A Mental Health Inclusion Strategy for the Church | Influence Podcast

May is Mental Health Month. In today’s episode, Influence magazine executive editor George P. Wood talks to Dr. Stephen Grcevich about a mental health inclusion strategy for the local church.

Dr. Grcevich is founder and president of Key Ministry. He is a child and adolescent psychiatrist with over thirty years of clinical experience and extensive research experience evaluating medication prescribed to children and teens for mental health disorders. A past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness, he is the author of Mental Health and the Church, published this year by Zondervan. (The link takes you to my review of the book.)


Mental Health and the Church | Book Review

In the spring of 1996, I entered an extended season of sadness. Not the kind of sadness where you wistfully wipe a tear from your eye with a Kleenex, by the way. It was the kind where you wake up in the middle of the night sobbing uncontrollably for hours. The sadness lasted for months.

A licensed Christian counselor diagnosed me with clinical depression. Through prayer, Scripture, counseling and the help of family and friends, I made it through that awful season, one of the worst I have experienced in my life. One I don’t ever want to enter again.

The first time I mentioned this episode in a sermon, I was surprised by the grateful response I received from a few members of the congregation. Though their words varied, their responses repeated a theme: “I’m glad to know that I’m not the only Christian who struggles with this.” After that sermon, I began to reference my depression if it was appropriate to the content and context of my message. I want people in the Church who struggle with mental health to know they are not alone.

May is Mental Health Awareness Month in the U.S. Summarizing statistics about the incidence of mental illness among U.S. children and adults, Dr. Stephen Grcevich writes, “more than fifty million Americans today experience at least one diagnosable mental health disorder on any given day” (emphasis in original). These disorders can be episodic or persistent, and they can vary in intensity and effect. Many churches have begun excellent “special needs” and “disability” ministries, but these ministries tend to focus on obvious, physical problems. By contrast, mental health disorders are a “hidden disability.”

Mental health disorders keep people away from church, unfortunately. Grcevich writes: “Whether we realize it or not, our expectations at church for social interaction and conduct, when combined with the physical properties and functional demands of our ministry environments, represent significant barriers to church involvement for children and adults with common mental health conditions and for their families. Church can feel like hostile territory for families impacted by mental illness.” The twin goals of Mental Health and the Church are to identify those barriers and to outline a “mental health inclusion strategy” for overcoming them.

The barriers include stigma, anxiety, executive functioning, sensory processing, social communication, social isolation and negative experiences of church. Stigma arises because churches mistakenly interpret mental health disorders as moral disorders. A child with ADHD lacks self-control in certain environments, for example. Self-control is a moral virtue. Ergo, the child has a moral problem. Right?

It’s not that simple. An ADHD child can exercise some degree of self-control, but certain environments stimulate the child’s hyperactivity and inability to focus. Too often, churches blame the child, not realizing that the way the environment of the Sunday school classroom (brightly colored walls with lots of decorations) or the nature of the activities (hyperkinetic worship followed immediately by sitting and listening for long periods) can work against ADHD children’s ability to control themselves.

The next three barriers — anxiety and other mood disorders, executive functioning weaknesses, and sensory processing disorders — describe how mental illness itself creates barriers to participation in church activities. Consider sensory processing disorders. Today, many churches darken the auditorium and light up the stage for the song component of their Sunday service. They crank up the volume and often use flashing lights in a well-produced, high-energy set of worship music. Many people love this. People with sensory processing disorders don’t. It’s overstimulating and distracting. Indeed, it literally can be painful to them.

The final three barriers pertain to the barriers that result from the clash between the first four barriers and church participation. People with mental health disorders find it difficult to communicate in what most of us take to be a normal church situation. They became socially isolated. And because churches don’t always treat people with mental health disorders well — including children — they and their families develop a bank of negative church experiences.

Grcevich believes churches can and must do better at ministry to people with mental health disorders. For each of the seven barriers just identified, he proposes a strategy for overcoming it. “Mental health inclusion is best understood as a mind-set for doing ministry rather than a ‘program’ for ministry,” he writes. He uses the acronym TEACHER to outline that strategy:

T: Assemble your inclusion TEAM.
E: Create welcoming ministry ENVIRONMENTS.
A: Focus on ministry ACTIVITIES most essential for spiritual growth.
C: COMMUNICATE effectively.
H: HELP families with their most heartfelt needs.
E: Offer EDUCATION and support.
R: Empower your people to assume RESPONSIBILITY for ministry.

Grcevich provides helpful suggestions and examples under each of these seven headings, but for purposes of this review, I think it will suffice simply to name the elements of the strategy.

