1.
Including Students with Common
Mental Health Conditions at
Church
Stephen Grcevich, MD
President and Founder, Key Ministry
Presented at Together Conference 2020
Mount Paran Church, Atlanta GA
March 7, 2020

2.
Goals for today…
• Review research demonstrating the need for an intentional
approach to mental health inclusion at church
• Recognize common barriers to inclusion at church for children,
teens and adults with common mental health conditions
• Explore how a set of mental health inclusion strategies could be
applied to potential obstacles in your church
• Identify five attributes of a mental health-friendly church

3.
How does having a child
with a chronic health
condition impact
attendance at religious
services?
• Data analyzed from three waves
of the National Survey of
Children’s Health
• Three samples (2003, 2007, 2011-
12) of approximately 100,000
families of children ages 0-17
• Examined the relationship
between specific disabilities and
families who identify as “never”
attending a religious service
Whitehead AL. J Scientific Study Religion 2018;57(2)377-395.

4.
Whitehead AL. J ScientificStudy Religion 2018;57(2)377-395.

5.
Why is church
participation so
difficult?
Traits associated with common
mental health conditions often
clash with “church culture” –
how we expect people should
act when we come together

6.
Why special needs
ministry models
don’t work with this
population
• Reluctance to self-
disclose because of
stigma, confidentiality
• Kids, teens will FLEE
activities that draw
attention to their
differences
• They want to be
included in what
everyone else is doing!

7.
The foundation of Key
Ministry’s mental health
inclusion ministry model
• Recognize non-essential features of
ministry activities, environments, that
make church attendance more difficult
• Implementation of strategies across all
areas of ministry to welcome children,
adults and their families

8.
Seven barriers to
including families
impacted by mental
illness at church
• Stigma
• Anxiety
• Capacity for self-control
• Sensory processing
• Social communication
• Social isolation
• Past experiences of church

9.
Welcoming
the Phillips
family
The Phillips family lives down the street from your
church. Becky (a single parent) is raising Josh (age 9)
and Jennifer (age 7). Josh was invited toVBS by a
friend from school, had a great time and wants to
come to church every Sunday. and to Awana on
Wednesday night.
Josh is on medication for ADHD and receives special
education services for dyslexia.
Jennifer has separation anxiety disorder
Becky has social anxiety disorder and agoraphobia
What might go wrong in the first month of her
trying to attend your church

10.
Defining the “win”
• Your ministry achieves a win when any family member of
someone with mental illness has a meaningful encounter
with your church.
• Persons with mental illness have spouses, parents, sons,
daughters, siblings who need churches too!
• Mental health ministry is central to other ministries with
vulnerable populations…
• Foster care/adoption ministry
• Prison ministry
• Substance use care and support

11.
Key considerations for an effective
mental health inclusion strategy…
• Inclusion is a mindset – not a program
• Kids with mental health issues have parents with mental health
issues!
• A good strategy benefits everyone and doesn’t require anyone
to self-identify
• Ministry owned by the people, supported by staff
• No church can include everyone with mental illness, but every
church can do more!

12.
Seven strategies for promoting mental
health inclusion (TEACHER)
• Assemble your inclusion team
• Create welcoming ministry environments.
• Focus on activities most essential to spiritual growth
• Communicate effectively
• Help families with their most heartfelt needs
• Offer education and support
• Empower the people to take responsibility

13.
Who needs a
seat at the
table?
Building your
inclusion
team
• Senior leadership
• Ministry directors on church-wide
implementation team
• Ministry departments may have
their own team
• Consider gifts, talents, passions of
church members, attendees

14.
What might our mental health inclusion
planning process look like?
• Leaders in each ministry area might identify potential
barriers, useful strategies in their area of responsibility.
• An alternate approach might be to focus on a strategy (or
several strategies) and implement the strategy across your
ministry departments or environments.
• Assigning responsibility for the plan (or components of the
plan) with deadlines for implementation important.

