Five reasons why you need to come to Inclusion Fusion Live


Our team is just a little excited to invite you to Inclusion Fusion Live 2019, our biggest weekend of the year for training churches and resourcing families for the work of fully including children and teens with disabilities and their families into the life of the local church. I’d like to share five compelling reasons why you need to block out the first weekend in April (the 5th and 6th) to join us in Cleveland to celebrate what God is doing in the field of disability ministry.

You’ll get the resources and relationships to start or grow a disability ministry at your church. Seriously – you’ll leave ready to do ministry.

Choose to attend day-long intensives on starting a special needs ministry, led by Doc Hunsley of Grace Church in suburban Kansas City and Beth Golik of our Key Ministry team. Marie Kuck from Nathaniel’s Hope Buddy Break (the largest church-based respite care network in the U.S. will give you the training you need to launch a respite ministry at your church. Brad Hoefs from Fresh Hope will be joining Catherine Boyle and myself to provide you with the resources to launch a mental health inclusion ministry.

In addition to our intensives, we’re offering two dozen workshops for pastors and ministry leaders offering practical ideas for including persons affected into all aspects of church life. Some of the highlights include sessions led by Lamar Hardwick on pastoring families with special needs, Tiffany Crow on helping ministry leaders and volunteers serve kids with problem behaviors and Jolene Philo and Katie Wetherbee, co-authors of Every Child Welcome have reunited to “cook up” a workshop designed to help volunteers become special needs ministry “master chefs.”

Because you’re a parent or family member of someone with a disability in need of some encouragement and support. We think it’s important that families be included in any gathering related to disability ministry and the church. We’ve created an entire workshop track for family members and caregivers with lots of content on marriage, sibling issues, self-care, partnering with church staff and sessions for fathers of children with disabilities.

Because you’ll discover new speakers and leaders you haven’t seen or heard before. We’ve always made a point of opening our conferences to any Christian with great ideas or resources to share related to disability ministry. Nearly half of our forty speakers have never presented before at a Key Ministry event, and for some, this is their first opportunity to speak at a national conference. We can promise you new content!

Because it’s lots of fun to hang out in person with like-minded Christians who you know from your time online. The ability to make connections and share resources online has been an incredible blessing to the disability ministry movement, but there’s nothing like being in the same room with other ministry leaders and family members who share the same passions and interests that you do. Want to meet the authors who write for our family blog and share their resources through our Not Alone Facebook page? Many of them are coming. We’re building time and opportunity into the schedule for networking for ministry leaders and families. Last year, we had ministry leaders and attendees from 21 states and Canada.

Because you’ve always wanted to check Progressive Field off the list of Major League ballparks you’ve visited in person. There are lots of fun and affordable activities for visitors  to Cleveland and Northeast Ohio. The Tribe will be at home against the Blue Jays all weekend long. The Rock and Roll Hall of Fame is a fun place to visit. The Cleveland Museum of Art has one of the finest collections in the world and admission is always free!

And here’s a sixth reason for good measure…for ministry folks on a budget, Cleveland is a reasonable drive from a surprising number of major cities. Some sample distances to our conference site…

  • 141 miles from Columbus
  • 143 miles from Pittsburgh
  • 157 miles from Detroit
  • 247 miles from Cincinnati
  • 288 miles from Grand Rapids
  • 304 miles from Toronto
  • 314 miles from Indianapolis
  • 331 miles from Chicago
  • 346 miles from Louisville
  • 381 miles from Washington DC

For those who prefer to fly, we have non-stop flights from over 40 U.S. cities to Cleveland Hopkins airport and from ten cities to the Akron-Canton airport

You can register here for Inclusion Fusion Live. Here’s a complete list of speakers, along with the tentative schedule for ministry intensives, workshops and main stage sessions. and a link for discounted rates ($99/night + tax if booked by March 14th) at the Courtyard Marriott Westlake,  our official conference hotel.

See…you have no reason not to join us on April 5th and 6th at Inclusion Fusion Live!


