The Tools we Need for the Child and Teen Mental Health Crisis

The Tools we Need for the Child and Teen Mental Health Crisis

If we want the children in our lives to thrive, we must be willing to do the work to make it happen. We must be willing to embrace the change they need.

If you imagine people who need to take care of their mental health, who comes to mind? Seriously. Chances are, you pictured adults in your life who are unstable or seem off in some way.

You’re right. We can all name at least one adult who needs to take care of their mental health, and we can include ourselves in the mix, too! Paying attention to our mental health is crucial for us to function positively in our relationships at work and at home. Who doesn’t appreciate a relationship with an emotionally healthy person?!

The truth is, we are in a mental health crisis. And the last few years have magnified the depth and reach of this crisis. Wounds that were tucked away beneath the surface refused to remain hidden. Fears reared their ugly head. And anxiety came roaring in with a vengeance. 

A mad, wretched, heartbreaking, overwhelming vengeance.

Alright, now think again about the people around you who need mental health care. How many of those people are interacting with children on a regular basis? How many of them have children?

Our children, your children, your students, your nieces, nephews, and neighbors are in pain. They are carrying the weight of an incredibly broken world on their young, never-equipped shoulders. And so much of this weight was placed there by adults who were meant to protect and support them. 

We must stand in the gap to care for these children. From toddlers to teens, it must be us.

And that is exactly why The Refuge Center held “Equip,” our Live Intentionally Speaker Series. We want to help adults gain the tools needed to address the child and teen mental health crisis. 

We had six amazing speakers share on several vital topics to enrich our understanding of the struggles that kids in our lives are battling every day. So, if you missed it, you’re in luck because we’re going to tell you what it was all about …

Recognizing Trauma in Children and Adolescents (Alice Stricklin, LMFT)

A lot of the trauma our kids are dealing with has occurred in the last three years. The effects of trauma don’t have to last a lifetime. It’s our responsibility to help children and teens heal from this trauma.

In order to understand trauma, we have to talk about the three main parts of the brain—primal, limbic, and cortical. The primal brain basically operates to keep us physically alive. The limbic brain is the control center for emotions and attachment, it’s basically our alarm center. Lastly, we have the cortical brain. This is where you can find impulse control, thinking, learning, and language. But guess what? Our cortical brain doesn’t fully develop until we are twenty-five. (This probably sheds some light on some of the uhh not-so-wise decisions made in your early twenties, huh?)

In light of that, think about what it must be like for a kid to experience trauma with a brain that is nowhere close to being mature enough to process it. When you watch a child having some major reactivity to a situation, you are witnessing their trauma response. 

Traumas can be put into three categories: big T, little T, and complex trauma. 

The big T traumas are the more obvious traumas that put your life in danger or the life of someone caring for you. Did you know that when a child watches someone like a parent being threatened, that child feels like they might die, too? They experience the harm even when they’re not directly harmed. 

Little t traumas are non-life-threatening experiences. This could be emotional neglect, humiliation, bullying, loss of a pet, or an injury. 

Complex traumas are made up of multiple life-altering incidents in a short time. This results in the child learning that they can’t trust people who should be caring for them. 

Kids respond to these traumas with a fight, flight, freeze, or collapse and submit (a.k.a. fawn) response. Fight response is going to be an obvious response because it will be strong. You can expect fighting, yelling, wailing, or belligerent behavior. The flight response looks like fleeing the situation. Freeze is another self-explanatory response. The child can’t move and they disconnect from the situation and their body. When a child collapses and submits, it’s as if they become smaller, a natural peace floods over them as they completely disconnect from what’s happening to them or around them. 

Nobody can process trauma when perceiving a threat. Our brains can process trauma when we’re in a safe space. Young kids typically freeze when they’re not in a safe space. Older kids tend to go to the fight or flight response.

How Can We Help?

We have to work within the brain’s natural processing. This means recognizing when it’s a trauma behavior or just a bad behavior and also seeking to understand rather than fixing by asking questions and validating. We can also help by removing parental stressors to create more peace within the home. Peace in the home gives the child a better sense of safety.

Warning Signs for Self-Harm & Suicidal Ideation (Amanda Fisher, LMSW)

When children self-harm, they are expressing internal feelings in an external way. Self-harm may manifest in cutting, burning, scratching, etc. These kids would tell you that they either feel numb or they feel too much. They may be using self-harm as a means of controlling or punishing.

If a child is experiencing suicidal ideation, it doesn’t include the actual follow-through of suicide. This happens when kids regularly think about the act of suicide. This can be slippery to catch because these kids may never talk about it out loud. They may be journaling, drawing, or watching shows revolving around suicide.

Unfortunately, there are a few myths floating around regarding suicide. It just isn’t true that people who want to do it can’t be stopped, that talking about it makes it worse, or that they don’t warn others. None of those things are truths.

There are warning signs for both self-harm and suicide.  Learn the physical symptoms and  behavioral patterns that indicate risk.

