How pastors can support mental health in the age of COVID-19.

The Barna Group surveyed pastors in mid-April regarding their personal mental and emotional health and the mental health of their congregations. The most significant finding from the survey was that only 30 percent of pastors reported feeling well-equipped to help their people deal with matters of mental or emotional health.

Our ministry team would like every pastor to feel confident in their abilities to support their congregants during the greatest economic and medical crisis most of us have experienced in our lifetimes. Here are nine specific ideas for how pastors and church leaders can help promote the mental health of their people while advancing the Gospel throughout what is likely to be a lengthy period of social, vocational and economic disruption related to COVID-19.

Talk about mental health during your preaching. One of the most encouraging findings from the Barna survey was that 39% of pastors reported they had already preached on the topic of mental health. A Lifeway study on Acute Mental Illness and Christian Faith in indicated that nearly two thirds of family members of persons with mental illness wanted their pastors to talk more openly about the topic at church, while a similar proportion of pastors reported preaching about mental illness “once a year, ” “rarely” or “never.” Preaching on mental health is one of the most direct ways of addressing the stigma associated with the topic and helps attendees feel more comfortable in seeking care and support from others in the church.

Combat social isolation. Our team strongly encourages pastors and church leaders to make available as many opportunities as possible for online interaction. Most churches have found ways of making worship services available online since states have mandated social distancing. We need to go further by making interactive small groups, Bible studies, Christian education, committee meetings and chats available online as well. Any church can make a point of calling and sending cards and letters attendees living in homes where someone is medically compromised and seniors who may be less tech-savvy.Whatever your church can do to in this time to help your people feel more connected will help mitigate increased risk for acute mental health and substance abuse issues.

Increase awareness among your people of how they might find counseling and other mental health services. With May 3rd-9th being Mental Health Week, the church I attend is hosting a chat between our lead pastor and a local psychologist from a Christian-oriented practice as well as an event featuring counselors associated with the church. Ensure that anyone providing counseling or support through your church has access to the technology to continue their work online for as long as social distancing is being practiced. Consider creating or updating your church’s list of mental health resources to identify practitioners and clinics available to see attendees during and after COVID-19..

Support the startup of a Christian-based mental health support group. The Grace Alliance and Fresh Hope are outstanding ministries with well-designed and established models for providing biblically-based support for teens and adults struggling with common mental health issues. Each ministry offers extensive online training for prospective leaders and low or no-cost resources for group participants

Build your church’s care and support resources. Given the numbers of individuals and families who have lost jobs or businesses, serious illness or death or major educational disruptions since the beginning of the pandemic, the need for care and support is likely to exceed your response capacity or that of your church’s staff. Encouraging as many of your people as possible to obtain training in Psychological First Aid is one way of greatly expanding your church’s capacity to respond to surges in demand from persons in crisis. Launching or growing a peer support ministry along the line of Stephen Ministry is more time-intensive, but an appropriate strategy for helping to meeting enduring care and support needs resulting from the pandemic.

Offer practical support. Unemployment is a significant risk factor for both suicide and death by opiate overdose. Helping people find work and navigate an unemployment benefits system grossly unprepared to meet the current demand is one tangible way to help. People need food and short-term rent support. Persons who have lost their jobs may not have the finances to access needed counseling or medicine, even if they still have health insurance through their employers because of high deductibles. Members of your congregation might greatly benefit from financial support to access emergency or short-term mental health care.

Provide opportunities to serve. Research from natural disasters suggests involving vulnerable children in family and community responses during times of potential danger increases resilience, defends against development of helplessness, and may help protect against post-traumatic effects through promoting a sense of agency and self-efficacy. Involving your people in ministry is a tangible way of demonstrating the love of Christ to persons in your church or the surrounding community experiencing acute need while affording them some measure of protection from the trauma often resulting from such impactful events.