Too many people in America suffer mental illness silently and alone. The church, an institution founded on the good news of Jesus Christ, should be a place of hope and help for them. Mental Health and the Church is an excellent resource for pastors and other church leaders, showing them how to do this. It is based on sound conservative theology, but it also is attuned to the best in contemporary, evidence-based psychology. I recommend it enthusiastically.

Book Reviewed
Stephen Grcevich, M.D., Mental Health and the Church: A Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions (Grand Rapids, MI: Zondervan, 2018).

P.S. This review is cross-posted with permission from InfluenceMagazine.com.

P.P.S. If you found my review helpful, please vote “Yes” on my Amazon.com review page.

Review of ‘Anxious: Choosing Faith in a World of Worry’ by Amy Simpson

Unknown Amy Simpson, Anxious: Choosing Faith in a World of Worry (Downers Grove, IL: IVP Books, 2014). Paperback / Kindle

Tune in to the evening news, and you are likely to hear stories that cause fear and anxiety to well up within you. America’s struggling economy, the Ebola pandemic, radical Islamic terrorism. Or perhaps you don’t watch the evening news but still find yourself anxious about your spouse, your children, your job, your life.

Then you read Amy Simpson’s new book. It says: “a lifestyle of worry is incompatible with a life of faith.” And you think to yourself, Is this woman for real? Does she not understand the hard things I’m going through?

Yes, and yes. Amy Simpson is for real. She understands. She’s a wife, a mother, a worker. Her mother is schizophrenic. Her brother-in-law survived stage-3 liver cancer. Her husband is a licensed counselor. She wrote a book on mental illness. When she says that worry and faith are incompatible, she’s not saying it from some airy-fairy height untouched by trouble.

Rather, she says that faith and worry are incompatible because that is what Jesus himself says. “Therefore I tell you, do not worry about your life.” Doing so shows that we have “little faith” (Matt. 6:25, 30). The key question, then, is not whether world events and personal troubles make us anxious or afraid, but whether we turn to God in faith in the midst of such things.

At the outset of Anxious, Simpson makes some common-sense distinctions between fear, anxiety, and worry that are very helpful. “Unlike fear,” she writes, “worry is not an immediate response to real or perceived danger; it’s anticipatory, rooted in concern about something that may or may not happen. Unlike normal anxiety, it’s not an involuntary physical response but a pattern we choose to indulge. It rises not from outside us but from within.” Fear and anxiety happen; worry is a choice.

And because we choose it in the first place, we can unchoose it on second thought. Simpson offers two good reasons to do so:

First, worry hurts us and by extension, those we love. The longest chapter in Anxious is chapter 3, “Worry’s Many Destructive Powers.” It outlines the many mental, physical, and relational problems that worry causes. If you want to avoid those problems, avoid worry.

But second, worry is based on bad theology. You might be wondering what theology has to do with good mental health. Simpson’s husband is a cognitive-behavioral therapist. What this means is that he helps his clients understand how their beliefs shape the emotional problems they experience. Long before cognitive-behavioral therapy was a gleam in a psychologist’s eye, Jesus showed the connection between wrong beliefs and negative emotions. “Look at the birds of the air,” Jesus said, just after telling his disciples not to worry; “they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?” (Matt. 6:26). Good theology contributes to good mental health.

Of course, good theology can’t stay in our minds. It must translate into action. Many of us affirm Jesus’ words with our heads, but they don’t trickle down into how our hearts feel or how our hands act. So, in chapters 6, 7, and 8, Simpson addresses “three things that keep us clinging to worry: a faulty perspective, a desire to possess and control the future, and a possessive attachment to the people and things of this world.” For me, these were the most challenging chapters of the book, revealing the subtle ways that my pride, control, and consumerism lie at the base of my worries.

Replacing worry with faith is not an easy thing, and Simpson doesn’t claim that it is. Throughout, she uses the language of process to describe the changes that need to take place, but also the language of repentance. Getting rid of worry is good mental health, but it is also a necessary spiritual practice. Our worry, driven by a desire to possess and control, comes between us and a God who alone is sovereign, and whose mercies alone can heal.

The book ends with a lovely statement about God that is worth sharing:

Why Trust God?

He never fails

He never leaves us

He never disappoints us

He loves us unconditionally

He’s the creator of all things

He transforms us from the inside

He forgives our sins

He knows everything

He rules the future

He is all-powerful

He is everywhere

He is good

He is great

He is


P.S. If you found my review helpful, please vote “Yes” on my Amazon.com review page.