Research That Matters (January 17 - 20, 2008)

In the National Survey of American Life (NSAL), 55% of the African-Americans with a diagnosable depression surveyed received no treatment for depression during their lifetime (Williams et al., 2007). Although depression is an issue affecting all races, the literature has noted that underutilization of mental health services among African-Americans continues to be an issue.

Differences exist in mental health help-seeking practices among African-Americans (Alvidrez, 1999; Hu, Snowden, Jerrell, & Nguyen, 1991; Moran, 2004; N.A.M.I., 2005). African-Americans make greater use of emotional assistance outside of traditional mental health settings, such as through ministers, for mental health problems (Cooper, Brown, Vu, Ford, & Powe, 2001 ; N.A.M.I., 2005). This qualitative text analysis explores how African-American Pentecostal ministers discuss depression in sermons they preached to congregations, with the purpose of exploring if the discussion was different than, or in concert with, views held by mental health professionals.

Methods:

A qualitative text analysis of 90-minute sermons from ten African-American Pentecostal ministers was conducted to explore the views on depression expressed in the sermon texts. The sermons were transcribed from recorded, unedited audio tapes obtained and purchased through an online church webpage. All the sermons were preached by ministers visiting a Pentecostal Holiness church in Los Angeles, California between the months of November 2006 and January 2007.

The ATLAS.ti software program was used to assist the data analysis. Themes were integrated into an overall explanation, or “grounded theory,” of the research arena. Grounded theory analysis strategies followed from the data as opposed to proceeding as a hypothesis to be tested (Corbin & Strauss, 1990).

Results:

The analyses yielded descriptive information on how Pentecostal ministers portrayed depression over the pulpit to African-American parishioners. Themes that emerged included: (a) depression is seen as a personal weakness (b) “saints” (parishioners) are encouraged not to cry when in painful situations, (c) taking psychotropic medication is seen as something to hide, (d) psychiatrists are not trusted to rely upon (“Jesus is the best psychiatrist”). Other words were used in addition to the word “depression”, including “having the “bottom fall out”, experiencing “cloudy or rainy days”, “goin' through”, and experiencing “troubles”, among others.

Conclusions and Implications:

This study provides some insight into how depression is discussed in the African-American Pentecostal church. The study sheds light on one reason why a segment of the African-American religious population could potentially have low levels of utilization of mental health services. There is a need for researchers and social work practitioners to network with pastors and church leaders in the African-American community. Also, there are implications for social work practice; there is a need to engage in assessment practices sensitive to culture and religion. This will help facilitate a return to the treatment setting after initial intake by depressed African-Americans holding such beliefs.