Being Examples to the Flock: The Role of Church Leaders and African American Families Seeking Mental Health Care Services

Within the context of Black churches, African American clergy have a significant role in the delivery of mental health care services for parishioners and their families. Working toward better linkages between faith-based communities and more formal mental health care could help to provide more culturally sensitive and timely mental health care for African American families. Using a salient part of an integrative model (Davey and Watson in Contemp Fam Ther 30:31–47, 2008), the roles Black church leaders have historically played for African American families seeking outside mental health care services are considered. We additionally provide an example of a recent collaborative partnership with a Black church that points toward some promising directions for future research and clinical collaborations between the field of couple and family therapy and the Black church community.     

Mental health counselling in the Black American Church: reflections and recommendations from counsellors serving in a counselling ministry

The goal of this study was to examine the relationship between “The Black Church”, the mental health needs of its members, and addressing those needs from the perspective of counsellors within the church. Four in-depth interviews were conducted with members of the mental health counselling team at one large, African American-serving church in the Midwest to explore their thoughts about their church pastor’s desire to expand their current ministry to a fully operating counselling centre. The findings suggest that “the Black Church” not only has a role and responsibility in addressing the mental health needs of African Americans within and outside of the church but can also use religiosity as a facilitator rather than a barrier to mental health service use among African Americans.     

Church service roles and anticipated support among older Mexican Americans

The purpose of this study is to see how feelings of anticipated support arise in church. Anticipated support refers to the belief that coreligionists will provide assistance in the future if the need arises. This model contains the following hypothesis: (1) people who affiliate with conservative Protestant congregations will be more deeply committed to their faith, (2) individuals who are more committed to their faith will attend church more frequently, (3) people who go to church more often will be more likely to occupy church service roles, (4) those who occupy church service roles will feel more highly valued by their coreligionists, (5) individuals who feel they are valued highly by fellow church members will receive more emotional support from them, and (6) people who receive more emotional support at church will have stronger anticipated support beliefs. Data from a nationwide survey of older Mexican Americans support these hypotheses.     

Black Church Leaders’ Attitudes About Mental Health Services: Role of Racial Discrimination

Black church leaders are often first responders to mental health issues in the Black community, yet few researchers have examined their attitudes about seeking outside mental health services. In order to fill this gap, we surveyed 112 church leaders in a northeastern urban Baptist Black mega-church (22 associate pastors, 34 deacons, and 56 congregation care givers) using The National Survey of American Life. Findings suggest church leaders more often relied on the church community and alternative health services, leaders who attended church more often tended to report not receiving any outside mental health treatment, the closer church leaders felt to all Black people, the less satisfied they were with help received from formal mental health services, and leaders who experienced more racial discrimination tended to report worse overall mental and physical health. Clinical providers and Black churches should develop collaborative partnerships to better meet the needs of this community.     

Any Given Sunday: Weekly Church Attendance in a Midwestern City

I analyze the weekly attendance figures from 71 Protestant churches from across the conservative‐to‐liberal spectrum in a Midwestern city using multilevel modeling (HLM 6.0). The impact on attendance of factors that are experienced by all churches in the city (bad weather, summer, religious holidays, and secular holidays) and factors unique to individual churches (size, if the church is liturgical or nonliturgical, and denominational affiliation) are assessed to determine if all churches experience similar week‐to‐week fluctuations or if differences exist based on congregational factors. I interpret the results in light of rational choice theory and the strict church hypothesis in an effort to explain changes in church attendance from one week to the next.     

Church Attendance in Northern Ireland: Catholics and Protestants Compared

While it is widely acknowledged that Northern Ireland is a religious society, Protestants still do not attend church as often as do Catholics. The aim of the present study, therefore, was to employ the Ajzen and Fishbein framework to investigate what factors help to explain why Catholics attend church more regularly than do Protestants. To this end, 333 undergraduate students in the faculty of Social and Health Science at the University of Ulster at Coleraine and Jordanstown were surveyed. For both Catholics and Protestants, attitudes were a stronger determinant of intentions to attend church than were their perceptions of normative and control influences. Of more importance, however, was the finding that the predictive power of the model was enhanced for the Protestant group. This would seem to suggest that for Catholics, church-attending behaviour may not be so much one of reasoned action but perhaps rather more one of habit.     

