the government to take care of our own. Consider the following:

What could your church do to support new mothers in spending more time with their infants – especially new mothers who live paycheck to paycheck? What about parents who have recently adopted a child – especially children with significant trauma exposure or special emotional, behavioral or developmental needs?

What could your church do to help support families in which parents regularly need to use unpaid family leave time to attend school meetings or transport kids to medical and therapy appointments? 

Does your church provide pastors and staff members with health insurance that enables each member of the family to access the medical and mental health care they need with affordable copayments and deductibles? 

If you’re interested in learning more about evangelical efforts to expand the availability of paid family leave, check out Families Valued.

*Some details were changed to protect the confidentiality of the families described in this post.

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What the Babylon Bee can teach the church about mental health ministry

The Babylon Bee is one of my guilty pleasures. For those of you who are unfamiliar, the Bee is a wickedly funny satire site written by Christians, for Christians – like the Onion, but better – that lampoons politicians of both parties, televangelists, Christian celebrities, denominations, Hollywood and pop culture. More so than anything else, the Bee makes fun of church culture.  If I have a couple of minutes between patients in the middle of the afternoon, I’ll go check out their daily updates. I’ll find my wife staring at me in the evening when I have my computer in my lap and appear to be laughing for no apparent reason.

The secret of the Babylon Bee’s success is that their satire is almost always rooted in an element of truth.

Adam Ford is the founder and editor of the Bee. My guess is the vast majority of readers are unaware that the Bee was launched as a consequence of Adam’s struggles with mental illness. Here’s an excerpt of an interview Adam did three years ago following the launch of the site with Daniel Darling of the ERLC for Christianity Today:

I’ve always been inclined toward art and humor, but never thought it would be my “thing,” really. After God saved me about 11 years ago, I was pretty sure I would be a preacher. That’s what I saw myself doing. But then about 6 years ago, I was blindsided by a serious generalized anxiety disorder/panic disorder/social anxiety that changed my whole life. I went from an extrovert to an extreme introvert, and things like speaking in front of people now terrify me. But I still had the strong desire to speak the truth to people. The webcomic and news satire site were born out of that.

Adam goes on in the interview to share his thoughts on the importance of satire in the church:

It’s important to look at what we’re doing, to “examine ourselves.” Satire acts like an overhead projector, taking something that people usually ignore and projecting it up on the wall for everyone to see. It forces us to look at things we wouldn’t normally look at and makes us ask if we’re okay with them. And sometimes it just makes us laugh.

As a daily follower of the site, an aspect of church culture Adam has been “projecting up on the wall for everyone to see” involves church customs and practices that cause discomfort for persons with mental illness – especially attendees with symptoms of social anxiety.

Just this past week, the Bee highlighted the ongoing propensity of too many Christians to assume mental health struggles are a direct consequence of personal sin, and that prayer and Scripture reading are sufficient to address all mental health concerns.

One of the most biting posts I’ve come across on the Bee challenged common attitudes in the church regarding mental illness.

The most prominent mental health-related theme regularly highlighted by the Bee involves customs and practices that are challenging for adults uncomfortable with social interaction – no big surprise in light of Adam’s personal experiences. Check out this litany of posts that describe a church-based minefield for someone with social anxiety disorder:

Screenshot courtesy of the Babylon Bee

Or, my favorite… Churchgoer Leaps Through Window to Escape Holding Hands in Prayer Circle

Adam helps us to find the humor and absurdities in our church customs and traditions. But he also expects us to “ask if we’re okay with them.” He regularly provides a lighthearted, first-person perspective as a prominent individual in Christian culture whose ministry has been shaped by his mental health condition. The Bee shines a spotlight on the challenges many people with anxiety experience in trying to be part of church.

For that we should be grateful. Not everyone is in on the joke.

In Mental Health and the Church: A Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions, Dr. Stephen Grcevich presents a simple and flexible model for mental health inclusion ministry for implementation by churches of all sizes, denominations, and organizational styles. The book is also designed to be a useful resource for parents, grandparents and spouses seeking to promote the spiritual growth of loved ones with mental illness. Available now at Amazon, Barnes and Noble, ChristianBook and other fine retailers everywhere.

Posted in Anxiety Disorders, Hidden Disabilities, Inclusion, Key Ministry, Mental Health | Tagged , , , , , , | Leave a comment

A letter to #MyYoungerSelf

Editor’s note: The Child Mind Institute has launched the #MyYoungerSelf campaign during Mental Health Month to counter the stigma for the 1 in 5 children struggling with these disorders. This May actors, athletes, social influencers, business people and others are sending a message of hope about their experiences growing up with a mental health or learning disorder. Here’s a letter from the leader of our ministry team to an eleventh grade boy who was going through a difficult time. 