15.
Using the
ministry
planning
tool

16.
Welcoming ministry
environments…
• Promote focus, attention
• Help attendees prioritize
important takeaways
• Support in processing
directions
• Supports kids in
maintaining self-control
• Reserved seating for
persons with agoraphobia

17.
Common considerations
in sensory-friendly
ministry environments
• Sound
• Lighting
• Flooring
• Window treatments
• Wall color
• “Fragrance-free” zones
• Seating
• Dress code

18.
A process for
becoming more
sensory-
friendly?
• Consider…
• Entrances
• Worship spaces
• Children’s/student
ministry spaces
• Vacation Bible School
• Sensory-friendly movie
• Role for online church

19.
Inclusion in
high-impact
ministry
activities
Prioritize what you MOST
want people to do to grow in
faith
• Weekend worship?
• Small groups?
• Missions/serving?
• Prayer, family devotions?

20.
Develop a mental
health communication
strategy
• Preach it from the pulpit!
• What NOT to say
• Website pictures, video
• Bulletins, printed materials
• E-communication
• Social media
• Online church inclusion

21.
What churches
are doing to
communicate
more effectively
• Praying for persons with
mental illness during worship
• Sermon series on mental
health-related topics
• Facebook video targeting
families with mental health
issues
• Interviews/prerecorded
testimonies of respected
members during worship

22.
Mental Health
Awareness
Sunday
• Strategy for introducing a
mental health ministry
• Outreach to friends,
neighbors
• Teaching on mental health-
related topics
• Great event for small-
medium size churches
• Church “conversation” can
be very powerful!

23.
Helping
families with
heartfelt needs
• Casseroles
• Respite care
• Counseling
• Current referral list
• Mental health
professionals
• Treatment facilities

24.
Mental
Health
Education
and Support
• Training for pastors, church staff, volunteers
• Seminaries
• Mental Health First Aid
• Trauma-informed care
• Christian-based mental health education,
support
• Fresh Hope
• Grace Alliance
• Celebrate Recovery
• My Quiet Cave
• Mental health support
• NAMI

25.
Empowering
your people to
assume
responsibility for
ministry
• Organic support –
“Grab a mop”
• Relational respite
• Stephen’s ministers
• Mental health liaison
• Coming alongside
friends at church

26.
The Role of
Mental Health
Liaison
• Primary mental health contact,
advocate at church
• Meets with new visitors with
mental health needs
• Maintains mental health referral
list
• Contact for professionals seeking
supportive churches
• Coordinates training for church,
lay leadership
• Obtains additional resources and
support from organizations like
Key Ministry

27.
The best
strategy?
Having a trusted
friend to come
alongside new
visitors at
church

28.
Five
characteristics of a
mental health
friendly church
• Demonstrates an intentional
inclusion planning process
• Educates church staff,
volunteers on mental illness
• Implements a mental health
communication strategy
• Provides practical help to
individuals, families affected
• Offers mental health-specific
education/support groups

29.
Initial steps to
implementing a
mental health
inclusion strategy
• Senior pastors
• Pray for discernment
• Pursue buy-in from staff,
board
• Church staff, volunteers
• Approach senior leadership
for support
• Developing personal ministry
• Respect church leaders
• “Be the church” where
you’ve been planted

30.
Taking the Next Step…Together

31.
Key Ministry promotes meaningful connection
between churches and families of kids with
disabilities for the purpose of making
disciples of Jesus Christ.
Free training, consultation, support and resources
What Does Key Ministry Do?

32.
Help from Key
Ministry
• Training
• Conferences
• Video training
• Roundtables
• Consultation to churches
• Resources
• Networking with other
ministries
• Social media, sermon
videos, research
• Someone to come alongside
your ministry!

