Are some lives more valuable than others? Seniors, the disabled and the terminally ill

The scenes unfolding in intensive care units and emergency rooms in New York City have fueled fears that a surge of COVID-19 patients will overwhelm the healthcare system so that the availability of respirators and other critical care resources will be insufficient and doctors and hospital officials will have to make life and death decisions about who gets access to treatment.

I found myself feeling pretty proud of my country this past week. Our leaders are going to extraordinary lengths in putting our economy at risk to reduce the loss of life from a virus far more likely to kill the old and vulnerable than the young and healthy. That’s truly the “pro-life” position. Even Governor Andrew Cuomo of New York, the same guy who lit up the Empire State Building to celebrate a new law allowing for abortion of pre-born children up to the moment of birth, tweeted this earlier in the week.

Are all lives equally valuable? We’re learning more about the thinking of our government officials and public health leaders as disaster preparedness plans are rolled out around the country in advance of the waves of COVID-19 patients anticipated in the coming days. The concept of the Imago Dei – the idea that every person, regardless of ability or disability, bears the image of God and is of incalculable value is increasingly at odds with a view of medical ethics shaped by philosophers, clinicians, the courts and healthcare policymakers.

Disability rights advocates were appropriately alarmed earlier this week when disaster preparedness plans in Alabama and Washington were reported to deny access to life-saving care to persons with severe intellectual or developmental disabilities. According to the report in ProPublica:

Some state plans make clear that people with cognitive issues are a lower priority for lifesaving treatment. For instance, Alabama’s plan says that “persons with severe mental retardation, advanced dementia or severe traumatic brain injury may be poor candidates for ventilator support.” Another part says that “persons with severe or profound mental retardation, moderate to severe dementia, or catastrophic neurological complications such as persistent vegetative state are unlikely candidates for ventilator support.”

When I started doing some background reading on this topic, I was stunned by the extent to which academics and policy makers devalue the lives of persons with disabilities. I’d strongly encourage anyone with interest in the principles and values that will guide decisions regarding access to care to read this paper from the prestigious medical journal The Lancet. The corresponding author of the paper is Dr. Ezekiel Emanuel, who at the time served as Chief of the Department of Bioethics at the National Institutes of Health (NIH) and authored a paper published this week in the New England Journal of Medicine that will undoubtedly be used as a guide for allocating scarce medical resources during the COVID-19 pandemic.

The World Health Organization (along with, not coincidentally the World Bank) uses disability-adjusted life years (DALY) as a guide to allocation of scarce healthcare resources. If you think this measure is what it sounds like, it is. Here’s a better description developed by Dr. Karen Whalley Hammell. Some excerpts:

Within the DALY, life is of value solely as a consequence of health status, thus burden of suffering is directly equated with functional limitation. This logic places greater emphasis on physical dysfunction than upon mental anguish (for example, depression) and cannot consider individuals’ different abilities to live well with physical dysfunction. Further, suffering is perceived to be due to physical limitations rather than pain, for example. This is particularly problematic given substantial research evidence demonstrating that perceptions of quality of life are not positively correlated with proximity to “normality”; and that pain has a greater negative impact upon the experience of quality of life than does extent of physical impairment, level of function or degree of independence. Further, the DALY ‘inaccurately equates disability with ill health irrespective of the reality that it is possible to have a significant degree of impairment and to be perfectly healthy.

Within the DALY, tetraplegia (‘quadriplegia’) is accorded a severity weighting of 1.0, which is the same score accorded death. Indeed, the weighting system dictates that the value of one year of life for someone without an impairment is of equivalent worth to the lives of 9.524 people with tetraplegia. Yet researchers have found high perceptions of quality of life even among people who have the highest levels of tetraplegia and low perceptions of quality of life among people deemed “normal”. This illustrates the DALY’s lack of a supportive evidence base and demonstrates the tendency for “experts” to parrot cultural beliefs that people would be ‘better off dead’ than disabled. It also highlights problems that arose because the DALY’s creators relied too heavily on the opinions of medical “experts” and failed to incorporate meaningful input from people who actually live with impairments.

The British Health Service (BHS) uses Quality Adjusted Life Years (QALY) to determine whether specific treatments will be made available for individual patients. This recent article describes how QALY is applied.

One year in excellent health equals one QALY. As health declines, so does the QALY measurement. The difference between being alive and dead is, on this measure, easy to express: Death represents the end of QALYs, a zero stretching out into infinitude. But ill health is trickier to measure. NICE uses questionnaires measuring people’s pain levels, mood, daily activity, limitations, and so on to arrive at rough estimates.

With some exceptions, the organization values one QALY at between 20,000 and 30,000 pounds, roughly $26,000 to $40,000. If a treatment will give someone another year of life in good health and it costs less than 20,000 pounds, it clears NICE’s bar. Between 20,000 and 30,000 pounds, it’s a closer call. Above 30,000 pounds, treatments are often rejected — though there are exceptions, as in some end-of-life care and, more recently, some pricey cancer drugs.

QALYs can be controversial. Take, for instance, the core calculation: the adjustment of life-years by quality. Who’s to say that life is worth less when lived with a disability or chronic condition?

In the Lancet article, Dr. Emanuel argued that a “Complete Lives System” be used to ration care in which adolescents and young adults receive priority. Dr. Emanuel’s system is clearly more just toward persons with disabilities but reflects perceptions that the lives of the very young and vey old have less value.

Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults over infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life. As the legal philosopher Ronald Dworkin argues, “It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies and worse still when an adolescent does”; this argument is supported by empirical surveys.

Dr. Emanuel authored a lengthy piece several years ago in The Atlantic with the title Why I Hope to Die at 75. His article truly needs to be read in its entirety, but as a physician with a foot in the world of academic medicine, his words reflect the mindset of the medical elite regarding the value of life – a mindset characterized by the sense that value comes from the productivity a person might contribute to society, that lives lived with significant physical or mental limitations are less desirable, and living too long creates undue care and support burdens upon our families. From Dr. Emanuel:

So American immortals may live longer than their parents, but they are likely to be more incapacitated. Does that sound very desirable? Not to me.

