How “prior authorizations” impact kids with disabilities…

ID-10082836I’m going to take the opportunity to vent today about an element of our modern healthcare system that is poorly understood by most families and the single intrusion into our child psychiatry practice most likely to overwhelm my anger management skills…”prior authorizations.”

When a parent leaves our office and drops a new prescription off at their pharmacy, they’re often informed they won’t be able to get their medication until someone from our office calls a clerk associated with their health plan or pharmacy benefit manager subcontracted by their health plan to authorize payment for the prescription.

It has become increasingly common for families to have coverage switched from one insurance company to another from year to year. Insurance companies will periodically cut deals with new pharmacy benefit managers that work from different algorithms of “preferred” drugs. We’ve historically had a limited number of families obtain secondary health insurance through Medicaid that paid for much of the cost of necessary prescriptions. Each of these events usually triggers a “prior authorization” request…in these cases, the insurance company or pharmacy benefit manager is generally refusing to pay for medication that has been demonstrably effective for that child.

All of this is presumably done in an effort to contain the cost of health care…but it may only be successful in containing the costs for the entity overseeing the pharmacy benefit.

shutterstock_174158831This process is a nightmare for families…especially families of kids impacted by significant disability. Insurance is very expensive. Families have larger and larger “deductibles” before insurance benefits kick in, and an increasing number of companies refuse to count the cost of medications families pay for out of pocket toward the deductible unless the medication is first “approved”…even though the insurance company isn’t actually paying for the medication. Families of limited income may have no recourse if insurers refuse to pay for medication or other necessary treatments.

We had a member of our office staff quit (to a large degree) because of her frustration with the process she needed to go through to get prescriptions authorized…and the verbal abuse from anxious family members who assumed we weren’t doing what we needed to for their kids to get their medication. I’ll paraphrase the end of the phone call that put her over the edge-after waiting on hold for an hour to speak to a clerk who refused to authorize the prescription written by our physician…

FCBTF staff: Can we have our doctor speak to your doctor who oversees these decisions?

Insurance clerk: We don’t have a doctor.

FCBTF staff: What are your qualifications?

Insurance clerk: I’m a college student.

I’ll share two particularly egregious anecdotes from personal experience this past year…

I was treating a very complicated kid with ADHD, separation anxiety, obsessive thinking and  inflammatory bowel disease who had major difficulties with academic performance, behavior and school attendance despite working with a very qualified counselor.  We found that the combination of a low dose of stimulant medication and atomoxetine (a non-stimulant medication approved for treatment of ADHD that has also been demonstrated to be helpful for several types of anxiety in kids) together with ongoing counseling was very effective in helping this kid to attend school and succeed in school for over a year.

One day, the parent calls us in a panic because their new insurance company refuses to pay for the atomoxetine. After our office staff literally spends hours on the phone with this company and I spend a half-hour (uncompensated, of course) writing a report describing the kid’s treatment and response to every medication they’d received, the company determined we would need to stop the current medication and rechallenge the child on their “preferred” medication even though the company’s “preferred” medication produced a serious adverse reaction fifteen months before. How could any physician in good conscience (or any parent) stop an effective treatment and subject a kid to medication that produced a significant negative reaction as a precondition for accessing healthcare benefits to which they were entitled?

More egregious was the case of a very complicated teen with a severe mood disorder who had been stable for over a year on a combination of medications that included aripiprazole. The parent goes to their pharmacy to pick up a refill and is informed that the medication is no longer covered. Despite the efforts of our staff to get the medication approved, the company insists on only approving an alternate medication. By day five, the police were searching for this teen who was missing from home. When the police found the teen, they required admission to the psychiatric unit of a local pediatric hospital. For three days, the staff of the local pediatric hospital fought with the insurance company that maintained their refusal to pay for the medication. The pharmacy benefit manager only relented when the hospital refused to discharge the patient until they had been stabilized on the prior medication.

The pharmacy benefit managers and insurance companies are shielded from liability in most states for their denials of coverage…they say they’re not practicing medicine but simply making determinations about the benefits covered.

I have a peer who works in a clinic serving indigent kids in another county in Northeast Ohio. She tells me she commonly has to see kids and families with a phone held to her ear while she waits on hold to speak with clerks at the Medicaid HMOs so that the patients she saw earlier in the day are able to get their prescriptions. Another colleague serves as Medical Director for Children’s Services at our county’s primary mental health center. Last year, they had two full-time employees on staff (supported by public funding) to deal with the necessary bureaucracy so that the patients served by the agency’s three full-time doctors could fill their prescriptions.

There were times early this year when our staff was spending so much time on hold with phone calls for prescription authorizations that patients couldn’t routinely get through to our office to schedule appointments. One company wants to delegate the responsibility for submitting prescriptions to our office staff. We had another company suddenly demand that someone from our office call to give a comprehensive history every time a patient goes to the drug store to fill a prescription. Upon completion of this review, our staff would then be given an authorization code that they would be required to call into the patient’s pharmacy before the prescription could be filled.