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An uncommon man with an extraordinary call

Editor’s note: Disability ministry is one area in which women are often called to serve in leadership positions and many of the available resources intended to support families are written by women, for women. As an example, fewer than 1,500 of the 17,000 followers of our ministry’s family support page are men. If the needs of families affected by disability are all too often ignored in the church, the needs of men from families affected by disability are most likely to be ignored.

Jeff Davidson was a pastor and the father of a son with special needs who was called by God to be a missionary to the special needs community – especially men raising children with intellectual or developmental disabilities. Jeff and his wife (Becky) launched a monthly worship service for families of individuals with special needs in their hometown of Cookeville, Tennessee during the fall of 2005. Shortly thereafter, the local ministry was providing faith-based support groups, weekly Bible studies, and regular family outings and activities. The ministry grew to the extent that Jeff left his full time staff position at church in 2010 to join his wife in launching Rising Above Ministries, a national ministry to bring the love of God and hope in Christ to special-needs families with support, encouragement, inspiration, and community.

Jeff was passionate about providing opportunities for Christian community for fathers of kids with intellectual and developmental disabilities. We invited him to write guest blogs for Autism Awareness Day and Father’s Day. Sensing the need for someone to speak into the unique spiritual and marital challenges of fathers, we hired Jeff to blog about issues relevant to fathers. Around that time, he received the vision for a book that would serve as a field guide for men to help them navigate the challenges of serving as a husband and a father in a family affected by disability. 

The team at Kregel Publications also recognized the need for such a resource, and signed Jeff to a contract to write The Special Needs Dad. The check for his advance had arrived at his home on the day Becky got back from the hospital after Jeff’s very untimely death in May of 2017. Within a week, Jeff’s literary agent had reached out to me (and others) because everyone involved with the project wanted to find a way to honor Jeff’s legacy and publish the book in his absence. After an appropriate time, they reached out to Becky who provided them with the content Jeff had already written for the book. The book Jeff intended for fathers, Common Man, Extraordinary Call: Thriving as the Dad of a Child with Special Needs is being published next week and will stand as part of the legacy of his ministry. The book is available through Amazon and other fine retailers.

Jeff was a true champion of fathers of kids with special needs. His ability to speak into the lives of men struggling with the feelings of hopelessness common to dads in families impacted by disability is irreplaceable. Get the book for any dad in your life raising a child with an intellectual or developmental disability. His words of wisdom will be a blessing to men who missed out on knowing him in this life.

For those of you who never had the opportunity to meet Jeff or listen to him preach or teach, I’d like to introduce him to you through one of my favorite posts that he wrote for our ministry, Embracing the Brokenness with Unconditional Love:

You have a choice, Dads. You can be like me and wallow in anger, denial, blame, and your own obsession to fix the brokenness. Or you can embrace the brokenness with unconditional love. Embrace your child with special needs just the way God created your child, and love him or her unconditionally and passionately with all your heart.

When you make that choice, you will realize that God has called and chosen you for a unique mission. God has placed you on a mission for your life and He desires to equip you for one of the most amazing experiences you could ever imagine.

I have seen dads never recover from their initial anger. I have seen dads wrestle all their lives with the blame question, and I have observed dads struggling with acceptance because of their denial of their children’s issues. Anger, blame, and denial will keep you from embracing your situation, accepting your child, and choosing to love and parent unconditionally.

When you lay down your personal issues, you will realize there is nothing your child can do or achieve that will ever make you love him any more than you already do. You will love him simply because he is your child.

I’ve been the dad of a child with profound special needs for over eighteen years now. I’ve come to treasure the sometimes small but exceedingly joyful moments that this journey has to offer. I’ve also learned to weather the walks on the dark side and recognize the triggers that set me off on that journey.

But to this day, I regret the early years when I allowed my anger, denial, and obsession with fixing my son to rob me of the sheer joy of just being my son’s dad. Eventually I came to understand the only statistic that really mattered; I have one son—and he had autism.

So I made a decision. A choice. I chose to love my son unconditionally just the way he was—autistic. I chose to embrace his differences, accept his challenges, and love him for who he was—my son. I chose to go into his world and engage with him without reservation and qualification.