The situation becomes of even greater concern when we confront the most dreadful of all possibilities: living with dementia and other acquired mental disabilities.

Ultrasounds don’t lie. As scientific advances continue to take place in maternal-fetal medicine (in utero surgery, gene therapy?), the battle to protect the rights of the unborn will be won as it becomes undeniably apparent that the child in the womb is fully human.

The pro-life cause of the 21st century will be changing hearts and attitudes to recognize that every person is of immeasurable value regardless of their age, physical or mental condition or capacity to provide tangible benefits to society. The same argument used to justify abortion will be used to justify physician-assisted suicide for the old and the disabled – caring for one’s parents or grandparents is an undue burden for young people and an intrusion upon their personal autonomy.

Overturning Roe v. Wade will be relatively easy in comparison to the challenge that our children and grandchildren will face – defending the value of all life in a culture that will have driven Christianity and its’ moral and theological foundations from the public square.


Our team has assembled a ministry resource center for churches and families to access during this time regarding COVID-19. Find trainings and resources created by our team, along with the U.S. Department of Health and Human Services Faith-Based Partnership Center, the Centers for Disease Control, Saddleback Church and others. Check it out today.





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Flattening the curve of the COVID-19 mental health epidemic to come

For the past few weeks, the attention of our government, medical community and public health systems has appropriately been focused on “flattening the curve” of a coronavirus epidemic that would otherwise result in a massive loss of life. I wouldn’t want to be working in an intensive care unit or emergency room for the next 4-6 weeks. My medical colleagues who do so are true heroes. I’m fortunate as a child psychiatrist to have only experienced mild inconvenienced over the last week or two. The lack of disruption in my routine has given me time to ponder a second rapidly approaching “curve” that threatens to overwhelm our service delivery system, resulting in significant loss of life and great suffering.

How might COVID-19 impact our society’s pre-existing epidemic of mental illness? Our medical system has experienced a similar pandemic in 1918-19 resulting from the “Spanish Flu.” The mental health epidemic likely to result in large part from measures taken to contain the spread of the coronavirus will be unprecedented.

My curiosity recently led me to check out the National Library of Medicine to explore the mental health effects of quarantines and “social distancing.” There’s not much research on the topic, but the available data doesn’t look pretty.

This study by Hawryluck and associates examined the effects of quarantine among adults in Toronto in response to the SARS epidemic in 2003. In a sample of 129 adults (68% of whom were healthcare workers) quarantined for an average of ten days. Symptoms of PTSD and depression were observed in 28.9% and 31.2% of respondents, respectively. PTSD symptoms were highly correlated with the onset of depressive symptoms.

The best paper I found was a review on the psychological effects of quarantine published three weeks ago by Brooks and colleagues. Here are some key findings from their review…

  • A study comparing PTSD symptoms in parents and children quarantined with those not found that mean PTSD stress scores were four times higher in children who had been quarantined. 28% (27 of 98) of parents reported sufficient symptoms to warrant a diagnosis of a trauma­-related mental health disorder, compared with 6% (17 of 299) of parents not quarantined.
  • Another study examining long-term impacts of quarantine among hospital staff following the SARS epidemic found that workers who were quarantined were 4.9 times more likely than peers who hadn’t to experience depressive symptoms three years later after controlling for age, gender, marital status, family income, and prior exposure to other traumatic events.

The authors summarized the research literature as follows…

Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma.

We have a couple of brief reports from China looking at psychological impacts of COVID-19.

  • A paper published by Xiang and associates last month in the Lancet called for urgent development of timely mental health support for patients and healthcare workers.
  • This clinical report from Liu and associates includes the results of a multi center survey of 1563 medical staff actively involved with caring for patients infected by COVID-19.  Based upon responses to four standardized measures, the prevalence of depression was estimated to be 50·7%, anxiety 44·7%, insomnia 36·1% and stress-related symptoms (defined as a total score of ≥9 in the Impact of Events Scale-Revised) as 73·4%

Another way of considering the situation is to contemplate the association of new COVID-19 related stressors with increased risk for mental illness. We know that life change events are associated with increased prevalence of depression, anxiety and schizophrenia. One of the most commonly used instruments to measure the impact of these events is the Social Readjustment Rating Scale (SRRS).

The SRRS score is based upon stressful life events that occurred in the last twelve months. Scores of 150 or below suggest a low probability of developing a stress-related disorder. Scores of 150 to 299 suggest a moderate level of stress, and chances of developing a stress-related disorder of approximately 50%. The likelihood of stress-related disorders is around 80% for scores of 300 or above. Here are some stressful events associated with the response to COVID-19 and the associated point value on the SRRS scale:

  • Change in health of family member (44)
  • Business readjustment (39)
  • Change in financial state (38)
  • Change in responsibilities at work (29)
  • Change in living conditions (25)
  • Revision of personal habits (24)
  • Change in work hours or conditions (20)
  • Change in school/college (20)
  • Change in recreation (19)
  • Change in church activities (19)
  • Change in social activities (18)
  • Change in number of family get-togethers (15)

When I think about this as a child psychiatrist, I’m interested in potential impacts on the kids and families I see in my practice…

Consider that the studies involving quarantine typically involved periods of 10-21 days. What happens when kids and adults are isolated for far longer periods of time?

How will my kids do if they’re stuck in homes where domestic violence or sexual abuse have already taken place?

How will my kids cope when their parents lose their jobs or their businesses?

How will the needs of my kids requiring special education services be met?

How will my kids with parents on the frontline of the COVID-19 epidemic (physicians, nurses, first responders) cope with the medical and mental health consequences their parents are likely to experience in the coming weeks?

How will my kids with anxiety cope with separation from their older relatives – aunts, uncles, grandparents and great-grandparents?

How will my kids with ADHD cope with the distractions of trying to learn at home?

How will my kids who develop much of their self-confidence and well-being from their extracurricular activities (sports, theater, music, dance, martial arts, scouts, youth groups) cope when denied access to those activities for an extended time?

How will my kids with autism adjust to the dramatic change in their routines?