Warning Signs of Self-Harming

  • appear withdrawn, or more quiet or reserved than usual
  • stop participating in their regular activities
  • have rapid mood changes
  • get angry or upset easily
  • have had a significant event in their lives, e.g. a breakup with significant other
  • suffer poor academic/school performance when they usually do very well
  • exhibit unexplained bruises, cuts or scratches
  • wear clothes that are inappropriate for the weather, e.g. wearing long sleeves on hot days.

(Note: This list provides some examples but is not exhaustive and should not be used for diagnostic purposes.) Sources: Klonsky, E. , et al. (2011) 

Warning Signs of Suicide

  • Talking about suicide, death, and/or no reason to live
  • Preoccupation with death and dying
  • Withdrawal from friends and/or social activities
  • Experience of a recent severe loss (especially a relationship) or the threat of a significant loss
  • Experience or fear of a situation of humiliation of failure
  • Drastic changes in behavior
  • Loss of interest in hobbies, work, school, etc.
  • Giving away prized possessions
  • Unnecessary risks; reckless and/or impulsive behavior
  • Loss of interest in personal appearance
  • Increased use of alcohol and/or drugs
  • General hopelessness
  • Recent experience humiliation or failure

(Note: This list provides some examples but is not exhaustive and should not be used for diagnostic purposes.)

The most helpful things you can do are to listen without shock, check-in and be available, offer zero judgment, give no lecture or debate, refrain from asking why, be direct, remove any means for committing the act, and seek professional help.

You can call the suicide/crisis hotline at 988 or text “hello” to 741741. You can also go online at Or you can personally go a step further and learn QPR suicide prevention training.

Emotional Intelligence for Young Athletes (Ben Zobrist, retired MLB player)

Stress and trauma extends beyond the walls of our homes and schools … and it bleeds all over the courts and fields that are meant for play and healthy competition. After thirty-three years on the field, Ben Zobrist has a wee bit of insight regarding the emotional intelligence of athletes.

Alrighty, raise your hand if you’ve ever found yourself a tad emotional during a competition? Maybe even kicked out of a game? There is something about competitive sports that brings out our best … and our worst. The act of regulating our emotions seems to get checked at the door as soon as we arrive at the field.

Emotional intelligence is the ability to perceive, understand, and manage your emotions both for yourself and for those around you. Adults are often severely lacking in emotional intelligence. In light of that, think about being a child without a fully developed brain. It is very challenging for kids to practice emotional intelligence.

Here’s the thing. We think of competition as a source of fun and entertainment. But the reality is that money is involved. Whether we tell them or not, kids know that travel or club sports are not free. The equipment, travel, and game fees all add up. And the parents are not the only ones who feel it. Kids carry this weight on their shoulders much more than we realize. That’s a problem.

Speaking of problems, there are quite a few to be aware of if we want to do better. 

Problems in Youth Sports

  • Unhealthy expectations. Kids are expected to excel in school and sports. It’s too much too early. The pressure is too excessive for kids—whether they’re eight or eighteen. 
  • Unhealthy adult involvement. This looks like hyper-criticism on one side of the coin and hyper-esteem on the other. Tearing them down while driving in the car, or building them up and over-inflating their sense of self around sports.
  • Unhealthy coaches. Grown adults who have very low emotional intelligence are not required to divulge this before teaching our kids the proper batting stance or perfect follow through on a jump shot. These coaches can have a very detrimental effect on the hearts and minds of kids.
  • Unhealthy environments. The environment kids practice and play in should be supportive and encouraging. It should not be a source of toxic stress and pressure. 
  • Toxic teammates. Sometimes kids are sitting on the bench, playing on the field, and riding to games with teammates who bully them every time they are out of earshot from the coaches.
  • Toxic attachments to the game. When kids become obsessed with their sport and their performance, it can take up too much space in their head. Their lives are imbalanced.

Imagine being passionate about a sport that also gives you shame and anxiety. Imagine wanting to play so badly that you try to shove down all the anxiety you get from toxic bullying teammates and coaches. And imagine having a parent who is vicariously living through you every time you’re up to bat, stand at the freethrow line, or try to scramble in the pocket. 

Now imagine being a kid who’s trying to mentally and emotionally wade through all of that without somebody to co-regulate them or process all the thoughts and feelings.

What Young Athletes Need

  • Young athletes need a safe space to exist without fear of rejection or shame if they fail. 
  • They need the space to be human and have feelings about their performance. 
  • They need to be seen for who they are
  • Give them language to verbally express their feelings by using an emotion chart
  • Normalize and destigmatize having feelings
  • An adult who is there to co-regulate their emotions
  • A common understood mindset of growth over performance

      So … How Do We Help Our Young Athletes?

      • Do your own emotional work. We cannot teach what we don’t embody. We can’t teach kids to handle emotions when we don’t know how to handle our own. And we definitely won’t be able to co-regulate if we are not emotionally stable. 
      • We have to be sure we are showing interest in more than their sport(s)
      • Recognize the effort your athlete puts into the sport
      • Create healthy boundaries around their competition
      • Give your kids/players common language to express emotions
      • Ask self-awareness questions for before, during, and after the competition or practice
      • Be approachable
      • Show them that who they are is not what they do
      • Be empathetic about their failures. Allow them to sit in their feelings
      • Appropriate their competition over the rest of their life. In the grand scheme of things … What will truly matter?

