The “church kid” who fears she won’t be accepted

A conversation I had with a college student has been bothering me for the last couple of weeks. My interaction was indicative of the challenges churches will need to overcome if they are to truly become effective at welcoming and ministering with teens and young adults with mental health concerns. I have the patient’s permission to share their story – some non-essential details have been changed to protect confidentiality.

This is a kid who has struggled for years with ADHD and anxiety and most recently experienced an episode of depression. She reported some improvement in her depression after initiating treatment at the end of last school year and was checking in at my request while home for a long weekend from her Christian college in the Midwest.

I was asking her a series of questions to assess whether her depression was an issue for her this school year. She told me that she’d found a circle of friends and that she was getting out at least once a week. They’d go out to dinner or check out musician friends performing near her school. I asked her if she’d joined any organizations or connected with a small group or Bible study, either on campus or at the church she attends while at school. She told me a number of her friends were involved with the LGBTQ organization on campus. That wasn’t a fit for her because she’s straight. As for becoming more involved at church, here’s what she said…

“I’m afraid that the church people won’t accept someone with my mental health issues. My LGBTQ friends are accustomed to feeling like outsiders. They seem more willing to accept me when I’m struggling.”

This is a kid from a family who did pretty much everything Christian families are supposed to do to pass their faith down to the next generation. Her parents took her to church every week while she was growing up. She went on a mission trip. Her older sister was very involved with the campus ministry when she attended college in a different part of the country. She wasn’t very involved with her church’s high school ministry for a variety of reasons – her extracurricular activities and schoolwork took up a great deal of time, cliques were an issue in her youth group and she wasn’t sure how to deal with unwanted attention from a boy at church. I’m sure it bothers her parents that she’s not more involved with the ministries that operate on her campus.

I’ve written before about the importance of changing perceptions regarding the church’s receptiveness to persons with mental illness. One of the most striking findings from Lifeway’s study of Mental Illness and the Church was that a majority of adults who don’t regularly attend worship services believed that persons with mental illness wouldn’t be welcome at church. But 21% of weekly churchgoers disagreed with the statement that most churches would welcome them if they had mental health issues.

One kid’s experience isn’t necessarily indicative of a larger trend. But it’s still incredibly sad when a kid raised in the church who is working through some mental health issues avoids getting connected with Christian community in a new town because of fears she won’t be accepted.

We have a lot of work to do.

KM_ForFamilies_Logo_Color_RGBKey Ministry helps connect churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. In order to provide the free training, consultation, resources and support we offer daily to church leaders and families, we depend upon the prayers and generous financial support of readers like you. Please pray for the work of our ministry and consider a financial gift to help us cover our shortfall in 2018 and expand the work of our ministry in 2019 and beyond!



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Reasons for praise, reasons for prayer

One of the churches that financially supports our ministry reached out to us this past week with an interesting request. They asked us to share with them areas of gratitude and praise with the intent of compiling a list of blessings that will be distributed to the congregation for members to use when they gather around their Thanksgiving tables in a couple of weeks.

I was assigned the task of putting together a list of our reasons for praise as a ministry. It was encouraging – and energizing to reflect upon all of the ways that God has been at work in extending his love to families affected by disabilities.

  • The group we lead on Facebook for Special Needs and Disability Ministry leaders is serving over 1,400 members as of the beginning of November.
  • Our blog is the eighth ranked Children’s Ministry blog in the world – and second-most shared through social media.
  • We’ve received 139 requests for ministry training or consultation since January 1 – more than double the number of requests we received just three years ago. That figure doesn’t include the 45 requests we’ve received for training or consultation for mental health inclusion since April. The volume of requests has more than doubled in comparison to the similar period last year.

  • We hosted approximately 250 disability ministry leaders and family members from coast to coast for Inclusion Fusion Live disability ministry conference this past April. In addition to those in attendance, video of the conference shared through Facebook Live has received over 44,000 views to date. Our team had the opportunity to train at a very similar conference in suburban Kansas City this past October 25th and 26th.
  • On the subject of training, we’ve continued to host our monthly Disability Ministry Video Roundtables, available to any interested ministry leader. We developed a series of instructional videos on mental health inclusion ministry. Usage of  our video training (not including Inclusion Fusion Live) is up 315% over our total for all of last year.
  • Mental Health and the Church, our book that presents a model for mental health inclusion ministry, has been extremely well-received and has opened doors for training and collaboration with other ministries.
  • We had an opportunity to participate in the 2018 Evangelicals for Life Conference, sponsored by the Ethics and Religious Liberty Commission of the Southern Baptist Convention and develop resources related to mental health inclusion for the ERLC’s website.
  • We serve churches large and small. One of the neatest praise reports we have to share came about when I had the opportunity to preach at a modest-sized Methodist church in Central Ohio. A church staff member announced that four members had come forward after the first service to volunteer for their disability ministry/mental health inclusion team!

  • We’re grateful for the opportunity to do training by video on mental health inclusion for from Asbury Theological Seminary in Kentucky.
  • We launched an additional platform this past Spring on the Patheos website to provide encouragement and support to families of children with special needs. That platform alone was accessed over 9,500 times in September, the last full month for which we have data. That’s in addition to the 3.36 million views we’ve had of our blogs and website to date. We have over 11,000 people subscribed to our e-mail lists (including over 4,800 subscribers to our blog via e-mail), over 13,000 followers on our main Facebook page, and over 17,000 on our Facebook page for families.

Above all, we’re grateful to be part of a movement of God that’s so visibly transforming the ways in which churches minister with families affected by disability. At the same time, we recognize the need for prayer as we seek to be faithful to our mission in the coming months.

Our team would very much appreciate your prayers for the following requests…

Inclusion Fusion Live 2019: We’re in the planning process for next year’s conference and beginning to receive submissions from potential presenters. We’ve also received a commitment from a keynote speaker who we believe will help us attract more ministry leaders and families. More on that later. Prayers are appreciated for a conference that will draw more leaders from more churches interested in starting or expanding their disability ministries, promote new collaborations between existing ministries and offer up and coming leaders in the field the opportunity to be noticed and network.

Mental Health Ministry Roundtable: We’re going to be launching a roundtable for churches interested in mental health inclusion in 2019. Catherine Boyle will be leading the first roundtable on Wednesday, November 14th. Free registration is available here. Pray that the roundtable will be a catalyst for more churches to become more intentional in their efforts to include families affected by mental illness.

Unexpected Blessings: Sandra from our team has a new book scheduled for release on November 20th to help special-needs families move past the pain and confusion of their circumstances and slowly, firmly face the future with hope. We’d hope that her book would find its way into the hands of thousands of people who would be encouraged by her wisdom, stories and experiences.

Sufficient financial support: Spending has significantly exceeded our donations to this point in the year. We’re looking at the prospect of significant cuts in next year’s budget that will greatly impact the scope of our ministry. Two of our five core staff members (myself included) volunteer their services, and our total expenses for this year will be approximately $75,000. We don’t have much to cut. We’d appreciate prayers that we’ll have the resources to be able to conduct and expand our ministry in the year ahead. If you or your church would be willing to provide monthly support or a one time gift to support our work, your donation will be much appreciated and will be put to good use.



