Mental Health and Youth Ministry – on the IVP Blog

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This was first published here on the IVP blog.

When I was 14, one of my best friends was Daniel. I didn’t know Daniel was clinically depressed or that his random outbursts were actually early signs of bipolar disorder. I didn’t understand that it wasn’t normal that Daniel’s room only contained a mattress, a guitar and a pile of black hoodies. All I knew was he was fun and unique to be around, and that he had an unusually broad talent for music.

We drifted apart over the years, so it came as a huge shock to me when he was found in a flat, dead at age 23, after swallowing a mix of alcohol and methadone.

Daniel was a disruption to the classroom environment. He was always in trouble and – as far as I know – had no-one working with him to identify or work with his root causes. To me though, Daniel was just a mate who I’ll never see again.

I’d like to think that I’m a passionate advocate for mental health. At least I believe that we neither spend enough or research enough to develop treatment for those who really struggle.

The NHS says that one in four adults and one in ten children will experience mental health problems, however only a small amount of the NHS budget has been historically set aside for mental health research, diagnosis or treatment. This is getting better (£11.9 billion in 2017/18), but the waiting lists are still too long, and the medical opinions between departments are still too rampantly inconsistent.

Could we, as youth workers and as Church, develop programs that genuinely support young people with poor mental health? After all, this is not something we might encounter as youth workers; we will encounter it and we should be prepared.

This is a vast landscape, and anything we can do needs focus, so let’s start with what we are not.

1. We are not doctors

As mental health is dialled up to 11 in the media, and the – much-needed – mission to re-educate the public on its seriousness is highlighted, pop-psychology has been dialled up too, and genuine illnesses are in danger of being sensationalised as almost fashionable.

Some have become reactionary to basic terms and there are thousands of websites and videos where you can be ‘self-diagnosed’. Some of these are helpful, but many are not. With the internet being the shape it is, we have no way of knowing if the guy at the other end of the keyboard is an actual MD, or a college drop-out sitting on his parents’ couch with a can of Monster and ill-fitting pyjamas.

With this as our main source of information, and without medical training, we too could fall into to the trap of cavalierly ‘diagnosing’ young people with mental health conditions. Even if we have been through clinical treatment ourselves, we shouldn’t be telling kids what they do and don’t have as if we were trained experts.

We’re not psychologists, psychiatrists, key-workers, or mental health nurses. Our job is not treatment, it’s support. We should follow medical advice, and refer young people to professionals.
We should help them get the help they need, and sometimes that help is simply not us.

2. We are not them

Empathy is a powerful tool in ministry. Being able to legitimately say, ‘yes, I’ve been in that hole and I know the way out’ can be really helpful. However, assuming we understand a young person’s mental health just because we have had a similar experience is not always the best route to take. It can easily lead to unhealthy over-dependency at one end of the spectrum, or a blank wall of rejection at the other.

Every young person struggling with mental health is different. We should let young people speak freely about their own condition, and help us to understand what they need and how they like to talk about it.

Our job is to support each young person’s individual needs as best we can, and partner up with family, key-workers, teachers, and doctors to create a consistent experience of boundaries and support.

3. We are not alone

It’s easy to get frustrated by conditions that we can’t understand, but our job isn’t to fix young people – it’s to lead them to Jesus. There are few things that do this better than creating a safe place of love and security in our ministries.

We’re not in this alone. We live in the community of faith surrounded by quality, compassionate people who – when we truly serve each other – create a unique place of acceptance and healing.

As youth ministers, it’s important that we don’t hold burdens for young people alone. We should have accountability in place where we can debrief and share with a select group of trusted people. This could be pastors, line-managers, counsellors, or a network of other practitioners.

We also have the Holy Spirit living in us; the very presence of Jesus. We are not in this alone, and we can love as He first loved us, and create safe places for struggling young people. We should begin by trusting God, supporting each other, and from that place of strength – loving young people.

 

Photo by Nik Shuliahin on Unsplash

The other ‘other’ side of mental health

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There are few health-related topics receiving as much media attention at the moment as mental health, and rightly so. It’s been a tragically misunderstood and vastly under-resourced part of human conditions for years.

The NHS says that one in four adults and one in four children will experience mental health problems, however only a small amount of the NHS budget has been historically set aside for mental health research, diagnosis or treatment. This is getting better (£11.9 billion in 2017/18), but the waiting lists are still too long, and the medical opinions between departments are still too rampantly inconsistent.

I know from first-hand experience with both anxiety and depression, just how debilitating poor mental health can be, and I have friends who have gone through incredibly serious treatment for significant mental health conditions.