Autism is just a label. Just like the word son. The former word describes him, but the latter word defines him.

My son is completely dependent on me for everything in his life. From the moment he wakes up until the moment he drifts off to sleep at night, my wife and I have to provide for his every need. He is incapable of surviving this world without us. He’s utterly helpless on his own. Without me in his life, he cannot survive; he won’t survive.

I love him because he is my son. Not because he has done anything to deserve or earn my love. In fact, there is nothing he can do or achieve that will make me love him more than I already love him. He is my son. I created him. He belongs to me.

That’s why I love him. I love him simply because he is mine. I challenge him, I teach him, and I pour myself into him daily. All throughout the day I encourage him, affirm him, and express my unconditional love for him. I think about him all day long. I know his thoughts, his mannerisms, and his needs so well.

Even though there is nothing that could make me love him more than I already do, I love him too much to leave him the way he is. Like all sons, there are times he makes a real mess out of things. That’s when I have to step in and clean up his mess. That’s what fathers do for their sons; they help them clean up their messes.

That’s called Grace.

I believe in him despite his challenges.

I embrace his differences because that’s how he was created.

I believe he is fearfully and wonderfully made, created for a plan and a purpose, and that he is destined to glorify God.

He is my son. So I am his warrior, protector, provider, encourager and equipper. God has created and equipped you to become the warrior, protector, provide, encourager, and equipper for your children and your family too.

The first step in becoming the special needs dad God calls you to be is understanding that God has called you and placed you on a unique mission for your life.


Common Man, Extraordinary Call offers growth and hope for men with little free time. And as they process their instructions, they’ll be able to mentor other fathers, creating a strong army of men who not only survive but thrive as capable dads to their children with special needs. Available through Amazon, Barnes and Noble and Christian Book.



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Amplifying Small Voices – Inclusion Fusion Live 2019

On behalf of the Board and staff of Key Ministry, I’m delighted to invite you to join us and Christ followers from across the U.S. and beyond to Inclusion Fusion Live 2019, our annual disability ministry conference. This year’s conference is scheduled for April 5th and 6th, 2019 at Bay Presbyterian Church in Bay Village, OH.

We anticipate that IFL 2019 will be among the largest, if not the largest disability ministry training in the U.S. during the coming year. We have a fabulous lineup of speakers and events in store, and our intent for this year’s conference is for attendees to leave with everything they need to start a new disability ministry, grow an existing ministry, or more effectively serve the children, adults and families who are already part of an established ministry.

I was in a meeting last week with Catherine Boyle (our mental health ministry director) planning for the year ahead when she talked about the importance of “amplifying small voices.” I found that expression to be a wonderful metaphor for a value that shapes our ministry, and a great way to draw attention to one of the aims of the conference.

Two of our ministry’s operating principles are that we are intentionally collaborative with other like-minded leaders and organizations and that we seek to create platforms to advance the cause of disability ministry and to share them with others. Every year we seek speakers with great ideas for ministering with families touched by disability who may not be regulars on the conference circuit or have access to large social media platforms for promoting their work. Those with the smallest voices often have the most important things to say. We’re very excited to introduce many new, powerful voices this coming April in Cleveland.

Headlining our lineup is our 2019 keynote speaker, Janet Parshall.

Her daily talk show, In the Market with Janet Parshall is broadcast on the Moody Radio network on over 700 radio stations nationwide. She challenges listeners to examine major news stories and issues being debated in the marketplace of ideas and speaks to them with the Word of God. In 2008 and 2011, she was awarded the National Religious Broadcasters On-Air Personality of the Year.

Throughout her career, Janet has been a devoted advocate of the principles and policies that strengthen the family. In February 2005, she was selected by President George W. Bush to represent the White House as public delegate to the United Nations Commission on the Status of Women. She speaks nationwide on public policy issues that impact family preservation and promotion, and has been a vocal advocate in the Christian community for the support needs of families affected by disability.

As a radio and television commentator, author and advocate for the family, Janet has appeared on numerous national television and radio programs, including Crossfire, Hardball, Nightline, Larry King Live, Donahue, The 700 Club, Hannity & Colmes and NewsNight with Aaron Brown, and has also appeared on various other programs on CBS, NBC, ABC, CNN, MSNBC, CNBC, CBN, PBS, the BBC and NPR. She has also been featured in People magazine.