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Discovering God’s Purposes in Mental Illness

Here’s a transcript of Dr. Grcevich’s teaching from the Sunday worship services at Fredericktown United Methodist Church in Fredericktown, Ohio, October 21st, 2018.

Thanks to Mary and Pastor Hasley for their gracious invitation for me to join you today! It’s probably safe to say that prior to today, the prospect of a child and adolescent psychiatrist teaching at your Sunday morning worship service was only slightly less bizarre than the thought of rearranging your work schedule to attend a victory parade in Downtown Cleveland in early February on the Wednesday after the Super Bowl.

Allow me to explain a little of how God arranged for our paths to cross today. Twenty years ago, a number of well-established families from our church adopted kids with very complex emotional, behavioral and developmental issues from orphanages in Russia and Bulgaria. I was at an elder meeting where our children’s ministry director spoke of the steps the staff was taking to help the families affected stay connected with church. None of the kids being served had obvious, outward signs of disability, but the severity of their behavior had become a major obstacle to their families in maintaining their involvement with the church.

I went back to my practice and found that many of the families of kids we were treating at that time were also experiencing significant limitations in their ability to maintain an active role in their churches. This really bothered me. Over the next few years, God opened lots of doors for me. I was involved with research that provided me the opportunity to travel widely. Wherever I went, I talked about the work our church back home was doing…and our church started getting LOTS of requests for help and support. As more and more folks recognized the need to help connect churches with families of kids with what we referred to as “hidden disabilities”, Key Ministry was launched sixteen years ago. We provide training, consultation, resources and support to churches and lots of encouragement and support to families of kids with a full range of disabilities. Over 17,000 parents follow our blogs and family support sites through Facebook, and we’re responsible for an online forum serving approximately 1,400 pastors and church leaders involved with every aspect of disability ministry. We’ll be hosting a large conference in Cleveland this coming April 5th and 6th, Inclusion Fusion Live for disability ministry leaders and families affected by disability from across the country. I’d be thrilled if a large contingent from your church would come.

Leaders from your church have been involved with a study of a book our ministry authored – Mental Health and the Church. The book presents a ministry model for churches seeking to become more intentional about welcoming children, teens and adults with common mental health conditions and their families. I don’t see our role as the church as being the place folks turn to for a cure for their mental health conditions so much as that this church, and churches like yours everywhere would be places where we can help our friends and neighbors who are struggling to find friendship, encouragement and support while they come to know and experience Jesus.

What I sense God wants me to do today is to help those of you who have struggled personally as a result of a mental health condition… anxiety, depression, ADHD, a mood disorder, an eating disorder or some other condition to consider God’s purposes in allowing you or a loved one to experience that condition. For the rest of you without personal experience of mental illness, I’m going to challenge you to consider how God may want to use you to share his love and his Gospel with individuals and families who are affected by a mental health condition.

I want to begin with a brief passage of Scripture today that will lend much to our understanding of God’s purpose in allowing so many who he loves -both inside and outside of the church – to experience mental illness.  From John 9:1-3:

As he (Jesus) passed by, he saw a man blind from birth. And his disciples asked him, “Rabbi, who sinned, this man or his parents, that he was born blind?” Jesus answered, “It was not that this man sinned, or his parents, but that the works of God might be displayed in him.”

In the First Century, the natural assumption of the typical Jewish person upon encountering someone with a significant disability would be that their disability was a direct consequence of personal sin. There are many Old Testament passages…and a couple of New Testament passages as well that can be easily interpreted to support that line of thinking. In that way, the attitudes and responses of many Christians in the 21st Century to persons with mental health conditions are strikingly similar to those of the residents of Jerusalem in Jesus’ time.

We as a church have a problem when it comes to mental illness. In 2018 it’s still very common in many Christian traditions for pastors and other church leaders to default to the assumption assume that mental illness is a direct result of personal sin. While there are situations in which mental health issues arise as a consequence of behavior the Bible labels as sinful – for example, it’s not uncommon for me to see teens in my practice become depressed or develop suicidal thinking or behavior after violating Biblical limits on sexual behavior – we need to be VERY careful before assuming that someone’s mental health struggles are a result of sinful behavior.

We’re also pretty inept at supporting our brothers and sisters in Christ with the encouragement and support they need when they experience a mental health condition that causes them to question the depth of their faith. I’ve found the Christian who finds himself or herself unable to pray away their depression or the person who concludes that their anxiety is a direct consequence of the insufficiency of their trust in God often experience a sense of pain and despair far beyond that of the non-believers who experience similar conditions.

We know that statistically speaking, many persons suffering from common mental health conditions turn first to their pastors and to their churches in search of help. Dr. Matthew Stanford of Baylor University published a study demonstrating that for too many individuals, those experiences become more of a hindrance than a help.  30% of attendees who sought help from their church for themselves or a family member because of a mental health condition reported negative interactions counterproductive to treatment. Many people – especially women are told they don’t have a mental health disorder or discouraged from taking medication prescribed for their mental health condition. Study participants described feeling abandoned by their churches. One in seven said their faith was weaker after approaching their church. One in eight quit attending church completely!

A recent study conducted by Lifeway Research and Focus on the Family reported that 55% of adults surveyed who don’t regularly attend church DISAGREED with the statement “If I had a mental health issue, I believe most churches would welcome me.”

As I shared earlier, I got involved with this ministry because of my concern that the families served by my practice like were much less likely to attend church because of the problems resulting from their child’s mental health condition. Dr. Andrew Whitehead from Clemson University published a study several months ago looking at the impact of disability upon church attendance from the National Survey of Children’s Health. He noted that kids with the following conditions were significantly more likely to report never having attended church…

  • Children with autism spectrum disorders are 1.84 times more likely to never attend church.
  • Children with depression are 1.73 times more likely to never attend church.
  • Children with Oppositional Defiant Disorder are 1.48 times more likely to never attend church.
  • Children with anxiety are 1.45 times more likely to never attend church.
  • Kids with ADD/ADHD were 1.19 times more likely to never attend church.

When it comes to kids and mental health, we’re often quick to assume that kids who struggle to control their emotions or behavior have parents who lack the dedication or commitment to discipline their children appropriately.

Many years ago, the church my home church hosted a special Disability Sunday service in which a couple came forward to share their experiences in looking for a church in suburban Cleveland for their family when their two young sons who had pretty severe ADHD. She summarized their experience with the following observation…

“People in the church think they can tell when a disability ends, and bad parenting begins.”

One of the saddest stories I’ve ever heard in my thirty-odd years of practice involved a family who came from out of state after their primary care physician paid their travel expenses. The parents had recently adopted a five-year-old boy with severe ADHD and an extensive trauma history. The father was fired from his job as the senior pastor of their church after their newly adopted son punched the son of an elder and the church’s board concluded the child’s behavior disqualified the pastor for his role.