Care Cloud ScheduleWe find ourselves needing to hire more staff to manage the process. Every time we have to increase our rates, we know more families will be priced out of their ability to access treatment through our practice. When our doctors have to take time away from kids and families to address insurance company mandated clerical tasks, less time is available for new appointments and kids and parents wait longer for care. When a kid on a stable regimen struggles after being denied access to medicine by an insurer or a pharmacy benefit manager, parents may have to pay for additional appointments to straighten out the mess or take time off for work and children may have to miss school. Most importantly, kids suffer.

Ponder the experience from the parent’s perspective. Imagine the fear when your child depends on a medication or treatment prescribed by a trusted physician. What do you do when a necessary treatment is unaffordable and an insurance company or their designated pharmacy benefit manager arbitrarily denies access to that treatment?

Dr. Danielle Orfi is a professor of medicine at NYU and authored this op-ed piece last week in the New York Times on the frustration this process causes for physicians and their staffs. From her article…

I bit my tongue for the remainder of my conversation with the insurance company, holding back long enough to obtain the prior authorization that would allow Mr. V. the 90 pills he needed each month. I tried not to break the phone when I finally slammed down the receiver.

I’m all for controlling medical costs and trying to apply rational rules to our use of expensive medications and procedures. But in the current system, everything seems to be in service of the corporate side of medicine, not the patient. The clinical rationale and the actual patient — not to mention the doctors and nurses involved in the care — are at best secondary concerns.

Feel free to share your story in the comments section below! Have you, or someone you know been adversely affected by nonsensical prior authorization requirements?

Photo courtesy of http://www.freedigitalphotos.net

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KM Logo UpdatedKey Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!

Posted in Advocacy, Families | Tagged , , , , , , | 2 Comments

Dr. G to be keynote speaker for Awana Ministry Conference 2014-Mississippi

JerusalemJudea…and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth.

Acts 1:8b (ESV)

Our Key Ministry team is delighted that Steve will be serving as the keynote speaker for this year’s Awana Ministry Conference on Saturday, August 23rd at First Baptist Church in Oxford, MS.

The theme of this year’s conference is all.

ALL AwanaEach week, more than 2,000,000 children and youth gather in Awana clubs all around the world. ALL Awana leaders are serving together in the work of the gospel to reach these children. But what about the family, community and world beyond your church? Are you bringing the hope of Christ to them?

Steve will be introducing conference attendees to families beyond the church in his featured presentation-There’s this kid…Including kids with emotional, behavior and developmental challenges in your ministry.

shutterstock_98689610One in five kids in the U.S. meet criteria for at least one mental health disorder, one in four experience a traumatic event by age 16, and a majority of the one in 68 kids diagnosed with autism spectrum disorders have average to high intelligence. For many, the environments in which we “do church” present subtle, but very real barriers to participation for kids with mental illness, trauma or developmental disabilities and their families. In this session, we’ll help Awana leaders identify potential pitfalls to kids with common disabilities becoming involved and staying involved with ministry, while exploring ideas for welcoming and including ALL kids in your ministry…many who may not otherwise have the opportunity to experience the hope of Christ.

In addition to the keynote presentation, Steve will be presenting three additional workshops…

Workshop 1: Helping kids with ADHD to grow spiritually. Steve relates our current understanding of brain functioning in kids and teens with ADHD with strategies to help them have a great Awana experience and overcome unique obstacles to spiritual growth.

Workshop 2: When kids become aggressive at church. This workshop is designed to help Awana leaders and volunteers develop strategies for serving kids at risk for behaving aggressively during ministry activities.

Workshop 3: Including kids in your ministry who struggle with anxiety. This workshop helps ministry leaders to recognize situations when anxiety represents a barrier to participation in Awana activities and develop strategies for welcoming and including kids with all types of anxiety into your programming.

In addition to Steve’s presentations, nearly 30 workshops will be available, addressing topics of interest to pastors, ministry leaders and volunteers serving kids of all ages.

PrayerCard2014bClick here to make your reservation for the conference. Early registration is available for $25.00 through August 12th, after which the cost is $30.00 (senior pastors and their spouses attend for free). For questions or additional information, contact Awana missionaries T.J. and Kathy Sipes at tjs@awana.org or kathys@awana.org.

Steve is very much looking forward to Southern hospitality and the opportunity to meet new friends of Key Ministry in Oxford, MS on Saturday, August 23rd!

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KM Logo UpdatedKey Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

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Incomplete…

shutterstock_64682575 2In our tenth and final segment of our series, Ten Things I Wish Church Leaders Knew About Families and Mental Illness, we’ll look at one of the most compelling reasons for churches to pursue intentional outreach to families impacted by mental illness…the reality that the church is incomplete without the gifts and talents of the kids and families in their surrounding communities who don’t know Jesus and don’t have a local faith community to call home.

