Americans are in a mental health crisis – especially African Americans. Can churches help?

Americans are in a mental health crisis – especially African Americans. Can churches help?

Americans are in a mental health crisis – especially African Americans. Can churches help?

The 160-year-old John Wesley AME Zion Church is one of the few predominantly African American churches that still exists in downtown Washington, D.C. Marvin Joseph/The Washington Post via Getty Images
Brad R. Fulton, Indiana University

Centuries of systemic racism and everyday discrimination in the U.S. have left a major mental health burden on African American communities, and the past few years have dealt especially heavy blows.

Data from the Centers for Disease Control and Prevention indicate that Black Americans are twice as likely to die of COVID-19, compared with white Americans. Their communities have also been hit disproportionately by job losses, food insecurity and homelessness as a result of the pandemic.

Meanwhile, racial injustice and high-profile police killings of Black men have amplified stress. During the summer of 2020, amid both the pandemic and Black Lives Matter protests, a CDC survey found that 15% of Black respondents had “seriously considered suicide in the past 30 days,” compared with 8% of white respondents.

For a variety of reasons, many African Americans face barriers to mental health care. But as a sociologist who focuses on community-based organizations, I find that strengthening relationships between churches and mental health providers can be one way to increase access to needed services. In research with my collaborators Eunice Wong and Kathryn Derose, I analyzed data on the prevalence of mental health care provision among religious congregations and found that many African American congregations offer such programs.

Need versus access

Roughly 1 in 5 Americans experience mental illness in a given year. Yet fewer than half of adults with a mental health condition receive mental health services.

African Americans utilize mental health services at about one-half the rate of white Americans. In part, this underuse may stem from African Americans’ often fraught relationship with medical establishments in the U.S., given their histories of racial bias and malpractice against people of color. Part of the reason may also derive from stigma among some African Americans perceiving mental illness and seeking help as signs of weakness. Treatment “deserts” where mental health providers are scarce may also be a factor.

Students participate in an activity about mental health and suicide prevention at Uplift Hampton Preparatory School in Dallas.
Students participate in an activity about mental health and suicide prevention at Uplift Hampton Preparatory School in Dallas in 2018. AP Photo/Benny Snyder

Care at church

One often overlooked resource for mental health care, however, are churches. For the past decade, the National Congregations Study has documented the prevalence of mental health care provision among places of worship in the U.S. Based on data from the NCS’ 2018 survey, 26% of congregations provide mental health programming, and 37% of people who attend religious services attend one of these congregations. Such programming can include support groups, meetings and classes focused on addressing mental health concerns.

Previously, my co-researchers and I analyzed 2012 NCS data to better understand mental health resources within religious congregations. One of our goals was to identify factors that contribute to a congregation offering mental health care. These factors include having more members, employing staff for social service programs and providing health-focused programs. Other significant predictors include conducting community needs assessments, hosting speakers from social service organizations and being located in a predominantly African American community.

Based on the new 2018 survey, 45% percent of African American congregations offer some form of mental health service and nearly half of all African American churchgoers attend a congregation with such programs. These rates show an increase since 2012, and are roughly 50% greater than those among predominantly white congregations.

This research supports longstanding observations about African American congregations as critical sources of spiritual, emotional and social support for their communities. Many religious people see their spiritual health and mental health as intertwined, and research indicates that spiritual practices, such as prayer and meditation, can also support mental health.

Strengthening support

Our research suggests that building collaborations between African American congregations and the mental health sector is a promising strategy to increase access to needed services. Given that 61% of African Americans say they attend worship services at least a few times a year, congregations may provide an accessible resource.

At times, pairing religion and mental health may prove harmful. Some congregations see mental health problems as a product of personal sin, for example, and stigmatize people suffering from mental illness.

[This week in religion, a global roundup each Thursday. Sign up.]

But congregations can also be helpful environments. When clinical treatment is supplemented with social support, the likelihood of successful outcomes is greater, and houses of worship often provide built-in social networks. People participating in a congregation-led grief recovery group, for example, can be involved in the congregation beyond their weekly meeting. In addition, some mental health professionals provide pro bono services for congregation-based programs.

Social worker Victor Armstrong, the director of North Carolina’s Division of Mental Health, Developmental Disabilities and Substance Abuse Services, asserts that African American faith leaders can play a “pivotal role” in mental wellness. He suggests shifting language to focus on “wellness” rather than “illness” in order to decrease stigma, among other recommendations.

