What barriers do churches encounter when they try to welcome and include families of children, teens, and adults with common mental health conditions or trauma? How should churches structure ministry for those diagnosed with ADHD, anxiety, attachment issues, mood disorders, post-traumatic stress syndrome, and other difficulties?
Bible Gateway interviewed Stephen Grcevich, MD (@drgrcevich) about his book, Mental Health and the Church: Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders and Other Common Mental Health Conditions (Zondervan, 2018).
Why did you need to write the book?
Stephen Grcevich, MD: Too many families I encounter through my work struggle to enter into the typical activities that take place at church. There’s been no broadly accepted ministry model for churches to follow if they want to be intentional about including children and adults with mental illness at church.
Why should churches care about mental health inclusion ministry?
Stephen Grcevich, MD: Persons with mental illness by far and away represent the largest segment of the disabled population, not just in the USA but throughout the world. More than 50 million Americans experience at least one mental health disorder on any given day.
Our attitudes toward persons with mental illness have negatively impacted the perception of the church among outsiders. According to one survey from LifeWay Research, 55% of USA adults who don’t regularly attend church believe that persons with mental illness aren’t welcome at church.
In the book, you suggest that the culture of the church contributes to mental health-related disability. How is that possible?
Stephen Grcevich, MD: Three ways in which mental illness differs from what we typically consider the focus of disability ministry at church is that it tends to be episodic, hidden, and situation-specific. People with common mental conditions may be very successful in a number of areas in life, but struggle greatly to meet certain cultural expectations at church. Examples include persons with social anxiety or persons with conditions associated with sensory processing differences.
Why is church participation often so difficult for individuals and families affected by mental illness?
Stephen Grcevich, MD: The inclusion model we present in Mental Health and the Church is grounded in the recognition of seven common barriers to church participation for persons with mental illness. These barriers include:
- Executive functioning
- Sensory processing
- Social communication
- Social isolation
- Past experiences of church
Why is mental illness so stigmatized in the church?
Stephen Grcevich, MD: The Nouthetic counseling movement emerged in the church during the 1960s and ’70s as a reaction to psychological theories and approaches to mental illness that appeared in many ways to be in conflict with traditional understandings of Scripture, especially behaviorism and the moral relativism that runs throughout Rational Emotive therapy. According to the Nouthetic view, as articulated by Jay Adams, mental illness in the absence of a clear organic cause is a manifestation of personal sin. That view still holds significant influence in many of our churches.
What are unique challenges of attending church for someone with an anxiety disorder?
Stephen Grcevich, MD: People with anxiety are “hard-wired” to overestimate the level of risk in new situations. They often fear acting in a manner that will result in embarrassment or humiliation when subject to the scrutiny of others. Consider some of the different ways that might play out at church:
- Someone visiting a new church for the first time
- Joining a small group where transparency and self-disclosure are expected
- Someone with agoraphobia who can’t find an open seat near an exit
- Someone with contamination fears associated with Obsessive-Compulsive Disorder when the congregation is encouraged to greet one another with handshakes and hugs.
What do you mean by executive functioning and how is it an impediment to church attendance?
Stephen Grcevich, MD: Executive functions are cognitive abilities involved in modulating other abilities and behaviors. Our capacity for self-control, our ability to apply what we learn at church in real life situations, the ability to self-regulate our emotions, to set priorities, to manage time, and to learn from our mistakes all depend upon our executive functioning capacity. The Bible clearly associates many of these attributes with spiritual maturity. Executive functioning capacity is diminished in the presence of a wide variety of mental health conditions.
Parents of kids with executive functioning weaknesses are often judged at church. A parent from my practice once said, “People in the church think they can tell when a disability ends and bad parenting begins.”
What can churches do to help?
Stephen Grcevich, MD: The inclusion model we put forth in the book suggests seven broad inclusion strategies, easily remembered by the acronym “TEACHER:”
- T: Assemble an inclusion TEAM
- E: Create welcoming physical ENVIRONMENTS for ministry
- A: Focus on the ACTIVITIES most critical for spiritual growth
- C: Develop a mental health COMMUNICATION strategy
- H: Offer practical HELPS to families both inside and outside of the church
- E: Offer EDUCATION and support to families affected by mental illness
- R: Give RESPONSIBILITY for the ministry to the people of your church
Why can’t people with mental illness be served by existing disability or special needs ministries?
Stephen Grcevich, MD: People with mental illness are reluctant to self-identify. They’ll flee any ministry that might draw attention to their differences. What they want most is to be treated like everyone else.
There are two important principles of an effective mental health ministry strategy:
- It’s a mindset, not a program
- A well-designed ministry strategy will benefit everyone in the church, not just individuals and families with mental illness.
What should people do if they feel called to launch such a ministry at their churches?
Stephen Grcevich, MD: First, approach your church’s senior pastor or senior leadership to gain their support. If they say no, consider the ways you can develop a personal ministry to individuals with mental illness within your sphere of influence, using the strategies shared in Mental Health and the Church.
What does Key Ministry do and how are you prepared to help churches through this process?
Stephen Grcevich, MD: Key Ministry (@KeyMinistry) helps connect churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. We’ve created several resources specifically for churches looking to implement a mental health ministry initiative:
- A free, downloadable planning tool
- A book study I’m leading on Facebook
- Resources on our website to help implement the strategies described in the book
- Availability to livestream with ministry teams
- In-person training at our Inclusion Fusion Live disability ministry summit on April 20-21
How does the Bible speak directly to the topic of mental health?
