In the early days of youth ministry enthusiasm, love for God and kids and an eagerness to tackle anything were the makings of a well-loved youth leader. The skills necessary to plan and coordinate events, build solid relationships with youth and work with church staff and parents came piece by piece as what began as a fun, first job gradually became a career as a professional youth minister. However, to go the distance as a well-rounded youth ministry expert requires the concerted effort to acquire the knowledge to handle the difficult situations that ministry regularly presents. Professional youth ministers whose career goal is to finish well strive to gain skill in helping youth and their families through some of life’s most difficult challenges. Few such situations are quite as hard as knowing how to minister to youth who struggle with mental illness.

Professional youth ministers regularly teach kids to handle peer pressure, how to relate to others, how to apply Scripture to their daily lives and how to grow in Christ.

So how can you make a difference for that fraction of teenagers for whom life takes a sudden and frightening detour into mental illness? According to the 1999 U.S. Department of Health and Human Services report on Mental Health, 3 percnet of youth will demonstrate the first symptoms of a serious mental illness such as schizophrenia or bipolar disorder between the ages 16 and 24. Is there anything you can do for these adolescents?

According to licensed psychologist Chris Amenson, Ph.D., youth ministers can have a lifelong impact in these most challenging circumstances. Amenson is an expert in the early detection and treatment of serious mental illness. He is the Faculty Chair of Pacific Clinics’ Training Institute, southern California’s largest non-profit provider of mental health services to children and youth. He leads ongoing training for Pacific Clinics’ clinical staff who work with more than 13,000 clients each year.

“In countries such as Australia, Sweden and England, everyone who works with youth is required to be certified in recognizing the early signs of serious mental illness,” Amenson says. “Those youth identified are referred for further screening by qualified mental health professionals.” Ninety percent of the time there is nothing out of the ordinary in these identified youth; for the 10 percent who are found to have schizophrenia or bipolar disorder, early treatment literally changes the outcome of their disease for the better.

“Without early treatment, the disease causes significant damage to the brain. It’s like the brain eats away at itself, rather like an auto-immune disorder,” he said. Recent research has demonstrated that within the first five years of the disease’s onset, the proper medication literally stops the progression of the illness.

“Fifteen years ago, I taught that there was nothing that could be done to prevent the predicable outcomes caused by schizophrenia and bipolar disorder,” Amenson says. “All that has changed. The key is early diagnosis.” Youth ministers are uniquely positioned to recognize the early warnings of schizophrenia and bipolar disorder. Their close relationship and ministry with late adolescents offers an excellent opportunity to spot a developing disease.

Amenson suggests the key is to become educated on the symptoms of these diseases. You need not be an expert; you only need to recognize something is amiss. Mild symptoms of full-blown schizophrenia or bipolar disorder will be the first to appear. Look for such indicators as:

· Unusual perceptions such as magical thinking or imaginary friends, distortions, illusions or hallucinations;
· Unusual fears such as strange guardedness, severe nihilism, bizarre obsessions or extreme guilt;
· Unusual behaviors such as disorganized speech, unpredictable behavior, insomnia with dread of something bad happening;
· Reduced emotional or social responsiveness;
· Significant deterioration in functioning in work or school, decrease in motivation, loss of interest in people, decrease in personal hygiene;
· Withdrawal from family and friends, increased disconnection from things and people that once provided pleasure, and family conflict or hostility.

These symptoms often are seen in teenagers and simply may be normal manifestations of this stage of life. This is why 90 percent of referrals are screened out from having a mental illness. In other cases, the troublesome behavior observed is symptomatic of other serious issues such as drug or alcohol abuse or the effects of sexual abuse along with a host of other problems that a professional can determine. However, for the 10 percent who are found to have schizophrenia or bipolar disorder, early diagnosis means everything.

At this point, you might be thinking, “OK, so I could learn to spot aberrant behavior, but how am I ever going to approach parents with the news that their child may have schizophrenia or bipolar disorder?” Amenson suggests using a medical analogy: “If I saw the symptoms of swine flu in your son or daughter, wouldn’t you want me to tell you?” Then move the analogy forward by saying, “Well, if I saw signs of a brain disorder in your child, wouldn’t you want to know? I advise that your son or daughter be screened by a qualified professional.” Using the term ‘brain disorder’ rather than ‘mental illness’ often disarms parents, according to Amenson.

Daunting as such a conversation would be for a youth minister, it is offset by the knowledge that if this adolescent is developing schizophrenia or bipolar disorder and gets early treatment, the entire course of his or her life will be altered dramatically. Early medical intervention will allow this person to maintain a dramatically more functional life than if the disease goes undetected and untreated.

How can youth ministers help youth in their churches who have been diagnosed with such mental conditions? Amenson advised one singular rule: Help from within your role! The role of a youth minister is to introduce youth to Christ by befriending, guiding and advocating for them. Problems occur when unqualified people try to move beyond their roles and provide treatment. Youth ministers are placed by God at significant points in the lives of youth. For the 1.3 percent of youth who will develop schizophrenia and the 1.7 percent who will become bipolar, youth ministers can make all the difference in their lives just by being their adult friend, guide and advocate.

To accomplish this, here is a list of Do’s and Don’ts:
(suggested by Dr. Amenson)

DO
§  Help from within your role and let it be the family’s job to determine treatment;
§  Focus on the afflicted youth’s strengths;
§  Maintain group norms for behavior by expecting all youth to adhere to the group’s expectations;
§  Treat mental health illnesses as any medical illness;
§  Expect fear and resistance from those with less understanding.

DON’T
§ Diagnose or treat, but refer to qualified mental health professionals. It is the family’s responsibility to take matters from here;
§ Don’t treat afflicted youth differently from others. Keep them included with family, friends, school and church by adhering to the same expectations as you have for all adolescents.

Sooner or later during the course of a youth ministry career, someone in your youth group will develop a life-altering brain disorder such asschizophrenia or bipolar disorder. You can make the transition to a true professional youth minister by educating yourself in preparation for such circumstances. Talk to your senior pastor and suggest having a mental health professional make a presentation at an upcoming staff meeting so your whole team is ready to make a life-long difference in the lives of young people. Read information on the early warning signs of serious mental illness (see the Web links below). Be bold and advocate that youth be screened professionally when they exhibit strange thoughts or behaviors. In so doing, God will use you to make a difference with your most challenged youth.

For Further Information:
• Australia’s Early Psychosis Prevention and Intervention Centre — Click on Learn More, then on Resources. There are excellent information sheets to download here.
• National Alliance on Mental Illness — This is a comprehensive site with the latest info on all types of mental illnesses.
• Depression and Bipolar Support Alliance — Click on Signs Symptoms to learn more.

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