Consider developing a mental health inclusion strategy to identify and overcome specific barriers families affected by mental illness might experience in engaging with your church. Recent research tells us families of children with depression, anxiety, ADHD and disruptive behavior disorders are far less likely to ever set foot in a church compared to their unaffected neighbors. Our ministry’s strategy has been to help churches recognize how functional limitations associated with common mental health conditions cause difficulties in meeting expectations for social interaction and behavior across our different ministry environments. A mental health inclusion strategy will help your church reach one of the largest underserved people groups in your surrounding community.

Invite individuals and families impacted by mental illness in the communities you serve to connect with your church. A key finding of the LifeWay study referenced earlier was that 55% of all unchurched adults believe that persons with significant mental illness won;’t new welcomed at church. Here’s a fabulous example of how one church in our home region created a video invite from the founding pastor for members to share through social media with individuals and families impacted by mental illness within their sphere of influence who don’t have a church.

Still uncertain about supporting the mental health needs of your congregation during this time? Our team would be happy to jump on Zoom with you or your ministry team to talk about specifics of your church’s situation. Use this form to contact Catherine Boyle (our mental health ministry director) and note in the form that you’d like to set up a videoconference to discuss next steps for your church. We don’t charge for consultations and seek to provide as many of our resources as possible to churches free of charge. You’ll find lots of additional resources for mental health ministry here, and COVID-19 specific resources here.

If you’re interested in a deeper dive, here’s video from a webinar I participated in this past Tuesday with Kay Warren and Dr.Tim Murphy sponsored by the HHS Office of Faith-Based Partnerships to help pastors and other faith leaders respond to the mental health needs of their people during the COVID-19 pandemic.

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Why does God allow Coronavirus and other types of suffering?

Over the last couple of weeks, I’ve posted prayer requests on Facebook for a young single mom who was critically ill and near death with a respiratory distress syndrome like that seen with COVID-19, and more recently, a young father who contracted the virus working as an ER nurse in the very same hospital where he now lies in intensive care, connected to a ventilator. A former coworker posted this reply to my prayer request:

This might be a controversial comment, but please don’t judge. I struggle with the topic after my husband passed away from a sudden heart attack when my boys were 7 and 9 yrs old. So if God is great, all knowing, all powerful…how do these things occur? Please delete, as it might be inappropriate. I pray, however for Travis and this family.

Earlier this week, I saw in my news feed that another young mom who serves as a mental health advocate within the Christian community and her husband lost their young child eight days after he was born. Families everywhere are in great distress as parents lose their jobs and businesses, kids with disabilities lose access to support services they depend upon and the medical precautions necessary to control the spread of the virus has left those who are ill desperately isolated and alone when they’re most in need of the presence and support of family and friends.

How should we respond to the question posed by my former coworker? Or parents who have lost a child? Or the family in which the care and support needs of a family with a disability become so overwhelming that the marriage falls apart? The Bible teaches us that we’re to be prepared to share with others the reason for the hope we have in Jesus, but the first question we’re likely to encounter when doing so is often some version of how can a loving and all-powerful God allow a young father to die and leave a wife and two little boys behind, or allow a child to grow up in a home where they experience ongoing physical and sexual abuse or allow millions of people in Third World countries to die of starvation, war or curable disease?

Here’s the message I sent to my coworker (privately) in response to her post:

I’m not sure I heard about your husband. Facebook can be rather selective in who sees what. I am so sorry for your loss! I saw the question you posed in responding to my friend’s prayer request. I’ll try to answer based upon my understanding of the Bible.

There’s an entire book of the Bible (Job) written on the topic of suffering. Job had suffered unjustly, but he never learned the reason for his suffering while he was alive. I suspect that’s true for most of us – we’ll never fully understand the reason for our suffering or the suffering of our loved ones on this side of Heaven.

A central theme in Christianity demonstrated through the Easter story is that God responds to suffering not by sparing us from it but by entering into it with us and by experiencing it for us. If you’re interested in the Christian perspective on why suffering exists, take a look at this conference talk from John Piper. He’s a retired pastor from a church in Minnesota who has written extensively on suffering. I’d encourage you to watch from the beginning but if you only have a few minutes, start at the 31:55 mark. His key point…

“The reason that suffering exists in the universe is so that Christ might display the greatness of the glory of the grace of God in himself as he suffers, by entering into it, suffering himself, that he might by grace deliver us from everlasting suffering.“

 

Upon further reflection, trying to put myself in the shoes of someone who hadn’t been immersed in Christianity for years and years, the response I sent to my former colleague felt inadequate. Piper’s quote sounds very narcissistic upon first hearing.