Why is it so difficult for individuals and families affected by mental illness to attend worship services and other common church activities? I’d argue that there are certain attributes associated with common mental health conditions that make it difficult for persons affected to meet the expectations in a typical church culture for conduct and social interaction. I’ll give you an example…

We know that many persons with anxiety are predisposed to greatly overestimate the risks of entering into new or unfamiliar situations. One in fifteen adults experience Social Anxiety Disorder, a condition characterized by persistent fear of embarrassing and humiliating themselves in social situations in which they are exposed to unfamiliar people or to possible scrutiny by others. Think about all the challenges that a mother of a child with an anxiety disorder who herself experiences social anxiety might encounter if they decide to come here to church for the first time some Sunday morning!

There are other barriers that individuals and families with mental illness are likely to face in attending church. We’ve already touched on stigma. Social communication can be a struggle for many. Churches are intensely social places. Someone with a condition that causes them to struggle to process body language as well as voice tone and inflection is at a distinct disadvantage. The level of sensory stimulation may be overwhelming for some persons with common mental health conditions. Mental illness produces social isolation. Some people isolate themselves as a result of their condition. Persons with depression may fall away from church, Bible study or small groups. Families of kids with serious emotional or behavioral disturbances may not have relationships with other families to invite them to church.

Mental illness runs in families. If a parent can’t attend church as a result of mental illness, all of their kids will likely miss out on the experience of church. The likelihood a young adult will be a regular church attender if they don’t attend regularly as a teenager is 3% If we don’t act to include children and adults with mental health issues at church, multiple generations will likely be lost!

I hope that we can all agree that this is not part of God’s plan. Scripture is clear that God’s intent is for all to be saved and for all to be part of a local gathering of believers. Scripture is also clear that everyone is given gifts from God intended for the benefit of the church as a whole. When anyone with gifts intended for the body is excluded, the church is less than God created it to be.

So…what is God’s purpose in allowing mental illness, and why might God choose not to affirmatively respond to the sincere prayers of someone who is hurting and in need of healing?

Here are four ideas…

  1. God uses the discomfort and distress associated with our experience of mental illness to draw us into a closer relationship with him.

Rhett Smith is a pastor and counselor who wrote a book titled – The Anxious Christian: Can God Use Your Anxiety for Good? The central hypothesis of the book is that if our anxiety becomes an impetus for us to turn to God, to deepen our relationship with God or to become more dependent upon God, then God’s purposes are fulfilled.

Go back through Scripture and take a look at what godly people do in response to the distress. In Psalm 102, the psalmist (possibly David) cries out to God when afflicted with symptoms consistent with depression. When the Prophet Elijah was filled with fear, fleeing from Jezebel after destroying the prophets of Baal, he turned to God in prayer (1 Kings 19) and God responded by comforting him and ushering him into an extended time of communion in preparation for the next phase of his ministry. What did Jesus do in his greatest moments of distress? He turned to his father in prayer!

If God valued being in relationship with each of us so much that sent his son to suffer horribly and to die to make that relationship possible, God’s likely to place a greater priority upon that relationship than upon our immediate comfort. If our experience of mental illness or our experience of a loved one with mental illness drives us into a deeper relationship with God, that’s a good thing from God’s perspective.

  1. God may use the experience of mental illness to cultivate within us a greater awareness of his sovereignty and an ability to manifest contentment in the midst of our distress that presents an unmistakable witness to his power and character.

John Piper has said that God is most glorified in us when we are most satisfied in him. Is it possible that God may choose not to relieve our suffering associated with mental illness because our ability to demonstrate contentment and joy in the face of suffering is when the works of God are most on display in us?

You’ve probably come across this verse before from Philippians 4:6-7

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.”

Paul was writing this letter to the church at Philippi while he was under house arrest, most likely chained to a Roman soldier. The theme that runs throughout the entire letter is Paul’s overwhelming sense of contentment in the knowledge that God was in control of his circumstances. This was written by the same guy who five to seven years before when he was writing to the Corinthians spoke of burdens so severe that he “despaired of life itself.” Paul never promises that the anxiety described in Philippians 4 will be taken away. What he is promising through our prayers is the sense of peace that comes from the recognition that God is in control of all things and submitting to his will.

  1. God may use people with firsthand experience of mental illness to comfort and minister to others who are affected. Check out 2 Corinthians 1:3-7:

Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, 4who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort too.[a] If we are afflicted, it is for your comfort and salvation; and if we are comforted, it is for your comfort, which you experience when you patiently endure the same sufferings that we suffer. Our hope for you is unshaken, for we know that as you share in our sufferings, you will also share in our comfort.

I had an opportunity last month to meet Kay Warren for the first time. Talk about a family with a devastating experience! I can’t imagine the pain Kay and Rick experienced after losing their young adult son Matthew to suicide after many years of therapy and multiple hospitalizations for mental health concerns. But God has seen fit to use them to launch a mental health ministry through Saddleback Church with the potential to impact untold numbers of families affected by mental illness. Almost everyone I know in mental health ministry has had some personal or family experience with mental illness that guides and shapes the ministry they offer to others.

Finally, is it possible that God might be using mental health concerns as an instrument for bringing about the salvation of those affected? What if God plans to use someone’s mental health condition…or the condition of a loved one as the means of connecting them with individuals and churches positioned to introduce them to the Gospel?

What might that mean for your church?

It might mean developing an overarching strategy for welcoming and including individuals and families affected by mental illness into all of your church’s ministries.

It might mean considering how the new spaces for ministry being created through your construction project might be sensory-friendly. Sensory processing differences are common in persons with anxiety disorders and ADHD in addition to being an issue for many persons with autism.

It will likely lead to a plan to include them in your small groups, and to ensure there are small group leaders trained to disciple and support them.

It will involve giving folks permission to talk about mental illness…and letting families affected by mental illness in the surrounding community know they’re welcome here. You’re off to a great start by inviting me! In the study referenced earlier from Lifeway Research and Focus on the Family, the most frequently expressed desire of church members with mental illness and their family members was to hear their pastors preach more frequently on mental health-related concerns.

It will mean providing tangible and practical help to address the needs of children and adults with common mental health conditions who are already part of your church and those without a church but are living in the surrounding community. That help might include…

  • Taking a casserole to a family when their child or their mother or father is admitted to a psychiatric hospital.
  • Having different couples in your small group take turns providing in home respite care and support to a family of a child with serious emotional or behavioral challenges who can’t find babysitters or appropriate child care so that the parents might enjoy an evening out or some quiet time together…or supporting families serving in foster care or families who have adopted children who struggle with emotions or self-control in the aftermath of significant trauma or neglect.
  • Maintaining an up to date list of mental health service providers to families in need or providing short-term financial assistance to individuals and families unable to access mental health care.
  • Offering someone who understands education law to attend school meetings with parents of children with mental health conditions to help them get the necessary accommodations and supports necessary to learn to their level of ability.

It may mean that your church begins to host educational or support groups for individuals and families in your area affected by mental illness. We work with a couple of awesome ministries…Mental Health Grace Alliance and Fresh Hope – that offer a variety of group models for churches seeking to care for and support persons in their communities with common mental health conditions or past experiences of trauma.

It may mean someone in your church volunteers to serve as a mental health liaison… a point person for including an individual or family into the life of the church who needs a little extra help in joining activities designed to help them grow in faith.

It also means that many of you are going to need to step up and embrace a role in ministry with persons with mental illness. Your pastor and church staff likely have more on their plates already than they can reasonably be expected to handle. Are you ready to “be the church” as opposed to being someone who goes to church?