      None of this will matter if we as caregivers and coaches don’t step up and commit to our own mental health so we can be fully present and pour positive things into the lives of young athletes. 

      Are Screens Destroying Your Family? (Stacey Jagger, LMFT)

      If you were sitting in a chair across from Stacey, her answer to that question might very well be a resounding YES, screens are absolutely taking a toll on your family

      Think about a favorite memory from childhood. In that memory, your senses are intimately involved. Our memories are about connection. And that connection makes us feel loved. 

      Kids today feel less connected because of social media. That means they fell less love. Screens are insulating us from connecting with others. In both their minds and bodies, kids get an adrenaline rush from screens. They are not developmentally capable of managing the adrenaline and sorting out the real from the virtual. This is a recipe for mental and emotional disaster.

      Convenience is ruling our lives.

      Approximately 20% of American kids enter school developmentally delayed. One out of six children have a diagnosis of mental illness with child aggression and unmanageable behavior, and it is increasingly becoming the norm. 

      Studies show that kids spend over seven hours a day in front of electronic media. There is a definite link between developmental and academic disorders to excessive screen time. As a result, children struggle to regulate their emotions, they can’t get to know themselves or process feelings, they are losing the ability to process emotions naturally, they are experiencing social anxiety in simple face to face interactions, and they are unable to maintain eye contact or focus for more than thirty seconds. 

      This is becoming a world-wide crisis. Kids need to interact with the outside world or they will continue to deal with nervous system deregulation. 

      The Solution: 30-Day Blackout

      Before you freak out and stop reading, take a deep breath and don’t panic. There are concessions for work and school projects, the bare-bones necessities.

      Should you take on this challenge, you can expect the first five days to be hellish. Days six and seven are what Stacey likes to lovingly call “The Door of Boredom” and “The Pit of Despair.” It’s at this point that kids are finally willing to do things they were unwilling to do before.

      When you do this, the brain and autonomic nervous system have a chance to reset. Their capacity for connection increases. Kids can actually believe you when you are talking to them. This part alone is reason enough to consider it, right?


      1. All gaming and social apps must be taken off of devices
      2. Work is to only be done during regular working hours
      3. Homework is done in a place like the kitchen
      4. From the evening until the morning is to be considered family time

      We must shift our mindset to regard screen time as the dessert rather than the main course. The main course should offer us opportunities for connection leading to emotional regulation, co-regulation, love, and security.

      Grief and Loss with Young People (Caitlin Coile, LPC-MHSP)

      The reaction to grief and loss can come in many forms, some of which are often unexpected. Anger, denial, acceptance, frustration, contentment … All of these can show up with grief and loss.

      As adults, we struggle to find our path through the trauma of grief and loss. For kids, this journey is completely chaotic, and they usually feel stuck in it. Huge thoughts and feelings are roaring around inside of them and they don’t have the maturity or tools to process all of it.

      So we have to watch them closely, keeping in mind that things may not look the same for kids as they do for adults. Watch how they are playing and interacting with others and be prepared for their grief to come in bursts. 

      Our Role Is to Be Present

      The adults in a grieving child’s life must act as their safe place, their soft place to land—whatever that looks like. We need to talk through their grief in a developmentally appropriate way. Depending on their age, they may not understand the permanency of the situation. When it comes to kids and loss, euphemisms are not the way to go because they add to their confusion. 

      So, we’ve got to provide opportunities to help kids  explore their grief. When we do this, it’s as if they have permission to build a life around their grief. Doing this doesn’t ignore their grief or loss, it makes room for it without letting it overwhelm their entire life. 


      There are ways to help our kids cope with this life trauma. You can create a tangible representation of their loss to help them cope. It honors the memories they have around their loss. This can look different for each kid. It could be a bracelet with a bead representing good memories. It could be writing or coloring. It could even be a collection of small stones. It just needs to be something that serves as a visible reminder.

      Kids often struggle to talk about what has happened. (And frankly, caregivers don’t always know what to say.) Reading books together is a great way to start a conversation and engage in a meaningful dialogue. 

      Reading Suggestions

      Ages 0-8: When Dinosaurs Die, I Miss You, The Invisible String

      Middle School: The Memory Box, One Wave at a Time, A Stone for Sasha

      High School: When a Friend Dies, The Grieving Teen, Grief Recovery for Teens

      You can find additional resources for helping kids deal with grief and loss at the Child Mind InstituteThe Dougy Center, The National Child Traumatic Stress Network, and, of course, The Refuge Center.

      The Refuge Center has a needs assessment that we offer for youth pastors. If you are interested, we will be hosting youth pastors and helping them learn ways to better support their young people on 10/27/22 from 1:00 to 2:30 and 11/10/22 from 10:00 to 11:30. 

      Adverse Childhood Experiences “ACEs” Scores (Dr. Thomas Cabell)  

      It is painfully clear that the last few years have thrown many of us back into our stories. We’ve become reacquainted with the things we carry deep inside.

      “The past is never dead. It’s not even past.”