That all said, there is another ‘other’ side.

As mental health is dialled up to 11 in the media, and the – much needed – mission to re-educate the public on its seriousness is highlighted, pop-psychology has also been dialled up, and genuine illnesses are in danger of being sensationalised as almost fashionable. People have become very reactionary to basic terms, there are thousands of websites where you can be ‘self-diagnosed’, and there are all kinds of misinformed instructional blogs on how to be treated.

Some of these videos and blogs are incredibly helpful, but many are not. With the internet being the shape it is, we have no way of knowing if the guy at the other end of the keyboard is an actual MD, or a college drop-out sitting on his parents couch with a can of Monster and ill-fitting pyjamas.

The dangers of self-diagnosis online

Please understand that I write this out of a genuine desire to get people who are really struggling in front of actual doctors. The internet, even when it’s right, is by its nature anonymous and impersonal. This means that even if you do get a correct diagnosis, the treatment suggested might not be at all helpful for you, and could even be harmful.

With the growing awareness of mental health conditions and symptoms there are, thankfully, more people seeing doctors. This has, however, led to an increased burden on the NHS, which makes it understandable why they have created online ‘mood assessment’ quizzes. Even this quiz, however, with its genuine research and actual stock GP questions is marked with the disclaimer: ‘The quiz is not designed to replace an appointment with your GP.’

Psychology Today warns us that self-diagnosis may be missing something important that a doctor would be able to tease out with you, they say ‘you may be overwhelmed by anxiety and think that you have an anxiety disorder. The anxiety disorder [however] may be covering up a major depressive disorder.’

I have two very good friends with diagnosed, long-term clinical depression. Both receive treatment from doctors for their conditions. One of these friends takes medication, which – in the main – helps, the other isn’t allowed that particular medication because it causes triggers for his (also diagnosed) hebephrenic schizophrenia. They can’t be treated the same way. One of them sees a counsellor at their office, the other cannot be alone in a room with someone unless there are no windows and they are facing the door – which has to be locked. They both have ‘depression’ but different treatment plans made specifically for them.

There is also a blurred line between feeling something and suffering with something. Anyone can ‘feel depressed’ for instance, however not everyone has ‘clinical depression.’ Mental health includes things like chemical imbalances, vitamin production issues, and beta misfires. Self-diagnosis and treatment may be replacing another important need in your life where you should, in fact, be working on resilience and maturity. Mental health and hypochondria have (very ironically) become a taboo pairing.

In Youth Work

When it comes to young people, media-sensationalising, youtube ‘experts’, and ‘10 questions to find out if you’re a psychopath’ online quizzes – many of which are aimed at teenagers – easily throws fuel onto this fire.

I have young people who tell me regularly that they can’t participate in an activity or follow a rule because of their self-diagnosed / undiagnosed ‘mental health.’ This also carries on to personality types and additional needs. I recently was told by a young boy in a classroom that he should be allowed to bang his lunch and disrupt the room because he had ‘dyspraxia.’ Not only is this a poor understanding of dyspraxia, but it made light of two other people in the room who genuinely do struggle with dyspraxia and are trying to manage it.

I wouldn’t want to make light of a young person’s self-identity, of course. There are many young people who do have genuine mental health concerns, and some are still without a diagnosis. However, there is still a line to be trod between total acceptance and total rejection.

I have other young people in my groups who, along with parents, carers and doctors, are working on mental health issues and have asked me to support those efforts. I am all for this!

So, here’s a few things you can do:

  1. Get educated. Learn about conditions and treatments. Find out about the diagnosis procedures and the nuances of what is done in support.

 

  1. Get connected. Find out what mental health facilities are available in your area, especially for young people. This goes beyond the NHS and will often include support forums and charities.

 

  1. Get compassionate. Always start with grace and mercy. Don’t immediately judge or write off a young person’s self-identity, but talk with them, ask questions, and work on it with them healthily and compassionately.

 

  1. Get supportive. Young people with additional needs and mental health conditions often have a ‘one sheet’ created by doctors, teachers and social workers. This single page gives information about that particular person, what their triggers are, and how to help them. Ask them to see it and be a part of their growth and management.

 

  1. Get honest. Don’t try to be a doctor. Always follow medical advice, and always refer young people to professionals. Strongly suggest seeing their GP, and even offer to go with them. This step can actually be a huge fear obstacle to overcome, especially with some mental health conditions, so be understanding. However, do be firm, challenging, and help them get the help they need.

7 Ways to Support Anorexic Young People

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Last night my wife and I watched the BBC2 documentary with Louis Theron on Anorexia, which has prompted this post.