“that suffering exists in the universe is so that Christ might display the greatness of the glory of the grace of God in himself as he suffers”

If God allows suffering so that he might be glorified, why is God’s glory of such great importance that the unimaginable suffering necessary to achieve it is justifiable?

Dr. Piper addresses this question in a blog post explaining why God’s passion for his own glory isn’t selfish. I encourage you to go back and read the whole thing because he does a wonderful job of explaining how God’s insistence on glorifying himself justifies the presence of suffering in the world and demonstrates why the death and resurrection of Jesus that we celebrate this weekend is truly the most wonderful event in the history of the universe. Here are some key excerpts:

How is God’s passion for his glory not a sinful form of narcissism and megalomania? The answer is that God’s passion for his glory is the essence of his love to us. But narcissism and megalomania are not love.

God’s love for us is not mainly his making much of us, but his giving us the ability to enjoy making much of him forever. In other words, God’s love for us keeps God at the center. God’s love for us exalts his value and our satisfaction in it. If God’s love made us central and focused on our value, it would distract us from what is most precious — namely, himself. Love labors and suffers to enthrall us with what is infinitely and eternally satisfying: God. Therefore, God’s love labors and suffers to break our bondage to the idol of self and focus our affections on the treasure of God.

He goes on to illustrate this principle through Jesus’ act of resurrecting his friend Lazarus from the dead:

Oh how many people today — even Christians — would murmur at Jesus for callously letting Lazarus die and putting him and Mary and Martha and others through the pain and misery of those days. And if they saw that this was motivated by Jesus’s desire to magnify the glory of God, many would call this harsh or unloving. What this shows is how far above the glory of God most people value pain-free lives. For most people, love is whatever puts human value and human well-being at the center. So Jesus’s behavior is unintelligible to them.

But let us not tell Jesus what love is. Let us not instruct him how he should love us and make us central. Let us learn from Jesus what love is and what our true well-being is. Love is doing whatever you need to do — even to the point of dying on the cross — to help people see and savor the glory of God for ever and ever. Love keeps God central. Because the soul was made for God.

Piper’s key take-home point:

Oh how we need to help people see that Christ, not comfort, is their all-satisfying and everlasting treasure. So I conclude that magnifying the supremacy of God in all things, and being willing to suffer patiently to help others see and savor this supremacy, is the essence of love. It’s the essence of God’s love. And it’s the essence of your love. Because the supremacy of God’s glory is the source and sum of all full and lasting joy.

It’s easy for us to not see beyond our circumstances and fail to consider God’s perspective on our suffering. If God created us to be in relationship with him forever, anything that advances that purpose, including allowing us to suffer for a time is justifiable as the most loving thing God could do. At the same time, our ability to remain steadfast in our faith while suffering with anxiety represents a more powerful witness that draws other people to God. In another sermon, Dr. Piper said that God is most glorified in us when we are most satisfied in him. Is it possible that the works of God are most on display in us when we demonstrate contentment and joy in the midst of distress?

May you and your family experience a blessed a joyful Easter as we worship and reflect upon a savior who didn’t leave us to suffer alone, but enters into our suffering with us.

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Many speakers who planned to attend our disability ministry conference have put together an Easter Sunday service for families affected by disability without a church. Most contributors have a disability themselves or a family member with a disability. Our teaching pastor for the morning is on the autism spectrum. We seek to inspire families and give them hope while calling attention to the gifts and talents the church misses out on when families with disabilities are excluded.

Our Not Alone Easter Service will be streamed at 9:00 AM Eastern Time on Easter Sunday on both the Key Ministryand Not Alone Facebook pages. The service will be available all throughout the day on Easter Sunday, and we’re encouraging our followers to host watch parties for friends and neighbors on their individual Facebook pages.