How will my kids with anxiety or OCD cope with their intrusive and distressing thoughts without the distractions of their school day and outside activities?

How will my kids who are planning to attend college in the next year or two cope with not being able to take their entrance exams (ACT and SAT) or visit schools of interest? How will they and their families cope as their 529 plans or other college savings are decimated by the downturn in the stock market?

How will my kids who have come to enjoy their freedom at college adjust to moving back in with their parents and being separated from friends?

How will my seniors cope with losing their last season with teammates, last chance to star in the musical, last opportunity to go to prom and last opportunity to receive a diploma in front of friends and family?  

That’s what I think about. What will all of us need to think about after the crush on our emergency rooms and ICUs from COVID-19 begins to resolve?

Dr. Xiang described a series of public mental health interventions in his paper – establishment of multidisciplinary mental health teams including psychiatrists, psychiatric nurses, clinical psychologists, and other mental health workers to support patients and healthcare workers, clear communication with regular and accurate updates about the COVID-19 to address uncertainty and fear, provision of psychological counseling using electronic devices and apps and technology to improve communication between patients and families, and regular mental health screenings of patients and healthcare workers for depression, anxiety, and suicidal thinking followed by timely access to psychiatric treatment for those with more severe conditions.

Little of what he suggests is realistic. Relatively few mental health services are currently available through our hospitals and clinics. The available professionals will be dealing with more acute need among established patients or clients. Mental health professionals will be getting sick or staying home to watch children or care for family members. Recent steps taken by the government to facilitate telepsychiatry services are enormously helpful, but won’t stop the mental health system from collapsing under a tidal wave of need.

More importantly, what can we do now to mitigate the mental health impact of actions being taken to control spread of the virus? How might a “mental health-friendly” church step up to meet needs of members, attendees and the surrounding community in such a time as this?

We can be as intentional in promoting social connectedness for the mental health benefits as we are in promoting social distancing for slowing the spread of COVID-19. No one should be alone. Every church member needs someone to talk with, pray with or serve alongside during this time. Churches need to be intentional in reaching out to every member and attendee.

We need to reach out to neighbors and coworkers who aren’t part of the church and demonstrate to them that they’re cared for and valued. This ministry doesn’t require three years of seminary education.

Check out the list of life stressors related to COVID-19 posted above. What can we do to provide tangible support to those around us experiencing acute stressors? Deliver food and household supplies for friends and neighbors who are quarantined? Offer child care for the healthcare or mental health professional who needs to work? Money or gift cards for neighbors or co-workers who lost their jobs in restaurants or entertainment venues? A spare computer or wireless access for the family next door with three kids doing school online at the same time?

It was wonderful to see so many friends inviting one another to join in online services this morning, but online church is just a start! We need to put the social infrastructure of our churches on the web this week. Christian education. Bible studies. Small groups. All of it. The research on the mental health benefits of church suggest the social connections and relationships that develop through church are critical. This coming Wednesday we’re offering an opportunity for churches interested in doing so. See the end of this post for information.

The availability of peer support will be extraordinarily important. There’s never been a better time to start a mental health support group online. Our friends at Fresh Hope or the Grace Alliance would be happy to help.

One more thought for now…hundreds of churches around the U.S. and around the world got together last month to host a Night to Shine for teens and young adults with developmental or intellectual disabilities. We do proms well! A great way to share the love of Christ with the teens and young adults of our communities would be through hosting proms this summer for seniors who won’t be able to go to prom if schools are closed during April and May.

At church this morning, my pastor spoke of the witness presented by the early church through caring for the sick during the plagues that impacted the Roman Empire. The sick during the plague before us are found in our hospitals hooked to ventilators but will soon turn up in emergency rooms following overdoses.

How might we respond in such a time as this?


This coming Wednesday (March 25th) at noon our Key Ministry team will be sponsoring a special event featuring Nils Smith, one of the world’s leading experts in online ministry. Our team will be engaging Nils in a discussion on Using Technology in Ministry With Vulnerable People. Interested in developing alternate ways of connecting together as the  church during a time when social isolation is required? This is the roundtable for you? The event is free, but early registration is encouraged! Click here if you’d like to join us this Wednesday.





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99% of Protestant pastors – churches are welcoming to persons with disabilities

LifeWay Research released the results of a study of 1,000 Protestant pastors and 1,002 Protestant churchgoers examining attitudes toward persons with disabilities and the supports churches provide to individuals with disabilities and their families. I found the results of the study quite interesting

Virtually every Protestant pastor and churchgoer believes a person with a disability would feel at home at their church, but fewer are taking active steps to make sure this is the case.

A new survey from Nashville-based LifeWay Research asked Protestant pastors and churchgoers about their church and those with disabilities.

Nearly every pastor (99%) and churchgoer (97%) says someone with a disability would feel welcomed and included at their church.

Let’s go through this study step by step…

Nearly all of the pastors surveyed endorsed the idea that local churches should invest in necessary facility modifications to make their churches more accessible. Churches are exempt from the accessibility requirements for public facilities under the Americans With Disabilities Act.

The study asked a number of questions about the supports churches should or do provide to individuals and families impacted by disabilities.

Here are responses to questions regarding the types of support churches are actively providing to persons with disabilities and their families.

The responses of the churchgoers were very similar to those provided by the pastors.

Some other statistical observations from the pastor study…

  • Pastors who “strongly agreed” their churches were welcoming were more likely to come from the South, be of “Other” ethnicity (White or African-American) and less likely to hold Masters or Doctoral degrees. Lutheran pastors were the least likely to strongly agree.
  • Pastors in the South and female pastors were most likely to endorse the need for structural accommodations for persons with disabilities.
  • Methodist and Presbyterian/Reformed pastors were more likely to endorse the provision of financial support than Baptist or Presbyterian pastors. Large church pastors (>250 attendees) were more likely than small church pastors (<50 attendees) to endorse such support.
  • Baptist pastors and pastors of larger churches (attendance >100 attendees/week) were more likely to provide extra teachers (buddies) for kids with disabilities in their Sunday school classes.
  • 71% percent of pastors of large churches (250+) report their churches providing respite or other types of family caregivers to give them a break.