For as in one body we have many members, and the members do not all have the same function, so we, though many, are one body in Christ, and individually members one of another. Having gifts that differ according to the grace given to us, let us use them: if prophecy, in proportion to our faith; if service, in our serving; the one who teaches, in his teaching; the one who exhorts, in his exhortation; the one who contributes, in generosity; the one who leads, with zeal; the one who does acts of mercy, with cheerfulness.

 Romans 12:4-8 (ESV)

I’ve never come across leaders in any church who thought they had more than enough gifted volunteers to completely fulfill the God-given vision they’d received for their ministry. One of the most significant obstacles our Key Ministry team often faces in persuading churches to pursue intentional ministry to families impacted by disabilities is the fear that people with gifts and talents indispensable to other ministries in the church will be “cannibalized” by the needs of disability outreach.

The reality is that all of our churches are surrounded by people with specific gifts and talents that God intended for use by the local church. Without them, the local church is incomplete. And for many reasons we’ve discussed in this series…negative experiences of  church in the past, absence of relationships with other families in the church, conditions that pose difficulties in the environments in which we “do ministry”…families impacted by mental illness all too often find themselves on the outside looking in. Those on the outside have gifts we desperately need.

Consider this…Do you think Rick and Kay Warren have gifts and talents that have greatly impacted the world for Christ? What about Chuck Swindoll? Or Perry Noble? Or Frank Page (former President of the Southern Baptist Convention)? All have experienced mental illness personally, or have had a child or grandchild with a serious mental illness or developmental disability. How would the church be diminished without their gifts?

As a former Chairman and now staff member at Key Ministry, I can attest that our work would be impossible without the time and talent of Board members, staff and volunteers who themselves are being actively treated for a mental health condition or have a child (or multiple children) receiving treatment. Life for each of them is not without bumps in the road, yet they serve magnificently.

Quoting from The Purpose Driven Life, God created us for community. And God intended for people impacted by mental illness to be an essential part of that community. We’re diminished without them. It’s time for the church to become more intentional about seeking them out and welcoming them into our local faith communities.

For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ. For in one Spirit we were all baptized into one body—Jews or Greeks, slaves or free—and all were made to drink of one Spirit.

For the body does not consist of one member but of many. If the foot should say, “Because I am not a hand, I do not belong to the body,” that would not make it any less a part of the body. And if the ear should say, “Because I am not an eye, I do not belong to the body,” that would not make it any less a part of the body. If the whole body were an eye, where would be the sense of hearing? If the whole body were an ear, where would be the sense of smell? But as it is, God arranged the members in the body, each one of them, as he chose. If all were a single member, where would the body be? As it is, there are many parts, yet one body.

The eye cannot say to the hand, “I have no need of you,” nor again the head to the feet, “I have no need of you.” On the contrary, the parts of the body that seem to be weaker are indispensable, and on those parts of the body that we think less honorable we bestow the greater honor, and our unpresentable parts are treated with greater modesty, which our more presentable parts do not require. But God has so composed the body, giving greater honor to the part that lacked it, that there may be no division in the body, but that the members may have the same care for one another. If one member suffers, all suffer together; if one member is honored, all rejoice together.

1 Corinthians 12:12-26 (ESV)

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KM Logo UpdatedKey Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!

Posted in Advocacy, Inclusion, Key Ministry, Mental Health | Tagged , , , , , , | 2 Comments

The sins of psychiatry…and psychology

shutterstock_55828699After our post on Thursday…a response to a blog frequented by senior pastors suggesting that demonic possession is a plausible explanation for the increased prevalence of mental illness, I’d planned to vent today about the unwillingness of church leaders to seek out qualified Christian leaders in the neurosciences to speak knowledgeably about mental illness-related topics. I’d even hatched this idea of contacting a half-dozen or so respected colleagues who share our faith from the scientific community and launching a “truth squad” to pastors and Christian publications which would provide consultation to leaders planning to write/speak about mental health topics and direct them to the best scientific resources in support of their teaching. My thinking then did a 180° degree turn.

I started wondering whether it’s possible that involving colleagues highly active in our professional communities might be more of a hindrance to our mission within the church as opposed to a help. I wonder whether I need to downplay what I do for a living or the work I was involved in earlier in my professional career if I’m to be effective in my role within Key Ministry.

From where I sit, it seems reasonable to conclude that the institutions of psychiatry and psychology (and many practitioners of those disciplines) have conducted themselves in a manner to betray the trust of church leaders, especially those leaders who adhere to traditional interpretations of Scripture. I’d hypothesize that one manifestation of the collateral damage resulting from this “falling out” between the church and the mental health community is the lack of understanding in the church as to how to most effectively minister to individuals and families impacted by mental illness.

