Engaging the Faith Community in Designing a Church-Based Mental Health Screening and Linkage to Care Intervention
Keywords:mental health, African Americans, mental health screening, linkage to care, churches
African Americans are disproportionately burdened by mental health issues (e.g., stress, chronic depression, and post-traumatic stress disorder). Upon review of mental health local/state/national data, a highly-engaged faith-based Community Action Board (CAB) raised concerns about the mental health needs of African Americans and addressed mental health as a priority health area in African American Kansas City churches. African Americans tend to experience barriers to mental health services (e.g., limited access, high cost, mental health-related stigma, non-culturally tailored mental health care). African American churches have many strengths that could increase reach, acceptability feasibility, and impact of mental health interventions tailored for African Americans. The CAB conducted a health needs assessment survey (N=463; 11 churches) to identify health concerns and potential strategies to inform the design of a church-based mental health intervention. Using a faith-community-engaged approach, the CAB developed the survey and used its findings to design a religiously-tailored, multilevel mental health intervention focused on prevention, screening, and linkage to care. The needs assessment identified intervention strategies (e.g., church-based screening, stress reduction/exercise programs, pastors promoting mental health) that were: (1) rated as highly important/feasible to implement, (2) included in the intervention design, and (3) successfully implemented in African American churches by faith leaders and university students and faculty.
Agency for Healthcare Research and Quality. (2010). 2010 National Healthcare Disparities Report, Rockville, MD. Retrieved from https://archive.ahrq.gov/research/findings/nhqrdr/nhdr10/index.html
Bauer, A. G., Berkley-Patton, J., Bennett, K., Catley, D., Bowe-Thompson, C., Lister, S., & Christensen, K. (2019). Dietary Intake Among Church-Affiliated African Americans: The Role of Intentions and Beliefs. Journal of Black Psychology, https://doi.org/10.1177/0095798419887629
Berkley-Patton, J., Bowe Thompson, C., Bauer, A. G., Berman, M., Bradley-Ewing, A., Goggin, K., ...Allsworth, J. E. (2020). A Multilevel Diabetes and CVD Risk Reduction Intervention in African American Churches: Project Faith Influencing Transformation (FIT) Feasibility and Outcomes. Journal of Racial and Ethnic Health Disparities, 1-12. https://doi.org/10.1007/s40615-020-00740-8
Berkley-Patton, J., Thompson, C. B., Bradley-Ewing, A., Marcie, B., Booker, A., Catley, D., … Petty, T. (2018). Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment. Evaluation and Program Planning, 67, 19. https://doi.og/10.1016/j.evalprogplan.2017.10.012
Briggs, H. E., Briggs, A. C., Miller, K. M., & Paulson, R. I. (2011). Combating persistent cultural incompetence in mental health care systems serving African Americans. Best Practices in Mental Health, 7(2), 1-25. https://doi.org/10.1177/0886109914531957
Bronfenbrenner U. The ecology of human development: Experiments by design and nature. In: Cambridge, MA: Harvard University Press; 1979.
Brown, J. A. (2004). African American church goers' attitudes toward treatment seeking from mental health and religious sources: The role of spirituality, cultural mistrust, and stigma toward mental illness. The University of North Carolina at Chapel Hill,
Burton, W. M., White, A. N., & Knowlden, A. P. (2017). A systematic review of culturally tailored obesity interventions among African American adults. American Journal of Health Education, 48(3), 185-197. https://doi.org/10.1080/19325037.2017.1292876
Campbell, M. K., Hudson, M. A., Resnicow, K., Blakeney, N., Paxton, A., & Baskin, M. (2007). Church-based health promotion interventions: evidence and lessons learned. Annu. Rev. Public Health, 28, 213-234. https://doi.org/10.1146/annurev.publhealth.28.021406.144016
Caret, R. L. (2019). Social responsibility and civic readiness as critical higher education outcomes. Metropolitan Universities, 30(4), 9-16. https://doi.org/10.18060/23551
Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. HHS Publication No. SMA 15-4927, NSDUH Series H-50. Retrieved from https://www.samhsa.gov/data/
Chatters, L. M., Mattis, J. S., Woodward, A. T., Taylor, R. J., Neighbors, H. W., & Grayman, N. A. (2011). Use of ministers for a serious personal problem among African Americans: Findings from the National Survey of American Life. American Journal of Orthopsychiatry, 81(1), 118-127. https://doi.org/10.1111/j.1939-0025.2010.01079.x