It would be a bit of an understatement to say that the claims made by pastors in this study are VERY inconsistent with the experiences of our Key Ministry team and other like-minded ministries resourcing churches for ministry with kids and adults with disabilities and their families. I’d hypothesize that the 17,541 parents who follow our family support ministry will have a different take on the study results.

When LifeWay conducted a similar study on the church and mental health five years ago, one of the most striking findings was the enormous disconnect between the supports pastors believed their churches were providing to adults with major mental illness and what families reported was available. I can’t comprehend why the crew at LifeWay didn’t use a similar design with this study and interview hundreds of family members of children and adults with disabilities. I strongly suspect the disconnect would be FAR greater than in the mental health study.

Here’s how I think the study is useful – aside from pointing out that lots of pastors either have a problem with the eighth commandment when they’re talking with surveyors or have a very unrealistic view of the ministry not taking place in their churches.

  • The information is helpful to ministries such as ours in understanding why so few churches are actively seeking help in establishing or growing their disability ministries. After all, if 99% of churches are already welcoming to families impacted by disabilities, why do they need us?
  • The shocking statistics contained in this report will draw attention to the topic of disability ministry and provide an impetus for conversations in many churches about the state of their disability ministries.
  • Churches will look at the LifeWay study and recognize different ways they can better support families in their congregations and communities impacted by disabilities. I’d be shocked if 6% of churchesmuch less 60% were providing respite or care for parents caring for a disabled child.

I’m interested in what church leaders and families impacted by disability think of this data. I’d like to think we could close up shop at Key Ministry and transition to some other area of service in the Kingdom. My experience and my gut tell me that lots of churches will continue to need our services and the services of other like-minded ministries despite the results of this study.

Here are links to LifeWay’s Pastor and Churchgoer studies regarding attitudes about disabilities in the church.

We’re still planning to host a very large disability ministry conference in Cleveland during the last weekend in April!

Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

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Seven ways to support kids with anxiety about the coronavirus


We’re busy preparing for a different type of epidemic in our practice than the one our pediatric hospitals are readying themselves for.

Talk and preparation for the coronavirus will very likely exacerbate anxiety symptoms for many of the children we’re treating, and precipitate anxiety in kids predisposed to anxiety who have never before exhibited symptoms.

What can parents do to support the mental health of their kids amidst talk of the coronavirus in the weeks and months ahead? Here are seven ideas…

  1. Model the response you would desire from your child in reacting to news about the virus or changes in your family’s routine resulting from parents working at home, schools being closed for an extended time or family members being quarantined. Kids learn how to respond to anxiety-provoking situations by watching how parents and trusted adults act when they’re anxious. Psychologists refer to this process as social referencing. If your anxiety about the virus is such that you can’t hide it from an anxious child, that’s probably an indication you should seek out professional help for yourself.
  2. Consider involving kids in your family’s preparations and response to the virus. The research from natural disasters suggests that involving vulnerable children in family and community responses to potential danger increases resilience, protects against development of helplessness and may help mitigate against post-traumatic effects through promoting a sense of agency and self-efficacy. I’d encourage parents to cultivate opportunities for their children to serve others in the months ahead. Your church may be planning deliveries of food or basic necessities to medically fragile individuals and families. You might also identify older neighbors with needs and involve your child in addressing their needs.
  3. Monitor exposure to attention-grabbing stories in the media. In my experience, kids with anxiety or Obsessive-Compulsive Disorder (OCD) are more vulnerable to the effects of media and discussions about potential dangers in school. Our practice treats lots of kids on the high end of the autism spectrum. I routinely see them in great distress following repeated class discussions about climate change. As a parent, you have little control over what your children are exposed to in school. I’d expect they’ll hear multiple discussions in coming days about hygiene and impacts on school activities resulting from the virus. There’s no reason to expose anxious kids to fear-mongering in the media designed to enhance ratings.
  4. Plan ahead by identifying lots of books and activities that can occupy an anxious child’s mind in the event schools are closed for an extended time or someone in your family is quarantined. We’ve discussed in the past ways in which snow days and extended time off from school can increase rumination on distressing thoughts among anxious or obsessive kids. Any school closures will likely result in cancelation of most or all extracurricular activities that kids and parents depend upon for occupying free time. Consider books, videos, crafts, art projects and other materials that may serve as a distraction to your child during what will likely be a very anxiety-provoking time. For kids with anxiety, the short-term benefits of technology probably outweigh the downside during extended school absences.
  5. One beneficial application of technology may be the use of videoconferencing technology to allay children’s fears about the health and well-being of older relatives. Kids and adults with anxiety often overestimate risk in unfamiliar situations. One of the best ways of allaying fears about the health of aunts, uncles, grandparents and great-grandparents is providing kids regular opportunities through FaceTime, Skype and Zoom to talk to their loved ones and see they’re in good health, especially if travel is discouraged for older adults.
  6. Finally, I’d encourage families of children taking prescription medication to have a 90 day supply of prescription medication on hand in the event of drug shortages resulting from the epidemic. If your insurance refuses to cover the cost of a 90 day prescription (common among children covered under Medicaid), apps such as GoodRx allow parents and caregivers to walk into a drugstore and pay as little as $5 to $20 for a 90 day prescription for each of the three most commonly prescribed medications for anxiety in our practice. Most anti-anxiety medications shouldn’t be stopped abruptly and I don’t want my most anxious patients running out of their prescriptions during a time when they’re most vulnerable.
  7. Finally, God has given us a wonderful opportunity to model faith in action in front of our children, as well as our friends, neighbors and coworkers. I can’t imagine how we could give our kids a better life lesson than allowing them to see each of us lean into our faith during a time of anxiety.

Let us then with confidence draw near to the throne of grace, that we may receive mercy and find grace to help in time of need.