The sin of psychiatry is allowing the credibility of the field to be compromised by the perceptions that the identification and categorization of mental illness is influenced by economic self-interest, and determinations of what does and does not constitute “mental illness” may reflect the values of the profession more than scientifically valid constructs. The advent of new diagnostic labels is seen as a manifestation of the influence of the pharmaceutical industry. Interpretation of research that shapes public policy regarding issues including marriage, parenting and adoption is unduly shaped by personal preferences or political viewpoint as opposed to scientific objectivity.

The sin of psychology is the embrace of a humanistic viewpoint regarding standards of right and wrong and the rejection of the concept of absolute truth by many prominent leaders in the field, encouraging vulnerable people to rationalize away distress caused by a guilty conscience, and lending credibility to patterns of behavior that we as Christians would characterize as “sin.”  One could argue that the “biblical counseling” movement was a direct response to the experiences of many believers as psychology gained more influence during the 1960s.

There’s an argument to be made that many pastors view the work of Christians in the field of psychology with significant distrust because the influence of humanism is seen as having corrupted the behavioral sciences.

Another contributing factor to the mistrust of mental health professionals among church leaders is the reality that compared to other physicians or academics, psychiatrists and psychologists are significantly less likely to be involved with church. A study published in Psychiatric Services indicated that psychiatrists are less likely to believe in God than physicians of any other specialty, are significantly less likely to identify themselves as Protestant or Catholic, and are three to six times less likely than other physicians to refer patients to clergy members or religious counselors when compared to religious physicians. Gross_2009_professors_religionThe mistrust of psychiatry isn’t limited to pastors…the same study suggested that religious physicians from other specialties are 40-60% less likely than their non-religious peers to refer patients to psychiatrists. Meanwhile, a 2009 study by Gross and Simmons of 1,500 full-time university professors (see figure on right) reported that 50% of academic psychologists are atheists and another 11% can be characterized as agnostic…higher percentages than any other academic field! Overall, approximately 10% of academics are atheists, and 13% are agnostics.

So here’s the question…are we going to allow distrust of the mental health profession to get in the way of the church reaching out to care for, welcome and include kids and families with conditions that create barriers to involvement in local congregations? AND…Can Christians in the mental health field help guide the church in this effort, or are they too tainted by their experience in the professions?

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KM Logo UpdatedKey Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

Posted in Controversies, Key Ministry, Mental Health | Tagged , , , , , , , , , , | 4 Comments

When church leaders talk about mental illness, spiritual evil and demons…

The ExorcismI really didn’t want to go here…

From time to time, I’ll skim the links referenced in Real Clear Religion. This past Tuesday, I came across a link to a featured post at Ministry Matters from Shane Raynor entitled Mental Illness and Spiritual Evil.

In his article, Raynor references statistics describing the proliferation of mental health diagnoses in recent years and common explanations for the phenomena. He then suggests that spiritual causes for the increased prevalence of mental illness may be overlooked…

Let me be clear. I believe mental illness is real. But I also believe that demonic influence, oppression, and in severe cases, possession are real too. Although mental and spiritual issues are two different things, we’d be both naive and foolish not to consider the connection between the two. I’m convinced that, in more cases than we’d like to admit, they feed off each other.

So far, nothing has been said that I’d take significant issue with, although respected theologians debate whether demonic possession continues to this day. But Raynor continues…

The Roman Catholic Church is upping it’s game on this. Many dioceses are training more priests in exorcism and deliverance, and earlier this year, the Vatican legally recognized the International Association of Exorcists, an organization of Roman Catholic Priests who perform exorcisms. The rise of occultism is considered a contributing factor for the increased demand. World famous Vatican exorcist Father Gabriele Amore one of the founders of the IAOE claims to have been involved in treating more than 70,000 cases of demonic possession.

Whether or not you agree with the Roman Catholic theology or methodology, you have to admit that at least Catholics are doing something to deal with an urgent problem of the churchwide level.

What are the Protestant denominations, particularly the mainline churches, on this issue?

The links included in the story clearly undermine the argument Raynor puts forward. Quoting from an article in the Telegraph cited by Raynor…

The church insists that the majority of people who claim to be possessed by the Devil are suffering from a variety of mental health issues, from paranoia to depression. Priests generally advise them to seek medical help.

But in a few cases it is judged that the person really has been taken over by evil, and an exorcism is required.

The need for exorcisms is “rare, very rare” said Fr Vincenzio Taraburelli, a priest in a church that lies just a few hundred yards from the Vatican. “In the cases where a mental illness is apparent, we try to send them to a doctor.”