      —William Faulkner

      There is a reason for this. Your limbic system never leaves you, and this is where our emotional core resides. And that emotional core is directly linked to the immune system, which lives mainly in our gut. So when you experience something awful, you might say you feel like you’ve been kicked in the gut, and wouldn’t you know it? There’s a reason for that, too.

      Our five senses are filtered through the limbic system. This is one reason why environment makes such a huge impact on how we experience trauma. To add to that, trauma is essentially like a separation from our body and emotions, a disconnection from ourselves. Trauma isn’t what happens to us but what we hold inside in the absence of an empathetic witness. 

      Stress in Relation to Trauma

      Stress comes in three main forms—positive, tolerable, and toxic. 

      • Positive stress is essential for a healthy environment.
      • Tolerable stress is stress that lasts for a longer amount of time but still has a time limit and is often met with adaptive coping skills
      • Toxic stress is strong, frequent, pro-longed adversity, such as: physical abuse, emotional abuse, neglect, etc. These stressors can continue for years.

      Prolonged activation of a stress response interrupts brain development and leaves a fingerprint on the physical structure of the brain. We cannot ignore stress! Its effects will make undeniable marks on us and even go so far as to shorten our lifespan and saddle us with long-term health problems. 

      Society tends to pay more attention to physical abuse—which is a special kind of hideous—but did you know that emotional abuse is more taxing to the body? And this includes when a child witnesses their parent being emotionally abused. Their bodies feel the threat.

      Kids need an adult buffer to combat this stress. For countless kids, emotional abuse has become a regular occurrence. So as scary and awful as it may be, it also feels like their norm. Having an adult who is present to process what is happening helps those children to not feel alone in their trauma. An emotionally healthy adult can help a child understand that emotional abuse is not okay.  

      When kids experience trauma after trauma, their immune systems never gets to shut off. The stress keeps their guts churning with anxiety. So, sometimes when a child is telling you their belly hurts but they have no other symptoms, it’s because their anxiety is in high gear. This may be especially prevalent at bedtime.

      What’s more, we now know that this heavy anxiety affects our hearts. The heart will actually give off signals to indicate that we need to pay attention to what is happening to our body. Toxic stress works its way from our gut, to our brains, and to our hearts. 

      In a nutshell …

      Adverse childhood experiences are the single greatest unaddressed health threat facing our nation today. 

      And the occurrence of these experiences has doubled in the last two years. 

      So, instead of asking the question, “What’s wrong with you?” we need to start asking, “What happened to you?”

      Ugly things are happening to our kids. We must do better. We must help the children around us. Their future depends on it.

      In the end …

      We need to take great care regarding the hearts of the children walking the halls of our homes and schools, playing on our ball fields, and showing up in our offices. We can teach kids how to navigate their feelings and communicate by giving them language to use and reassuring them not to fear any of their feelings. This is all part of being available co-regulators. 

      At The Refuge Center, we look at trauma like this: Trauma is not so much what happens to me, it’s what happened to me in the absence of an empathetic witness

      If we want the children in our lives to thrive, we must be willing to do the work to make it happen. We must be willing to embrace the change they need.

      By Shelby Rawson

      Shelby is a local writer, ghostwriter, and editor by trade. She avidly supports the mission of The Refuge Center and its pursuit to intentionally care for the mental health of our community.

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      Supporting Grieving Children

      Supporting Grieving Children

      Helping your child process their grief now will have a lasting impact on not only them but the people they have relationships with in the future. It can have a tremendous effect on how they handle stress, loss, and other life events in the future.

      Something about a new teacher, a loaded backpack, and crisp, white notebook paper signals a fresh start. But this isn’t true for all of our kids. The excitement of a new school year may be clouded by mixed emotions, especially still being on the heels of covid.

      Many of our children have experienced loss. They may have lost loved ones or their sense of safety. They may have lost the family unit because of divorce or years of social interaction because of isolation. It’s important to know how to support grieving children in each of their losses, even if they are only perceivedlosses.

      The grieving process varies by a child’s age, development, and personal experiences. Some children may seem unaffected by loss, while others openly express their feelings.

      You can have one family of five children whose parents separated and then divorced. Even though these kids have had the same parents and lived in the same house, the way each of them experienced that life can be vastly different.

      The older children may have seen it coming, may have wanted the fighting to stop, and feel a sense of relief. Those kiddos in the middle are watching the older siblings but can’t quite process what’s happening and feel pulled to take sides. Meanwhile, the youngest is still waiting for their mama and daddy to live together again.

      Their feelings are all over the spectrum … relief, anger, bitterness, confusion, sadness, hurt, grief, fear, loneliness, and even shame. And they bring that with them onto the school bus and through the doors of every classroom. 

      The following details will help you understand the difference between normal grief and traumatic grief and when to consider reaching out for help.

      What is grief?

      Grief is a natural, internal response to the loss of someone or something we care about. In children, grief can feel like a jumbled mix of emotions. They may feel sad and lonely as they miss their loved one and at the same time, angry and frustrated because they just don’t understand why or how something so awful could happen.