Hebrews 4:16 (ESV)


Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

Posted in Hidden Disabilities, Key Ministry, Mental Health, Parents | Tagged , , , , , , , , | Leave a comment

Disability ministry and the coronavirus

Pastors and church leaders (if they haven’t already begun planning) will likely initiate many discussions in the coming weeks about the impact of the coronavirus on worship services and other church activities. In areas where local health emergencies have been declared from the coronavirus, worship practices have already been modified. Catholic churches in Southern California have issued statements highlighting the changes, which include a ban on communion by cup, receiving the bread from hand to mouth, and holding and shaking hands during prayer and greetings.

I would hope that ministry to individuals and families with disabilities won’t become an afterthought in the church’s response to a possible pandemic. The disability community is likely to be more severely impacted than the general population by the coronavirus. Persons with intellectual and developmental disabilities will probably experience greater susceptibility to life-threatening infection from the virus associated with their higher prevalence of chronic illnesses.

One study of more than 120 children with profound intellectual disability accompanied by multiple medical disabilities reported that 12% of patients had three or more hospital admissions for respiratory illnesses in the previous five years and 25% required some form of chronic respiratory treatment. Children with cerebral palsy often have a cluster of respiratory problems such as recurrent aspiration pneumonia, chronic bronchitis and (nocturnal) respiratory insufficiency, and as many as 40% die as a result of respiratory infections. Respiratory illness is the leading cause of death in adults with intellectual disabilities. Adults with intellectual disabilities are 2-3 times more likely to develop diabetes and use of second generation antipsychotics appears to be a contributing factor to coronary heart disease.

This graph was derived from initial data on 44,000+ patients from China infected with coronavirus, describing fatality rates based upon age and the presence of concomitant medical illness:

If I were responsible for leading a church’s disability ministry, some assumptions I’d make about the impact of coronavirus upon those served by my ministry and affected individuals and families outside the church would include…

  • They will be more likely to avoid worship services and other group activities at church because of their greater susceptibility to severe infection.
  • Caregiver burden will increase enormously if they are unable to attend school or work for extended periods of time resulting from closures or their own risk of infection. How will families make up for the lost income when members need to stay home with their children or siblings? Who will care for them when their caregivers get sick? I fear we’ll hear of more cases like this one in China, in which a 16 year-old boy with cerebral palsy was found dead after his father (and sole caregiver) and brother were quarantined for suspected coronavirus.
  • Children and adults with autism will struggle greatly to adapt to the changes imposed upon their daily routines.
  • Access to necessary healthcare – especially medication – appears likely to become a major concern.
  • Quarantines (both voluntary and involuntary), school and work closures will lead to a spike in acute mental health needs while access to mental health services becomes even more difficult as a result of practitioners becoming ill or needing to care for their own families and the relative absence of telepsychiatry services.

We might look at this crisis as presenting a great opportunity to share the love of Christ with the disability community during a time of need while showing families who are already part of the church the extent to which they are cared for and valued. Here are some ideas for how churches might respond…

  • How might the church step up to provide meals and run errands for individuals and families unable to leave their homes because of the risk of infection?
  • Small groups might consider offering “relational respite” to families inside and outside of the church, following current guidance from the U.S. Centers for Disease Control (CDC).
  • Would this be a good time to start a Bible study or small group for families in your disability ministry that meets through videoconferencing? Or what about an online mental health support group?
  • Churches that have a stand-alone worship service for attendees with intellectual disabilities might consider making the service available online.
  • If your church offers a counseling ministry, consider making counseling available through a secure, online videoconferencing system. My practice uses Zoom, the same app we use at Key Ministry for church consults and our Disability Ministry Video Roundtable.
  • Make individuals and families served by your ministry aware of any benevolence funds your church makes available to attendees with short-term financial emergencies.

I’d encourage anyone leading a disability ministry who isn’t already part of the Special Needs and Disability Ministry Leaders group we help to facilitate on Facebook to consider joining us. The group will provide opportunities to share ideas and support as the impact of the coronavirus unfolds. The CDC has also launched an outstanding website with up to date information and support that will be valuable to your church leadership in your planning process.

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.

Philippians 4:6-7 (ESV)


Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

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Disability ministry training will be far more accessible in the 2020s

Together Conference, Mount Paran Church, Atlanta, Georgia, March 9, 2019

This post in the third in a series examining ten disability ministry trends to watch in the coming decade. Today Dr. Grcevich will look ahead to how pastors and ministry leaders will acquire the knowledge, training and support in the next ten years to care for and include children and adults with all types of disabilities.

90% of U.S. pastors and church leaders should be able to access live, high quality disability ministry training within a half-day drive of where they live.

2020  Ministry Plan, Key Ministry

With this being the third time our team has prepared to host Inclusion Fusion Live, I’ve found myself impacted by two thoughts each time we go through the process.

  1. The extent of the financial and logistical challenges many attendees overcome to be part of our conferences in person. Jess Cummings shared her firsthand experience at tending our initial live conference here. We have visitors this year registered from Norway who are coming expressly to attend the conference. I always wonder how many people we would host if everyone who wanted to come had the resources to do so.
  2. The number of people who have such a strong calling to educate church leaders on disability-related issues or to provide encouragement and support to families impacted by disabilities that they are willing to give of their time and bear the cost of their travel to speak at our conferences. We were overwhelmed by the proposals to this year’s conference. We had the space in our facility to accept a little more than half of the submissions we received. The generosity of our speakers allows us to make #IFL2020 available to as many church leaders and families for as low a cost as possible.

As the disability ministry movement continues to expand, God appears to be providing the resources and circumstances for tens of thousands of pastors, church leaders and volunteers to receive training and support for ministry with children and adults with disabilities (both visible and hidden) in the years ahead.

All Access Disability Ministry Conference, Houston, TX, February 22, 2020.

Factors that will drive an expansion in training will include:

Demonstrable interest in disability ministry-related training and content. We had over 85,000 video views of presentations from last year’s conference, representing a 98.1% increase over 2018. Attendance has been up year over year. Membership in the Special Needs and Disability Ministry Leaders Facebook group we lead is up 26% over the last year, and total membership is approaching 2,000. Every conference our team has traveled to over the last several years has been very well attended.

