Keneshia Bryant

Building Partnerships With Rural Arkansas Faith Communities to Promote Veterans' Mental Health: Lessons Learned

Background: The Mental Health–Clergy Partnership Program established partnerships between institutional (Department of Veterans’ Affairs [VA] chaplains, mental health providers) and community (local clergy, parishioners) groups to develop programs to assist rural veterans with mental health needs.Objectives: Describe the development, challenges, and lessons learned from the Mental Health–Clergy Partnership Program in three Arkansas towns between 2009 and 2012.Methods: Researchers identified three rural Arkansas sites, established local advisory boards, and obtained quantitative ratings of the extent to which partnerships were participatory.Results: Partnerships seemed to become more participatory over time. Each site developed distinctive programs with variation in fidelity to original program goals. Challenges included developing trust and maintaining racial diversity in local program leadership.Conclusions: Academics can partner with local faith communities to create unique programs that benefit the mental health of returning veterans. Research is needed to determine the effectiveness of community based programs, especially relative to typical “top-down” outreach approaches.

A rural African American faith community's solutions to depression disparities.

OBJECTIVE The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. DESIGN AND SAMPLE A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. MEASURES The primary data sources for this qualitative research study were focus groups. RESULTS Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. CONCLUSIONS The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community.

“Too Blessed to be Stressed”: A Rural Faith Community’s Views of African-American Males and Depression

Among African-Americans, the faith community has a long history of providing support to its members. Because African-American men tend to delay and decline traditional depression treatment, the faith community may be an effective source of support. The aim of this study was to determine how a rural African-American faith community describes and perceives experiences of depression among African-American males. A convenience sample of 24 men and women participated in focus groups and interview. Four themes were identified: defining depression, etiology of depression, denial of depression, and effect of masculine roles on depression experience.

Addressing Mental Health Needs: Perspectives of African Americans Living in the Rural South

OBJECTIVE Rural African Americans are disproportionately affected by social stressors that place them at risk of developing psychiatric disorders. This study aimed to understand mental health, mental health treatment, and barriers to treatment from the perspective of rural African-American residents and other stakeholders in order to devise culturally acceptable treatment approaches. METHODS Seven focus groups (N=50) were conducted with four stakeholder groups: primary care providers, faith community representatives, college students and administrators, and individuals living with mental illness. A semistructured interview guide was used to elicit perspectives on mental health, mental health treatment, and ways to improve mental health in rural African-American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data. RESULTS Stressful living environments (for example, impoverished communities) and broader community-held beliefs (for example, religious beliefs and stigma) had an impact on perceptions of mental health and contributed to barriers to help seeking. Participants identified community-level strategies to improve emotional wellness in rural African-American communities, such as providing social support, improving mental health literacy, and promoting emotional wellness. CONCLUSIONS Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and provision of mental health education to the general public may improve use of services in this population.

Dimensions of Religion, Depression Symptomatology, and Substance Use Among Rural African American Cocaine Users

Research has shown a relationship between depression, substance use, and religiosity but, few have investigated this relationship in a community sample of African Americans who use drugs. This study examined the relationship between dimensions of religion (positive and negative religious coping; private and public religious participation; religious preference; and God-, clergy-, and congregation-based religious support), depression symptomatology, and substance use among 223 African American cocaine users. After controlling for gender, employment, and age, greater congregation-based support and greater clergy-based support were associated with fewer reported depressive symptoms. In addition, greater congregation-based support was associated with less alcohol use.

Rural African Americans' Perspectives on Mental Health: Comparing Focus Groups and Deliberative Democracy Forums

Abstract:A number of approaches have been used to obtain community members’ health perspectives. Health services researchers often conduct focus groups while political scientists and community groups may hold forums. To compare and contrast these two approaches, we conducted six focus groups (n = 50) and seven deliberative democracy forums (n = 233) to obtain the perspectives of rural African Americans on mental health problems in their community. Inductive qualitative analysis found three common themes: rural African Americans (1) understood stresses of poverty and racism were directly related to mental health, (2) were concerned about widespread mental illness stigma, and (3) thought community members could not identify mental health problems requiring treatment. Deductive analyses identified only minor differences in content between the two approaches. This single case study suggests that researchers could consider using deliberative democracy forums rather than focus groups with marginalized populations, particularly when seeking to mobilize communities to create community-initiated interventions.

Development of a Faith-Based Stress Management Intervention in a Rural African American Community

Background: Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities.Objectives: To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community.Methods: The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB).Results: The community identified the key concepts that should be included in a stress management intervention.Conclusions: The faith-based “Trinity Life Management” stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress–distress–depression continuum.

Using Deliberative and Qualitative Methods to Mobilize Community Around the Mental Health Needs of Rural African Americans

Abstract Abstract—Deliberative methods obtain informed and well-reasoned public input on health topics but are rarely accompanied by rigorous qualitative methods that can ground findings in community members’ shared experiences. In this project, we used Deliberative Democracy Forums, a deliberative process, to bring diverse community members together to collectively discuss mental health among rural African Americans, brainstorm solutions to address mental health needs, deliberate alternate solutions, and indicate steps for future action. By using rigorous qualitative methods to document the deliberative process and analyze deliberative dialogue, we produced a strong evidence base to inform future health care policy and research. In this article, we document our approach, present forum findings, and discuss the impact of deliberation on policy and research. We conclude that the combination of deliberative process and qualitative methods used in our project can produce a deeply contextualized understanding of mental health and identify community-initiated solutions to address mental health needs in resource-poor communities, which can help guide public health research and provide an evidence base for public health policy.