Dr. Steve Grcevich's presentation from the Together Special Needs Conference at Mount Paran Church examines research on the association between common disabilities and church attendance in children and teens, identifies seven common barriers to church attendance for families impacted by mental illness and introduces a model for mental health ministry applicable to churches of all sizes and denominations.

1. It’s the Mental Health
Disabilities That Keep Kids
Out of Church!
Stephen Grcevich, MD
Child and Adolescent Psychiatry
President and Founder, Key Ministry
Presented at Together Special Needs Conference
Mount Paran Church, Atlanta GA
March 9, 2019

2. What we’ll learn today
• Examine recent research on the association
between common disabilities in children and
adolescents and family church attendance
• Identify seven common barriers to church
attendance among families of kids with common
mental health conditions
• Discuss the limitations of “special needs ministry”
in supporting children and teens with mental
health-related disability
• Introduce a model for an effective mental health
inclusion strategy in your church.

3. How do chronic health
conditions in children
and teens 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 phone surveys of approximately
100,000 families of children ages 0-17
• Examined the relationship between a
range of disabilities and families who
identify as “never” attending a religious
service
Whitehead AL. J Scientific Study
Religion 2018;57(2)377-395.

4. Who’s missing from church?
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
Autism Depression TBI ODD/Conduct Anxiety Speech LD ADHD
Odds of not attending church vs. kids without
disabilities
Odds of not attending church
Whitehead AL. J ScientificStudy Religion 2018;57(2)377-395.

5. Who’s missing from church?
• Children with autism spectrum disorders are 1.84 times
more likely to never attend church.
• Children with depression are 1.73 times more likely to
never attend church.
• Children with Conduct Disorder/Oppositional Defiant
Disorder are 1.55 times more likely to never attend
church.
• Children with anxiety are 1.45 times more likely to never
attend church.
• Children with learning disabilities are 1.36 times more
likely to never attend church.
• Kids with ADD/ADHD are 1.19 times more likely to never
attend church.
Whitehead AL. J ScientificStudy Religion 2018;57(2)377-395.

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

7. A different way of thinking
about mental health ministry
How do we connect
churches and families
impacted by mental illness
for the purpose of making
disciples of Jesus Christ?
• Why mental illness is
different from other
disabilities
• Why church is difficult
• What would a mental
health inclusion model for
churches look like?

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

9. Why is church so difficult for families
impacted by mental illness?
• Attributes of common
mental conditions
produce challenges in
environments where
ministry takes place.
• Church culture – how
we expect people to
act when we gather
together

10. 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

11. A foundation for a mental
health inclusion ministry model
• Recognition of how non-essential attributes of
our ministry environments and practices
interfere with participation for children and
adults with common mental health conditions
• Implementing strategies across your ministry
environments to help individuals and families
join activities most critical for spiritual growth.

12. 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

13. Stigma
WHAT THEN IS WRONG WITH
THE “MENTALLY ILL?” THEIR
PROBLEM IS AUTOGENIC; IT
IS WITHIN THEMSELVES.
Jay Adams
• Mental illness
defined as sin,
parenting problem
• If it’s not a disability,
why would disability
ministry serve them?
• Widespread
perception they’re
not welcome at
church

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

15. A perception that persons with
mental illness aren’t welcome…

16. Anxiety
CORE DIFFERENCE: PEOPLE
WITH ANXIETY MISPERCEIVE
RISK IN UNFAMILIAR
SITUATIONS
• Social anxiety
• Separation anxiety
• Agoraphobia
Fears specific to church:
• Fear of scrutiny
• Performance worries
• Anxiety results from
lack of faith

17. Meet the Phillips Family
How would your church serve them?
• Josh is “neurotypical.” His
friend from school invited him
to your VBS. Josh had a great
time and wants to come every
Sunday.
• Jennifer (daughter) struggles
with separation anxiety
• Tammy (mother) has social
anxiety disorder and
agoraphobia
What challenges might they
face the first time they attend a
weekend worship service at
your church?

18. Self-control
COGNITIVE ABILITIES
INVOLVED IN MODULATING
OTHER ABILITIES AND
BEHAVIORS
• Behavioral inhibition
• Verbal working memory
• Non-verbal working
memory
• Emotional self-
regulation
• Reconstitution

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

20. Sensory
processing
NOISE, LIGHT, TOUCH, SMELLS AND
TASTE EXPERIENCED AS AVERSIVE
THAT OTHERS FIND ENGAGING
Challenges for kids:
• Pick up and drop-off times
• High energy worship
• Aggression
Challenges for adults:
• Greeting times (hugging,
handshakes)
• High-energy worship
• Multiple conversations in close
proximity

21. Social
communication
CHALLENGES AT CHURCH FOR
PERSONS WHO STRUGGLE TO
PICK UP ON SOCIAL CUES
• Body language
• Tone, inflection of voice
• Facial expressions
Church-specific challenges:
• Small groups
• Small talk
• Bullies
• Unfamiliar situations

22. Social
isolation
HOW DO FAMILIES FIND
YOUR CHURCH IF THEY
DON’T CONNECT WITH
FAMILIES ATTENDING
YOUR CHURCH?
• Kids seen as less
desirable friends
• Less involved in
extracurricular
activities
• Time, financial burdens
of pursuing treatment
• Lack of affordable child
care leaves parents
with fewer social
outlets

23. Past
experiences
THE APPLE OFTEN DOESN’T
FALL FAR FROM THE TREE!
• Children of parents with
bad (or no) church
experiences aren’t
going to church
• Kids depend on parents
for transportation
• Parents have mental
health issues too!
• Inconsistent attenders?

24. Why special needs ministry models
don’t work with this population
• Stigma and confidentiality concerns make
parents, adults reluctant to self-disclose
• Kids and teens will FLEE any activity that
identifies them as “different”
• What most kids and adults with common
mental health conditions want is to be included
in what everyone else is doing!

25. Why has the church ignored the
need for mental health inclusion?
• Stigma
• Failure to recognize impacts of common
conditions on church involvement
• Variable understanding about mental
illness among pastors, church leaders
• We haven’t had a ministry model!

26. What might our planning
process look like?
• Leaders in each ministry area might identify
potential barriers, useful strategies within 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.

27. Mental Health Ministry is
Family Ministry!

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

29. 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 staff and students
• No church will be able to include everyone
with mental illness, but every church can do
more to be more welcoming and inclusive

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. Coming Alongside Your
Ministry

33. Help from Key Ministry
• Training
• Conferences (Inclusion Fusion Live –April 5-6)
• Video training
• Book study
• Consultation
• Available to church, ministry teams
• Resources
• Networking with other ministries
• Social media, sermon videos, research to
support your ministry
• Support

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