Recognizing Mental Health Concerns in Kids and Teens
Not all youth pastors are equipped to recognize and address mental health concerns. Many youth pastors feel incompetent when dealing with mental health concerns and feel shame in asking for help.
By Drew Ryan
May 28, 2026
What do you say to the 15 year old girl sitting across from you who buries her face in her hands, sobbing uncontrollably upon telling you her uncle has been sexually abusing her?
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How do you respond when you find out the next morning that the happy, go-lucky, free-spirited 22 year old who used to regularly attend your youth group died by suicide a couple of nights ago. "Did I miss something? Was something there? Were there warning signs? How did I miss it? Surely, they have the wrong name? Surely something happened after high school to have caused this?"
Or
What do you do when the 13 year old who shares in confidence that they have thoughts of ending their life but no plan or means or any real desire to hurt themselves, and that "it only happens when things at home are bad"? How do you respond when you're told that "you're the only one I can trust"? Inevitably, your inner dialogue goes a little something like this: "Do I disclose to this kid's parents? They just said that it only happens when things at home are bad. What does 'bad' even mean? What would they do to this kid if they knew? Should I tell our pastor? They said 'I' am the only one they trust. What if they follow through and did hurt themselves? Would I make it worse if I did tell? I don't know what to do."
Youth pastors serve oftentimes as a first responder to kids and teens in mental health crises. Churches oftentimes look to youth pastors when there is a mental health crisis in a teen. Parents deflect responsibility off to youth leaders when feeling powerless in their relationships with their teenagers. The message? Fix my kid, because I can't. But how do you fix a kid? What does that even mean? And how do you even begin to help?
Youth pastors and youth leaders commonly feel inadequate and ill-equipped to provide care to adolescents in mental health crises. According to a study published in the journal Mental Health, Religion & Culture, entitled "Adolescent mental health: the role of youth and college pastors”
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50 percent said they had received training related to mental illness, but only 26 percent reported they felt qualified to work with young people dealing with significant mental health issues.
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78.7 percent had worked with one to 10 adolescents a year whom they knew or thought had mental health issues.
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76 percent had referred an adolescent congregant to a Christian counselor, a psychologist or a psychiatrist, but pastors who made referrals were most likely to do so to a Christian counselor. (1)
Many graduate from Bible colleges or seminaries who struggle to adequately equip their students with proper clinical care techniques to address the copious amount of mental health concerns kids and teens and their parents face. At times, depending on the church, churches are mistrusting at best of secular psychotherapy, thinking secular psychotherapy will indoctrinate their kids, and completely dismissive at worst, stating secular psychotherapy is not Biblical, therefore regarding secular psychotherapy irrelevant, as it conflicts with personal worldviews(2). Lead pastors themselves who are entrusted with the pastoral care of their parishioners often discourage secular psychotherapy, resulting in youth workers with a sense of fear, afraid of losing their job. Youth leaders, who are in direct care of the adolescent, are then left with a lack of both internal and external resources and feeling stuck with little to no direction. Shame inescapably permeates the worker, reinforcing messages of "I am not good enough," "I am not enough," and "I don't have what it takes."
3. Hunter, William & Stanford, Matthew. (2014). Adolescent mental health: the role of youth and college pastors. Mental Health. 17. 10.1080/13674676.2014.966663.