      Our children need support to cope with grief. Young children may not be able to put complex emotions into words, so those big feelings are stuck in their bodies and minds which can increase feelings of isolation. According to Caitlin Coile, LPC-MHSP, Director of Children and Teens Program at the Refuge Center, the internal experience of a child might include:

      • Emotions such as anger, guilt, relief, fear, and sadness
      • Thoughts of trying to understand and believe what happened
      • Physical responses such as sleeplessness, stomach aches, headaches, and loss of appetite
      • Spiritual questioning about life’s meaning and the nature of God

      What are the outward signs of grief in children?

      Outward signs of grief vary for each person. Common themes in children include expressing mixed feelings, having difficulty concentrating or sleeping, or experiencing outbursts of crying or anger. Additionalnoticeable signs may reveal themselves in these areas:

      • Academics – Declining grades, incomplete work, memory loss, overachievement, language errors, inattentiveness, daydreaming
      • Behavioral – Noisy outbursts, disruptive behavior, non-compliance, risk-taking, hyperactive-like behavior, isolation, or withdrawal, need for attention
      • Social – Withdrawal from friends or activities, drug use, changing relationships, sexually acting out, stealing, difficulty being in groups
      • Physical – Stomach aches, headaches, heartaches, accidents, sleep difficulties, loss of appetite, low energy, skin condition, nausea, increased illness, and rapid heartbeat

      You may only see kids display a few of these signs, experience signs at different times, or simply feel grief without any noticeable signs. Checking in with your child and looking out for signs of struggle will help you provide the support your child needs to begin healing. 

      Keep in mind that your kids may not always want to talk to their parents—this can be especially true for teens. They may be more open to sharing their hearts with a coach, teacher, aunt, or uncle. If your kids have a safe person to share with, have a conversation with that person. The point is to have an adult who is positively involved in the grieving process.  

      How can you support a grieving child?

      Parents may choose to talk openly about loss from an early age which helps children understand loss as a part of life. Still, significant loss in childhood can lead to confusion and sadness that lasts for months or even years. Grief support for a child may include:

      • Providing a safe environment for active listening
      • Trying to understand your child’s experience
      • Being available when he or she needs you to be close
      • Setting age-appropriate limits on information related to the loss
      • Avoiding false hope of replacing what was lost
      • Encouraging activities that still bring joy

      For children, loss can feel unexpected and intense. Whether they are four or fourteen, our kids may not know what to do with all that is swirling around inside them. There are books and online resources for caregivers to learn how to help children express and work through difficult or confusing emotions.

      You should also be aware that all grief is not the same. It’s important for parents to know the signs of traumatic grief.

      What is traumatic grief?

      Traumatic grief refers to the experience after a highly traumatic loss, such as the death of a parent. Imagine losing the person who has shown you safety, provision, encouragement, and love. Now imagine being a kid who is often too young to fully grasp what is happening.

      Bereavement can be traumatic in childhood for so many reasons.  Our children may experience more distress if someone close to them dies tragically rather than from natural causes. If significant distress occurs, the loss may lead to symptoms of post-traumatic stress. Post-traumatic stress can play out in symptoms like these:

      • Lingering severe sadness and fear
      • Acting the event out when playing
      • Outbursts of anger and ongoing irritability
      • Trouble sleeping
      • Triggered by memories of the trauma
      • Continually negative feelings

      Children who experience collective trauma may also feel traumatic grief. Collective trauma refers to a traumatic event that affects a large number of people, such as a tragedy at school or a pandemic. Parents should watch for signs of difficulty coping, such as bedwetting, nightmares, irritability, and difficulty concentrating. 

      Since outward symptoms may not be present, it’s important to screen for traumatic grief by asking your child about feelings following a loss. If there are signs of traumatic or complicated grief, parents can assure their children that they are not alone and provide the support needed to heal.

      Is my child depressed?

      Although grief and depression have similarities, there are key differences. Grief is a natural reaction to a significant loss that usually lasts for about six months or longer if the person is unable to process the loss adequately. Depression is a disorder that causes significant problems with mood, energy, sleep, and appetite and can last for many years.

      When should you seek professional help?

      While grieving is a healthy response to loss, supporting someone through grief can be difficult. You may have no idea how to help your child on your own. Signs of complicated grief include:

      • Suicidal thoughts or behaviors
      • Chronic physical symptoms without medical cause
      • Depression with impaired self-esteem
      • Persistent denial of the loss
      • Alcohol and/or drug use
      • Intense feelings of guilt or responsibility
      • Major and continued changes in sleeping or eating habits
      • Unsafe/harmful risk-taking behavior

           Helping your child process their grief now will have a lasting impact on not only them but the people they have relationships with in the future. It can have a tremendous effect on how they handle stress, loss, and other life events in the future. Learning how to untangle thoughts and feelings as a child teaches them not to fear overwhelming emotions and empowers our kids to communicate what is going on inside of them.  

      If you think your child is experiencing traumatic or complicated grief, you might consider seeking professional help. At the Refuge Center, we offer many resources to help adults and children walk toward healing.

      And don’t forget to register for Live Intentionally 2022.  The topic this year is EQUIP: The Tools You Need to Address the Teen and Mental Health Crisis.  Subject such a childhood grief and loss will be presented.