Youth ministries can be rife with all kinds of eating disorders – and classically we respond to this epidemic by simply talking about self image and inner value. As if we could convince them that they are beautiful, then they’ll suddenly get better and start eating normally again. Messages on identity are genuinely important, but rarely do they adequately address the needs of a young person dealing with a diagnosed mental disorder like anorexia.

And that’s where we should start. Diagnosed anorexia is treated in mental health departments. It is often wrapped up in anxiety, paranoia, and other chemical vulnerabilities in the mind. This means that the condition, the symptoms, and the treatments are dramatically different depending on personality.

  • For some young people, anorexia means a pathological and carnal phobia of food, and what eating does to their bodies.
  • For others, it is a form of self-harm or punishment; a painful response to inordinate guilt or a denial of things they feel they don’t deserve.
  • For some it is a response to trauma or tragedy – a way of making change happen to be more acceptable to themselves or others.
  • For again others, it creates a numbness that enables them to deal with other painful or overwhelming feelings.

Thus you will find young people who are filled with shame about how they deal with eating and exercise – and they will hide from you. You will then find others who are proud, and even militant about their sense of confused piety and discipline. Some will have no intention of recovery, and others will have no acceptance of their problem. More than likely, however, several of these things will exist together in a constant state tension and battle.

Anorexia – like any mental health problem – is never clean lined or simple.

It also comes with all kinds of misunderstandings and resentment. ‘Why don’t you just eat more?’ or ‘Don’t you know that you look better with more meat on your bones!’ As if they could just pull themselves up by their bootstraps and think suddenly objectively or rationally.

Anorexia smothers rational thinking. It comes with intense feelings of guilt, fear, judgement and social anxiety – and it proffers its own destructive solutions.

So what do we do about it as youth leaders?

1. Remember that we are not doctors.

We’re not psychologists, psychiatrists, key-workers, or mental health nurses. Our job is not treatment, or job is support.

We should remember to work with professionals and to recommend or report to them to do what we can’t.

2. Treat them like distinct and individual people

Mental health needs a fuller understanding across the board. I’ve tried to demonstrate above some of the many different ways young people might experience this condition. Each of them will need a different response and will play by a different set of rules.

We can’t learn broad responses – we need to work with them individually.

3. Ask them what they need

Allow them to speak into their own condition, and to help you understand what language they need. This will also help you be able to look out for their triggers and provide for the care of those triggers in your projects.

4. Love them unconditionally

It’s easy to get frustrated by conditions that we can’t understand. But our job isn’t to fix young people – it’s to lead them to Jesus. There are few things that do this better than creating a safe place of love and security in your ministry.

5. Don’t enable

Make sure you know enough of them, and have spent enough time with their family – and maybe even nurses or social workers – to be able to help them recover. This means creating similar boundaries within your projects for them as they’ll be experiencing at home.

6. Be for their recovery

Show that your proud of them when they’re doing well and when they’re working with doctors. Mental health conditions tend to come with a pathological suspicion of treatment. Help them with encouragement that they’re doing the right thing by getting help.

7. Don’t minimise their experience

Whatever kind of grip eating disorders have, or whatever form they take, they are always destructive. Be careful not to demonise or trivialise conditions like anorexia in how you joke or talk. Always here young people out and take them seriously about what it is they’re feeling – whether or not you can relate.

Exploring Emotional Health – with Liz Edge

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It was through adolescence that I began to feel a void in dialogue between my Christian faith, and being diagnosed with anxiety and depression. No one seemed to want to talk about emotional health and God in the same conversation; it was as if they simply didn’t mix.

Over the years, I was convinced that others out there must be thinking similar thoughts to me. I couldn’t be the only teenage Christian living in the void. As I got older, I would ask myself;

Why am I so anxious all the time, even though the Bible tells me not to worry?

Does God still love me, even though I self-harm?

How can I be a Christian and be diagnosed with depression?

As I gained more insight into the area of mental and emotional health, I realised Christian’s aren’t exempt from experiencing poor mental health. Being a follower of Christ is a lived experience, and that includes living with illnesses of all kinds.

If we pause, taking a moment to look at the reality people are currently facing, we’ll see that:

  1. Globally, an estimated 350 million people of all ages suffer from depression and it is the leading cause of disability worldwide. (WHO, 2015)
  2. In the UK, anxiety disorders are estimated to affect 5-19% of all children and adolescents. (NHS, 2014)
  3. The majority of people who are reported to self-harm are aged between 11 and 25. (Mental Health Foundation, 2017)

Here we have three statements that show a snapshot of the many challenges adolescents face in our society today.