In addition to the featured presentation, we have 36 workshops in eight sessions over two days organized in ministry-focused and family-focused tracks providing detailed instruction on a broad range of topics covering practical issues related to disability inclusion at church and sessions to provide encouragement and support to parents and caregivers of children and adults with disabilities.

During the first day of IFL 2019, we’ve scheduled three day-long ministry intensives for pastors, church staff members and key volunteers seeking resources and support for substantial ministry initiatives. The intensives will include:

Starting a Special Needs Ministry in Any Size Church – presented by Stephen “Doc Hunsley of the SOAR Special Needs Ministry of Grace Church in Kansas City and our own Beth Golik of Bay Presbyterian Church.

Has God called you or your church to start a Special Needs Ministry, but you don’t know where to begin? Whether you are a small church or a large one, this intensive will answer the questions of how, what, and why. You will learn the steps to take from learning the theology of Disability Ministry to how to get senior leadership on board. You will fill your toolbox with how to deal with different types of behaviors, how to recruit and train volunteers, understand the different classroom environments as well as curriculum options available, engaging and partnering with church staff and community organizations, how to help your ministry to become outward focused, and helping your church become an inclusive place for those with special needs. You will receive all the information you need and more! After this intensive, you will realize that YOU can do special needs ministry at your church!

Buddy Break Leadership Training – presented by Marie Kuck of Nathaniel’s Hope.

Buddy Break is a free respite program created by Nathaniel’s Hope where kids with special needs and their siblings have fun and establish meaningful friendships with other kids and adults while parents and caregivers get a much needed break from their responsibilities. Buddy Break represents the largest church-based respite network in the U.S., serving families in over 100 locations across 26 states and Puerto Rico. Participants in this intensive will receive the necessary training required for their church to participate in the Buddy Break respite network and will receive a credit toward the purchase of the Buddy Break Start-Up kit.

Developing a Mental Health Inclusion Ministry Strategy – presented by our own Stephen Grcevich MD and Catherine Boyle of Key Ministry and Brad Hoefs of Fresh Hope.

One in five children and adults in the U.S. experience a significant mental health condition at any given time. Few churches have any plan for welcoming and including families affected by mental illness. In this intensive, attendees will be given all of the necessary tools and resources for formulating a church-wide mental health inclusion strategy. We will identify barriers to church participation for children and adults with common mental health conditions and introduce an array of interventions for including them in the full range of ministry activities most critical for spiritual growth. Everyone who registers for this intensive will be provided a copy of Dr. Grcevich’s book, Mental Health and the Church and is encouraged to review the key ideas in advance of the conference.

Here’s how you can plan to join us!

Register online for Inclusion Fusion Live…

The All Access ticket includes entrance to all Main Stage presentations and your choice of any workshop presented during the conference. We recommend this option for pastors, church staff members or volunteers. This ticket doesn’t include Ministry Intensives (separate ticket required at a cost of $69) or boxed lunch options (available to purchase during the registration process). We’re offering “Early Bird” pricing: $49 for All Access tickets by December 31; $59 by January 31; $69 by February 28; $79 by March 31; $89 after March 31.

The Family Track ticket is available for a reduced cost of $19 ($29 after March 31st) and includes entrance to all Main Stage presentations and Family-Focused workshops on Friday evening (April 5) and all day on Saturday (April 6). We recommend this option for parents, family members and caregivers of persons with disabilities who aren’t necessarily interested in starting or growing an inclusion ministry in their church. As with the All Access ticket, boxed lunch options for Saturday are available at the time of registration.

For those of you who are unable to join us in person in Northeast Ohio for the conference, we will be offering a free livestream through our ministry’s Facebook page of the main sessions on Friday evening and Saturday morning, including all of our featured speakers and all talks and interviews presented on the conference’s main stage following the main sessions later on Friday evening and throughout the day on Saturday.