Another priest interviewed for the article described the requests he receives for exorcisms…

“People come to me thinking that with an exorcism they can resolve all the problems they have in their lives. A child is doing badly at school? With an exorcism, we can make him study. They see exorcists as a last resort. Out of 100 people I receive, there will be one who has need of me as an exorcist.”

Including the time I spent in my general psychiatry residency and child psychiatry fellowship, I’ve been treating kids and families for a little over 28 years. In those 28 years, there was one time that I entertained the possibility of demonic influence…this particular patient was probably the most severely traumatized kid I’d ever cared for, having been removed from parents who were heavily involved with occult practices. To suggest that demonic influence in any way may account for the increased prevalence of mental illness on a website that serves as a resource for thousands of pastors and church leaders has great potential for harm.

More people in the United States seek mental health care from pastors than psychiatrists or primary care physicians.  Nearly a quarter of those who seek help from clergy in a given year are experiencing the most impairing mental disorders. Most of those are never seen by a physician or mental health professional.

The first time I encountered a pastor at a ministry conference who insisted that kids with autism are demon-possessed, I was so startled I had no idea what to say. But kids can…and do get hurt by this thinking. Check out this article from Indianapolis Monthly (starting at Page 94) about an young preacher in training who attempted an exorcism with a teen boy with autism. Or this story of an eight year-old boy with autism in Milwaukee who died during an attempted exorcism.

So…what do we make of the numerous references in Scripture to Jesus and the apostles exorcising demons? Was the phenomena more common during Jesus’ earthly ministry? Did demon possession cease at the end of the Apostolic age or does it still exist to this day?  If so, how would we recognize someone who was possessed? Here’s what Scripture would suggest…

  • They may exhibit extraordinary strength (Matt 8:28, Mark 5:3-4, Luke 8:29)
  • They typically demonstrated knowledge of the presence of Jesus or apostles immediately (Matt 8:29, Mark 5:7, Luke 8:28, Acts 16:17)
  • They might be mute (Matt. 9:32, Luke 11:14)
  • They might experience seizures (Matt. 17:15-18)
  • They may be involved with occult practices (Acts 16:16-18)

Demon possession is not the reason for the increase in the prevalence of mental illness in modern society.

A brief comment on Shane’s comments about the connection between mental and spiritual issues…Are there situations in which sin, or patterns of sinful behavior lead to symptoms of mental illness for the person involved in the pattern of sin? Absolutely. Are there situations in which mental illness negatively impacts the ability of a person to grow in faith? Absolutely. But we have to be EXTREMELY CAREFUL when telling people who approach the church for help that they have a sin problem (after all, we ALL have a sin problem!) when they truly have a mental health problem.

Our ministry seeks to help churches minister to/with families of kids with mental illness, trauma or developmental disabilities. While we provide lots of services to churches, our role is truly to support local congregations in evangelism and outreach to a population we believe is greatly underrepresented in the church. We know that far too many people have been wounded by the church from accusation during episodes of mental illness, and we have a difficult time encouraging those who have been wounded to give church another try. Do we run the risk of misrepresenting God (see Job 42:7) when we leap to the conclusion that sin is the cause of a specific episode of mental illness without a very thorough understanding of that person’s mental and spiritual condition?

Image: The Exorcism, from The Tres Riches Heures du Duc de Berry, by the Limbourg Brothers.

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KM Logo UpdatedKey Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!

Posted in Controversies, Key Ministry, Mental Health | Tagged , , , , , , , , | 5 Comments

I’m not like “those kids”

shutterstock_15545299In the ninth segment in our series…Ten Things I Wish Church Leaders Knew About Families and Mental Illness, we’ll look at why churches don’t need to launch a new “program” connect with and welcome families of kids with mental health concerns… and explore why programs may be counterproductive to effective inclusion.

I just got off the phone with a consultant who works with families to identify residential placements and therapeutic boarding schools for kids with significant emotional, behavioral or learning disorders. The biggest problems for the kid in question we were discussing are social interaction, obsessive thinking and attention/organizational problems. The consultant’s observation (to paraphrase) was on target, and pointed out the challenge we see with many kids who are high-functioning intellectually, but struggle with social or emotional disabilities…

The kid will reject anywhere with the resources to help with the social stuff because they’ll take one look at the place and say “I’m not like THOSE kids.”

This, in a nutshell, is the challenge associated with including families of kids impacted by mental illness or developmental disabilities at church. The kids (and their families) are exquisitely sensitive to perceptions of being “different” from everyone else. This is a key reason why they don’t fit into most “special needs ministry” models and why they’re inclined to avoid “programs” that draw attention to their differences.

One observation…When we’re involved with launching church-based respite ministries, in churches that provide “buddies” to both kids with disabilities AND THEIR TYPICAL SIBLINGS, it’s not uncommon for the majority of kids served to have mental health disabilities as opposed to kids we traditionally think of as having “special needs.”