 

 

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An Easter service for the disability community

It was one month ago today when most Christians last experienced a Sunday worship service inside a church building. The quarantines and social distancing necessitated by the coronavirus have produced the unintended benefit of reminding us of how much we value corporate worship. I’ve seen many friends express their sense of loss on different social media platforms, especially during Easter Week.

Our experience of church over the last four weeks is what every week is like for too many families affected by disability.

Easter is celebrated this year in the middle of Autism Awareness Month. The largest study ever undertaken examining the relationship between disability status and church attendance found that families with a child with autism are 84% less likely than their friends and neighbors without disability to have set foot inside a church in the past year. The rates aren’t much better for families of children with common mental health conditions. Church attendance is:

  • 73% less likely when a child has depression
  • 55% less likely when a child has conduct disorder
  • 45% less likely when a child has an anxiety disorder
  • 36% less likely when a child has a learning disability or developmental disability
  • 19% less likely when a child has ADHD

Our mission is to help connect churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. We had a large conference planned for April 24th and 25th featuring over seventy speakers who were giving of their time and talent to train pastors and resource families to make church far more accessible to the disability community – especially individuals and families impacted by autism, mental illness and other “hidden disabilities.” God and our state and local government officials had other plans.

Our team wanted to do something to increase awareness of the needs of the disability community while putting their gifts and talents on display. What better way to do that on this very unique Resurrection Sunday than to put together a special worship service for families impacted by disability who don’t have a church this Easter morning?

Our Not Alone Easter Service will be streamed at 9:00 AM Eastern Time on Easter Sunday on both the Key Ministry and Not Alone Facebook pages. The service will be available all throughout the day on Easter Sunday, and we’re encouraging our followers to host watch parties for friends and neighbors on their individual Facebook pages.

This isn’t simply a worship service…it’s also intended to be a disability ministry teaching tool. Over thirty of our conference speakers had a hand in putting the service together. Barb Newman will demonstrate how to adapt teaching for all types of learners while presenting the children’s message. Ryan Wolfe has an Easter message for adults with intellectual or developmental disabilities.

Most people appearing the service either have a disability themselves or an immediate family member with a disability. With April having been designated Autism Awareness Month, our worship pastor (Kyle Broady) and the pastor sharing the benediction (Lee Peoples, together with his wife Sandra) have sons with autism. Our teaching pastor, Lamar Hardwick described his experience of leading a church as a person with autism in I Am Strong, Lamar is a remarkable preacher with a special message for us this Easter.

We intend for the service to demonstrate the amazing gifts and talents the church is deprived of when individuals and families impacted by disability are left out of the church. We hope that many taking part in the service will consider how God might use their gifts and talents in ministry to others.

We trust you’ll find encouragement and comfort in what we intend to be Key Ministry’s one and only original worship service. Our hope for next Easter is that ALL of us… persons with autism, mental health concerns, developmental disabilities or any disability will be worshiping our risen Lord together inside the churches we call home.
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Our team at Key Ministry has assembled a 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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Caring for our neighbors in a COVID-19 mental health crisis

How can the people of God provide the most tangible care and support to their friends and neighbors in the midst a long and drawn out medical and mental health crisis?

For the last couple of weeks, our team has been wrestling with the short and long-term mental health implications of COVID-19. We know churches are the first place many will turn to in the days and weeks ahead as life becomes more difficult. Even the American Psychiatric Association (APA) recognizes that pastors and other faith leaders serve as gatekeepers or “first responders” when individuals or family members experience mental health problems. One recommendation of the APA that we have echoed in our work with churches is for pastors and lay leaders to learn more about the basics of mental health conditions and appropriate responses through programs such as Mental Health First Aid (MHFA).

Our team came up with the idea of providing an online mental health first aid course for churches and lay leaders around the country. We reached out to a highly respected organization led by a pastor who is a national trainer for MHFA and a contact within the Partnership Center of the U.S. Department of Health and Human Services to brainstorm the necessary steps to make the training happen.