The encouraging news is that research shows teenagers want to talk about these challenges with trusted adults; they want to break the silence and no longer identify them as ‘taboo’ topics. Whether it is because young people are facing these adversities themselves, or because friends/family are struggling, they want to talk and therefore we must listen.

So, for those of us working with young people, we’re left with a conundrum: How do we even begin to effectively support the young people we engage with in exploring their emotional well-being and Christian faith? Where does the conversation begin in this vast arena?

Exploring Emotional Health: six workshop outlines for youth leaders will enable you to begin these vital conversations. It is a practical resource which breaks open the void in exploring these challenges with teenagers. The book covers six key topics and even includes ready to go workshops on: self-esteem; anxiety; depression; self-harm; identifying and coping with emotions.

Each chapter presents an essential understanding of every topic so you are equipped to run the creative workshops. The flexibility of how they’re written means they could used as a series during term-time or simply as a one-off at a residential weekend.

A decade since my personal experience, there are still teenagers today asking the same questions. By using Exploring Emotional Health you’ll be helping to close the void in openly discussing emotional health and Christian faith. Don’t wait for someone else to talk to them – be the one to start the conversation today.

Exploring Emotional Health can be purchased for £9.99 from various Christian book shops, including KevinMahyew.com.

References:

Mental Health Foundation (2017), Self-harm [online]. Available at: <https://www.mentalhealth.org.uk/a-to-z/s/self-harm> [Accessed 7 February 2017]

NHS (2014), Anxiety [online]. Available at http://www.nhs.uk/conditions/anxiety-children/Pages/Introduction.aspx [Accessed 27 June 2017]

World Health Organisation (2015), Depression [online]. Available at: http://www.who.int/topics/depression/en/ [Accessed: 30 October 2016]

 

Liz Edge is a professionally qualified Youth Work Practitioner holding a First-Class BA (Hons) Degree in Youth Work & Ministry. She is the author of Exploring Emotional Health and has contributed to the work of local and national organisations; these include Romance Academy, selfharmUK and Premier Youth and Children’s Work.

As a freelancer, Liz is able to offer a wide range of youth work through education, training and intervention. Her practice is made authentic by drawing from her own life’s adversities, including living with depression and anxiety for over a decade.

In all her pioneering work, Liz’s ethos is to provide holistic support to adolescents in their relationships and to promote positive wellbeing; with themselves, with others and with the wider world.

You can find out more about Liz at Liz-Edge.co.uk and can follow her on Twitter @LizEdge_ and Facebook /LizEdgeYouthWorker – she’d love for you to say Hi!

Youth Work and Mental Health – A Gentle Poke

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When I was 14, one of my best friends was Daniel. I didn’t know Daniel was clinically depressed or that his random outbursts were actually early signs of bipolar disorder. I didn’t understand that it wasn’t normal that Daniel’s room only contained a mattress, a guitar and a pile of black hoodies. All I knew was he was fun and unique to be around, and that he had an unusually broad talent for music.

We drifted apart over the years, which meant it came as a bigger shock when he was found in a flat, dead at age 23, after swallowing a mix of alcohol and methadone.

Daniel was a disruption to the classroom environment. He was always in trouble and – as far as I knew – had no-one working with him to identify or work with his root causes. To me though, Daniel was just a mate who I’ll never see again.

I’d like to think that I’m a passionate advocate for the mental health world. At least I believe that we neither spend enough or research enough to develop treatment for those who really struggle. Classrooms are simply not geared for it, and the health service doesn’t really step into that gap. Self medicating is all too often the only option that seems available.

I also truly believe that the Church is supposed to define and lead culture – that we should be setting the trends, making the calls and leading the charges. Can we then, as youth workers and as Church develop programs that specifically work with young people during the early signs of mental health issues? Can we cultivate a culture in our programs that leaves room to observe, identify and even treat young people who are going through these struggles?

Daniel was my mate, but there was at the time no language to discuss these problems, or develop an awareness that this could be happening to someone I knew. The language is more available today, but I’m not sure if we’re any closer to implementing real, culture-saturating change.

Bill Hybels said “the local church is the hope of the world.” Can we be this hope that the world is so desperately craving? Daniel’s mum said, “I hate to think another young life could be wasted as tragically as Daniel’s has been.” Can we be the answer to her prayers?

Please, talk to your young people regularly and clearly about mental health. Talk to your team about how to organically identify and respond to needs. Finally, lets keep talking to God – crying out to him for healing and restoration; for the redemption of a culture that lifts up the broken and downtrodden, and helps all people live a life to the full as Jesus taught (John 10:10).