Limited church budgets for travel-related expenses will drive creation of more local training opportunities. A 2017 survey of over 4,000 senior pastors of evangelical churches reported the average church budget in the U.S. is around $125,000. With little evidence to suggest the precipitous drop in church attendance and church giving will end anytime soon, expectations that significant numbers of church leaders will have the resources to travel to access disability ministry training are probably unrealistic, particularly for smaller congregations.

Too many people are being called to leadership in the disability ministry field for God to not provide them the opportunity to serve through training others. Earlier this afternoon, I found the program from the 2010 Accessibility Summit – a national disability ministry conference that used to be hosted by McLean Bible Church outside of Washington DC. Ten years ago, there were maybe 10-15 people in the country who would’ve been considered as recognized experts in the disability ministry field. Finding speakers with the credibility to draw church leaders to a conference would have represented a significant challenge. Not anymore. If I had to guess, there are at least 100 highly qualified speakers who have demonstrated excellence through training at national events. I wouldn’t think that assembling a solid lineup of trainers and topics would be an obstacle to anyone interested in putting on a disability ministry conference today.

Wonderfully Made Conference, Overland Park, KS, October 24, 2019

We have easily-replicated models for offering reasonably large and broad disability ministry trainings. I know of at least two new conferences that were started by participants from #IFL2018. Our team has developed a “playbook” for the necessary tasks and activities required to stage #IFL2020. We’d be more than happy to share our experiences with others looking to start a new conference. The team at Ability Ministry has a disability conference model they’re using in Kentucky and Tennessee that they can bring to your region.

Seminaries will recognize the need to provide disability ministry training for their students and alumni. Such training is more likely to take the form (initially) of special events than don’t require changes in curriculum.  We had our first experience with a seminary training event this past November at Winebrenner Theological Seminary in Western Ohio. The level of interest and attendance clearly exceeded the expectations of the event organizers.

Training events provide opportunities for deeper relationships with others who share similar ministry passions and interests. Thanks to social media, those of us serving in disability ministry have been able to make connections with one another and become familiar with each other’s ministry. According to Seth Godin, we could be viewed as a “tribe” responsible for starting a movement. I’ve found the online relationships we form become much deeper relationships when we get to spend time together teaching and worshiping in the same space. Most of the people involved with the movement either have a disability themselves or are related to someone with a disability. Not that this is our primary motivation, but one of the benefits of offering disability ministry training is the opportunity for encouragement and support just by being with one another for a couple of days. The synergies that form when we’re together with our tribe help fuel the movement.

Networking dinner, Inclusion Fusion Live 2019, Bay Village, OH, April 5, 2019

Here’s a map (current as of February 23, 2020) of disability ministry conferences and training opportunities that our team maintains. The most current conference listings and map can always be found here.

Keeping in mind that some of the conferences on this list may have a more narrow focus than the conferences listed above, what would have to happen for us to be able to say that the goal from our ministry plan at the beginning of this post had been fulfilled?

Have a conference to add to our list? Contact or with links and essential information.

Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

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The legacy of a faithful servant

Twenty-five years ago today, the Lord honored my dad with a pretty remarkable sendoff.

My father was raised in a Catholic home, but had a “born again” experience when I was a freshman in high school. He became a passionate student of the Bible, and for many years helped lead the Christian Businessmen’s Bible Study in our hometown of Boardman, Ohio together with Dr. Charles McGowan, his personal physician who had been instrumental in leading him to Christ. He served faithfully on the Board of the Rescue Mission, a ministry serving the homeless in Youngstown. He’d been invited to serve as a national speaker for CBMC near the end of his life, but health problems left him unable to travel.

While my dad was a teacher for many years, his primary career was as a broadcaster. He had a classic, deep voice for radio, and was an early rock and roll DJ in the late ’50s. He later went on to start the telecommunications department at Youngstown State University, launching a public radio (WYSU) and television station (WNEO/WEAO). After he retired, his last job was working for the Catholic Diocese of Youngstown, helping to grow a cable television station started to reach people in his area who couldn’t get to church.

Throughout his life, he was actively involved in the ethnic Catholic church where he was baptized. One of his passions was teaching the Bible to his fellow Roman Catholics. He developed and led a popular study in a nearby Catholic church in which participants covered the entire Bible.

A woman who was active in my father’s Bible Study had died, and her family had asked him to deliver the eulogy at her funeral. Per my mother’s account, my dad finished the eulogy, looked down at her, stepped down from the pulpit and died at that very moment of a massive heart attack, right at the foot of the altar, in front of the cross. How could you ask for a better finish to your life than to be sharing God’s word in front of God’s people in the middle of God’s house?

His outlook on life was pretty much summed up in Philippians 1:21-23…

For to me to live is Christ, and to die is gain. If I am to live in the flesh, that means fruitful labor for me. Yet which I shall choose I cannot tell. I am hard pressed between the two. My desire is to depart and be with Christ, for that is far better.

He made quite an impression on my wife not too long after we’d been married when he was excited about having a heart attack because to him it meant he was getting closer to meeting Jesus. He wanted to meet Paul next, because he had a laundry list of questions he hoped to get clarified about the Epistles.

The way he lived over the last twenty years of his life made a big impression on me and my family. My sister served on staff for a period of time in her Catholic parish in a role we evangelicals would describe as an Executive Pastor. She continues to serve as a eucharistic minister while caring for her daughter (my niece) with disabilities. My only two regrets about his passing at a relatively young age (69) were that my two daughters never had a chance to meet him, and that he didn’t get to be a part of this ministry. My dad was a tech nerd way before his time, and he would’ve done a great job heading up our media team. He’d be impressed by the 200,000+ views of the videos from last year’s Inclusion Fusion Live, and pleased by the ways in which technology is being used to spread the Gospel.

My motivation for getting together with others to start this ministry seventeen years ago came from an appreciation of the spiritual legacy my dad passed down to us. I saw that all too often that wasn’t happening for far too many families coming to a child psychiatry practice like mine. My dad may have taught thousands of kids in school and started three different broadcast stations, but his lasting legacy is a result of his faithfulness in being a good witness for Jesus and pointing people to Jesus whenever he had the opportunity.

