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Children and adolescents with mental health conditions are less likely to attend religious services than unaffected youth. Depression is associated with a 73% reduction in the likelihood of attending a worship service, while the presence of disruptive behavior disorders, anxiety disorders, or attention-deficit/hyperactivity disorder are associated with 55%, 45%, and 19% reductions, respectively. In this paper, we hypothesize lower rates of church attendance resulting from functional limitations associated with mental health conditions that make entry into a church difficult. Children and youth with mental disorders experience more difficulty meeting common expectations for social interaction and self-control in worship services, small groups, Christian education, service activities, and other church functions. Given the heritability of these conditions, their parents often experience similar challenges engaging in ministry activities. We propose a mental health inclusion model for use in churches of all sizes and denominations. The model facilitates recognition of common barriers to church engagement and assimilation and application of inclusion strategies across ministry activities and environments offered to all.
Little data are available examining the impact of mental illness upon church attendance, despite mental illness representing the most common cause of disability worldwide among youth ages 10-24 (Gore et al., 2011). The preponderance of research on mental health and religion examines religion and religious participation as a psychological and social resource for coping with stress (Koenig, 2009).
Religiosity has been associated with reduced risk of depression and is robustly associated with more rapid remission of depression in patients with serious mental illness and reduced risk of suicide (Koenig et al., 2012; Koenig, 2007). In a study of over 100,000 U.S. healthcare professionals, attendance at religious services at least once per week was associated with a 68% lower hazard of death from despair (i.e., alcohol, drugs, suicide) among women and a 33% lower hazard among men compared with participants who never attend (Chen et al., 2020).
There is similar outcome data for anxiety disorders. Religious interventions decreased symptoms more rapidly than secular interventions in randomized studies of participants with anxiety disorders (Koenig et al., 2012).
The presumption throughout the literature is that participation in worship services and other religious activities promotes positive mental health outcomes. An alternative hypothesis is that persons with more severe manifestations of mental illness...