Hey Doctor Grcevich,

Yes, DOCTOR Grcevich. You’re actually going to pull it off – getting accepted to med school before you graduate from Boardman. An amazing accomplishment.

There are many days at work when I wish I could go back to high school knowing what I know now. God gave me the opportunity to write you this letter from the future to encourage you during an especially hard time.

I’ll share a few things that may help you get through these days…

That image in your mind of a future as a fiercely autonomous family doc practicing in some snowy location out west?  The only part of that you’ll see is the snow. You’re going to end up as a child and adolescent psychiatrist! WHAT? Literally thousands of kids won’t have to endure the stuff you’re going through right now because of your help. That should help you get through many years of late night studying.

You’ll have a second career in ministry, but you won’t be a minister. God actually has something in mind that may impact more people. It ties into the child and adolescent psychiatrist thing.

And this…You’re NEVER going to believe the wife God has in store for you. Her beauty is exceeded only by her character. You’ll be the envy of many of your friends and colleagues for much of your adult life.

The thoughts and emotions you’re currently experiencing will end.

You’ll receive this letter in the late winter of 1977-78. Your life feels like it is crashing and burning. You may be the smartest kid in your class, but you might also be the biggest underachiever. You’re barely getting a “C” in AP calculus I, and you’re fighting with your guidance counselor about taking AP Calculus II as a senior because they think you’ll fail next year and they don’t have another class to put you in if you do. Other grades are lower than they should be. You’re often up at 4 AM doing the homework and test preparation you should have done the night before but couldn’t force yourself to do. You don’t have any study halls because you literally can’t get anything done when you have one and spend the entire 50 minute period staring at the clock. This lack of self-discipline extends to other areas of your life. You’re probably the best athlete in your school not playing on a varsity team because you couldn’t force yourself for two years in a row to do the necessary conditioning work in the summer to be ready for football two-a-days.

There’s an explanation for what you have. In the future it will be called ADHD, but the term hasn’t yet been invented. It’s a brain disorder characterized by issues with inattention, disorganization, motivation, self-discipline, procrastination and sometimes, impulsivity and/or hyperactivity. There’s a related condition called “hyperkinetic disorder of childhood,” but no one in 1978 would think it applies to you. It’s still common four decades later for very bright kids to go undiagnosed because they can underperform academically for a long time without their grades dropping so low where teachers and school officials notice. I bring it up because you’re so hard on yourself. Maybe you’re doing the best you can with the abilities you have?

But that’s not the difficult part of your life at this moment…

The thing that hurts you the most is that you’re desperately lonely. If  you were growing up in 2019, I’d hope a good clinician would ask enough questions to recognize the extent to which anxiety impacts your life. Seriously…you were given a prized season ticket as a member of your middle school basketball team to your high school’s sold out games and you never went because you weren’t sure anyone would sit with you? How have you gotten  through nearly three years of high school without once eating lunch in the cafeteria? You’re afraid of embarrassing yourself in line or think you have lots of friends but no friend group to sit with? Pretending for years that you have no interest in girls because that gave you cover for avoiding situations that made you feel uncomfortable? Remember the one party you’ve attended in high school? How you left when you heard someone mention the possibility of playing “spin the bottle?” Do you think other kids sit for hours trying to work up the courage to call someone on the phone? You’ve never been to a dance in high school. Saturday nights are spent holding back tears thinking about the things you’d like to do while listening to classic rock on WDVE or WMMS.

Today, there are psychologists and counselors who can help with the types of anxiety you experience. They use an approach called cognitive-behavioral therapy in which they help kids like you to recognize all the silly, non-sensical thoughts that cause you to avoid doing things you need to do to not be lonely. Your school’s psychologist is trying to help, but he couldn’t know how – the research hasn’t yet been conducted. I can tell you that doing what you’re doing now…thinking that if you achieve enough and develop enough status that girls will seek you out and peers will welcome you into their circles…won’t work.

It probably doesn’t help that your parents have extraordinarily high expectations for you. Not every mom points out sites for their kid’s inaugural activities on the family vacation to Washington DC.  You may be misinterpreting what they say and it’s possible your folks are just trying to build your confidence, but I understand how you’d conclude anyone short of the most desirable girl in your school would be perceived as a disappointment at home. That’s a lot of pressure on someone with so little social experience

Since I need to get back to my work, here’s what you’ll most need to know to get through this time in your life…

Take some chances! If you had any idea how many other kids feel the same way you do…unsure of themselves, lacking confidence, wanting someone to see them as they are and like them anyway, hoping someone will want to sit with them at lunch, go with them to the basketball game, or be their prom date…you’d be a lot less anxious and uncomfortable around the other kids at school and your last year and a half of high school will be filled with lots of great memories. I see it every day in my office. Kids who you’d think have it all together. Girls you think are unattainable. You’ll see. You’ll have a conversation on the night before your last day of high school with the last person in your class you’d expect to be lonely.

