Collaboration between Clergy and Mental Health Professionals: A Review of Professional Health Care Journals from 1980 through 1999. (Research and Theory)

Article excerpt

Given the frontline role of community clergy in mental health care, this study examined how collaboration with clergy was viewed by mental health and other health professionals outside of the religious community. Searches of health care journals on Medline and PsycINFO yielded 44 articles from nonreligious journals from 1980 through 1999 that specifically addressed collaboration between clergy and mental health professionals. Seven themes were identified through content analysis, including the benefits of collaboration to each profession, the need to increase the clergy's knowledge about mental heath, and the importance of referrals. Discussion about interdisciplinary referrals significantly increased over time, [r.sub.0], (1, N = 44) = .31, p < .05).

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Clergy in our society function as frontline mental health workers. Numerous studies over the past 40 years have demonstrated that tens of millions of Americans, approximately 4 of 10 who have mental health concerns, seek assistance from clergy (Weaver, 1995). Surveys by the National Institute of Mental Health found that members of the clergy were more likely than were psychologists and psychiatrists combined to have a person with a mental health diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (third edition, revised; American Psychiatric Association, 1987) come to them for assistance (Hohmann & Larson, 1993). Further highlighting the prominent role that clergy play, the U.S. Surgeon General's 2000 report on mental health (Satcher, 2000) stated that 1 in 6 adults and 1 in 5 children annually obtained mental health services either from a health care provider, the clergy, a social services agency, or a school. This frequent use of clergy should not be a surprise, given their availability, their accessibility (Weaver, Revilla, & Koenig, 2003), and the high trust that Americans have in members of the clergy (Gallup & Lindsay, 1999). Indeed, young adults have ranked clergy higher in interpersonal skills, including warmth, caring, stability and professionalism, than they did either psychologists or psychiatrists (Schindler, Berren, Hannah, Beigel, & Santiago, 1987).

According to U.S. Department of Labor data from 1998, there were approximately 353,000 Jewish and Christian clergy serving congregations in the United States (4,000 rabbis, 49,000 Catholic priests, and 300,000 Protestant pastors). In a review of 10 studies, clergy consistently indicated that they devoted an average of 15% of their working time, based on a 50-hour work week, to pastoral counseling (Weaver, 1995). This totals approximately 138 million hours of counseling services annually, a volume that is roughly equivalent to each of the approximately 100,000 members of the American Psychological Association delivering 26.5 hours per week of services. This estimate does not take into account the 92,000 nuns in full-time religious vocation in the Roman Catholic Church (Stark & Finke, 2000), the 10,000 clinically trained hospital chaplains (VandeCreek & Burton, 2001), or clergy and religious workers from other religious traditions (e.g., Orthodox Christianity, Buddhism, Hinduism, Islam) in the United States.

Considering the widespread influence of clergy in counseling, mental health professionals can gain significant benefit from expanding their contact with clergy and other community religious professionals. Clergy are accessible helpers who have established patterns of responding to personal problems. They are often in long-term relationships with individuals and their families, a circumstance that enables them to observe changes in behavior that may indicate early signs of distress (Weaver et al., 2003). Clergy can use this knowledge to link persons in crisis with mental health professionals who have been trained in preventive interventions. This may prove particularly useful among African Americans and Hispanic Americans, because these groups have the highest rates of religious involvement in the United States (Gallup & Lindsay, 1999). …