Let me ask you some uncomfortable questions! It’s what I do at my “day” job.

How important is your faith in Jesus to you? Important enough for you to NEED to share it with someone else?

How important has your church been in helping you to come to faith and grow in your faith? Important enough that you want other people you know…friends, neighbors, people you know from work or school, extended family – to have a similar experience?

Important enough that you’re prepared to take seriously the Great Commission to go and make disciples? To not be content with simply putting your tithe or offering in the collection plate and paying the staff of your church, or supporting some individuals or ministries to do it?

So, if your relationship with Jesus is important enough to you that you want others to experience the peace, comfort and joy that you have experienced, how might you allow God to use you so that the works of God might be displayed through you – and through the people who come to experience Christ through you?

Consider who God has placed in your life who is affected by mental illness who needs to know Jesus and needs the care and support of a loving church family. Consider how you might help them to experience the love of Christ. Consider how you might welcome them into the ministries of your church.

When I wrote the book on mental health inclusion with the help and support of our ministry team that some of you have been studying in recent weeks, I listed seven broad strategies for welcoming children and adults with mental illness and their families into the church. If I had a “do-over,” I’d include an eighth strategy. The eighth strategy would sound something like this…

Most children and adults with common mental health conditions can participate in most activities at church if they’re accompanied by a trusted person to help them know what to expect and help them to fit in without drawing attention to themselves.

Invite them to church. Make introductions. Be their friend in youth group. Offer to babysit their kid when you know their child is too much for the typical teenager to handle. Take them a casserole when their child gets admitted to the hospital or when they’re busy transporting a family member to outpatient treatment several days a week.

Who do you know who is affected by mental illness and doesn’t yet know Jesus? Here’s my challenge to you. Reach out to at least one person or one family this week and invite them to church or do something for them as a tangible expression of Jesus’ love.

Small things done with great love will change the world. And allow the works of God to be placed on display!

If you’d like to learn more about our ministry, or if you know of churches and families who might benefit from what we offer, please, don’t be strangers and check us out! Can I close by praying for you guys and for your church?

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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An invitation to our readers to brainstorm about God’s purposes in mental illness

I’m working on a project over the next week or two and I’d like to extend an invitation to our readers to lend your ideas and input.

I’ve been invited to teach during the Sunday morning worship services on October 21st at Fredericktown United Methodist Church in Fredericktown, Ohio. A group of leaders at the church have been working through our ministry’s book on mental health inclusion as part of their strategy to better serve persons with disabilities. I’m planning to tie together their study by addressing the topic – Discovering God’s Purposes in Mental Illness. I’m planning to start by using John 9:1-3 as Scripture text and supplementing with other references.

What teaching or reading have you come across that’s been helpful to you in better understanding the topic? Are there sermons or blog posts that have been particularly impactful that you’d like to share? If you’re an individual with mental illness, or a parent or spouse of someone with mental illness, what do you think the people of the church need to hear on this subject?

Please post your ideas, links and references in the comments section below so that all of our readers might benefit.

I’m planning to share my teaching on the blog as an extended post on the evening of the 21st. Fredericktown is approximately 50 miles northeast of Columbus. I’d be delighted to see you in person.

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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Should I teach them the right way to care for patients?

Allow me to digress today and share from one of my “tent-making” jobs that provides my family with the financial support necessary for me to spend some of my time serving in the leadership of our ministry.

In addition to my unpaid work with Key, I have three jobs for which I receive financial compensation. One is my child and adolescent psychiatry practice. Another is the teaching position I hold at the medical school from which I graduated. The third is a consulting position I hold with a large child and adolescent community mental health agency in a county approximately an hour from where I live.

In my position with the mental health center, I’m implementing a redesign of the system through which families of children and teens with mental health conditions access psychiatric care. The plan utilizes available child and adolescent psychiatry resources to expand the capacity of primary care practices to identify and treat youth with serious mental health conditions, and emphasizes interdisciplinary training of early-career mental health professionals.

My work with the mental health center has probably been the most gratifying of my three paying jobs over the past year. We’ve hired a wonderful new medical director with board certifications in three different specialties, including child and adolescent psychiatry along with four bright and highly motivated nurse practitioners newly licensed over the last year. We’ve more than doubled the number of kids seen by the agency’s medical department over the last year and plan to quadruple our service capacity by next summer.

A large part of my job involves providing training to the medical and psychological staff of the agency and the legally required collaboration with our nurse practitioners. The training and collaboration is essential to the success of the plan. We want to train our clinicians in the most current, evidence-based practices before they’ve developed bad habits or experienced a work situation in which they were required to cut corners. The kids served by our mental health agency are incredibly complicated. Those who are referred to medical services more often than not have experienced significant trauma. Very few come from intact families. Their families of origin are often characterized by multigenerational histories of serious mental illness and substance use.

This past Wednesday, a very experienced nurse who helps provide care coordination for kids served by our clinic pulled me aside and told me she had to counsel one of our nurse practitioners to “don’t listen to Dr. Steve.” Here’s what happened…

I’d explained the process we use to initiate treatment with ADHD medication. We typically start children on the lowest dose of medication available and increase the dose on a weekly basis (the American Academy of Pediatrics practice guidelines suggest every three to seven days) in the absence of significant side effects until the child’s symptoms have resolved. By following the recommended procedure, our clinician was creating an administrative nightmare for themselves and for our agency.

Our care coordinator arrived that day to eight “prior authorization” requests from the insurance companies responsible for managing benefits for kids enrolled in Ohio Medicaid and private insurance. Basically, the insurance companies demand a review process that can take an hour or longer to complete in which a staff person from our agency has to justify the need for the prescription written by their psychiatrist or prescriber before the family is permitted to get the medication. The prior authorization process can take longer than the standard amount of time some insurance companies allocate for the child’s complete evaluation. The process is likely required whenever a new patient is seen, when medications are changed, or in some instances, when the dose of a medication is adjusted.

By following the proper procedure, our clinician was generating an unsustainable volume of prior authorization requests, most of which represent an exercise in futility. From what our staff explained to me, the typical procedure among the insurance companies that cover the kids seen in our clinic is to approve one prescription every thirty days for thirty pills from a highly restricted medication formulary. Spending the time on a prior authorization or appeal represents a waste of limited resources. Increasing the dose after a week means the family will run out of medicine ten days early with no recourse to get more.

Another conversation overheard in the hallway later in the morning. One of our prescribers wanted to conservatively increase the dose of a serotonin reuptake inhibitor by half a pill per day for a child they were treating for anxiety. Conservative dosing is especially important in our kids because those with trauma or other conditions impacting self-control are very susceptible to problems with impulsivity as the dose of these medications are increased. They were informed the dosing strategy would be impossible because their patient’s insurance company would refuse to pay for more than thirty pills per month for a product that would typically cost less than $10/month at a local pharmacy.