      Blog written by Masters Level Intern, Lindrel Moates and edited by Shelby Renee Rawson

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      The Church and Mental Health

      The Church and Mental Health

      The truth is, we all need a safe place to untangle our narratives, and therapy can be windshield wipers for the soul.

      What is Mental Health, really?

      “She has mental problems.” 

      How many times have you heard words like this being said about someone? Or how many times have yousaid something like that? We often say things like that without realizing what we’re actually perpetuating. 

      For decades, the topic of mental health has carried with it shame and stigma. People have thought someone with “mental health issues” is broken or having a breakdown. We have pictured someone we think of as crazy sitting in a “mental hospital.” And we fear what we don’t understand.

      We don’t know what we don’t know. 

      Mental health is actually how we think, feel, and act. It is how we handle relationships and stress. It’s the story we tell ourselves about how others feel about us. It is the little voice inside our heads that has been talking to us for as long as we can remember—whether that voice is good, bad, or somewhere in between.

      Have you ever had a business deal fall through and at 2 am lay awake thinking, Am I a failure? 

      Have you ever had a relationship fail and found yourself wrestling with the question, Was I not enough?

      Lost someone that mattered very much and wondered, How can I go on without them? 

      Had a teenager who was struggling with self-harm or an eating disorder and you felt at a loss to know how to help them? 

      These questions and the way we navigate them are our mental health. It’s not so much about what happens to us, as much as how we interpret what happens to us.  

      There is no person whose income is high enough, whose job is important enough, whose talent is great enough … to prevent them from coming to grips with these questions. There are also many things in our formative years that can impact our emotional well-being—addiction, abuse, neglect, etc. These issues do not discriminate. 

       Mental health is not about being broken. It’s not a niche issue. And it’s not something that only applies to some people. This is a topic that is applicable to 100% of humans. That means it applies to me, your best friend, your child, your pastor, your parents, and you.


      How did the pandemic impact our mental health?

      Through the pandemic, we have seen an increase in relational poverty, anxiety, depression, grief and loss, helplessness, loneliness, reminders of past trauma, toxic reactivity, substance abuse, eating disorders, suicidality, self-harm, and crisis in marriage. Every single one of those things directly affects our mental health.

      Globally, we’ve all just lived through 800 days of hard. We have experienced a shared traumatic reality, which means that our neighbors and friends likely had less capacity for empathy when we needed them. 

      It really is true that “the body keeps the score.” Our nervous systems have been impacted in significant ways. And for many people, the challenges exceeded their coping skills. “Grace tanks” ran very low.

      So from a data perspective … In 2021, Psychology Today reported that:

      • Anxiety disorders affect 40 million U.S. adults each year
      • Some 16.1 million Americans age 18 and up experience Major Depressive Disorder annually
      • Eight million adults live with PTSD in a given year


      Young people are feeling it, too.

      American adolescence is undergoing a drastic change. Three decades ago, the gravest public health threats to teenagers in the United States came from binge drinking, drunken driving, teenage pregnancy, and smoking. But today, this isn’t the case. These have since fallen sharply, replaced by a new public health concern—soaring rates of mental health disorders.

      To this point, in two articles, The New York Times reported that:

      “In 2019, 13 percent of adolescents reported having a major depressive episode, a 60 percent increase from 2007. Emergency room visits by children and adolescents in that period also rose sharply for anxiety, mood disorders and self-harm … 

      And for people ages 10 to 24, suicide rates, stable from 2000 to 2007, leaped nearly 60 percent by 2018, according to the Centers for Disease Control and Prevention.

      The decline in mental health among teenagers was intensified by the Covid pandemic but predated it, spanning racial and ethnic groups, urban and rural areas and the socioeconomic divide.”

      The New York Times, ‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens

       In a rare public advisory, in December 2021, the U.S. Surgeon General warned of a “devastating” mental health crisis among adolescents. Numerous hospital and doctor groups have called it a national emergency, citing rising levels of mental illness, a severe shortage of therapists and treatment options, and insufficient research to explain the trend.

      These “statistics” are our students, our nieces and nephews, our grandchildren, the kid bagging our groceries or making our iced coffee. These numbers are describing our children

      Of all of the painful stats, perhaps the most troubling, is that the suicide rate in Tennessee is climbing. Things are trending … in the wrong direction.

      When you get inside the most current suicide stats – you see that suicide is 4x more likely to impact men. In fact, if you are a white male in your 30s and 40s, you are at the highest risk by a long way.

      Life is consistently challenging us, and when we look at the latest data we’re seeing that life for many in our quasi-post-pandemic world can be almost unbearable.


      Why should the church care about this issue?

      Mental health is a human issue. We all have hurts, habits, and hang-ups. Every one of us will face hardship and suffering at some point in our lifetime. It’s unavoidable.

      Churches generally have impactful missions programs, focusing on the “least, the last, the lost.” 

      I would contend that our buildings and services are filled with people who look “fine” and seem “great” but are feeling like the “the least, the last, and the lost” on the INSIDE. 

      Marital crisis, anxiety and panic, addiction, loneliness, grief … These are issues every bit inside our church walls as they are outside our church walls. Even pastors are not exempt. Twenty-three percent of pastors have personally struggled with mental health conditions.