The unprecedented situation in which our country finds itself is bringing to light many vulnerabilities in our disaster relief system. We quickly discovered that no remote training option exists for MHFA, and live trainings are precluded by orders issued by most state governments against gatherings of ten or more people. The same orders have caused churches to close, leaving staffs scattered and pastors under extraordinary strain, having to completely rethink their methods of doing ministry while managing feelings of helplessness from their inability to provide their customary care for the sick and dying during the pandemic.

We’ve concluded that the rapidly mounting support needs emerging as a result of the social isolation, quarantine, economic and job losses from steps taken to mitigate COVID-19 will require an entirely different approach than people are accustomed to from their churches – an “all hands on deck” response from all of God’s people far exceeding the capacity of our pastors and church staff alone.

Dawn Skaggs is a national expert on disability inclusion in emergency management who planned to offer a workshop at our now canceled conference on the church’s role in disaster preparedness. She also serves as a psychological first aid mentor for a course offered through Johns Hopkins University School of Medicine that represents an outstanding resource for pastors, church staff and individual Christians who want to be better prepared to care for and support their neighbors in the days and weeks ahead.

Psychological first aid (PFA) is a concept similar to physical first aid for coping with stressful and traumatic events in crisis situations and at disaster sites. PFA was partially funded by the U.S. Centers for Disease Control and is recommended or endorsed by the Institute of Medicine, the National Institute of Mental Health, the American Red Cross, and the American Psychiatric Association. Psychological first aid may be defined as a compassionate and supportive presence designed to mitigate acute distress as well as to facilitate access to continued care. The approach taught at Johns Hopkins was developed in response to trauma experienced by soldiers and military personnel during the Kuwait War and further refined following the attacks on the Twin Towers and the Pentagon on 9/11.

I first heard about psychological first aid from Dawn during a ministry idea share our team conducted last Monday. I was able to complete the free, seven module online course in five days while maintaining my child psychiatry practice in the midst of an unusually busy week of trainings and responsibilities for Key Ministry. Having personally gone through the course, here’s why I’d recommend it to any pastor or church leader interested in quickly building capacity to care for large numbers of hurting people during the pandemic.

  • Psychological first aid is a skill set anyone can master – it was intended for persons with no training or experience in the mental health field whatsoever. It’s not treatment. It’s better characterized as a means of helping people rebound from adversity through fostering necessary resilience to function in the midst of adverse circumstances.
  • Psychological first aid was specifically designed to respond to surges in need associated with natural disasters and other traumatic events. It is most effectively implemented by people familiar with available supports within their local communities.
  • Psychological first aid offers practical ideas for responding in conversations with people experiencing COVID-19 related distress or loss. Spouses and children unable to comfort loved ones who are sick or dying in hospitals or other care facilities. Men and women who have lost their jobs or businesses. College students separated from peer support while facing an uncertain future. Healthcare workers who watch the sick die alone while knowing they themselves are at great risk of contracting the virus and experiencing a similar fate.
  • Psychological first aid provides a framework for helping people tap into their faith to cope with the realities of their immediate situation.
  • Psychological first aid serves a vital triage function in identifying persons most in need of medical, mental health or spiritual support and optimizing the ability of healthcare professionals and pastoral care to help the most people with limited resources.

Christians run to, and not away from neighbors in distress. One factor contributing to the growth of the early church was the self-sacrifice demonstrated by Christians who stayed in the cities to care for victims of the plagues that periodically ravaged the Roman Empire during the second and third centuries. Eighteen centuries later, we’re blessed to have an advanced healthcare system capable of helping the vast majority of people infected by the coronavirus to experience a full and complete medical recovery. The system isn’t remotely prepared to care for all of the people who will be incapacitated by anxiety, depression or PTSD in the weeks and months to come.

How will the Christians of the 21st Century church respond to the victims of this pandemic?

Click here to learn more about or to enroll in the free course in psychological first aid offered by Johns Hopkins University through Coursera.
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Our team at Key Ministry has assembled a 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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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.

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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?

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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.
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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)

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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 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)

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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 beth@keyministry.org or catherine@keyministry.org with links and essential information.
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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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