Greater collaboration between congregations and mental health providers could help stem the growing mental health crisis, particularly within African American communities.The Conversation

Brad R. Fulton, Associate Professor, Indiana University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Republicans Want Health Care, Too

Republicans Want Health Care, Too for urban faithI’m a registered Republican. I didn’t vote for Barack Obama. I believe in free-market enterprise. I like smaller government. There, I said it. It’s out!

That said, I think government plays essential roles in any civilized society. Defense, interstate highways, basic education to name a few. And there is one more role I would add to the list. Health care!

I know we have the most advanced medical treatment in the world — and the most expensive. I wouldn’t want to see it compromised. But I have to admit that something is wrong with the picture when the working poor and a sizable portion of the middle class don’t have access to these benefits. I am coming to believe what the rest of the modern world has concluded — that health care is a basic human right. To be last in line of industrialized nations to provide medical treatment for all our citizens is not something I am proud of.

I like government close to home. That’s one reason I’m a Republican. But I also have to admit that Social Security has served us fairly well, and I have no real complaints about how my Medicare is working. Oh, yes, the bureaucratic paperwork is aggravating and I hate talking to a computerized recording, but I guess that’s not too different from the way most large corporations function these days.

I seriously doubt that health-care reform can be accomplished without raising our taxes, but, frankly, that’s one of the taxes I wouldn’t mind paying. Compared to the costly wars we have funded recently, health care seems like a rather redemptive investment.

Do I like what Obama is proposing? Actually, I do. While I wouldn’t want a government takeover of our health-care system, I do see the value in a system that insures every citizens’ access to competent medical treatment.

Obviously it’s a very complex issue. And I’d be the first to acknowledge my ignorance in many of the complicated realities of this confusing medical world. I do know, however, that it makes no sense to see my low-income neighbors go to the hospital emergency room for ailments that could be treated inexpensively in a community clinic. And I do know from personal experience that physicians prescribe expensive and unnecessary procedures just to protect themselves from lawsuits. I guess these are a couple of the reasons why they say the system is broken.

I like competition. That’s one reason I like what Obama is proposing. I think I’m ready to let the government give health care a try. Our free-enterprise approach, while propelling us to the top spot in medical advances, has failed to figure out a system that shares the benefits with the whole of society. And that’s a justice issue.

Say what you will about Obama, on this one I believe he’s on the right side. We may disagree strongly about his politics and his methods, but his push to see that all citizens are being rightly cared for — especially the poor — is a push in the right direction.

And I’m still a Republican.

The Heart of Reform

Five reasons why the church should support health-care reform. An urban pastor’s view.

The Heart of Reform for urban faithI approach the discussion about health-care reform from the perspective of an urban minister. I’ve worked with urban core neighbors, neighborhoods, congregations, and community groups for more than 20 years. I’ve watched people struggle to access basic health services in the shadow of world-class hospitals. I know hardworking people caught in the “catch-22” level of income: They make too much to access Medicaid but too little to afford health insurance premiums. They work for companies that either don’t offer health insurance or offer it partially at a level these employees can’t afford.

Workers are forced to use a patchwork of health fairs, free clinics, and doctors who will see them occasionally without cost (God bless these). They put off illness or pain until it becomes chronic or unbearable and then make a dash to an emergency room. The health costs they incur are a greater portion of their household income than most Americans. The cost to their dignity is inestimable. But the cost to America’s integrity is even higher.

At the same time, I know that health-care costs are spiraling upward for higher-wage neighbors. The monthly cost for my family’s health insurance is higher than our mortgage payment. Our benefits are stripped down and our co-pays and deductibles are higher than ever.

I know people whose prescriptions are no longer covered, whose important procedures are denied, and whose insurance has been dropped. Many people have filed bankruptcy due in large part to unpayable medical bills.

In short, while the health-care system has not been working for the working poor for a long time, it is not working for more and more middle-income neighbors. None of this begins to factor in the significant levels of abuse of the system by those who game it — professional health-care providers, the insurance industry, and consumers of health-care services. The current system is not sustainable, it is not reasonable, it is not just. It does not reflect what we know is best about or for America.