You need to be a little less judgmental of your peers. Not everyone can endure the stuff you’re going through. Maybe the reason so many kids in your class drink excessively is they’re using alcohol to overcome their own anxieties in social situations? Maybe they violate sexual boundaries because they’re afraid of ending up alone – like you?

You know how you often think late nights, early mornings and intense sadness are God’s way of preparing you for difficult challenges in the future? God won’t waste any of the hurts you’re currently experiencing. You’ll develop a reputation as an outstanding clinician because you’ll know the right questions to ask and be able to empathize when kids with issues similar to yours are struggling. You may find yourself having to choose between your profession and your faith, or needing to take some very unpopular stands. I trust your experiences in difficult times will give you confidence you can endure the consequences of doing the right thing when the time comes.

King Solomon was right. God really does order our paths. I never imagined the life I have now. Looking back, there are no accidents. Without certain setbacks and experiences, you’ll never meet the people who will be most important to you in life. Seek to honor and glorify God and trust that all things will work together for good.

One last piece of advice…don’t get too attached to the Browns unless you’re looking for an unending source of frustration and disappointment!

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Janet Parshall…Disability Ministry Champion

Editor’s note: Janet Parshall will be serving as keynote speaker for Inclusion Fusion Live, a national disability ministry conference sponsored by Key Ministry. Click here to learn how you might join us for the conference on April 5th and 6th, 2019 at Bay Presbyterian Church in Bay Village, Ohio.

Janet Parshall is one of America’s most prominent talk show hosts. Her radio program is heard for two hours every weekday on over 700 stations through the Moody Radio Network. She regularly discusses very contentious social and political topics with guests on her program, which seeks to examine major news stories and issues being debated in the marketplace of ideas from the perspective of the Word of God. So, you ask… How does Janet end up being selected to serve as the featured speaker for a large disability ministry conference we’re hosting this coming week?

When our ministry was seeking to get the word out last year about our book describing a model for outreach and inclusion with families affected by mental illness, Janet was the most prominent person within the Christian community to offer us her platform. On the very day that Mental Health and the Church was released, she afforded me the better part of an hour to help get the word out about the book. She’s done the same for other disability ministry advocates, including Diane Dokko Kim, Shannon Royce and Emily Colson. I was delighted to learn that Janet was a fan of the work being done by our Key Ministry team when I was interviewed for her program.

This past September, I had the opportunity to present as part of an expert panel convened by the Office of Faith-Based Partnerships of the U.S. Department of Health and Human Services to advise the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) on the role of faith-based communities in improving access to treatment, services and support for individuals and families touched by mental illness. Who should I happen to find at the conference table on the opposite side of the room from me? Janet! We had the opportunity to get together for lunch. It was at that meeting that I felt led to extend her an invitation to serve as the keynote speaker for Inclusion Fusion Live.

Janet’s long history of advocacy for persons with disabilities isn’t the only reason why I wanted her to have the opportunity to attend our conference and connect with the leaders and speakers in attendance. I knew Janet could speak into disability issues from the perspective of someone who has been there and done that.

Janet’s daughter, Sarah Parshall Perry has served for several years on the writing team for Key for Families/Not Alone, our blog and Facebook page for providing encouragement and support for families of children with disabilities. A sample of Sarah’s writings for our ministry may be found here. Sarah is the author of the best-selling book Sand in my Sandwich, the title of which is derived from a statement by her son (Noah) prior to his autism diagnosis in which he was attempting to describe the texture of the strawberry jelly in his sandwich. More recently, Sarah has eloquently described her family’s experiences as Noah has been identified with several co-occurring mental health conditions along with autism.

In addition to Janet’s keynote presentation, Janet and Sarah will be interviewed together about their family’s experiences by Brian Dahlen and Jannelle Nevels, our emcees for the conference and co-hosts of a popular morning drive time show on our local Moody affiliate serving northern Ohio and Northwest Pennsylvania.

We would be delighted for as many of our readers as possible to join us in person for Inclusion Fusion Live. This is an opportunity to gather together with other families impacted by disability and church leaders seeking to support and care for them. Attendees will have an opportunity to meet Janet in person and to get a signed book. Blog readers and Moody Radio listeners can get an additional $10 off our deeply discounted family tickets by entering the code MOODY at checkout. Click here to learn more about the fabulous lineup of speakers for Inclusion Fusion Live and to register for the conference.

Key Ministry depends upon the prayers and generosity of Christians who support our mission of connecting churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. Our mission is to connect churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. Your financial support is essential to our ability to continue our work throughout 2019. Please consider making a gift to our ministry if God has provided you with the means to do so.

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