A small but growing literature recognizes the varied roles that clergy play in identifying and addressing mental health needs in their congregations. Although the role of the clergy in mental health services delivery has not been studied extensively, a few investigations have attempted a systematic examination of this area. This article examines the research, highlighting available information with regard to the process by which mental health needs are identified and addressed by faith communities. Areas and issues where additional information is needed also are discussed. Other topics addressed include client characteristics and factors associated with the use of ministers for personal problems, the role of ministers in mental health services delivery, factors related to the development of church-based programs and service delivery systems, and models that link churches and formal services agencies. A concluding section describes barriers to and constraints against effective partnerships between churches, fo rmal services agencies, and the broader practice of social work.
Key words: African American; help seeking; ministers; pastoral care; referral; religion
Sociology and social work have a long tradition of documenting the centrality of religious concerns and institutions in black communities for some time (Frazier, 1974; Lincoln & Mamiya, 1990; Mays & Nicholson, 1933). Collectively, this documentation suggests that faith communities have occupied a primary role in black communities, encompassing a broad range of issues, including civic and political concerns, educational pursuits, and economic and community development. Empirical findings indicate that religion has a special prominence in the lives of African Americans, with churches assuming a particularly influential role. Survey evidence demonstrates that nearly nine of 10 black Americans view black churches as fulfilling multifaceted roles in black communities and as having a positive influence on their lives (Taylor, Thornton, & Chatters, 1987). Black adults display high levels of religiosity across a variety of religious indicators, including church membership rates and frequency of public behaviors such as church attendance, as well as private devotional practices (for example, prayer and reading religious materials) (Ellison & Sherkat, 1995; Taylor, 1988a, 1988b; Taylor & Chatters, 1991).
An equally long tradition of faith-based initiatives and work in black communities has been concerned with the health and well-being of individuals and families (Gilkes, 1980; Levin, 1984; Olson, Reis, Murphy, & Gem, 1988). The past few years have seen a general resurgence of interest in the connections between religious involvement and a range of human behaviors among African Americans and the general population. Social sciences research documents associations between religious involvement and a variety of attitudinal and behavioral outcomes, including marital quality and duration (Call & Heaton, 1997; Heaton & Pratt, 1990; Lehrer & Chiswick, 1993), receipt of social support (Taylor & Chatters, 1988), contraceptive use (Goldscheider & Mosher, 1991), and fertility (Mosher, Williams, & Johnson, 1992). A growing literature shows that religious factors are linked with specific behaviors affecting health, such as drug, alcohol, and tobacco use (Brown & Gary, 1994; Cochran, Beeghley, & Bock, 1988; Gottlieb & Gree n, 1984), as well as the use of health care services (Levin, Chatters, Ellison, & Taylor, 1996; Levin & Vanderpool, 1992). In addition, studies indicate that religious involvement is associated positively with life satisfaction, self-esteem, and other aspects of well-being (Ellison, 1993; Thomas & Holmes, 1992) and self-rated health (Musick, 1996) and is related inversely to depression and distress (Brown, Ndubuisi, & Gary, 1990), long-term physical disability (Idler & Kasl, 1997), and mortality risk (Bryant & Rakowski, 1992; Strawbridge, Cohen, Shema, & Kaplan, 1997). …