We’re hoping to fill the church throughout the two days of IFL 2019  with pastors, ministry leaders and families from all across the U.S. for a time of prayer, worship, learning and collaboration for the purpose of helping individuals and families affected by disability to be welcomed and fully included in the worship and ministry offered through the local church. Our team would love for you to join us!




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A fun look at Key Ministry’s work with churches in 2018



Key Ministry depends upon the prayers and generosity of Christians who support our mission of connecting churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. Giving in 2018 has substantially lagged behind our expenses, and we’re facing the prospect of major cuts to the training and consultation we can offer to churches and support and encouragement offered to families. As we approach the end of 2018, your financial support is essential to our ability to continue our work in the year ahead. Please consider making a gift to our ministry if God has provided you with the means to do so.

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Helping families discover their unexpected blessings

For most people, their first thought upon learning their child or loved one has a serious disability wouldn’t be to consider themselves blessed. What if that disability represents the instrument through which someone comes to recognize their need for God, becomes connected to a church where they come to know Jesus and profess their faith in him, or provides the impetus for growing into a deeper relationship with God?

Our ministry exists for the purpose of connecting families of kids with disabilities to churches for the purpose of making disciples of Jesus Christ. Our primary strategy has been to connect families with churches with the recognition that the local church is God’s primary mechanism for producing Christ followers. In the process of developing our plans for 2019, I’ve come to appreciate the variety of ways through which God is using staff and volunteers associated with our ministry to point families affected by disability to Jesus and how their efforts support and complement the efforts of the local church.

Sandra Peoples is a member of our Key Ministry team who has clearly received spiritual gifts, talents, knowledge and personal experiences intended for the benefit of the church as it seeks to minister with families of children with special needs. She’s written a remarkable book that will be a great source of comfort and encouragement through revealing “the joys and possibilities of life in a special needs family.”

In Unexpected Blessings, Sandra provides wisdom grounded in Scripture to address the doubts, questions and fears common among parents of children with serious disabilities. She’s a gifted writer in that she’s able to address the most basic questions parents are likely about the purposes and character of God in their family’s experience of disability while offering new insights and understanding for spiritually parents and grandparents. Some topics she addresses in the book that will be of great benefit to parents and caregivers of children with special needs include…

Why did God allow my child’s disability to occur, or choose not to take away my child’s disability in response to my prayers?

Working through feelings of grief and loss associated with the changes in expectations resulting from disability.

Ideas for strengthening and reinforcing one’s faith while caring for a child with a disability.

How parents and caregivers can rediscover their purpose in the aftermath of the lifestyle changes resulting from their child’s disability.

Sandra’s Southern Baptist tradition precludes her from serving as a pastor. But as I read through Unexpected Blessings, I found myself thinking that the teaching presented in her book is exactly what I would hope the families of children with disabilities to experience as a result of being connected to a local church. I wish we had the resources to get a copy into the hands of every pastor so they might better understand the spiritual needs and struggles of families in their community with children with special needs.

The sad reality is that many families of children with autism, other developmental disabilities or common mental health conditions will never experience the benefits of belonging to a local church, and many families who are able to attend church will never experience sound preaching on the topics addressed in her book. For that reason, Unexpected Blessings is an essential resource for any parent, grandparent or caregiver of a child with special needs, regardless of where they find themselves in their faith journey.

I’m grateful and honored that someone associated with our ministry wrote a book that conveys such a depth of wisdom and understanding about the nature and character of God reflected through the experience of disability. Every parent of a child with special needs will derive hope and encouragement from Sandra’s words.

Unexpected Blessings is available on November 20th through Amazon, Barnes and Noble, LifeWay and other fine retailers. Individuals who preorder the book will receive additional benefits, including a free audio version.


Key Ministry depends upon the prayers and generosity of Christians who support our mission of connecting churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. Giving in 2018 has substantially lagged behind our expenses, and we’re facing the prospect of major cuts to the training and consultation we can offer to churches and support and encouragement offered to families. As we approach the end of 2018, your financial support is essential to our ability to continue our work in the year ahead. Please consider making a gift to our ministry if God has provided you with the means to do so.




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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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