Christensen, K., Berkley-Patton, J., Shah, B., Aduloju-Ajijola, N., Bauer, A. G., Bowe Thompson, C., & Lister, S. (2020). HIV risk and sociodemographic factors associated with physician-advised HIV testing: What factors are overlooked in African American populations? . Journal of racial and ethnic health disparities, 7(1), 121-128. https://doi.org/10.1007/s40615-019-00641-5
Clements, J. M., West, B. T., Yaker, Z., Lauinger, B., McCullers, D., Haubert, J., . . . Everett, G. J. (2020). Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race. Diabetes Research and Clinical Practice, 159, 107984. https://doi.org/10.1016/j.diabres.2019.107984
Cochrane, J. R. (2006). Conceptualising religious health assets redemptively. Religion and Theology, 13(1), 107-120. https://doi.org/10.1163/102308012X13397496507900
Compton, M. T., Thompson, N. J., & Kaslow, N. J. (2005). Social environment factors associated with suicide attempt among low-income African Americans: The protective role of family relationships and social support. Social psychiatry and psychiatric epidemiology, 40(3), 175-185. https://doi.org/10.1007/s00127-005-0865-6
Corrigan, P. W. (2020). Community-based participatory research (CBPR), stigma, and health. Stigma and Health, 5(2), 123. https://doi.org/10.1037/sah0000175
Cruz, M., Pincus, H. A., Harman, J., Reynolds III, C. F., & Post, E. P. (2008). Barriers to care-seeking for depressed African Americans. The International Journal of Psychiatry in Medicine, 38(1), 71-80. https://doi.org/10.2190/PM.38.1.g
Delphin-Rittmon, M. E., Flanagan, E. H., Andres-Hyman, R., Ortiz, J., Amer, M. M., & Davidson, L. (2015). Racial-ethnic differences in access, diagnosis, and outcomes in public-sector inpatient mental health treatment. Psychological Services, 12(2), 158. https://doi.org/10.1037/a0038858
Derose, K. P., Williams, M. V., Branch, C. A., Flórez, K. R., Hawes-Dawson, J., Mata, M. A., . . . Wong, E. C. (2019). A community-partnered approach to developing church-based interventions to reduce health disparities among African-Americans and Latinos. Journal of racial and ethnic health disparities, 6(2), 254-264. https://doi.org/10.1007/s40615-018-0520-z
Glasgow, R. E., McKay, H. G., Piette, J. D., & Reynolds, K. D. (2001). The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient education and counseling, 44(2), 119-127. https://doi.org/10.1016/s0738-3991(00)00186-5
González, H. M., Tarraf, W., Whitfield, K. E., & Vega, W. A. (2010). The epidemiology of major depression and ethnicity in the United States. Journal of psychiatric research, 44(15), 1043-1051. https://doi.org/10.1016/j.jpsychires.2010.03.017
Hankerson, S. H., Fenton, M. C., Geier, T. J., Keyes, K. M., Weissman, M. M., & Hasin, D. S. (2011). Racial differences in symptoms, comorbidity, and treatment for major depressive disorder among black and white adults. Journal of the national medical association, 103(7), 576-584. https://doi.org/10.1016/S0027-9684(15)30383-7
Himle, J. A., Baser, R. E., Taylor, R. J., Campbell, R. D., & Jackson, J. S. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States. Journal of anxiety disorders, 23(5), 578-590. https://doi.org/10.1016/j.janxdis.2009.01.002
Hollingsworth, D. W., Cole, A. B., O'Keefe, V. M., Tucker, R. P., Story, C. R., & Wingate, L. R. (2017). Experiencing racial microaggressions influences suicide ideation through perceived burdensomeness in African Americans. Journal of Counseling Psychology, 64(1), 104. https://doi.org/10.1037/cou0000177
Howard, G., Moy, C. S., Howard, V. J., McClure, L. A., Kleindorfer, D. O., Kissela, B. M., . . . Safford, M. M. (2016). Where to Focus Efforts to Reduce the Black–White Disparity in Stroke Mortality: Incidence Versus Case Fatality? Stroke, 47(7), 1893-1898. https://doi.org/10.1161/STROKEAHA.115.012631
Hudson, D. L., Neighbors, H. W., Geronimus, A. T., & Jackson, J. S. (2016). Racial discrimination, John Henryism, and depression among African Americans. Journal of Black psychology, 42(3), 221-243.https://doi.org/10.1177/0095798414567757
Idler, E., Levin, J., VanderWeele, T. J., & Khan, A. (2019). Partnerships between public health agencies and faith communities. American Journal of Public Health, 109(3), 346-347. https://doi.org/10.2105/AJPH.2018.304941
Israel, B. A., Eng, E., Schulz, A. J., & Parker, E. A. (2013). Methods for community-based participatory research for health. San Francisco, CA: Josey-Bass.