I think the way he’d want to be remembered today is for folks who knew him to enjoy a little breakfast (his favorite meal), spend some time in the Bible and to be intentional in passing on their faith in Jesus.

Well done, good and faithful servant!


Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

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Emerging from the silos…Disability ministry as a mindset, not a program

By Ossewa – Own work, CC BY-SA 4.0,

This post in the second in a series examining ten disability ministry trends to watch in the coming decade. Today Dr. Grcevich will suggest that disability ministry will be less ’siloed” – offered as a support for inclusion within all the essential ministries of the church as opposed to a separate, “stand-alone” ministry department.

Spend time at a conference on church growth with senior pastors or executive pastors and one of the most common management challenges discussed is the propensity for different ministries of the church to become “siloed.” Tony Morgan (a prominent church consultant and leadership coach) wrote an entire book on the problem.

What do we mean when we describe an organization as “siloed?”

Organizational silos describe the isolation that occurs when employees or entire departments within an organization do not want to, or do not have the adequate means to share information or knowledge with each other. Siloed teams often end up working in isolation from the rest of the company, leading to a plethora of internal and external problems.

Silos in a church might consist of the worship team, men’s or women’s ministries, small group ministry, missions/outreach, children’s ministry, student ministry, pastoral care, facilities management, technology and (of course) the disability ministry team.

Two examples immediately come to mind when I consider how silos impact ministry. I’m familiar with a church that offered several online groups for families impacted by special needs of which the special needs ministry director was unaware. Or the church that launched a major adoption ministry initiative without including anyone from their disability ministry in the planning process, even though adopted children are twice as likely to have a diagnosed disability by the start of kindergarten and 50% have an identified disability by eighth grade.

Look again at the picture at the top of the post. Silos are the antithesis of inclusion. Are we truly practicing inclusion when we set aside a designated space for the special needs ministry at the expense of including most, if not all participants in age and developmentally appropriate ministry environments, launch a Young Life Capernaum group without fully considering how participants might engage with the established student ministry or offer Grace Groups or Fresh Hope groups for individuals and families impacted by mental illness without also considering how attendees might enter into other small groups offered by the church?

Don’t get me wrong… all of the ministry initiatives described above are good. They’re points of connection for individuals and families outside the church. It’s as if the church is a house and our disability ministries are in the foyer. Is someone really a member of the family when they only ever get to set foot in one or two rooms of the house and never get the opportunity to eat in the kitchen?

Catherine Boyle (our mental health ministry director) developed the concept of a mental health liaison – a primary contact person for church members and visitors who might require assistance before or during an initial visit or benefit from accommodations in church activities they find challenging. Her model represents a helpful way of thinking about the evolution of the disability ministry leader’s role over the next ten years. They’ll increasingly be called to serve as a liaison with ministry leaders from all the departments of the church to help them identify the obstacles that hinder persons with disabilities from fully entering into the practices, activities and events used by the church to form disciples.

The disability ministry leader’s role will be to train leaders in other areas of ministry to form a mindset in which they identify and proactively address barriers to participation before they become a problem. Examples…

  • The small group ministry leader begins to consider how someone in a wheelchair or with limited mobility can be included in groups that meet in members’ homes, or how to support someone with social anxiety or social communication challenges in being part of a group.
  • The missions director considers the supports a young man with an intellectual disability might need to have an impactful experience on an urban mission trip.
  • The director of outreach conceptualizes effective outreach to “Night to Shine” guests living in group homes fo the other 364 days of the year.

The second focus for the disability ministry leader in working with colleagues in other ministry departments is to help them identify the spiritual gifts and natural abilities of persons with disabilities and to provide them with the encouragement and opportunity to “exercise their spiritual muscles” through serving in the church and/or developing a personal ministry outside of the church. In reality, the church needs to do a better job of helping all members and attendees to develop and use their gifts and talents, especially persons with disabilities. As America becomes increasingly less Christian and church members attend worship less and less frequently, congregations in the coming decade will come to depend upon the gifts of persons with disabilities.

How often do you see kids and adults with disabilities serving in visible roles during weekend worship services? One way churches communicate who and what they value is is by who is seen and what is said on Sunday morning. When persons with disabilities are never seen and never heard, it’s not beyond the realm of possibility that they and their families will never feel like they matter to the church. Going forward, we’ll see more persons with disabilities serving in more prominent roles in their churches.

An essential goal of collaborations between the disability ministry leader and leaders in other departments should be helping children and adults to cultivate authentic spiritual friendships in the church. Persons with disabilities are all too often the most lonely people in a culture becoming overwhelmed with loneliness. I can’t begin to tell you how many parents come into our office who desperately want their child to experience one true friend. If we can’t help kids and adults to form meaningful friendships outside of the “disability bubble” in the church, where else might they find it?

Bottom line: While the number of churches with identified disability ministries will likely grow during the coming decade, leaders from other areas of ministry will grow in their capacity to practice inclusion and the church will become substantially more intentional about promoting biblical friendship between persons with and without disabilities.


Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.


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Disability ministry will become essential to the church’s witness in the 2020s

This post in the first in a series examining ten disability ministry trends to watch in the coming decade. Today Dr. Grcevich will explore the forces that will propel ministry with the vulnerable – highlighted by ministry with persons with disabilities – to the forefront of the church’s public witness.

Compared to a lot of my friends involved with ministry, I get to spend much of my time at work surrounded by colleagues who are either indifferent or openly hostile to the claims of Christianity. I’m a member of the least religious medical specialty. And let’s just say that academic medicine isn’t exactly enthusiastic about people like me. Over time, the one thing that I’ve found will make people in my workspace take notice of my faith in a positive light is the support provided to kids and families with disabilities passing through their clinics by churches Key Ministry works with. I’d argue that involvement with disability ministry is one of the most powerful witnesses churches can present to segments of society most likely to view Christianity with skepticism.

It’s been nearly five years since I wrote about my friend Ethan, an extraordinarily gifted child psychologist who died tragically in his late 30s of a ruptured aortic aneurysm. We became friends out of mutual respect for the care we provided to the patients we held in common. Otherwise, we had nothing in common. Ethan was passionately progressive in his politics, a graduate of the University of Michigan and a self-proclaimed atheist. We had two other Christian friends in common – one who started a ministry to incorporate the gospel message into free, evidence-based social skill training with kids with autism spectrum disorders and another serving as executive director of a faith-based international hosting program for orphaned children.