I found myself wondering whether the day represented a sign from God that it might be time for me to move on to a different type of work. I’ve found myself exhibiting truly unhealthy displays of anger when some pharmacy benefit manager gets in the way of a kid under my care getting access to medication that I think they need. I said a few things this past Wednesday that were unbecoming of an elder and ministry leader  (use your imagination!) that would have likely earned me a one way ticket to anger management class if I were working in a big, bureaucratic system. Later in the day, I was looking up a research paper for one of our clinicians on an older drug that hasn’t been used in any significant way for the last ten years for which he struggled to find information online. This older drug was the only covered alternative to two earlier generic forms of Concerta that had already been found by the FDA to be inferior to the original drug, but hadn’t been removed from the market because they weren’t clearly unsafe.

I could never work as a clinician at the mental health center I described. I need far more time than the insurance companies allow to do a thorough and complete evaluation, especially with complicated kids. The burden of having to collect clinically irrelevant information required by the electronic record and the distraction of having to type answers into a computer while talking to patients wouldn’t leave me with the cognitive capacity to do my best for my patients. But the biggest problem I’d face is knowing that the kids I’d be treating would be getting a lower standard of care than they could. They’d wait longer to get better, and they might be exposed to a greater risk of side effects in the process. Our agency doesn’t have the money to hire the staff necessary to fight the system. Following the redesign of our state’s public mental health system, we get paid less per hour for providing psychiatric care than we did when I served as the agency’s Medical Director twenty years ago.

I need to get to work on the core of the training we’ll be giving our young clinicians over the course of this year, and I have a dilemma. Do I train them in the best way I know how to take care of the kids in their care, or do I tell them what they’ll need to know to give kids the level of care their insurance company is willing to pay for and to go home at night with a clear conscience?

It’s getting harder and harder to sustain the level of care we offer through our practice. We’ve declined contracts with any insurance companies for many years because the terms of those contracts would essentially necessitate us to provide “assembly-line” care. Doctors are compensated very well under insurance for seeing three, four or more patients per hour and very poorly for longer appointments with their patients. Much to the surprise of my residents and fellows, I don’t get “rich” running a practice like ours. I made less money last year than I did in my first year out of training in 1991. Given the huge increases in in durance premiums and deductibles in recent years, fewer and fewer families have the resources to access our services outside their insurance plans, and we don’t have the resources to have a staff person available six days per week to run interference with their pharmacy benefit managers. It’s becoming impossible for a small practice like ours to survive that seeks to provide thoughtful and personalized care while hiring the army of support staff necessary for dealing with pharmacy benefit managers and the record-keeping demands resulting from billing regulations.

I wonder if there’s any correlation between the rise in suicide rates and the decline in access and availability of mental health care in this country and the rise of insurance companies and pharmacy benefit managers empowered by all levels of government to hire high school graduates to micromanage the work of medical professionals with many years of training and experience?
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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Redefine Grace: A Simple Christ-Centered Approach for Students

It is without question that many of us wonder where WE as individuals fit in to our ever-changing society. We may enter into each day with confusion, doubt and uncertainty and cannot help but search for our place. Regardless of our age, stage of life or financial status, we all grapple with these fundamental questions in one way or another: “Who am I?” “Where is my place?” “How can I possibly make a difference in this world?” For the youth and adolescent population, these questions are not only ever-present, but they are magnified. Now add depression, anxiety and the multitude of challenges young adults and adolescents face to the mix. These questions move from magnified to incredibly intense!

When intense and magnified questions are present, there is an even greater need for answers and resources, especially ones that provide a simple, Christ-centered approach. At the Grace Alliance, we believe in a collaborative effort when answering these questions and are grateful for the opportunity to point individuals to partnering organizations with deep insight and expertise, like Key Ministry. Along with our collaborative partnerships, the multitude of requests for a young adult and student focused curriculum prompted us to dream about a resource that would meet a new need.

After a year of research, dreaming and constructing, we finally created a simple, Christ-centered resource, Redefine Grace! This is far more than just a workbook or comprehensive set of tools to “fix” some of the fundamental problems that exist for today’s youth and young adults. Rather, Redefine Grace is an invitation to explore these aforementioned questions and a roadmap to help rediscover, redesign and redefine God’s presence in the midst of a challenging stage of life.

Here are four key points as to why this project was so special for us and how we designed Redefine Grace to impact young people.

1) Why Does Redefine Grace Exist?

It doesn’t take much for us to witness the changing reality of mental health within our society today, specifically for youth and adolescents. Maybe this reality even hits close to home for you. Research published by the National Institute of Mental Health now demonstrates that 1 in 5 youth between the ages of 13 and 18 years old are living with a diagnosable, serious mental illness and 75% of all lifetime cases of mental illness begin by the age of 24. Unfortunately, a 10-year delay between onset and intervention still remains. Our hope is for Redefine Grace to exist as a tangible and accessible resource that plays a critical role in decreasing the time it takes for these individuals to receive the care that they truly need.

2) What Makes Redefine Grace Unique?

In an attempt to remain accessible, inviting and relevant to the adolescent and young adult population, Redefine Grace takes on a unique language, structure and format with three main sections that make up each chapter: Rediscover, Redesign and Redefine. As youth and adolescents arrive with uncertainty, doubt and questions, longing for genuine answers and a freedom to explore, this curriculum invites readers to encounter the reality that they are not alone. They are invited to rediscover characters from the bible who also navigated through various trials and life obstacles, demonstrating the resiliency and hope that is accessible to each and every one of us today. Redefine Grace incorporates compelling facts and tools that are not only written in a non-intimidating language but also tools that touch on relevant topics such as identity, life balance, expectations, purpose, social media and community. Finally, Redefine Grace leaves students with a tangible “next step” and a knowledge that each and every week is an opportunity to redefine their stories with the confidence that they are no longer defined by the challenges that they have experienced or will continue to experience.

3) How is Redefine Grace Used? 

As many of us can recall from our own youth, the way we approach adolescents and young adults cannot be done with a “one size fits all” mentality – each individual is unique in their physical, mental, spiritual, emotional and relational needs and therefore requires a resource that has the flexibility to meet these needs. Redefine Grace is specifically designed with this idea in mind and has the ability to be used individually, one-on-one in a mentorship relationship and as a small group.Our desire is to meet adolescents and young adults right where they are, whether on their mountaintop or in their deepest and darkest valley.  This is exactly what we witnessed with the Redefine pilot group that launched at Baylor University:

“As a public health major, masters in counseling grad student, and Redefine facilitator, I have observed and studied the impact mental health difficulties have on young adults. Ultimately, what I have found is that everyone needs to be heard, supported, and given hope. Redefine groups do just that by providing a community in which individuals can explore spiritual truths, psycho-educational facts, thought-provoking questions and empowering tools. When faith and mental health insight come together in a group setting, one is able to identify their challenges and the grace and hope needed to move forward and live out their God-given calling. I am so excited about the new Redefine curriculum and the impact it will have on our current & future generation of young adults!”

 -Faith Badders, Redefine Facilitator 

4) What is the hope for Redefine Grace?

Redefine Grace provides real faith, real facts and real opportunities to love and care for our body, mind and spirit, as well as the relationships that flow from a balanced, whole-health lifestyle. Adolescents and young adults often assume that they have to “get it all together” in order to seek whole-health care and a fruitful relationship with God. Our hope is that Redefine Grace offers an invitation for students to come as they are and explore what it looks like to experience God’s grace and peace through a process of redefining their story.