33.
Connect with Key Ministry
• www.keyministry.org
• Twitter: @KeyMinistry
• www.facebook.com/keyministry
• steve@keyministry.org

34.
Supplemental slides

35.
People with anxiety
overestimate
threat, risk when
entering unfamiliar
situations
• Social anxiety
• Separation anxiety
• Agoraphobia
• Obsessive-Compulsive
Disorder

36.
What church activities are challenging
for children and teens with anxiety?
• Separating from parents at
worship
• If they are made to be a center
of attention
• Unfamiliar situations…
retreats/mission trips
• Self-disclosure in small groups
• Large group social situations
• Transitions between age-group
ministries

37.
Strategies for ministry leaders serving
kids and teens with anxiety
• Lots of pictures and video to
prepare kids, families for new
experiences
• Promote opportunity for kids,
families to tour your campus
before their first visit
• Use kids from many schools
as “greeters”
• Sensitivity to allowing
“preferred” roommates on trips
• Using cell phone cameras for
kids with separation anxiety

38.
Tips for church staff and volunteers
when kids and teens are anxious
• Don’t call attention to an anxious child
• Avoid interventions that make them feel “different
• Observe for problems at “drop-off”
• Designate a private place for kids/parents in distress
• Watch for kids who are alone with parents in sanctuary
• Offer to meet with parents when a child’s anxiety
appears to interfere with ministry participation

39.
Self-control
Executive functioning refers to
cognitive abilities involved with
modulating other abilities and
behaviors.
• Behavioral inhibition
• Verbal working memory
• Non-verbal working memory
• Emotional self-regulation
• Reconstitution

40.
One parent’s lament…
“People in the
church believe
they can tell when
a disability ends
and bad parenting
begins.”

41.
Understanding
why “structure”
helps people with
executive
functioning deficits

42.
The more kids have to process, the less capacity
they have for self-control

43.
When are kids most at risk
for aggressive behavior at
church?
• Transition times before and after
children’s worship
• Christian education activities
when environment is more
chaotic, unstructured, supervision
less consistent
• Following high stimulation, high
energy activities
• Evening activities

44.
How might having
ADHD impact church
participation?
• Difficulty sitting through
adult worship service,
• Keeping hands to self
difficult in worship,
Sunday School
• Prone to immediate,
negative reactions to
authority figures
• Teens may struggle with
time management,
prioritizing church
activity, susceptible to
negative peer influences

45.
Unique
challenges
presented to
the church
by kids with
ADHD:
• Church environments are generally
less structured than school
• Churches rely upon ministry volunteers
who lack training as educators
• Parents, physicians often withhold
effective ADHD medication for
weekends
• Many church activities occur when
ADHD medication has worn off

46.
ADHD inclusion strategies (children/youth)
• Registration/sign-in needs to be orderly
• Staffing for transition times before/after services
• Use of color, lighting
• Engaging, not overwhelming
• Communication strategies
• Reinforce key point(s)
• Use of personal stories, experiences
• System for getting helps, resources to parents
• Family worship experiences geared to kids?

47.
Sensory Processing
NOISE, LIGHT, TOUCH, SMELLS AND
TASTE THAT OTHERS FIND ENGAGING
ARE AVERSIVE
Challenges for kids:
Pick up and drop-off times
High energy worship
Vulnerability to aggressive behavior
Multiple conversations in close proximity

48.
Social Communication
DIFFICULTIES AT CHURCH
FOR PERSONS WHO
STRUGGLE TO PROCESS
SOCIAL CUES
Church-specific challenges:
• Small talk
• Small groups
• Bullies
• Unfamiliar situations

49.
Social Isolation
HOW DO PEOPLE FIND YOUR
CHURCH IF THEY DON’T KNOW
SOMEONE ATTENDING YOUR
CHURCH?
• Parents less likely to connect with
neighbors through children’s
activities, friendships
• Isolation as a symptom of
depression, anxiety

50.
Past Experiences of Church
THE APPLE OFTEN DOESN’T
FALL FAR FROM THE TREE!
• Lack of support from church
in a time of need
• No one noticed when they
were missing
• No help offered when a child
experienced struggles
• Adults with mental health
concerns as children never
got in habit of attending