Pathways to mental health care by members of a rural community in South Africa

This study explored mental health help seeking pathways followed by Black South African rural community dwellers in the Limpopo province of South Africa. Ten participants (5 females and 5 males) aged between 18 and 59 years receiving services from a rural mental health care facility in the Limpopo province were the informants. They presented with psychotic disorders?=?50%, substance-use mental disorders?=?20%, mood disorders?=?20% and epilepsy?=?10%. They completed a semi-structured one-to-one interview on their pathways to mental health care services. Data were content analysed. The results showed that help seeking pathways for mental health involve several entry points. These include the utilisation of western medicine when experiencing acute symptoms, and a preference for traditional medicine when faced with chronic but manageable symptoms. The findings suggest that families and significant others are important facilitators for individuals navigating the mental health care pathways.     

Theology Matters: Comparing the Traits of Growing and Declining Mainline Protestant Church Attendees and Clergy

Using surveys, this study gathered and examined demographic and religious characteristics of attendees and clergy of a group of growing mainline Protestant churches in Canada and compared them to those from declining mainline Protestant churches from the same geographical region and group of denominations. In total, 2255 attendees from 22 churches (13 declining and 9 growing) participated along with their church’s clergy (N = 29). Several notable differences between the characteristics of growing and declining churches were identified. When other factors were controlled for in multivariate analysis, the theological conservatism of both attendees and clergy emerged as important factors in predicting church growth.     

The impact of stigma on behavioral health care utilization among active duty service members

This study assessed the relationship between the stigma of seeking psychological help and use of outpatient behavioral health services over a 2-year period among active duty military service members initially referred for neuropsychological evaluation secondary to their histories of mild traumatic brain injury. Although research has examined how stigma predicts proxies for help-seeking (i.e., attitudes towards/intentions to use services), very little research has looked at actual behavior, and studies that do have largely focused on previous use. In this study, we examined the relationship between participants’ stigma and subsequent behavioral health use. Our results indicated that whereas greater self-stigma (i.e., negative self-judgments for seeking psychological help) was associated with attending fewer behavioral health care sessions, public stigma (i.e., perceptions of public attitudes towards people who seek psychological help) was not associated with service use. These findings support the need for addressing the self-stigma associated with seeking behavioral health care.     

Empowering Latino Church Leaders to Deal with the HIV-AIDS Crisis: A Strengths-Oriented Service Model

Ideology and attitudes of Latino church leaders in the United States toward HIV/AIDS are explored. A qualitative approach utilized with emergent categories including: a desire within the Latino church for greater acceptance of HIV/AIDS sufferers, the supposed contaminating influence of HIV/AIDS individuals over other church members, and the feelings of helplessness many church members experience in relation to the HIV/AIDS crisis. Understanding ideological resistance that prevents engagement is here identified and a strategy of empowerment of church leaders is recommended to overcome it including: adopting a strengths-oriented service model that focuses on resources religious denominations already have, as opposed to a financially driven, medically oriented service model that highlights what churches often do not have; church leaders educating health care agencies on how to use religious beliefs to motivate church members to work on behalf of HIV/AIDS patients; the power of doctrinal ideology in affecting church and civil society’s response to HIV/AIDS.     

The Church as an Agent of Help in the Battle Against Late Life Depression

Late life depression has become recognized as a serious mental health problem. Almost 1 in 6 elderly suffer (often in silence) with late life depression. New care delivery agents need to be uncovered and mobilized. Because older Americans' religious habits positively impact their sense of well-being and physical health, the church becomes an ideal medium to offer educational programming focused onprevention and early intervention. This article presents a proposal for how the church could become an agent of help to depressed elderly and their families.     