As Ethan became aware of our work through Key Ministry and the ministries of our two mutual friends, he clearly became more curious about Christianity. The concept of 200 churchgoers giving up a weekend night to care for kids with special emotional, behavioral and medical needs didn’t fit with his previous understanding of evangelicals. He offered to help our ministry with any training needs that might arise. He accepted an invitation to join the Board of the autism center. Our last conversation occurred when he was called in to help after kids on an outdoor camping experience sponsored by a Christian organization witnessed the death of a peer during a severe weather event. He wanted to better understand how Christians might process traumatic events like this one. I don’t know whether he made a profession of faith before he died, but the witness of our professional friends unquestionably impacted him.

Disability ministry also demonstrates the authenticity of our faith to children and youth currently attending church and represents one approach to recapturing influence among young adults who were raised in the church, but no longer attend. Early last year, LifeWay Research released results of a survey examining the reasons why two-thirds of teens raised in the church stop attending regularly as young adults.

An active and vital disability ministry directly addresses several common criticisms of young adults who have left the church – it demonstrates integrity with the Gospel message, provides opportunity for connection both with persons being served by the ministry along with others involved with serving and addresses unmet social needs.

This past weekend, I was involved as a volunteer as our church hosted our first ever Night to Shine prom for teens and adults with intellectual and developmental disabilities.

When the video was shared during worship this morning, our pastor commented on how nice it was that the church was getting positive media coverage. I’d argue that the coverage for Night to Shine (with thirteen churches hosting in our region) represented the single most positive publicity for the evangelical church across Northeast Ohio of the entire year.

The church will be seeking to advance the Gospel in the presence of an increasingly hostile culture during the decade to come. If caring for individuals and families with disabilities can get people in my line of work to take notice, our witness will be impactful among those  more open to the claims of Christianity.


Inclusion Fusion Live (#IFL2020) is the largest disability ministry conference in the United States. Pastors, ministry leaders, families and caregivers from throughout the U.S. and beyond will gather in Cleveland on April 24-25 to share encouragement and ideas for welcoming and serving individuals with disabilities and their families. Ministry intensives offer in-depth training on special needs ministry, mental health ministry and trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.

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Ten disability ministry trends to watch in the 2020s

When our team sat down in 2010 to engage in the planning process that led to the creation of this blog and all the other resources we make available to churches and families, we had some ideas about the direction disability ministry might take in the 2010s. In retrospect, God was clearly at work laying the foundation of a disability ministry movement with a scope and impact far greater than anything we could have imagined at the time. The last ten years have been characterized by:

  • A massive increase in the number of churches actively pursuing some type of intentional disability ministry.
  • Many large, influential churches embracing different types of disability ministry.
  • Disability ministry training is more available – Live training events are becoming far more numerous and accessible, while we have experienced a proliferation of online resources for pastors and other church leaders seeking to start or grow ministries.
  • Ministry leaders have become far more connected to one another and are making use of their connections for idea-sharing and support.
  • Widespread recognition of the need for ministry strategies for welcoming and including individuals and families impacted by mental illness and the growth of ministries helping churches provide Christian-based mental health education and support.
  • An explosion of Christian parents with books, blogs and social media presence offering encouragement and support while increasing awareness in the church of the needs of families impacted by disability.
  • Events such as Night to Shine that have engaged hundreds of churches and drawn attention to the ministry needs of adults with intellectual disabilities.
  • Substantial progress in inclusion of kids with intellectual disabilities and their families since the beginning of the decade so that their attendance at worship services is no longer statistically different than the general population.

The beginning of a new decade has provided our team with an impetus to brainstorm what the next ten years of disability ministry might look like as we develop a plan for 2020 and beyond. Today, I’ll share a non-exhaustive list of ten predictions for how the disability ministry field might evolve and grow over the next ten years. This list will serve as an introduction to a series of posts over the next few months in which we’ll do a deeper dive into each trend.

  1. The church’s care for vulnerable people will grow in importance as a strategy for gospel witness in a culture becoming increasingly hostile and skeptical to traditional Christianity.
  2. Disability ministry will be less ’siloed” – less of a stand-alone ministry and more of a collaboration with all of the essential ministries within the church.
  3. Live disability ministry training will become much more available – through seminaries, churches and parachurch organizations.
  4. Radical expansion of ministry with individuals and families impacted by “hidden disabilities” – this expansion will include mental health ministry and will ultimately encompass senior adults with memory loss and persons of all ages experiencing consequences related to trauma.
  5. The terms “special needs ministry” and “inclusion ministry” will slowly fall out of use.
  6. Ministry in the 2020s will be characterized by an expanded focus on care and support of families impacted by disability.
  7. Euthanasia of the disabled will become the pro-life cause of the mid 21st century.
  8. Disability inclusion in Christian schools will become much more common.
  9. The historically African-American church will play an increasingly prominent role in advancing the disability ministry movement.
  10. More ministry will take place by the end of 2030 with less funding available than exists in 2020.

What trends would you add to this list? Any items on the list that you disagree with? Feel free to engage with us and one another in the comments section below, on Facebook or Twitter or in the Special Needs and Disability Ministry Leaders group that we moderate on Facebook.


Consider joining us in Cleveland on April 24th and 25th for Inclusion Fusion Live, Key Ministry’s national disability ministry conference. Pastors, ministry leaders and families from around the country are coming together to be encouraged and equipped to better serve families affected by disability who attend their churches. Ministry intensives are offered on starting a special needs ministry, developing a mental health inclusion ministry and ministering with persons with a history of trauma. Choose a MINISTRY TRACK or a FAMILY TRACK to select from over 50 workshops representing ministry-focused and family-focused topics. Either ticket will give you access to all main stage presentations including our featured speakers, numerous quick takes (TED Talk-style presentations), and worship. Early bird pricing is available. To learn more or to register, click here.


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