Overall, we see Redefine Grace as a simple resource that can be used in collaboration with Key Ministry and other incredible organizations. We know and believe that it takes all of us working together to see a great impact for students.



Natalie Franks M.A., OTR/L serves as Executive Director of Programs for The Grace Alliance. To reach Natalie, learn more about the Redefine Grace curriculum, or to view all of the Grace Alliance’s offerings to support individuals and families affected by mental illness, check out their website,

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Advancing the cause of disability ministry

I’m pleased to announce to our readers that Barb Dittrich will be taking on an expanded role with our Key Ministry team. In addition to continuing the ministry she’s established to train and support parent mentors for families impacted by disability, Barb will become  our ministry’s Director of Advancement, effective immediately.

When we discuss advancement in the context of our ministry, we’re referring to the process of identifying people with the available time, talent and treasure to support the mission to which we’ve been called…connecting families of kids with disabilities to local churches for the purpose of making disciples of Jesus Christ.

Prior to joining our team, Barb served as the Executive Director of SNAPPIN’ Ministries, an organization that provided outreach to help parents of children with every sort of special need, from learning and emotional disabilities to physical disabilities and chronic diseases. She was very successful over many years in procuring the volunteers and resources necessary for sustaining their ministry with families touched by disability.

I want to share with our readers why we’re asking Barb to assume this expanded role. The scope and impact of our ministry – along with the ministry done by other like-minded organizations is exploding.

  • Our network of churches prepared to welcome families of kids with disabilities has more than doubled in size since the first of the year!

  • We received 101 requests from churches for consultation or training from January – July 2018 compared with 112 requests for all of 2017.
  • We’ve received over 160 requests for mental health ministry training or resources since releasing Mental Health and the Church this past February.
  • The Facebook group we provide for for providing resources and support for special needs and disability ministry leaders now has over 1,300 members and continues to grow weekly.

  • Our Inclusion Fusion Live disability ministry conference attracted more than 250 disability ministry leaders and family members. The main stage sessions made available through our Facebook page have been viewed more than 40,000 times!

Why did we need to ask Barb to take on an expanded role – for no additional pay? To borrow a term from the football training camps that have opened across our home region over the last two weeks, we’re “outkicking our coverage” -meaning that we’re providing far more ministry resources than we’re able to pay for. And we require significant help just to sustain the level of ministry training and support we’re already providing, much less to continue to grow in response to the need. We’re averaging around 20,000 unique visitors to our website per month, and approximately 40,000 page views per month across our blogs and platforms, not counting the approximately 5,000 church leaders and family members who subscribe to our blogs by e-mail.

We’re trying to do our work on a budget of roughly $7,000/month…and we brought in a little over $5,000/month for the first half of this year. We’re currently operating with a core staff of five, including two (your humble blogger and Catherine Boyle, our Mental Health Ministry Director) who volunteer all of their time to our ministry. Our team of approximately two dozen volunteer writers who create the content for churches and families also volunteer their services. We had no money to pay the speakers who came to our conference, and most had to pay their travel expenses as well to attend. We’re frugal!

Finding the money to support our ministry has been an ongoing challenge. Our two target audiences (pastors/church staff and families of kids with disabilities) are not noted for their discretionary income. I HATE bringing up the issue of finances or doing anything that makes it harder for churches with limited budgets to access the resources they need to help families. We can’t sustain what we’re doing much beyond the end of this year at our current pace. And that’s why we need to ask Barb to reallocate some of her time to help ensure we’ll have the resources we need to go forward.

We understand that many of the churches and families we serve don’t have any financial resources to share. We very much appreciate your prayers and encouragement! If you do have the ability to help us financially, your support would obviously be a great blessing! We’re also looking for a few “angels”…an individual, family, foundation, corporation or church that could help with a few very large needs…

  1. We’d like to put on another large disability ministry conference in 2019 for church leaders and families from throughout the Eastern U.S. and Canada. We could host an excellent conference with a larger audience and broader impact than this past year’s Inclusion Fusion Live for $15,000 while making the conference available to church leaders and families for a nominal cost.
  2. Outside of our personnel costs, the largest ongoing expense for our ministry involves the cost of getting our resources to church leaders and families through the use of social media advertising and e-mail. We spend close to $1,000 per month between social media and e-mail distribution. An angel who could cover those costs would be a great blessing! $2,000 per month would like allow us to more than double the current reach of our ministry.
  3. We’d like to produce a series of high quality, brief, “on-demand” training videos for church staff and volunteers addressing the most common questions and challenges they’re likely to encounter in the course of disability ministry. The videos would be made freely available through our website and social media platforms. We would film this in conjunction with next year’s Inclusion Fusion Live conference and invite the broad range of speakers in attendance to contribute. If an “angel” would be interested in funding this project, we’ll reach out to local videographers for cost estimates.

Any “angels” interested in helping to meet our need can feel free to contact me ( or Barb ( with any questions or ideas.

We know God has the resources to meet the need. We appreciate your prayers for Barb in her new role and for our ministry as a whole…that we’d honor God while remaining faithful to our mission and carrying out the plans he has for us!
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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It’s the hidden disabilities that keep kids out of church

A landmark study in the disability ministry field was published by Dr. Andrew Whitehead of Clemson University in this month’s Journal for the Scientific Study of Religion examining the impact of a variety of physical, developmental and mental health disabilities upon church attendance using data generated from the National Survey of Children’s Health (NSCH).

What makes this study a “game changer” is the suggestion that the kids who are least likely to attend church aren’t necessarily those who have been the traditional focus of the disability ministry field – kids with intellectual or physical disabilities. The study found that the children most likely to be excluded from church are those with autism spectrum disorders and common mental health conditions – anxiety, depression, Oppositional Defiant Disorder, Conduct Disorder and ADHD.

For the purpose of this study, Dr. Whitehead accessed data from three waves of the NSCH (2003, 2007, 2010-11) and compared the reported rates of children never having attended a religious service in the past year among kids with no identified disability to rates among children with twenty different chronic health conditions included in the survey. The large sample size of the survey – 95,677 phone interviews were conducted for the 2010-11 wave – allows for meaningful statistical comparisons.

Dr. Whitehead noted that children with no reported chronic health condition were significantly less likely to report never attending church services compared to the population as a whole. In contrast, kids with the following health conditions were significantly more likely to report never having attended church

  • Children with autism spectrum disorders are 1.84 times more likely to never attend church.
  • Children with depression are 1.73 times more likely to never attend church.
  • Children with traumatic brain injury are 1.71 times more likely to never attend church.
  • Children with Oppositional Defiant Disorder are 1.48 times more likely to never attend church.
  • Children with anxiety are 1.45 times more likely to never attend church.
  • Children with speech problems were 1.42 times more likely to never attend church.
  • Children with learning disabilities were 1.36 times more likely to never attend church.
  • Kids with ADD/ADHD were 1.19 times more likely to never attend church.
  • Kids with bone, joint and muscle problems were 1.15 times more likely to never attend church.