So…what’s a church to do if they want to be effective in including kids and families impacted by mental illness in the communities they serve? Strategies will differ, but churches looking to break out of the program mentality need to demonstrate…

  • Intentionality about establishing and maintaining relationships with kids and families impacted by mental illness
  • A mindset of seeking to understand the uniqueness of each child’s/family’s situation to include them in those activities deemed most critical to spiritual growth by that church’s leadership.

Here are some examples of how intentionality about relationships might play out…

One large church where our team went to train hypothesized that kids and adults with mental health concerns were likely overrepresented in their population of “irregular attenders.” Parents with ADHD are likely to struggle with time management and follow-through, just as their kids do. One strategy we recommended was to identify volunteers who task would be to call or text message parents who had missed church two or more weeks in a row to express care/concern, invite them back the following week, and see if they could benefit from any help/assistance.

A church might support church members in establishing “Grace Groups” offered through Mental Health Grace Alliance or support groups through NAMI for kids and families and help to promote the availability of those groups in their local communities.

Front Door Screen ShotA church might look at using online worship resources and services as a tool for connecting with families impacted by mental illness and other disabilities in their surrounding communities.

A church might look at event-based or relational respite as strategies for establishing relationships with families impacted by mental illness and other disabilities.

Here’s what a mindset of approaching inclusion as a process as opposed to a program might look like...

It may look like church staff or key volunteers building relationships with parents that offers them the insight to help families connect first with church through ministry environments and experiences in which their kids are most likely to be successful.

The middle schooler with agoraphobia might be more comfortable watching large group worship on their iPad, but do just fine as part of a small group meeting at someone’s house.

The kid with separation anxiety may struggle to go on a mission trip, but thrive in activities where families collectively have the opportunity to serve together.

The kid with ADHD may have a difficult time sitting through a discussion in youth group, but be totally engaged while loading trucks at a food bank or rehabbing houses with peers and adult volunteers.

Even a cursory reading of the Gospels suggests that Jesus in His earthly ministry was very intentional about meeting each person He encountered at their point of deepest need. We weren’t created as “one size fits all” beings. There may be one way to God (through Jesus) but there are lots of ways for the church to help kids and families to come to know and experience Jesus. Taking the time to appreciate the unique gifts, talents and struggles of kids and families impacted by disability, especially those with disabilities that are less obvious and to craft individualized responses to inclusion that take into account those unique differences is more likely to help those families get involved and stay involved at church.

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KM Logo UpdatedKey Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!

 

Posted in Hidden Disabilities, Inclusion, Key Ministry, Mental Health, Strategies | Tagged , , , , , , , | 1 Comment

The top four reasons for attending…or hosting the Front Door Church

j-5aZT6iyhqJD6-jVwHY7dALMP4xaMYZZDPOzyvKDEsIt’s the hottest craze since the microwave oven – the ability to attend church on your computer without even leaving your own home.

Key Ministry saw a need in this area and filled it. There is a huge gap in church attendance for families struggling with someone who has a developmental delay, mental health issue or special need. Why not create an opportunity for people to attend church, and end isolation in Christian community by attending church while also assisting them to find a local church home? Thus was born THE FRONT DOOR CHURCH.

Since the pilot program began, we have received many “atta boys”, but even MORE questions surrounding online church. So, we’re going to answer some of the most frequently asked questions here, while ALSO inviting you to attend, or even consider HOSTING an hour of church online.

  1. I have NO clue what THE FRONT DOOR CHURCH is. ~ Well, then you should check it out for yourself! It’s as simple as clicking on http://go.mediasocial.tv/cbcfrontdoor, signing in through your Facebook account by clicking the “f connect” button on your upper right, watching the service streaming online, and sharing your prayer requests or connecting with others in attendance on the Livewall. Several pastors have commented that they might refer members to The Front Door when they can’t make it to church in person, but they would have to really know more about it. Well, again, attending for yourself is a great way to determine if this would be a great tool for your church members.
  2. shutterstock_24510829What do you DO at The Front Door Online Church? ~ It’s a lot like regular church. Our “host” is much like the greeter or usher at a church building. They welcome you and help you access anything you need to fully participate in the service.  They show you how to locate the embedded online Bible for your use during the sermon. They tell you how you can take notes during The Front Door Church and e-mail them to yourself. They listen to the pastor’s message with you. And they even pray with you on the Livewall, and throughout the week, if you share a request.
  3. What if I get there late or have to leave early? ~ You are welcome ANY time! We understand how complicated life can be. Having the opportunity to connect to a community of faith is a blessing no matter how long you can connect. We’re here for you.
  4. How do you become a host for The Front Door Church? ~ We’re GLAD you asked that, because we definitely NEED more hosts! Here’s the criteria: Do you want to do something you’ve never done before to reach people who have never been reached before with the saving message of Christ? Do you enjoy communicating and connecting with others? Is there a group of people that you could extend an invitation to join you at online church? Do you feel comfortable sharing spontaneous prayer with and for others? Is there a time of day that works best for you where you sense others would join you at online church? Do you have access to a computer and feel capable with Facebook? These simple requirements make you the perfect host!

