Outcomes of Faith-Based Mental Health Interventions with African Americans: A Systematic Review of the Literature

Background: Research suggests that the course and persistence of mental illness may be more chronic for African Americans than for non-Hispanic whites. Further, African Americans tend not to seek professional mental health providers to manage psychological problems. Instead of formal mental health service providers, African Americans often seek help from church and clergy to manage mental illness. Consequently, faith-based interventions have emerged to respond to racial disparities in mental health while incorporating a preference for informal care and clergy support among African Americans. However, literature on faith-based interventions specific to mental health issues is extremely limited, and even more so among African Americans. This current systematic review examines the literature in order to better understand the scope, impact, and efficacy of faith-based mental health interventions with African Americans.

 Methods: We searched nine electronic databases for peer-reviewed articles published since 1980 that examined faith-based mental health intervention outcomes among African Americans. Articles that met criteria for inclusion in the review systematically went through a process of data extraction to identify information about the study population, setting, study design, faith-based intervention, adaptations, mental health outcome measures, data analysis, and results. The methodological quality of studies meeting inclusion criteria was appraised using the Methodological Quality Rating Scale (MQRS). Sociocultural adaptations including: language, persons, metaphors, content, concepts, goals, methods, and context were examined.

 Results: The literature search identified 627 articles from the targeted databases. Most of the articles were eliminated at the outset because they were descriptive studies (195), were conducted in other countries or languages (137), studied non mental health related health issues (95), were qualitative studies or case studies (51), or focused on childhood issues (13). Twenty-eight articles remained for more detailed review. Ultimately 5 studies were included in this systematic review and described outcomes of faith-based mental health interventions that included African Americans participants.

 Conclusions: From a thorough review of these five studies several conclusions can be made regarding the nature, efficacy, and potential impact of faith-based mental health interventions. First, we see that there is great variety in the types of settings in which these faith-based interventions occur. Second, four of the five studies sought to increase knowledge around mental health issues instead of addressing treatment or symptoms. Third, when considering the efficacy of these interventions none of the studies analyzed here reported null or negative effects. All five of the studies in this review report some improvement in mental health outcomes. However, overall methodological quality of the studies was low with a mean score of 4 out of 17.

 Implications: The study highlights a gap in the mental health outcomes literature with regards to African Americans and faith-based research settings, outcomes, and intervention development. Although social work practice literature highlights the importance of incorporating religion and spirituality among African-American interventions, minimal work has been done in this area. We discuss ways that interventions can be adapted to address the spiritual wellness of persons with psychological distress.