Mental Illness and Your Ministry

What you need to know about the mental illness issues families are dealing with today—and why we’re all so reluctant to talk about it.

Justin and Brenda are dismayed to hear these words coming from the children’s minister at their church, where they’ve been attending for less than a year. Justin sighs in frustration as Brenda draws in a breath.

“But you said he was welcome,” she protests. “You said you wouldn’t turn a child away.”

“He’s disruptive,” the leader says firmly. “He distracts the other children. I’m not turning him away; I just can’t have him in our children’s ministry program anymore.”

Justin and Brenda look at each other and shake their heads. Whether the leader wants to call it that or not, yet another church is turning away their son. And by extension, their entire family has lost its church home.

They thought they did everything right. After their son showed symptoms of a brain-based disorder, they were slowly frozen out of their place in their previous church, and they had searched for a new spiritual home. They were upfront about their child’s challenges and needs. And at this large and well-resourced church, they thought they’d found a place they could all call home. Now the pastor they thought was their advocate was showing them the door and pointing them toward a place they were starting to suspect didn’t exist—a church in their community where their family would be truly welcome.

Brenda and Justin’s story is far from unusual. Many families affected by mental illness find church homes among people who are understanding and accommodating. But great numbers bounce from church to church, seeking places where they can enter into the Jesus-centered community they want and need. Some give up on church altogether.

Recognize Your Role

When it comes to families affected by mental illness, we’re not talking about a small group of people at the margins of society. In fact, like other forms of illness, mental illness is a highly mainstream experience. Each year, nearly 20 percent of adults in the U.S. suffer from a diagnosable mental illness. That translates to almost 53 million people. Among children, the percentages are similar, with 21.4 percent of adolescents (between 13 and 18 years of age) and 13 percent of children ages 8 to 15 experiencing a diagnosable mental illness. Over the course of a lifetime, nearly 50 percent of people will experience mental illness. That means millions of families in our society spend at least part of their time in a mental-health-related crisis. And the effects of mental illness touch us all, whether or not we recognize them.

What Is Mental Illness?

Mental illness is a broad term, covering diagnoses ranging from depression and anxiety disorders to eating disorders, bipolar disorder, schizophrenia, and everything in between. Various forms of mental disorders manifest differently and respond to their own types of treatment. What they have in common is that they disrupt normal functioning (by affecting thought processes, emotions, behaviors, or social connections) and that they’re based in the most complex organ of the human body: the brain.

Many people don’t realize mental disorders most often begin early in life. Half of all cases of mental illness begin by the age of 14. Seventy-five percent begin by age 24. Anyone in children’s, youth, or family ministry will regularly encounter families affected by mental health problems, whether or not ministers or even families are aware of what’s happening.

The most common forms of mental illness in the United States are anxiety disorders, followed by depression. To complicate matters, many people live with more than one form of mental illness—particularly in the case of anxiety and depression, which are so closely linked, they can be hard to differentiate. Both forms of illness can affect children, and many children live in households affected by parents’ anxiety or depressive disorders.

Depression falls into a category known as mood disorders, which also includes bipolar disorder. Attention-deficit disorders (such as ADHD) and autism spectrum disorders (ASD) are developmentally based and often diagnosed in childhood, typically beginning before 7 and 8 years of age, respectively. Other categories of mental illness—like psychotic disorders, eating disorders, and personality disorders—are less common but can be highly disruptive and even life-threatening.

Families Affected by Mental Illness

Families affected by any form of mental health challenges need help. Unfortunately, many don’t receive what they need. Fewer than 50 percent of adults who need mental health treatment receive it; among children, 80 percent go untreated. There are several reasons behind this gap between need and care, and among them are barriers to access and the terrible stigma attached to mental health problems.

Perhaps in part because of these challenges, research has shown that churches are the first places many people go when they’re looking for help with mental illness. Among people who have sought treatment, nearly 25 percent have gone first to a member of the clergy. Though this number is steadily declining, it is a higher percentage than those who have gone to psychiatrists, general medical doctors, or anyone else. And this pattern holds true not only for people of faith but also for those who rarely darken the doorway of a house of worship. Unfortunately, many church leaders are ill-equipped to help people get the care they need. And children’s and youth ministries are critical points in any effective strategy for response.

Often unaware, churches play a critical role in our mental health care system. And whether or not you have decided to be in a mental health ministry, you are.

Embrace Truth

Faced with so many opportunities to help people in need, why do we have so few resources for ministry to these families? Why do we talk so little about mental health in our churches? Why do so few people know how to respond?