Stephen Grcevich, MD: Many of the figures who played major roles in advancing God’s purposes throughout history as described in Scripture wrestled with thoughts and emotions we might associate with mental illness from a 21st century perspective.
Consider the prophet Elijah: fearful and exhausted, praying in the wilderness for God to take his life (1 Kings 19:3-5).
Or the many places throughout the Psalms in which David describes, anxiety, hopelessness, and despair, accompanied by signs and symptoms frequently associated with depression (Psalm 6, Psalm 13, Psalm 38).
Or Jeremiah, the “weeping” prophet (Jeremiah 20:14-18).
Or the Apostle Paul, who arrived at the point where he despaired of life itself (2 Corinthians 1:4-8).
I find it remarkable that so many of people who were used by God throughout Scripture to perform great works experienced periods of intense distress and adversity while serving God that would likely be indicative of mental illness today.
What biblical principles are foundational for properly relating to people with mental health issues?
Stephen Grcevich, MD: I think the story relayed in the book of Job is a wonderful illustration of important biblical principles around caring for others impacted by mental illness. In addition to the incredible relational and material losses and physical suffering Job experienced, we get a detailed picture of his overwhelming mental anguish in chapter 30.
One key principle we recognize in Job is that personal righteousness doesn’t offer protection from suffering, including the suffering associated with mental illness. A second principle is that we may never understand in this lifetime God’s purposes in allowing ourselves to experience a particular type of suffering. Job never found out from God why he had to endure all he endured. The story also illustrates the importance of reflecting the true nature and character of God as we support others experiencing mental illness.
Many well-meaning Christians have unintentionally caused great pain and driven people away from the comfort and support of the church through their insistence that mental illness is necessarily the result of a lack of faith or a failure to recognize or repent of some personal sin. Scripture is clear that mental illness is sometimes a result of personal sin: King Saul, Nebuchadnezzar, and the episode involving King David in Psalm 38 serve as examples. Nevertheless, it’s incredibly presumptuous of us to assume we can discern God’s purposes in someone else’s distress. We need to be very careful before concluding that someone’s mental state is indicative of a spiritual problem as opposed to a medical condition or disorder involving the brain.
One additional principle consistently on display throughout Scripture is that godly men and women turned to God for comfort during times of mental anguish or distress. Is it possible that God allows us to experience such distress because our discomfort serves as an impetus for drawing us into a closer relationship with him?
What is a favorite Bible passage of yours and why?
Stephen Grcevich, MD: Only one? I’m going to pick two for the purpose of this conversation. Let’s start with John 9:1-3: As he went along, he saw a man blind from birth. His disciples asked him, ‘Rabbi, who sinned, this man or his parents, that he was born blind?” “Neither this man nor his parents sinned,” said Jesus, “but this happened so that the works of God might be displayed in him.”
Jesus challenged the common understandings of disability throughout his earthly ministry. On any given day, in excess of 50 million children and adults in the USA experience symptoms of one or more mental health conditions. Wouldn’t it be marvelous if the church became more intentional about welcoming and including them for the purpose of sharing the gospel with them and making them disciples? What if their mental health disability brings them to a place where they might use their gifts and talents to honor God and fulfill his purposes?
The other Scripture passage is Mark 2:1-12, describing the actions of the four friends of a man with paralysis who cut a hole in the roof of the house where Jesus was teaching out of their determination to get their friend into Jesus’ presence. What are we willing to do to get our friends and loved ones impacted by disability into the presence of Jesus—persons with physical, intellectual, developmental, emotional or behavioral conditions that make it difficult for them to experience Jesus through the ministries of a local church?
What are your thoughts about Bible Gateway and the Bible Gateway App?
Stephen Grcevich, MD: I’ve found Bible Gateway to be an indispensable resource for my writing and personal study. I struggle to memorize Scripture by chapter and verse, but remember specific themes or key words in the context of larger passages. The ability to quickly locate a larger passage of Scripture or a specific verse quickly through Bible Gateway’s search function in multiple translations is very valuable. People with a broad range of common mental health conditions, including ADHD, depression, anxiety and other mood disorders may struggle more than others with specific memory tasks and functions. The availability of a resource like the Bible Gateway App helps them to more fully participate in Bible studies and other Christian education activities.
Mental Health and the Church is published by HarperCollins Christian Publishing, Inc., the parent company of Bible Gateway.
Bio: Dr. Stephen Grcevich (MD, Northeast Ohio Medical University) serves as the founder and president of Key Ministry. He is a child and adolescent psychiatrist who combines over 25 years of knowledge gained through clinical practice and teaching with extensive research experience evaluating medications prescribed to children and teens for ADHD, anxiety, and depression. Dr. Grcevich has been a presenter at over 35 national and international medical conferences and is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI).
In his role as president of Key Ministry, Steve serves the primary vision caster and spokesperson for Key and plays an important role in Key’s efforts to develop collaborations with church leaders, professionals and organizations both within and outside the disability ministry movement. He is responsible for strategy and oversees the implementation of Key’s ministry plan. He regularly blogs at Church4EveryChild and frequently speaks at national and international ministry conferences on mental health and spiritual development. He is the author of Mental Health and the Church.
Steve and his wife Denise live in Chagrin Falls, Ohio. They have two daughters – Leah is married, lives in Alabama and is in the process of applying to medical school, and Mira attends Belmont University and is majoring in psychology. Steve’s work serves as a distraction from the abysmal performance of Cleveland’s professional sports teams.
Get biblically wise and spiritually fit by becoming a member of Bible Gateway Plus. Try it right now!