Hopefully, this gives you a good flavor for what we are doing over at The Front Door Church. We would love for you to be a part of it. If you have any additional questions or would like to move forward with hosting a service, please contact barb@keyministry.org.

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KM Logo UpdatedKey Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

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Updated: Families impacted by depression…How can the church help?

shutterstock_145410157This is the eleventh post in our Winter 2013 blog series Understanding Depression in Kids and Teens…A Primer for Pastors, Church Staff and Christian Parents. Today, we’ll offer some specific strategies for churches seeking to serve and welcome kids (and adults) with depression and their families.

How can churches help families impacted by depression to experience the love of Christ? Here are some thoughts…

Give those with depression permission to talk about it. Steve Scroggin, President of Care Net (a network of pastoral counseling centers in North Carolina) made the following observation about depression in a USA Today story on pastoral suicide…

“Clergy do not talk about it because it violates their understanding of their faith,” said Scoggin. “They believe they are not supposed to have those kinds of thoughts.”

Our friend Matthew Stanford from Mental Health Grace Alliance was quoted in the same article…

Stanford, who studies how the Christian community deals with mental illness, said depression in Christian culture carries “a double stigmatization.”

Society still places a stigma on mental illness, but Christians make it worse, he said, by “over-spiritualizing” depression and other disorders — dismissing them as a lack of faith or a sign of weakness.

When church leaders are willing to talk about depression, they send a clear signal that they’ve likely worked through the stigma associated with the condition in the church. Given the statistics suggesting that depression is more common among pastors than in the general population, lots of leaders have firsthand experience with the topic. It also demonstrates to persons in the church with depression that it’s safe to be authentic about their pain and struggles in the context of Christian community.

Consider offering faith-based support groups. Mental Health Grace Alliance has an excellent model for such groups. In our concluding post in this series, I’ll touch on the theme that God may use the pain and suffering associated with depression to draw people into a closer relationship with Him. We have the hope of the world in Jesus. Who better to share with people who struggle with hopelessness!

Provide them with tangible help. As we’ve discussed in previous posts, high quality mental health services that are also affordable are in very short supply. Several churches in our area offer excellent short term counseling…in some instances, the counseling is made available for free. Knowledgeable advocates within the church willing to assist parents and families in accessing mental health care through their health insurance or local agencies provide an invaluable service. Free respite care for parents struggling with depression can be an incredible blessing. Churches prepared to include kids with special emotional, behavioral and healthcare needs will likely serve a disproportionate number of parents suffering from depression…the condition being more common among parents of children suffering from anxiety, depression, ADHD and other disruptive behavior disorders.

Perry NobleI’ll conclude with a link to a remarkable video from Perry Noble…Perry is a very prominent pastor from NewSpring Church in South Carolina who is much in demand on the conference circuit. Two years ago, he preached a sermon on the topic of depression during which he shared from his personal experiences. This is lengthy, but well worth it. Please share with your friends who are impacted by depression…Perry subsequently wrote a book describing his experiences with depression and anxiety, along with a thought-provoking blog post that we discussed here.

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shutterstock_24510829Key Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

Posted in Advocacy, Depression, Families, Hidden Disabilities, Key Ministry, Mental Health | Tagged , , , , , , , | 1 Comment

Invitation to Speakers…Inclusion Fusion 2014

IMG_0361It’s time again for us to offer an invite to any member of our larger family in Christ with excellent ideas to contribute to the field of disability ministry to serve as a presenter for Key Ministry’s Inclusion Fusion Disability Ministry Web Summit!

The theme of Inclusion Fusion 2014 is INNOVATION. If you or someone you know is implementing an innovative ministry strategy for serving kids or adults with disabilities, is an excellent communicator and would value a platform to share ideas with other leaders in the special needs/disability ministry communities, here’s an invitation to apply to our faculty for Inclusion Fusion 2014, scheduled for November 12th and 13th.

Emily Colson PromoWe’re looking for cutting-edge presentations from pastors, ministry leaders, volunteers and families called to the field of disability ministry. Our Program Committee encourages presentation of diverse views and ideas and encourages submissions from leaders working in small church environments.

chartApplicants are required to submit completed video presentations, posted to YouTube with the setting listed as “private.” Presentations shall be no longer than 20 minutes in duration (fifteen minutes or less preferred), and offered in either “Ted Talk” or interview formats. You may register by clicking here or by accessing the QR code at right through your device.

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abstract yello youtubeWe’re featuring videos of past Inclusion Fusion presentations on Key Ministry’s new YouTube channel!  Viewers can access EVERY VIDEO from past Inclusion Fusion Web Summits ON DEMAND. The videos from past Web Summits have been viewed over 20,000 times…we hope you’ll find them as helpful as many others have!