Simply put, many churches allow fear, misunderstanding, and discomfort to keep them from ministry to children and families in need. And behind these negative responses is a stigma. In general, society responds to people with mental illness in ways we wouldn’t dream of responding to people affected by other forms of disease or disorder. We openly (and inaccurately) associate mental illness with violence and predatory behavior. We laugh at depictions of mental health problems, dismiss people as “crazy” or “lunatic,” even attribute disorders to demonic possession. Misinformation, mythology, and inexcusable ignorance are perpetuated. We mock people for seeking treatment. We assume the incurable nature of most mental illness means it’s untreatable. People who have treatable disorders that don’t interfere with their work may still be fired or refused to be hired. We discriminate against people we’re afraid to invite into our social circles. We make accommodations for people with physical disabilities but expect everyone to think, feel, and behave at the same level. And in many of our churches, we’re more than willing to acknowledge the value of medical treatments for all kinds of diseases, disorders, and injuries—except those that affect the brain.

Fighting the Stigma

Stigma is showing cracks in its foundation as more people talk about mental illness and public figures share their stories. But this devastating wall still stands. And it remains firmly intact in many of our churches. Like all strongholds, dismantling stigma begins with embracing truth.

This truth comes in three forms: medical, experiential, and theological. Anyone in ministry needs a basic understanding of various types of mental illness and how they’re treated. Everyone in the church needs to hear more stories from people who live with mental illness or love people who do. And we all need to consider what it means to follow Jesus’ example when we’re aware of people in need. How might Jesus respond to a family in crisis, or a family looking for a loving community and a place to call their spiritual home?

How to Help

Many people feel uniquely unqualified to help people affected by mental illness. With other forms of illness that are highly disruptive to people’s lives, or even debilitating—cancer, diabetes, multiple sclerosis—we know we have help and support to offer. But when it comes to mental illness, laypeople are often stymied. We stop focusing on support and fixate on “fixing.” And when we don’t know how to cure the illness or fix the symptoms, we throw up our hands and walk away in the face of great vulnerability and need.

The thing is, we can’t cure those other diseases either. So we help. We can do the same for people affected by mental illness. Here are 10 ways we can minister to families living with mental illness.

1. Draw near.

Many of us tend to draw away from people with mental illness because we don’t understand what they’re going through, we feel intimidated by their needs, or we’re fearful. But people in crisis need others to draw toward them, not away. And people who are living with mental illness need assurance that God and his people still love them when they’re vulnerable and in need.

2. Resist the temptation to try to fix people.

You’ll probably be in over your head if you try, you might do more harm than good, and you’ll probably overlook what the person actually needs from you. Like anyone who lives with a health problem, people affected by mental health challenges need to be accepted, loved, and cared for. You can do all of that without trying to fix all their problems or cure their maladies.

3. Get educated.

You don’t have to get a degree in psychology, but all church and ministry leaders need a basic working knowledge of mental illness and various forms of treatment people might be going through. Spend a couple of hours reading about mental illness on the website for the National Institute of Mental Health. Check out the resources available from the FaithNet program of the National Alliance Mental Illness (NAMI). Attend an educational NAMI workshop. Read a few good books on the subject.

4. Get equipped.

If faith communities are the first places people go for help with a mental health problem, every church must seek the necessary tools to respond well and with confidence. You probably have at least one person in your church who’s trained in basic first aid. Consider getting trained in Mental Health First Aid; they even have a version focused on young people. And bring your fellow church leaders and volunteers with you for this helpful seminar.

5. Find partners.

Most regions have a system of care that’ll welcome your church or ministry’s involvement. This system might include counselors, psychologists, psychiatrists, hospitals, residential treatment facilities, nonprofit organizations, other faith communities, and others who are providing care in your community. Ask them what they provide and how you can come alongside them to improve the overall response to mental illness in your area. You’ll probably also discover great resources for people who come to you for help.

6. Connect people to professional resources.

Because people in crisis most often turn to church and ministry leaders, you’re a gatekeeper to mental health care. One of the most important roles you can play is in knowing what’s available in your area and helping people find it. It’s a good idea to compile a list of local providers and facilities you can recommend. Ensure you include a variety of qualifications (psychiatrists as well as therapists, for example) and specialties (most counselors and doctors of psychology tend to focus on different age groups and types of mental health challenges). And don’t wait until there’s a crisis in your church; make this information widely available so people will have it when they need it—and you’ll have it ready when you need to refer a child’s parents to professional care.

7. Address practical needs.

Remember what your church does for people in crisis, and apply those same ideas to people living with mental illness. Do they need meals when a member of the family is in a behavioral health hospital? Do they need financial assistance because of lost work or expensive treatments? someone to care for children? rides to doctor or therapy appointments? a listening ear or a hug on Sunday morning? You already know how to help with these kinds of needs.

8. Recognize and address needs for spiritual care.

A mental health crisis is often accompanied by a spiritual crisis. When emotions and thoughts are disrupted, both adults and children wonder whether God has abandoned them; if he’s punishing them; and how, if he’s loving, he can allow such painful experiences to happen to them. Some question whether life is worth living. Referring people to professional mental health care is important, but it won’t answer these questions. People need the loving care of their spiritual leaders, reminding them God loves them and will not leave them.

9. Host a support group.