So, I am completely on board with the call for quality, accessible, affordable health care for all citizens. I’m advocating for this from the perspective of an urban Christian minister on the one hand, and as an American citizen on the other.

As a Christian minister, I am convinced that quality, accessible, affordable health care for all is a moral imperative. As an American citizen, I am personally convinced it is a right that’s implied in the very intent of our Constitution and historic social contract. But it is as a Christian minister that I offer the following considerations on health-care reform to the church I love:

1. The Samaritan principle sets the tone for the Christian church regarding care for the poor, uninsured, and desperate in our land. Simply put, in the care a Samaritan extends to a wounded, helpless victim, Jesus declares what it means to be an authentic neighbor. If we have the resources to help and heal, we should. Not because we’ll get reimbursed. Not because there’s profit involved. Not because we’ll get recognized or rewarded. But because it reflects the caring, healing intention of God for God’s people in relationship to one another and in witness to the world.

We cannot pass by because we presume somebody else will take care of uninsured people. We cannot ignore what’s happening because it’s just bigger than us or beyond us. Jesus calls us to see, respond, help, comfort, and restore — as if those left out and wounded were our very own.

2. Jesus’ ministry of healing was conducted in the face of structures and regulations designed to control, limit, and exclude. I’ve been reading the Gospels again during this time of national concern about health care. Health and healing was front and center for Jesus. Undoubtedly, Jesus’ healings were a sign that he was the anticipated Messiah and that a new era was beginning. However, Jesus’ healings also confronted, exposed, and undermined age-old systems that, in the name of health care, prevented healing from occurring.

Jesus cut through the red tape, system-serving regulations, and control-oriented rituals to actually offer what God desired for people — healing, restoration, and a future of dignity and hope. Instead of defending the current status quo practices that place ordinary folks in similar binds, the people who follow and claim to reflect Jesus should consider how he judged and exposed the ineffectiveness and meanness of structures that served themselves at others’ expense.

3. The context of community, inclusion, and sharing resources to assist the neediest — central in the early church witness — is a pattern and principle to renew. Beginning with Acts 2, we see the earliest believers holding things in common, pooling resources, and selling off assets in order to meet the needs of the weakest among them. It was not about me and mine, but we and ours. In the perspective of that early faith community, my personal self-interest includes your well-being. They realized that we are deeply interconnected with one another.

The apostle Paul affirmed this principle with his counsel to the church in Corinth that we are members of one another, that no part can say to another, “I don’t need you.” To what extent are there such awarenesses or practices in the church today? And to what extent is our sense of community — over against asserting individual privilege and private rights — bearing witness to the larger community and nation of what is good, possible, and godly?

4. Christian leaders should be leading the health-care dialogue by seeking the truth and speaking the truth. To this point, it doesn’t seem to me that there has been a debate or dialogue about health-care reform. Much of the so-called debate to this point has focused on myths, distortions, and outright lies about proposed health reform legislation. The news media focus has been on misinformed people shouting down congressional leaders, calling them Nazis, and burning them in effigy.

I’m convinced Christians should not only not be a part of those scenarios, but that we should make a contribution to the dialogue that is fact-based, truth-seeking, civil, and that moves all to find the common ground necessary to ensure that quality, accessible, affordable health care is available to all American citizens.

If the news media or partisan groups play to distortions and extremes, then people of Christian faith have a significant role to get the facts, convey them in understandable ways, and create conversations that deal in what’s real. We are the people whose scriptures declare, “you will know the Truth and the Truth will set you free” (John 8:32). We are the people who are reminded that “God has given us, not a spirit of fear, but of power, of love, and of self-discipline” (2 Tim. 1:7).

5. Let us embody and advocate for the principles, practices, and norms of the beloved community toward which Jesus pointed. Christians have no stake in propping up old-order systems, or aligning ourselves with self-serving institutions, or playing to sub-Christian social stratifications. At personal, community, and systemic levels, Christians are challenged to practice now the norms and promises of the future described in the Scriptures.

I love the way Bible scholar Walter Brueggemann puts it: “God’s future is enacted as present neighborliness.”

Is not quality, accessible, affordable health care for all one such act of “present neighborliness” that is a signal of the direction God intends the future to move? I think so. And I invite Christians and people of other faiths to join me and others in this kairos moment — this period of unique opportunity to witness something magnanimous and restorative in our generation.

This article appears courtesy of a partnership with Sojourners.