The study also noted a number of other chronic health conditions that had no effect on church attendance. Those conditions included:

  • Tourette Syndrome
  • Epilepsy
  • Hearing problems
  • Vision Problems
  • Intellectual disability (2010-11 wave)
  • Cerebral palsy (2010-11 wave)

Dr. Whitehead’s interpretation of the study results was that conditions that negatively impact upon social interaction or communication are those that result in the greatest impact upon church attendance.

It appears that across a range of chronic health conditions, those that areprimarily characterized by deficiencies in social interaction or might impede communication are most consistently andsignificantly associated with disengagement with attendance at religious worship services. Furthermore, these results strongly suggest that the higher probability of children with particular health conditions never attending religious services has been stable over time. Prior research signals that thisis likely due to factors attributable to barriers within congregations as well asthe characteristics of the children’s disability. As Ault, Collins, and Carter point out, the behavioral characteristics of children with various chronic health conditions play an important role in structuring if and how they will be integrated into congregational life. Children with autismspectrum disorders, developmental delays, and conduct disorders allmanifest a range of social and behavioral characteristics that routinely resultin strained social encounters and interactions. Likewise, children with speech problems might not be able to communicate as easily as their peers. The particular behavioral characteristics or physical limitations associated with these health conditions appear to limit these children’s ability to attend religious services.

Dr. Whitehead’s analysis didn’t include data examining the frequency of church attendance among kids with the chronic health conditions identified in the study. My hypothesis is that not only is it less likely that families of kids with autism, mental health concerns and other hidden disabilities will ever attend church, but those who do attend church are able to attend less frequently than families unaffected by those disabilities.

The findings of his study are consistent with the hypotheses that underlie the inclusion model our team developed for churches seeking to become more intentional about welcoming families affected by mental illness. I’d add to his observations about social communication and interaction that conditions impacting a child’s capacity for emotional regulation and self-control also appear to cause great challenges at church. The highly significant association reported between church attendance, depression and anxiety likely results from the impact those conditions have upon the ability or willingness to enter into social interactions and relationships at church.


If your church is prepared to act, our team is prepared to help!

We have a simple and flexible model for mental health inclusion ministry that we believe is useful for churches of all sizes, denominations and organizational styles.

We have a complete library of free training videos to help pastors, church staff and volunteers to understand and implement our mental health inclusion model.

We have trained and experienced staff and volunteers available to help address questions and challenges that arise as your church seeks to develop a mental health inclusion strategy. Your inclusion team can use this link to contact our ministry team for help.

Dr. Whitehead’s study is a clear call to pastors and ministry leaders that it’s time we do more to ensure that there’s a welcoming church available for every child and every family!

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 sexual revolution, our kids and suicide…a new look

Two years ago in this space, we examined a study released by the U.S. Centers for Disease Control looking at the relationship between sexual identity, sexual activity and high-risk behaviors in teens, with a focus on the data examine the relationship between sexual activity and suicide. The CDC released updated data several weeks ago from the most recent Youth Risk Behavior Survey of approximately 15,000 teens, completed in December 2017. Results from the 2017 survey suggest that many high school students are engaged in health-risk behaviors associated with the leading causes of death among young people in the United States. During the 30 days before the survey…

  • 39.2% of high school students nationwide (among the 62.8% who drove a car or other vehicle during the 30 days before the survey) had texted or e-mailed while driving.
  • 29.8% reported current alcohol use, and 19.8% reported current marijuana use.
  • 14.0% of students had taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told them to use it one or more times during their life.
  • During the 12 months before the survey, 7.4% had attempted suicide.
  • Nationwide, 39.5% of students had ever had sexual intercourse and 9.7% had had sexual intercourse with four or more persons during their life.
  • 8.8% of high school students had smoked cigarettes and 13.2% had used an electronic vapor product on at least 1 day during the 30 days before the survey.
  • Forty-three percent played video or computer games or used a computer for 3 or more hours per day on an average school day for something that was not school work.

The prevalence of many health-risk behaviors is significantly higher among sexual minority students compared with heterosexual students. The reasons for this difference aren’t completely clear, but trauma appears to be a significant factor.

According to the survey, sexual minority youth are four times more likely to have been physically forced to have sexual intercourse when they did not want tocompared to heterosexual youth, three times more likely to have experienced sexual violence in the last twelve months compared to the general population, and two to three times more likely to have experienced physical or sexual dating violence.

Suicidal thinking and the severity of suicidal behavior are HIGHLY correlated with sexual activity in teens. Students who experienced sexual contact with the same or both sexes are approximately 294% more likely to report having attempted suicide compared to students who had sexual contact with the opposite sex only and 567% more likely to report having attempted suicide than students with no sexual contact. Boys who experienced sexual contact with the opposite sex only were 232% 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 188% more likely to report having attempted suicide than those with no sexual contact.

Since the time of our original post two years ago, I’ve continued to be struck by the association between early involvement in sexual activity and an increased risk for anxiety, depression, suicidal thoughts and suicidal behavior among the kids who pass through our practice. I wish parents, educators and church leaders would come to recognize that many teenagers aren’t remotely prepared to manage the intensity of emotions that results when relationships become sexualized. Those who ultimately commit suicide represent casualties of the sexual revolution.

There are lots of limitations to the conclusions that can few drawn from the study. We can’t tell from the way the data is presented whether suicidal behavior increases as the total number of sexual contacts increases. We don’t have a breakdown that shows suicide statistics comparing rates between heterosexual and sexual minority youth who have been victims of sexual violence. We don’t know whether rates of suicidal behavior “normalize” among teens with same-sex attraction who refrain from sexual activity.

Some thoughts that crossed my mind after reviewing this study…

Maybe we need to think about mental illness as a sexually transmitted disease, at least in the teen population? My guess as to why we don’t think of it that way is that there isn’t a way to make sex more safe from an emotional standpoint. Condoms don’t protect against emotional trauma.

Do our kids need to develop resilience and learn self-control more than they need “safe spaces?” When one in fourteen high schoolers reports having attempted suicide at least once during the preceding twelve months, clearly millions of kids are struggling to cope with the emotional challenges of adolescence. We’ve made significant strides in reducing smoking rates in teenagers by emphasizing the effects upon health and laws that make it more difficult to access cigarettes. Does our suicide crisis necessitate we make a similar effort to reduce sexual activity in teens?

We need a #MeToo movement to protect teens from sexual violence – especially teens who are members of sexual minorities. Maybe we need to consider raising the age of sexual consent? Maybe our more progressive churches led by members of sexual minorities could take the lead in changing attitudes regarding “coming of age” experiences between adults and LGBTQ youth? How is it acceptable in 2018 that a movie glorifying sexual predation and abuse can not only be nominated for, but win Academy awards?

I came away from this study impressed by the need for pastors and church leaders who work with youth to become more trauma-informed. One in fourteen high school students (and more than one in five sexual minority youth) have experienced forced intercourse, and one in ten (three in ten among sexual minority youth) have been victims of sexual violence.  The results of this study suggest that a better understanding of trauma is essential to those serving all kids – especially kids with same sex attraction– in youth ministry settings.

