Abstract: Rural Residents' Depressive Symptoms and Help-Seeking Preferences: Opportunities for Intervention Development in Non-Mental Health Settings (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Rural Residents' Depressive Symptoms and Help-Seeking Preferences: Opportunities for Intervention Development in Non-Mental Health Settings

Schedule:
Friday, January 13, 2017: 3:50 PM
Preservation Hall Studio 7 (New Orleans Marriott)
* noted as presenting author
Addie Weaver, PhD, Assistant Professor, University of Michigan-Ann Arbor, Ann Arbor, MI
Joseph Himle, PhD, Professor, University of Michigan-Ann Arbor, Ann Arbor, MI
Mark Elliott, Pastor, Hillsdale Church of the Nazarene, Hillsdale, MI
Jessica Hahn, Pastor, Trinity Lutheran Church, Hillsdale, MI
Deborah Bybee, PhD, Professor, Michigan State University, East Lansing, MI
Background/Purpose: A shortage of mental health providers in rural areas has persisted for decades. As a result, rural residents have limited access to evidence-based treatment. This unacceptable access disparity reflects an understudied social justice issue. To close this gap, opportunities for delivering evidence-based treatment in non-mental health settings must be considered. In general, Americans prefer seeking help for mental disorders from clergy and rural residents have indicated a willingness to seek mental health services if available through churches; therefore, it seems that adapting evidence-based treatment for delivery in the church setting may offer a logical, promising way to increase rural residents’ access to effective, acceptable care. This study examines rural residents’ depressive symptoms, help seeking preferences, and perceptions of a church-based group depression treatment. This work informs the feasibility and acceptability of adapting and implementing group cognitive behavioral therapy for depression for delivery in church settings within a rural Midwestern community.

Methods: As part of community-based participatory research aimed at increasing access to effective, acceptable mental health treatment, researchers and clergy collaborated to administer a cross-sectional mail survey to members of two churches in a rural Midwestern community.  One-hundred congregants received surveys assessing demographic characteristics, depressive symptoms, help seeking preferences, and perceptions of church-based depression treatment; 63 congregants responded. Depressive symptoms were assessed via the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistical analyses were performed.

Results: Demographics: Respondents were, on average, 61 years old (SD=16.4). Two-thirds were (N=42) women and 73% (N=46) were married. About 80% (N=51) of respondents identified as white.

Depressive Symptoms: PHQ-9 scores suggest 12.9% (N=8) of respondents screened positive for Major Depressive Disorder (MDD), whereas another 24.4% (N=15) experienced mild to moderate depressive symptoms.

Help-Seeking Preferences. When asked who they would go to for help if feeling down or blue, respondents most frequently endorsed clergy (59%), family (59%), and friends (59%). Almost 50% indicated they would seek help from primary care providers; though only 22% reported that they would go to mental health professionals. Respondents were also asked who they would recommend to a friend feeling down or blue. Three-quarters of respondents (76%) indicated they would recommend clergy and 60% reported they would recommend a primary care provider. Interestingly, 54% of respondents suggested they would recommend a mental health professional. Forty-eight percent of respondents indicated they would recommend either a friend or family member to a friend feeling down.

Perceptions of Church-Based Group Depression Treatment: Sixty percent (N=37) of respondents indicated church-based group depression treatment would benefit persons who were feeling down. Two-thirds of respondents (67%; N=41) indicated, if feeling down or blue, they would consider attending an evidence-based group depression treatment offered at church, whereas 80% (N=50) indicated they would encourage a friend with emotional problems to attend this type of group treatment.

Conclusions and Implications: Results suggest delivering evidence-based depression treatment within church settings may provide a viable option for increasing access to care in this rural community. Given all respondents were church members, research replicating this study within the larger rural community is needed.