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1,090). The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief “it’s up to me to handle my own problems.” This view was endorsed by 42% in the current national sample of veterans and was found in multivariate analysis to predict less treatment seeking in the next year. Mediation analysis revealed that veterans with higher ratings of social support were less likely to believe they needed to solve mental health problems on their own, indirectly equating to higher odds of treatment use. Simultaneously, findings indicated that posttraumatic stress disorder (PTSD) had a direct effect on more mental health visits but was also associated with higher endorsement that one needed to handle one’s own problems and thus had an indirect effect of reducing mental health visits. Both social support and PTSD affected veterans’ perceptions of needing to solve one’s own problems, significantly predicted follow-up with mental health care. As a result, the findings indicate that clinicians’ should explore veterans’ belief systems about perceived treatment need as well as investigate the role of social support to improve mental health treatment utilization.     

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help‐Seeking Among East Asian Immigrants to North America

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro‐Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help‐seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help‐seeking and use of services. This paper reviews the literature on help‐seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified.     

Forging a Collaborative Relationship Between the Black Church and the Counseling Profession

In the field of counseling, there has been a growing awareness of the important role the Black church plays in African American communities. Although counseling professionals have begun recognizing the influence the Black church has in the lives of African Americans, there seems to be little information on how counselors can collaborate with African American congregations to meet the mental health needs of African American clients. The authors examine how counselors can use the psychological and social strengths of the Black church. Strategies and implications for collaborating with this institution are also discussed.     

Promoting Healthy Behavior from the Pulpit: Clergy Share Their Perspectives on Effective Health Communication in the African American Church

African Americans continue to suffer disproportionately from health disparities when compared to other ethnicities (ACS 2010; CDC 2007). Research indicates that the church and the pastor in the African American community could be enlisted to increase effectiveness of health programs (Campbell et al. in Health Edu Behav 34(6):864–880, 2007; DeHaven et al. in Am J Public Health 94(6):1030–1036, 2004). The objective of this study was to investigate African American pastors’ perceptions about health promotion in the church and how these perceptions could serve as a guide for improving health communication targeting African Americans. Semi-structured interviews with African American clergy revealed that pastors feel strongly about the intersection of health, religion and spirituality; they also believe that discussing health screening and other health issues more frequently from the pulpit and their own personal experiences will ultimately impact health behavior among congregants. This study suggests that African American clergy see themselves as health promoters in the church and believe this communication (i.e., pastor-endorsed health information materials) will impact health behavior among underserved and minority populations.     

New Church Rising

Abstract I had the privilege of participating as a Campbell Scholar at Columbia Theological Seminary in Atlanta with a group of theologians from Kenya, Egypt, Argentina, Jamaica and the US. The theme for our eight weeks together was “The Mission of the Church in an Age of Uprooted People”. This intensive time of dialogue and study helped clarify how the church as a whole has been uprooted from God's desired unity, and provided the space to reflect on the future of the global church from a congregational perspective. The result is this paper in which I explore the present state of Presbyterianism, Protestant denominationalism, and the church as a whole, while also envisioning new paths forward in our global, multicultural age.     

Church Voting Recommendations,Voter Preferences,and Political Decisions

In Switzerland, two key church institutions—the Conference of Swiss Bishops and the Federation of Protestant Churches—make public recommendations on how to vote for certain referenda. We leverage this situation to directly measure religious organizations’ power to reflect and shape human decision making. That is, using a direct measure of voters’ commitment to their religious institution, we analyze whether they are more likely to vote in line with this organization's voting recommendation. We find that these recommendations do indeed wield influence, implying that even in a secularized world, religion plays a crucial role in voting decisions. Our results hold for both aggregate and individual-level voting decisions.     

The Role of the African-American Church in Education About Teenage Pregnancy

The sharing of ideas among the church and mental health systems must be initiated when confronting the problem of education about teenage pregnancy in the African-American community.     

Mental Illness and the Ministry of the Local Church

Due to the stigma associated with mental illness in America, religious leaders and their congregations might be fearful of caring for and worshipping alongside a person with mental illness. This article recounts some of the challenges encountered by the pastor of a small congregation in attempting to provide care for a church member suffering with schizophrenia. It is proposed here that congregations need to grow in courage as they attempt to serve people who struggle with mental illness, just as people with mental illness exhibit courage in venturing out to participate in church life.