We are facing a mental health crisis. Nine out of 10 American adults recognize it. Addie Weaver, assistant professor of social work at the University of Michigan, believes churches can be part of the solution. For her, the delivery of mental health care to underserved groups, particularly those in rural areas, is a social justice issue. Drew spoke with her last week about her research on church-based mental health care. You can learn more from her in our final Science, the Church, and Mental Health session on Thursday.
How did growing up in rural Pennsylvania motivate your work?
Where I grew up, a lot of folks are not able to access the health care they needed. There are cost challenges, transportation challenges, a lack of available providers, and also a social acceptability challenge.
A lot of rural folks just aren’t comfortable seeking mental health services. There’s a big stigma associated with it. Rural communities are still socially very well-connected. If you walk into a mental health clinic, the person checking you in could be a friend of your cousin or something like that. People worry about a lack of anonymity.
I felt the lack of mental health services available in rural areas was unacceptable. For 50-60 years now we’ve seen a lack of mental health professionals serving rural communities. So, I became committed to trying to find ways to build capacity to support mental health in rural areas that worked for residents, aligned with their preferences for care and addressed this treatment access gap.
What is unique about mental health delivery in rural contexts?
There just aren’t as many health-care services available in rural areas. We’ve recently seen a startling decline in rural hospitals. A lot of them are closing for financial reasons.
People in rural areas are still less likely than people in urban and suburban areas to have adequate health insurance. So that’s another big barrier.
Often folks in rural communities have substantial travel burden to get care. It can mean an hour drive each way and money for gas. It requires time off work and reliable transportation. The communities I work with here in Michigan don’t have Uber or Lyft.
Do you find differences in the mental health needs of rural residents?
What we found typically in academic literature is that rural residents are just as likely as urban residents to experience mental health needs. There are some studies that suggest people in rural areas might have a little bit higher prevalence with depression, and we have seen that there have been some increases in suicidality which is a very big concern.
The bigger issue is that rural folks do not have access to care. We know that when mental health needs go untreated there’s a lot of additional negative consequences that happen for the individuals, their families, their work, and their social lives. That is why we are so committed to trying to bridge that treatment gap.
- Listen to the full interview on our YouTube page.
- Learn more about Addie Weaver’s Raising Our Spirits Together research.
- Register for Thursday’s webinar hosted by the Synod of the Covenant.
- We have collected resources on mental health for the church.
- The American Psychiatric Association produced a mental health guide for faith leaders.
- As soon as it is available, we will share the Raising Our Spirits Together curriculum with you.
How did you start working with churches to meet this treatment gap?
I grew up in a United Methodist Church in rural Pennsylvania, and I saw time and time again how my community looked to their pastors for support and guidance when they were experiencing emotional difficulties, psychological distress, and mental health needs. As I got older, it became more apparent. Clergy were often the preferred frontline providers of people’s mental health support. There is research to suggest that this is the case in general in the US as well as to show how clergy perceive their role in church-based mental health care.
As I began my work in Michigan, I approached 21 clergy who were commonly supporting congregants who were experiencing depression for a variety of reasons. Clergy were saying they have some tools, but they wanted a deeper toolbox. We began to talk about some of the strategies pastors were using and saw quite a bit of alignment with cognitive behavioral therapy (CBT). That led us to create a program that bridges the strengths of pastors and those of CBT.
That program is Raising Our Spirits Together, right? Tell us about it.
Clergy are amazing small group facilitators, but we did not want to burden them with prep time. So, we created a technology-assisted program with an accompanying workbook. Each session opens with prayer and scripture. It has a character-driven storyline: Billy experienced depression, got help from CBT, and our animated videos show how she uses those tools in her life. Our clergy partners helped design Billy’s story. The curriculum also includes the basics of CBT, images, quotes, and other content tailored to rural life.
What impact did it have on participants?
We piloted two groups and saw phenomenal participation. People attended 7.3 of the eight sessions. We also saw clinically significant decreases in depressive symptoms. By the end of the program, folks who entered with clinical depression had mild symptoms, if any.
A National Institute for Mental Health grant is funding a randomized control trial to evaluate Raising Our Spirits Together. This research is almost finished, so we will know more about its impact later this year, and then we will offer this program to more churches.
You’ve highlighted the significance of pastors in this program. What is the significance of the word, “together”?
The group format builds community and helps participants understand that they aren’t alone in how they were feeling. With depression, it’s very common to think there’s something wrong with you. It can be really powerful for folks to come together and see: Oh, wow! These people are experiencing what I’m experiencing.
We found that people really supported each other. At the end of groups, folks would commonly exchange contact information. If somebody was having a hard week, the group would work together and lift them up.
I love that — letting church be what church should be. What advice do you have for clergy on the frontlines addressing mental health?
Be okay with challenging conversations. Folks are in some really dark places. Validate where they are, and remind them that you know it’s not something that’s wrong with them. Remind them that there are ways to get better. Connect them to the support of the church: resources in scripture, support groups, prayer and prayer chains; and make sure that if you don’t see them at church for several weeks, there is someone to check on them.
Finally, find resources for your community that you’re comfortable sharing with people: crisis lines, primary care, or mental health providers. It’s not a weakness to also get support outside the church.
Thank you, Dr. Weaver. We are grateful for the ways you are working alongside pastors helping the church to address this mental health crisis. Blessings to you in this important work!