      The church community CAN act as a holy place of refuge for those who are suffering emotionally.

      The Bible is full of verses that tell us God is our hiding place. Psalm 27:5 says, “For in the day of trouble He will conceal me in His tabernacle; in the secret place of His tent He will hide me; He will lift me up on a rock.” THIS is who God is. 

      When you feel lost, when you feel less than or dead last, sometimes the only thing you want to do is hide away. And what better place to hide than in the shadow of the wings of the One who loves you and cares for you more than you could ever ask or imagine? He knows your every thought and no tear you shed goes unnoticed.

      The church should be a place where we feel seen.

      Being with Jesus—in relationship with him, in his presence—does not mean we won’t suffer. His own disciples struggled deeply with anxiety and self-doubt and one even took his own life. Abundant life in Christ is not about living without pain or having all the answers or cures. It is about trusting that God and all his provisions will be enough for us to not only survive but thrive.

      We can encourage those who suffer to seek the help they need from professionals who have the expertise to provide it. And by this we can declare the truth that God’s power is made perfect in our weakness. (2 Corinthians 12:9)

       In the church, we need more real, open, honest conversations. This strengthens our emotional muscles. When we listen to others in their pain, it gives them dignity. Telling our story with safe people begins to give our pain purpose and meaning.


      How does the church know when to refer for professional counseling services?

       Counseling is a space to process the burdens, barriers, and the shame stories of our experiences. It’s meant to be a place to become free of bondage.

      “Therefore, since we are surrounded by such a huge crowd of witnesses to the life of faith, let us strip off every weight that slows us down, especially the sin that so easily trips us up. And let us run with endurance the race God has set before us.” (Hebrews 12:1) 

      Counseling is for people:

      • who have tried typical coping skills and are still “stuck” in habits, relational conflicts, shame, blind spots, etc.
      • who are struggling to cope (not eating, sleeping well, excessive anger, depression, panic attacks, etc.) or are in acute grief
      • who want to improve their relational skills by being proactive
      • and who feel alone in their suffering or who feel too much shame to tell their story with anyone else outside the parameters of confidentiality.

      The truth is, we all need a safe place to untangle our narratives, and therapy can be windshield wipers for the soul.

      If we don’t transform our pain we will transmit it.

      Counseling can help us achieve congruence where our “insides match our outsides,” where actions and values align. Without congruence, we lack peace.

      Counseling can also help people explore their spiritual brokenness. Psalm 139: 23-24 says,  “Search me, God, and know my heart; test me and know my anxious thoughts. See if there is any offensive way in me, and lead me in the way everlasting.” 

      Some people are terrified to think that God will “search” them. In the deepest places of their soul, they consider the choices they have made in their life and wonder, Does God like me? Will He be angry with me? Will he reject me? Is he too busy with someone else? Will I be able to hear him if I seek him?  

      Counseling can be a place to process these fears and any trauma that may stand in the way of a full and rich relationship with God. You are not alone in your questioning and doubting. Sitting with somebody who hears you and sees your hard, your hurt, your unspoken struggles can open your heart to healing in ways that you can’t do in solitude and isolation.


      In addition to scripture, what are the phrases Christians and church staff can offer to someone who is hurting?

      Being a safe place for hurting people looks like this: 

      • Tell me more about that …
      • You are important in my life.
      • I am so glad you are here
      • What is happening at home?
      • I can’t begin to imagine what you are going through, but I am here for you.
      • You matter.
      • If you want to talk about how you are feeling, I will listen—No matter how long it takes.
      • If you don’t want to talk, I am happy to sit here in silence with you, or just let you have a space to cry. I am so glad to be with you.
      • You are not a burden to me.
      • I don’t understand everything about how feelings work, but I know mine always seem to be changing.
      • It sounds like you are feeling hopeless. Would you mind if I carried hope for you for a while?
      • I am so sorry for your loss.
      • I wish I had the right words, just know that I care.


      What are some things the church can do about the mental health crisis?

       #1 Host and engage in QPR or Mental Health First Aid Trainings

      Most of us would know how to help if we saw someone having a heart attack—we’d start CPR, or at the very least, call 9-1-1. But too few of us would know how to respond if we saw someone having a panic attack or if we were concerned that someone might be showing signs of self-harm, or addiction. 

      QPR: Question, Persuade, Refer. What questions to ask if you are concerned someone may harm themselves or have suicidal thoughts, steps to encourage them to seek help, and referrals to get them the support they need. (You can do a 60 min training online or free.) 

      Mental Health First Aid: Mental Health First Aid teaches you how to identify, understand, and respond to signs of mental illness and substance use disorders. It takes the fear and hesitation out of starting conversations about mental health and substance use problems by improving understanding and providing an action plan that teaches people to safely and responsibly identify and address a potential mental illness or substance use disorder. 

      When more people are equipped with the tools they need to start a dialogue, more people can get the help they need. Mental Health First Aiders can even save lives. This is an eight-hour training and can be done in person or online.

      #2 Host Mental Health Talks/Q&A’s (trauma, depression, marriage, grief and loss, media, etc.) This can consist of live or recorded sessions.