Finally, how is it still socially acceptable in this day and age for advertisers and social media platforms to promote sexual behavior in youth when a clear association exists between sexual behavior and suicide? Hats off to Abercrombie and Hollister for getting rid of their shirtless models. And how is it OK for parents to facilitate opportunities for their teens to engage in sexual contact with other teens? How are “coed sleepovers” for teens acceptable? How is it OK for the nation’s “paper of record” to celebrate the sexualized relationships of teens in the pages of its’ magazine?

In the midst of a culture that puts great pressure on teens and adults to define themselves through their sexual attractions and prowess, the church has the ability to introduce our youth to a better – and safer better way of discovering their true identity!.


shutterstock_138372947Know a family impacted by disability in need of help finding a local church? Encourage them to register for Key for Families. We can help connect families with local churches prepared to offer faith, friendship and support, while providing them with encouragement though our Facebook communities. Refer a friend today!

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Traditional churches and the mental health system…Irreconcilable differences?

Two weeks ago, I shared a post on the topic of Why the church and the mental health system should work together. Upon further reflection, I think a better question is: Can the church and the mental health system work together? And sadly, I’m coming to suspect the answer to that question is NO…so long as that church adheres to traditional teaching and Biblical interpretation addressing human sexuality.

Since my last post, I spoke at an event sponsored by a mental health board here in Ohio that serves a large and diverse population in a region of our state that most sociologists would describe as “culturally conservative.” The panel discussion that followed my talk on how the mental health system could help churches serve individuals and families affected by mental illness was dominated by LGBTQ-oriented questions and statements.

During the panel discussion, one attendee strongly implied that the inclusion of statistics in my presentation from Lifeway Research and Focus on the Family and referencing organizations such as Saddleback Church and the ERLC represented an act of hostility toward the LGBT community. I’d think the reaction would’ve been pretty similar from any secular group of mental health professionals anywhere in the country.  I found myself very encouraged by the presence of a pastor on the panel involved in ministry with at-risk kids who also represented a more traditional Christian perspective pertaining to human sexuality.

The church’s teaching on sexuality is a big issue to a great many people in the mental health field. Let me try to summarize what I see as a prevailing view among many mental health professionals

Sexual minorities represent a vulnerable population. Their status as a sexual minority is largely immutable and an essential component of their identity. The increased prevalence of mental illness and suicidal behavior reported among sexual minorities is a function of the shame and condemnation of their lifestyle they experience from contact with the larger culture. Failure to accept and affirm them in the expression of their sexual identity (with sexual activity representing an integral component of such expression) is tantamount to assault upon their dignity. Any statements or teaching with the potential for causing guilt or distress increase their risk for suicide and a variety of mental health conditions.

Contrast that with what I would consider a traditional Christian view of sexuality…

God intended for sexual relationships between one man and one woman in the context of marriage. In Jesus’ words…

He answered, “Have you not read that he who created them from the beginning made them male and female, and said, ‘Therefore a man shall leave his father and his mother and hold fast to his wife, and the two shall become one flesh’?

Matthew 19:4-5  (ESV)

The Bible clearly teaches that alternative sexual relationships are sinful and disrupt our relationship with God. See Leviticus 18, Romans 1, or 1 Corinthians 6. In the final passage, Paul emphasizes that once we become Christians, our bodies are not our own – they – and everything we have belongs to God! In the next chapter, he expounds on this teaching by noting that husbands and wives are to give their bodies to one another – and one another only! The expectation for sexual expression outside of marriage is self-control.

Moreover, the Bible has very different thoughts than the larger culture on the source of our identity. Paul makes a point in Romans 6 that we take on a new identity when we come to faith in Christ…

We know that our old self was crucified with him in order that the body of sin might be brought to nothing, so that we would no longer be enslaved to sin. For one who has died has been set free from sin. Now if we have died with Christ, we believe that we will also live with him. We know that Christ, being raised from the dead, will never die again; death no longer has dominion over him. For the death he died he died to sin, once for all, but the life he lives he lives to God. So you also must consider yourselves dead to sin and alive to God in Christ Jesus.

Let not sin therefore reign in your mortal body, to make you obey its passions. Do not present your members to sin as instruments for unrighteousness, but present yourselves to God as those who have been brought from death to life, and your members to God as instruments for righteousness. For sin will have no dominion over you, since you are not under law but under grace.

Paul continues in Galatians 3

For as many of you as were baptized into Christ have put on Christ. There is neither Jew nor Greek, there is neither slave nor free, there is no male and female, for you are all one in Christ Jesus.

Throughout Romans 7, Paul describes the internal struggle on the struggle between our old and new identities…

For I do not understand my own actions. For I do not do what I want, but I do the very thing I hate. Now if I do what I do not want, I agree with the law, that it is good. So now it is no longer I who do it, but sin that dwells within me. For I know that nothing good dwells in me, that is, in my flesh. For I have the desire to do what is right, but not the ability to carry it out. For I do not do the good I want, but the evil I do not want is what I keep on doing. Now if I do what I do not want, it is no longer I who do it, but sin that dwells within me.

The traditional Christian view of sexuality and identity is radically countercultural and the teachings are essential to the faith and not easily dismissed as belonging to a different time and context. Life would certainly be easier for believers such as myself if they could be easily dismissed. But we don’t get to decide which of God’s commands we choose to honor and which we can easily dismiss. We put ourselves in the position of God when we assume we can do so. And when we do so, the Gospel loses its power and allure.

The reality is that the traditional Christian view of sexuality and identity is irreconcilable with very closely held values and beliefs of an influential majority of mental health practitioners. How do we work with folks who view our core beliefs as an assault on their dignity and the dignity of those we serve? Churches or individuals who support traditional marriage and expressions of sexuality are pariahs to them. Given the incompatibility of the prevailing views on sexual expression between churches and the mental health community, I think there will be little possibility for partnership unless at least one of the following conditions is met…

  • The church abandons traditional teaching on sexuality and marriage and seeks to affirm alternative definitions of marriage and avenues of sexual expression.
  • The church is predominantly composed of members of a protected class.
  • The church has an unimpeachable reputation in the community for work on behalf of social justice and downplays public pronouncements or teaching related to sexual expression.

I met a very kind and compassionate pastor at my recent presentation who started a church specifically to serve the LGBTQ community. When I asked her how the church was doing, she indicated they were struggling and explained her challenge by stating that gay and lesbian people aren’t in the habit of going to church on Sunday. What I wish I had said in the moment is that I can’t imagine why a watered down version of the faith that declares  our sexuality to be off-limits to God would be appealing to anyone. While I fervently hope that individuals with mental illness and their families come to be included in their larger family in Christ, we can’t compromise the integrity of the gospel message to bring about that goal.

When I first launched this blog eight years ago, my intent was to build a bridge between two worlds…the “church” world I inhabited as an attendee and a leader and my “work” world inhabited by kids and families impacted by mental illness or developmental disabilities. While I certainly see myself as qualified to serve as a guide to church leaders as they seek to understand the struggles of families impacted by those conditions, I no longer feel I belong in gatherings of my fellow mental health professionals. My values and beliefs are too incompatible with those of the vast majority of my peers.

The chasm between my two worlds is widening…making the need for the church to extend the love of Christ to kids and families on the other side of the chasm even more imperative.

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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