Kasper, J. D., Ensminger, M. E., Green, K. M., Fothergill, K. E., Juon, H.-S., Robertson, J., & Thorpe, R. J. (2008). Effects of poverty and family stress over three decades on the functional status of older African American women. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(4), S201-S210.https://doi.org/10.1093/geronb/63.4.S201
Lucas, T., Manning, M., Hayman, L. W., & Blessman, J. (2018). Targeting and tailoring message-framing: the moderating effect of racial identity on receptivity to colorectal cancer screening among African–Americans. Journal of behavioral medicine, 41(6), 747-756. https://doi.org/10.1007/s10865-018-9933-8
Mezuk, B., Rafferty, J. A., Kershaw, K. N., Hudson, D., Abdou, C. M., Lee, H., . . . Jackson, J. S. (2010). Reconsidering the role of social disadvantage in physical and mental health: stressful life events, health behaviors, race, and depression. American journal of epidemiology, 172(11), 1238-1249. https://doi.org/10.1093/aje/kwq283
Michalak, E. E., Jones, S., Lobban, F., Algorta, G. P., Barnes, S. J., Berk, L., . . . Maxwell, V. (2016). Harnessing the potential of community-based participatory research approaches in bipolar disorder. International journal of bipolar disorders, 4(1), 1-9. https://doi.org/10.1186/s40345-016-0045-5
National Alliance on Mental Illness. (2016). Why faith is so important for African American mental health. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/February-2016/Why-Faith-Is-Important-to-African-American-Mental
National Center for Health Statistics. (NCHS; 2016a). Health, United States, 2015: With special feature on racial and ethnic health disparities Retrieved from https://www.cdc.gov/nchs/data/hus/hus15.pdf
National Center for Health Statistics. (NCHS; 2016b). Summary health statistics: National health interview survey: 2014, Table A-7. Retrieved from http://www.cdc.gov/nchs/nhis/shs/tables.htm.
Patton, D. U., Woolley, M. E., & Hong, J. S. (2012). Exposure to violence, student fear, and low academic achievement: African American males in the critical transition to high school. Children and Youth Services Review, 34(2), 388-395. https://doi.org/10.1016/j.childyouth.2011.11.009
Peterson, T. H. (2014). Reviving and revising the civic mission: A radical re-imagining of "civic engagement." Metropolitan Universities, 25(3), 17-30. Retrieved from: https://journals.iupui.edu/index.php/muj/article/view/20579/20179
Pew Research Center. (2015). American’s changing religious landscape. Retrieved from http://www.pewforum.org/files/2015/05/RLS-05-08-full-report.pdf
Plummer, B. (2012). The cost of untreated mental illness in greater Kansas City Retrieved from https://healthforward.org/wp-content/uploads/2015/11/overview-cost-untreated-illness-greater-kansas-city.pdf
Resnicow, K., Campbell, M. K., Carr, C., McCarty, F., Wang, T., Periasamy, S., . . . Stables, G. (2004). Body and soul: a dietary intervention conducted through African-American churches. American journal of preventive medicine, 27(2), 97-105.https://doi.org/10.1016/j.amepre.2004.04.009
Rogers, G. (2007). Exploring the relationship between religiosity and attitudes towards seeking mental health help among African American churchgoers.
SAMHSA. (2015). Results from the 2014 national survey on drug use and health: Mental health detailed tables. Retrieved from http://www.samhsa.gov/data/population-data-nsduh/reports?tab=38.
Sattin, R. W., Williams, L. B., Dias, J., Garvin, J. T., Marion, L., Joshua, T. V., . . . Narayan, K. V. (2016). Community trial of a faith-based lifestyle intervention to prevent diabetes among African-Americans. Journal of community health, 41(1), 87-96. https://doi.org/10.1007/s10900-015-0071-8
Sharma, A. (2000). A community needs assessment guide: A brief guide on how to conduct a needs assessment: Loyola University Chicago Center for Urban Research and Learning.
Ward, E., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women's attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing research, 62(3), 185. https://doi.org/10.1097/NNR.0b013e31827bf533
Ward, E. C., Clark, L. O., & Heidrich, S. (2009). African American women’s beliefs, coping behaviors, and barriers to seeking mental health services. Qualitative health research, 19(11), 1589-1601. https://doi.org/10.1177/1049732309350686
Watkins, D. C., Assari, S., & Johnson-Lawrence, V. (2015). Race and ethnic group differences in comorbid major depressive disorder, generalized anxiety disorder, and chronic medical conditions. Journal of racial and ethnic health disparities, 2(3), 385-394. https://doi.org/10.1007/s40615-015-0085-z
Williams, D. R., Gonzalez, H. M., Neighbors, H., Nesse, R., Abelson, J. M., Sweetman, J., & Jackson, J. S. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the National Survey of American Life. Archives of general psychiatry, 64(3), 305-315.https://doi.org/10.1001/archpsyc.64.3.305
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: evidence and needed research. Journal of behavioral medicine, 32(1), 20-47. https://doi.org/10.1007/s10865-008-9185-0
Copyright (c) 2021 Jannette Berkley-Patton, Ph.D., Carole Bowe Thompson, Dr. Joah Williams, Kelsey Christensen, Cassandra Wainwright , Rev. Eric Williams , Andrea Bradley-Ewing, Alexandria Bauer, Dr. Jenifer Allsworth
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