An environment of distrust between mental health professionals and church leaders has developed. Clergy have not enthusiastically endorsed ideologies expounded by formal mental health providers or referred individuals for formal mental health services. At the same time, mental health specialists have characteristically made little attempt to include clergy or church members in their treatment for individual members of congregations when in fact such links could improve outcomes.
(Blank,. 1671) Unlike physical health programs, where links between formal care providers and community facilitators thrive in churches, mental health programs do not have strong links or trust between formal and community providers. As Blank concludes, formal attempts to ease the distrust between formal care providers and church providers can only improve the quality of care available to underserved populations.
Blank does not attempt to draw a data-driven conclusion from this study, but does speculate that urban church leaders may have more formal education and counseling training than their rural counterparts; that the quality and/or availability of formal care for Blacks is not as good as it is for whites, leading to an increased utilization of the informal care network provided by the church; and that Black churches have a more ingrained image of themselves as a primary service provider to the community (Blank, 1671).
Because of the disadvantage rural African Americans face when attempting to seek formal mental health care, the authors suggest that creativity and consensus-building among formal care providers and Black church leaders is necessary in order to create programs capable of bridging the gap caused by socioeconomic, racial and ethnic factors which prevents rural Blacks from utilizing the formal mental health care system (Blank, 1671).
Adkinson-Bradley discuss ways in which therapists can gain insight into the Black church and work toward an understanding of the Church which can lead to cooperation and increased uptake of mental health services by African-Americans. Adkinson-Bradley discusses the history and characteristics of the Black church which lead to an effective atmosphere for informal mental health care as well as a wide range of other social services, including medical care, education and literacy, economic development and prison outreach services.
The tools used in the church are also discussed; the author notes “the use of prayer as an active agent to bring physical, mental, emotional, spiritual relief and revitalization is liberally used in the worship services of most Black churches (Adkinson-Bradley , 150). ” The authors also note the importance of altar prayer and pastoral prayer rather than confession, which allows the participating congregant to have resolution rather than the more sterile redemption of the confession. This is seen as an especially important coping mechanism for African-American women.
(Adkinson , 151). Collaborative strategies between the formal care system and the church are also discussed, with specific recommendations being given to ease the connection and facilitate the relationship between the therapist and the church leaders and congregation. The authors specifically recommend beginning with an understanding of the history and origins of the Black church (Adkinson , 151). Beyond that, an assessment of the churches in the area the therapist hopes to serve should be conducted before initiating contact with the church leader.
The authors recommend determining the demographic characteristics of all churches in the area, including average age of congregants, average socioeconomic status and willingness of the church leadership to participate in community mental health programs as well as the church’s current involvement in community programs and the resources available for the programs (Adkinson , 152). This includes involvement in traditional pastoral services, such as grief management support offered by African-American funeral directors, as well as links to the formal mental health care system (Adkinson ,1 52).
Therapists are also instructed by the authors to cultivate personal relationships within the community rather than remaining a formal resource. The authors suggest that a group or agency which wishes to provide services to an African-American church congregation should appoint a counselor to act as liaison between the agency and the church, creating a personal relationship rather than a business relationship with the church leader.
This not only allows the therapist and the church leader to become personally familiar with each other and develop a relationship of trust, but it helps the church leader to tailor the services offered to his church in order to make the most impact. The therapist can also offer support and guidance to the church leader, offering knowledge about signs and symptoms of mental health issues as well as guidance on where to obtain formal care assistance for his congregants (Adkinson, 152).
A close relationship between the therapist and the church leader also allows exploration of traditional coping mechanisms and other therapeutic offerings of the church, such as prayer and music, in order to maximize their benefit for congregants in need. Finally, the authors note that respect for the traditions and practices of the church are essential for maintaining a rapport with the congregants.
Specific examples cited are ensuring that ministers, church leaders, elders and congregants who have earned advanced degrees must be referred to by their formal titles; and that in most Black churches, it is inappropriate for a child to refer to an adult using only their first name; counselors should not encourage undue formality by children by asking to be referred to by their first names, but rather should conform to church norms of “Miss” or “Miz”, “Brother”, or “Sister” (Adkinson , 153). Cultural sensitivity and observance of social norms are seen as vital for gaining the trust of the congregants as well as the clergy.