This document discusses why families of children with mental illness often do not attend church and provides suggestions for how counselors can help. It examines research finding conditions like depression, anxiety, and ADHD are associated with lower church attendance. It then outlines seven common barriers these families face, such as stigma, anxiety, and social difficulties. The document proposes a mental health inclusion model for churches and provides strategies counselors can use to support these families and advise churches, such as helping clients develop skills to participate and advocating for their needs. It concludes by emphasizing the importance of churches having an intentional inclusion process and providing support services.

1. Why Families of Kids With Mental
Illness Don’t Attend Church - And
How Counselors Can Help
Stephen Grcevich, MD
Child and Adolescent Psychiatry
President and Founder, Key Ministry
Presented at American Association of Christian Counselors
Nashville, TN
October 11, 2019

2. Learning Objectives:
• Examine the relationship between the presence of
mental health conditions in children and
adolescents and family church attendance.
• Identify seven common barriers to church
attendance and ministry participation for families of
children with common mental health disorders.
• Introduce a range of approaches counselors might
employ in supporting clients with church
participation and churches in their ministry with
families impacted by mental illness.

3. Potential Conflicts of
Interest (last five years)
Source of Conflict: Company:
Consultant Ironshore, Shire
Grants/research support Stark County ADAMAS Board
Sisters of Charity Foundation
Speakers’ Bureaus N/A
Other financial support N/A
Publishers Harper Collins/Zondervan

4. How do chronic health conditions in
children and teens impact attendance
at religious services?
Whitehead AL. J Scientific Study Religion 2018;57(2)377-395.
• 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

5. Whitehead AL. J Scientific Study Religion 2018;57(2)377-395.

6. Whitehead AL. J Scientific Study Religion 2018;57(2)377-395.
Conditions associated with
decreased church attendance
• Autism (with mental health comorbidities)
• Depression
• Conduct Disorder
• Anxiety Disorders
• Learning Disorders
• ADHD

7. Conditions NOT associated
with lower church attendance
• Asthma
• Diabetes
• Tourette’s Disorder
• Epilepsy
• Hearing problems
• Vision problems
• Intellectual disability (in most recent cycle)
• Cerebral palsy
Whitehead AL. J Scientific Study Religion 2018;57(2)377-395.

8. 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!

9. A population too big to ignore?
Prevalence of common mental health
conditions in teens
0
5
10
15
20
25
30
35
Anxiety Depression ADHD PTSD
Prevalence Severe Impairment
Source: National Institute of Mental Health

10. Can someone be “disabled” at church and
function well in other life activities?

11. A different way of
thinking about mental
health ministry
• Evangelism and outreach to
families impacted by mental
illness as an underserved
population
• What would a mental health
inclusion model for churches
look like?

12. Why is church
participation so
difficult?
Traits associated with
common mental health
conditions often clash with
“church culture” – our
expectations for how people
should act when we gather.

14. What’s been missing is a widely accepted
mental health inclusion strategy

15. 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.

16. What are some
potential barriers to
church attendance?

17. Seven barriers to
church attendance
for families of kids
with mental illness
• Stigma
• Anxiety
• Capacity for self-control
• Sensory processing
• Social communication
• Social isolation
• Past experiences of
church

18. How can
counselors
help?
• Asking clients about challenges attending
church
• Help clients acquire necessary skills,
strategies to navigate ministry
environments
• Advocating for clients with their churches
• Becoming a mental health inclusion
champion at their church

19. What church
activities are
challenging for
children and teens
with anxiety?
• Separating from
parents at worship
• Unfamiliar
situations…
retreats/mission
trips
• Self-disclosure in
small groups
• Large group social
situations
• Transitions
between age-
group ministries

20. Challenges at church for adults
with anxiety
• Visiting a new church
for the first time
• Fear of becoming focus
of attention
• Lack of available
seating near an exit
(agoraphobia)
• Meeting new people
• Joining a small
group/self- disclosure
• Using the phone

21. 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

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

23. How can a counselor champion mental
health inclusion in their church?
• Meet with your senior pastor/leadership team
• Resource your church leadership
• Education
• Direct them to available resources
• Key Ministry
• The Grace Alliance
• Fresh Hope
• Offer to serve on the inclusion team
• Lend your credibility to your church’s ministry

24. Seven mental health inclusion
strategies (TEACHER)
• Assemble your inclusion team
• Create welcoming ministry environments.
• Focus on ministry activities most essential to
spiritual growth
• Develop an effective communication strategy
• Help families with their most heartfelt needs
• Offer education and support
• Empower the people of your church to
assume responsibility for ministry

25. What might your church’s
planning process look like?
• Leaders in each ministry area might identify
potential barriers, useful strategies within their
area of responsibility.
• Alternate approach - focus on a strategy (or
several strategies) and implement them across
your ministry departments, environments.
• Assigning responsibility for the plan (or
components of the plan) with deadlines for
implementation important.

27. Key considerations for an effective
mental health inclusion strategy…
• Inclusion is a mindset – not a program
• A good strategy benefits everyone and doesn’t
require anyone to self-identify
• Ministry is owned by the people and
supported by staff
• No church will be able to include everyone with
mental illness, but every church can do more
than they’re currently doing!

28. Five marks of churches that are
doing mental health inclusion well
• An intentional inclusion planning process
• Educational opportunities for pastors, staff and
volunteers
• Mental Health First Aid
• Becoming trauma-informed
• Implementation of a communication strategy
• Tangible help provided to families impacted by
mental illness
• Education/support groups

29. What churches are doing to
communicate more effectively
• Praying for persons
with mental illness
during worship services
• Interviewing highly
respected members of
congregation impacted
by mental illness during
worship services.
• Saddleback’s Hope for
Mental Health
Community

30. Mental Health Awareness Sunday
• Strategy for announcing
mental health inclusion
strategy, welcoming
friends, neighbors
• Teaching in worship on
mental health-related
topic
• Great event for small-
medium size churches
• Church “conversation”
can be very powerful!

31. Mental
health
awareness
cards
• Crossroads
Mansfield
developed mental
health education
brochures for
churches
• A resource for
church members to
share with friends
and neighbors
• Available through
the Church and
Mental Health blog

32. Next
Steps
• An area to help
persons with mental
health concerns
enter into the church
community
• Facilitates entry into
groups
• Services provided
by local counseling
center in the church
• Mental health crisis
response team for
attendees

33. Helping families
with their most
heartfelt needs
• Casseroles
• Respite care
• Current mental health
referral list
• Counseling

34. Church models
for increasing
counseling
availability
Fieldstone Counseling
Khesed Wellness

35. Taking the Next
Step…Together

36. 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?

37. How We
Help…
• Training
• Conferences
• Video training
• Roundtables
• Consultation to church teams
• Resources
• Networking with other ministries
• Social media, sermon videos, research to support your ministry
• Supporting your ministry!

38. Connect with Key
Ministry
Catherine Boyle –Director
of Mental Health Ministry
• keyministry.org
• Twitter: @KeyMinistry
• facebook.com/keyministry
• www.keyministry.org/contact/
• steve@keyministry.org
• catherine@keyministry.org