Have you ever stopped to consider the challenges that teens with common mental health conditions might encounter in fully participating in the activities and programs offered by the typical church?
It's a question we must consider if we are invested in the lives of children and teens with mental illness and value the importance of passing our faith on to future generations. According to a recent study from Baylor University, the likelihood of someone becoming a regular church attender in young adulthood is highly dependent upon an established pattern of church participation during the teen years. The percentage of adolescents who attend church less than once a month who become weekly attenders in young adulthood is 3.2 percent.
To appreciate the struggles that teens might experience in attending worship services, participating in youth group, serving in outreach activities or going on mission trips, we need to recognize how attributes of mental conditions common to this population cause difficulty functioning in the environments where ministry takes place. We also need to see how the interaction of those attributes with common elements of church culture – our expectations for how people should act when we gather together - creates real barriers to church involvement for teens with mental illness.
Here are seven potential barriers to church involvement we might consider for teens with common mental health conditions and their families:
#1 - Stigma: Teens with mental health conditions aren't likely to receive the accommodations and supports that assist with inclusion in school while they're attending church. The stigma associated with mental illness combined with fear of being singled out for special attention and confidentiality concerns often cause teens and their parents to avoid any mention of their support needs to student ministry staff and volunteers.
#2 - Anxiety: Anxiety may represent the mental health condition that prevents the greatest number of teens from attending church. Compared to their peers, teens with anxiety disorders often misperceive the level of risk in new or unfamiliar situations. Consider the range of experiences that might produce intense discomfort or distress for a teen with anxiety seeking to engage at church:
- They may struggle with the level of self-disclosure expected as a small group participant.
- They may fear becoming the focus of attention during a worship service, small group or youth ministry activity. The prospect of reading from Scripture during a worship service or performing on the worship team might be overwhelming.
- Kids with social anxiety are often intensely uncomfortable with the process of making new friends among unfamiliar, same-age peers from other schools. They may struggle to fit in following transitions from children's ministry to middle school ministry, or middle to high school ministry where they are likely to encounter older peers with established friend groups.
- Teens who continue to experience separation anxiety may be able to attend church services but experience great distress at the prospect of an overnight retreat or an invitation to participate in a mission trip in a distant city.
#3 - Self-control: Teens with ADHD or other conditions that impact executive functioning (anxiety disorders, mood disorders, psychosis) often struggle to get to worship services or other church activities on time. They may experience more difficulty delaying gratification and avoiding negative peer influences and patterns of behavior (substance use, sexual activity) likely to disrupt friendships and relationships with kids from church. They may be prone to intense spiritual experiences on mission trips or retreats but struggle to maintain a spiritually disciplined life when back in their daily routines.
#4 - Sensory processing: Sensory processing differences are often associated with autism spectrum disorders but are very common among teens with anxiety disorders and youth with ADHD. Kids with sensory differences may be averse to light, noise, touch and smells that others find engaging. Activities at church that may provide intense discomfort include...
- Worship services with loud music and spectacular light shows
- Perfume, cologne and body sprays
- Hugs, handshakes and other physical contact
- Multiple conversations taking place in close proximity
#5 - Social communication: Kids with anxiety disorders are prone to misinterpret the body language, facial expressions, tone and inflection of voice of their peers. Kids with ADHD often drive peers away through interrupting others when they speak or through impulsive words or actions. Their social communication struggles often interfere with their ability to fully participate in small groups that form the foundation of the discipleship process in many churches.
#6 - Social isolation: A wide range of mental health conditions common to teens may lead to withdrawal from relationships with peers involved at church or inhibit the development of friendships that lead to invitations to church activities. Kids who are depressed withdraw from interests or activities they previously enjoyed, including church. Kids with social anxiety may have a smaller circle of friends to invite them to church. They are less likely to be involved in the range of extracurricular activities that bring their parents into contact with other families who might invite them to church.
#7 - Past experiences of church: Kids with mental health conditions often become targets of bullying because the subtle nature of their disabilities makes them more acceptable targets than kids with overt special needs. In addition, their challenges in regulating their emotional responses to bullying reinforce the behavior among those looking to get a reaction from their targets. When teens encounter their tormentors at church, many will question the authenticity of Christianity and develop perceptions that Christians are hypocritical. Kids who are anxious or obsessive will experience more difficulty in getting past church experiences associated with hurt or discomfort.
Does your church have any type of inclusion strategy to help welcome children and teens with common mental health conditions and their families into your worship services or Christian education activities? What about adults with mental health conditions? Our team at Key Ministry has developed a book to guide churches in developing a mental health outreach and inclusion strategy, and offers lots of free resources and supports to churches seeking to welcome and serve families affected by mental illness in the communities we serve.
The groups offered by the Grace Alliance are an outstanding strategy for supporting individuals and families living with mental illness. In addition, they are preparing to launch the Redefine Grace Group, a small group experience for students (high school & college). As a child and adolescent psychiatrist, I'm well aware that the apple often doesn't fall far from the tree and parents with mental illness often have kids with mental illness. We as the church need to be prepared to welcome and embrace children and teens affected by mental illness while coming alongside parents who are seeking to raise them in the faith.
Stephen Grcevich MD is a child and adolescent psychiatrist in Chagrin Falls, Ohio, serving as president and founder of Key Ministry, an organization that promotes meaningful connection between churches and families of kids with disabilities for the purpose of making disciples of Jesus Christ. He is the author of Mental Health and the Church, a guide for churches seeking to minister with families impacted by mental illness, published by Zondervan in February 2018.