      #3 Supporting the work and initiatives of local counseling groups. Providing funding for congregants to get mental health support, seeing counseling agencies as missional, etc.

      #4 Offering your space for local support groups (grief and loss, sexual trauma, men’s emotions, etc.)

      #5 Decreasing the stigma through shared or related resources in your own bulletins/social media accounts, etc. especially suicide hotlines (800) 273-8255)

      #6 Get the support YOU need. Every leader needs a safe place. DO YOUR OWN WORK! This is not intended to be another laundry list of things added to your plate. This is about living a life of freedom and spaciousness so you can offer love and care from a place of FULLNESS and overflow. Be the healthiest version of you that YOU can be (spiritually, emotionally, physically, etc.) 

      Be intentional about having leaders, professionals, and friends in your life who ask you hard questions, give you feedback about your blind spots, and who challenge and encourage you. These are your 24/7 “iron sharpens iron” people. (Psalm 27:17) This might be a counselor, spiritual director, pastor, small group leader, Life Coach, Enneagram teacher, Celebrate Recovery or AA, other men’s groups, a learner (reading, podcasts), or your daily practices (such as the Examen, Headspace, etc.) 

      Leaders must embrace and model this first. We can’t give what we don’t have. We can’t give help if we can’t ask for it. Fundamentally, we must first be a safe/secure place for ourselves before we can offer that to others.

      It’s time to shift the mental health mindset. 

      It’s time to bring what has been hidden in darkness into the light. 

      And it’s time to accept the beautiful hard truth about mental health. 

      We can do better.

      We can be better.

      Blog written by Co-Founder and Executive Director, Amy Alexander, LMFT and edited by Shelby Renee Rawson

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      Crisis: Knowing When to Call

      Crisis: Knowing When to Call

      Simply put, a crisis is when you need serious and urgent help from others because your own ways of coping are not effective enough at the moment.

      The Refuge Center for Counseling Tweet

      On July 16th, the new number for the mental health crisis changed to an easy to remember three digit number, 988.  So many people hear about crisis resources and helplines, but never believe they will be in the situation where they need these resources for themselves. Even the word “crisis” elicits all sorts of ideas from different people. Maybe you think about someone who is suicidal or someone who seems “out of control.”

      While these are common and important examples of what a crisis might be, there are other types of crises that you may have not considered. A family who is going hungry due to lack of food resources, an elderly person in need of healthcare access, or someone who needs to get connected to metal healthcare providers are all additional examples of what a crisis may look like.

      When you experience a crisis, you may feel certain sensations in your body. Your breathing may be strained, your heart may race, or your chest may feel heavy. Internally, you may feel confused, angry, helpless, shame/guilt, vulnerable, anxious, or hopeless. It may be difficult to self-regulate during a crisis and bring your body back to its natural equilibrium state.

      Simply put, a crisis is when you need serious and urgent help from others because your own ways of coping are not effective enough at the moment.

      Many external and internal factors can lead to a moment of crisis. Perceived loss and traumatic experiences can cause someone to depend on coping and problem-solving skills to regulate. When these skills are not sufficient for the individual to return back to a state of being emotionally regulated, this increases the individual’s anxiety and fear. Often in this elevated state, external regulators such as substances, other people, or belief systems may be utilized. An individual usually comes out of crisis once the situation or internal experience is changed in some way. Making a call is one of the best ways to deescalate the situation.

      Luckily, making the call in a crisis has become simpler and easier than before. Tennessee offers two numbers, the 211 helpline and 988 hotline.

      When to call 211

      The new Tennessee helpline is now active and ready to provide callers with the resources they need. The 211 helpline is active 24/7, 365 days a year. The professionals on the other end have access to 10,000 health and human service programs, so you can be pointed towards the arms of others waiting to help. If you need immediate food, water, shelter, or safety, call 211. If you need housing or employment assistance, call 211. If you are struggling with your mental health, but not in crisis, call 211 to get mental health resources.

      When to call 988

      Another important three-digit number to remember is the 988 Mental Health Crisis and Suicide Hotline. If you or anyone you know is in crisis, especially if that includes considering suicide, calling this number will connect you with trained mental health professionals to deescalate the situation. Depending on the intensity of the need, the professional on the other end of the line will help walk you through your moment of crisis, refer you to local mental health providers, or provide you with immediate emergency services. The 988 line is there to serve you no matter if you are experiencing a panic attack or actively wanting to complete suicide. 988 also works for text or you can even chat online at

      Regardless of your circumstances, if you find yourself in a situation and don’t know the way out, just dial three numbers and speak with someone who can offer a helping hand. You don’t deserve to sit in the darkness alone, there is hope at the other end of the helpline.

      If you are unsure if you are having a crisis, it never hurts to call 211 or 988. There is no shame in saying “I need help.”

      If you do not believe you are in crisis and would like to get connected to mental health professionals, The Refuge Center for Counseling is also waiting with open arms. To make the first step and schedule an appointment, call 615-591-5262.

      If you would like additional information on the new 211 helpline, you can find it here If you would like additional information on the new 988 mental health crisis hotline, please visit

      Blog written by Master’s Level Intern, Madison Josey and edited by Weatherly Hulsey

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