Mental Health Ministry as an Evangelism and Outreach Strategy

“People in the church think they can tell when a disability ends and bad parenting begins.

So began the testimony of a couple at my church’s inaugural Disability Ministry Sunday, describing their experience of looking for a church in suburban Cleveland with two young boys with moderate to severe ADHD. 

I began conducting an informal survey in the aftermath of that service 25 years ago of parents whose children were patients of the child and adolescent psychiatry group practice I led at the time. I asked them one question at their child’s next follow-up visit: “Have the problems that led you to seek help from our practice impacted your family’s ability to attend church or your place of worship?” 

Their responses—along with the responses of other families raising children with “hidden disabilities”—led to the recognition that they are far less likely to be active in a church than is typical for our community and the establishment of the ministry in which I’ve served for over 20 years. A growing body of research supports that observation. 

Noted sociologist Andrew Whitehead published a study examining the impact of physical, mental health, and developmental disabilities upon church attendance using data generated from nearly 100,000 phone interviews conducted in each of three waves of the National Survey of Children’s Health (NSCH). His findings on the impact of mental health on family church attendance were eye-opening.

  • Families raising a child with depression were 73% less likely to have attended church in the past year.
  • Families of children with disruptive behavior disorders (Oppositional Defiant Disorder, Conduct Disorder) were 55% less likely to attend.
  • Families of children with anxiety disorders were 45% less likely to attend.
  • Families of children with ADHD were 19% less likely to attend.

The church attendance problem isn’t confined to families with children. According to the 2011 Baylor Study of Religion, adults who reported significant anxiety or depression were more than 50% less likely to attend weekend worship services. They are also far less likely to be engaged in regular prayer, Bible study or other spiritual disciplines. Given that one in five children and 57.8 million adults are experiencing one or more significant mental health disorders at any given time, the church is faced with an enormous opportunity to present the gospel and engage with a vast population with untapped gifts and talents intended for the growth and edification of the church.

Why might the presence of common mental health conditions have such a dramatic impact on church attendance and engagement? Factors contributing to the mental health community being underserved include:

Stigma: In 2013, Lifeway Research conducted a telephone survey of 1,001 U.S. adults in which 55% of non-churchgoers disagreed with the statement: “If I had a mental health issue, I believe most churches would welcome me.” The perception among outsiders that mental illness will be interpreted by churchgoers as evidence of a lack of faith or diligence in religious practice represents a barrier to inclusion. 

Difficulties navigating the demands of church culture—our expectations for how congregants will act and interact when we gather: Persons with anxiety disorders are prone to misinterpret risks in entering new or unfamiliar situations. First-time visitors may fear being singled out for attention. Someone with social anxiety may be wary of scrutiny from everyone they interact with when visiting a church. Expectations for self-disclosure in small groups may cause intense discomfort for teens or adults. Social communication deficits often accompany common mental health conditions. They desire authentic friendships and desperately want to belong to a church where they can be recognized for their gifts and talents, but small talk and engagement in groups may be difficult. Most mental health conditions negatively impact executive functions—higher-order brain processes involved with mediating capacity for self-discipline, emotional regulation and self-control. Abnormal sensory processing commonly occurs with autism, ADHD and anxiety disorders. The sensory stimulation (lights, sounds, smells, touch) in environments where worship and ministry take place may feel overwhelming.

Social Isolation: Individuals and families impacted by mental illness are less likely to have friends who invite them to church activities. Options for childcare are often limited. Children with mental health conditions are less likely to take part in extracurricular activities where they might connect with other families actively engaged at church. 

Past Experiences of Church: The multigenerational expression of mental illness suggests many children and teens with no experience of church likely have parents whose church experience was disrupted by their own mental health issues. Serious mental illness (SMI) is highly heritable. An effective mental health inclusion strategy for children and youth also needs to address the challenges parents experience resulting from their own mental health conditions. Mental health ministry is family ministry. Historically, mental health ministry has involved the provision of counseling and support for persons who are already part of the church. What steps are outwardly focused congregations taking to build relationships with families lacking a local church connection?

What Your Church Can Do

In light of these factors that cause the mental health community to be underserved, here are some things your church can do to prepare to serve these families well.

Become educated. Offer training to church leaders, staff, key volunteers or small group leaders. An updated Lifeway study of 1,000 Protestant pastors reported only one church in five offers any formal training for pastors, staff or key leaders on recognizing symptoms of mental illness, and fewer than one in five have a counselor on staff skilled in serving persons with mental illness. Churches are increasingly seeking out training on Mental Health First Aid, Spiritual First Aid, or trauma-informed care. Other churches have invited mental health professionals to educate church staff and attendees on recognizing signs of mental illness and helpful strategies for providing care and support. 

Develop a strategy. Engage your leadership team in designing and implementing a strategy for welcoming and including individuals and families impacted by mental illness across all the ministries of the church. Key Ministry offers free consultation to church teams interested in mental health outreach and inclusion and authored Mental Health and the Church, presenting a model for churchwide mental health inclusion sufficiently flexible for congregations of all sizes and denominations.

Combat stigma in the church. The 2013 Lifeway study reported the most common request of churches from families of adults with serious mental illness was for pastors to talk about mental illness from the pulpit, because doing so enabled them to openly share their struggles with others. Pastors might address mental-health-related topics in sermons, or offer prayer for persons impacted by mental illness during worship services. Use your church’s social media platforms to educate your congregation and provide your members with content they might share with friends, neighbors and co-workers outside of your church who are struggling with mental illness. An intentional communication strategy helps change perceptions that persons with mental health challenges aren’t welcome at church.

Provide biblically-based mental health support groups. Mental Health Grace Alliance and Fresh Hope are Christian nonprofits offering biblically-based mental health support models that have been successfully implemented in hundreds of churches in North America and beyond.

Empower your people for outreach. Arguably, the most effective and impactful mental health inclusion strategy is the presence of a trusted friend to come alongside newcomers with mental health challenges. Persons in your congregation with firsthand experience of mental illness are ideally suited for this type of outreach because they can anticipate situations likely to cause discomfort for their friends, family members and neighbors and help them navigate challenges in attending worship services, joining a small group or participating in service activities. Mental health outreach is truly a ministry that is most impactful when owned and performed by the people of the church with support from staff.

The statistics suggest every church in America is positioned to share the gospel with substantial populations in the communities they serve for whom mental illness is a barrier to attendance and engagement. The fruits of mental health outreach are the presence of friends and neighbors with gifts and talents without which the church is incomplete.

To hear more from Stephen Grcevich and other forward-focused church leaders, join us in-person or online next week at the Amplify Conference on October 17th and 18th at Wheaton College in Wheaton, Illinois.