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The Doors of the Church Are Open: Contextualizing Black Churches As a Place and Space for Mental Health and Longevity Among African Americans
Methods: The Churches study involved six focus groups with older African Americans from three churches in southeastern Michigan (n=50) and explored their attitudes toward depression, factors that impact treatment seeking, and coping strategies. As depression is associated with increased risk of morbidity and mortality, how it manifests among older African Americans (and the influence of the church in this context) is important to consider regarding longevity and quality of life. Papers in this symposium address the language of depression, the role of spirituality in shaping how depression is defined, the role of family support networks, and expectations about formal care for mental health.
Results: The first paper examined if the language used by older, church-going African Americans maps onto the Diagnostic and Statistical Manual of Mental Disorders (DSM). Participants described depression with terminology from the DSM as well as synonyms for depression. Generally, the language used by participants focused on possible causes of depression and its impact on functionality, more so than the symptoms themselves. Some words used by the participants mapped well onto the DSM, while others did not. The second paper involved a phenomenological examination of the role of spirituality in shaping how older black women define and discuss depression. Findings suggested that depression was discussed in the context of balancing treatment with spiritual practice, as a strong faith orientation was found to act as a buffer against depressive symptoms. Participants agreed that while physical health problems require immediate attention, mental health care is different. The third paper used a mixed methods approach to explore the role of family support in the mental health outcomes of older men. This paper used the Churches data to build a conceptual framework, which was then tested with a nationally representative sample of older, church-going African American men from the National Survey of American Life (n=401). Results from the confirmatory factor analysis indicate a good fit between the tested model and the observed data, providing additional depth to our understanding of the importance of family support networks in black male identity, successful aging, and mental health outcomes. Using the full Churches study sample, the final paper examined factors related to seeking formal care and found that health and well-being were considered to be both, physical and spiritual, and play a central role in the church communities. Issues related to privacy, respect, education, accessibility, credentialing, and consistency of providers are centrally important to the willingness of these older adults to engage in services.
Implications: Collectively, these studies add depth and breadth to our understanding of the social and cultural context of depression management and the acceptability of mental health interventions targeting African Americans who are affiliated with their churches.