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We all want to be chosen…

-6fdcd1d076e57720In the eighth segment in our series…Ten Things I Wish Church Leaders Knew About Families and Mental Illness, we’ll look at why helping people to feel like they’ve been chosen is critical to the success of outreach and inclusion efforts when families have mental health concerns.

Allow me to digress today to draw an analogy for church leaders from recent events in the city Key Ministry calls home.

As some of you may have heard, a certain highly skilled basketball player from Northeast Ohio who “took his talents to South Beach” four years ago decided this past Friday to return to our region to raise his family and play for the Cleveland Cavaliers. His announcement followed by two days the news that our city was selected to host our first major political party convention in eighty years.

-21e9ea6502dfbed5To say that the locals were jubilant is a bit of an understatement. We’ve been through very difficult times here in Northeast Ohio. Our area lost tens of thousands of people in recent years. Thousands lost jobs when one of our major banks was absorbed during the mortgage crisis. The majority of the people live in parts of the region “favored” for winters that are extraordinarily bleak and snowy in comparison to other Midwestern cities. Anyone old enough to drive to the game the last time ANY Cleveland team won a championship in a major sport is now eligible for Medicare.

The real reason for the city-wide celebration…Nobody ever chooses us! But in a 48 hour period, we were chosen to host a Presidential nominating convention and the best basketball player in the world publicly declared his desire to play here and raise his family here.

-99433acf3f097779Kids with significant mental health conditions and their families desperately want to be chosen. Life for them is often punctuated by bitter disappointments…not being chosen for the team during pickup games at recess, not being asked to Homecoming or Prom, not getting into the college of their choice, and with increasing frequency, kids and adults with mental illnesses are confronted by insurance and medical bureaucracies that choose to deny access to the best clinicians and treatments for their conditions.

I’d encourage church leaders to put themselves in the shoes of a parent with mental illness, or the parent of a child with mental illness. I’ve had a number of discussions with someone who was very active in their local church but experienced a series of setbacks that led to their absence from a small group and weekend worship…this person was most discouraged that no one from their church ever reached out to them. No one took time to see why they stopped coming or if they needed someone to pray with them. No one brings casseroles when your teenager is hospitalized in the psychiatric ward.

People who struggle with mental illness (or their caregivers) very much want to be pursued. For someone to recognize that they have value. Isn’t that the mission of the church? Aren’t we the hands and feet of the Savior who pursues the lost sheep? Don’t we serve a God who chose us and is lavish in the grace he extends to us? From Ephesians 1…

Blessed be the God and Father of our Lord Jesus Christ, who has blessed us in Christ with every spiritual blessing in the heavenly places, even as he chose us in him before the foundation of the world, that we should be holy and blameless before him. In love he predestined us for adoption as sons through Jesus Christ, according to the purpose of his will, to the praise of his glorious grace, with which he has blessed us in the Beloved. In him we have redemption through his blood, the forgiveness of our trespasses, according to the riches of his grace, which he lavished upon us, in all wisdom and insight making known to us the mystery of his will, according to his purpose, which he set forth in Christ as a plan for the fullness of time, to unite all things in him, things in heaven and things on earth.

Ephesians 1:3-10 (ESV)

Maybe church leaders could learn something from Northeast Ohio’s “prodigal son” in the way he reached out to our community upon his return?

LeBron_James'_pregame_ritualI feel my calling here goes above basketball. I have a responsibility to lead, in more ways than one, and I take that very seriously. My presence can make a difference in Miami, but I think it can mean more where I’m from. I want kids in Northeast Ohio, like the hundreds of Akron third-graders I sponsor through my foundation, to realize that there’s no better place to grow up. Maybe some of them will come home after college and start a family or open a business. That would make me smile. Our community, which has struggled so much, needs all the talent it can get.

Reach out to people who have been marginalized, recognize their value, help them to use their talents for something larger than themselves. That would work. It also looks a lot like the first century church.

Photos from the Cleveland Plain Dealer and Wikimedia Commons

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Inclusion Fusion 2014We hope you, your church and your family will be able to join us on November 12th and 13th for our third Inclusion Fusion Disability Ministry Web Summit! Register now by heading over to our Key TV site and logging in with your Facebook Account.

We have a little surprise for you when you arrive…we’re featuring videos of past Inclusion Fusion presentations on the site AND by clicking on the You Tube icon on the right side of the screen, viewers can access EVERY VIDEO from past Inclusion Fusion Web Summits ON DEMAND. Videos from our past Web Summits have been viewed over 20,000 times…we hope you’ll find them as helpful as many others have!

Posted in Key Ministry, Mental Health | Tagged , , , , , , , | 3 Comments