Religious Beliefs, Attitudes towards Mental Health Treatment, and Mental Health Utilization among Southern Rural African Americans

According to the Mental Health: Culture, Race, and Ethnicity---A Supplement to Mental Health: A Report of the Surgeon General (DHHS, 1999; 2001) formal mental health services are underused by all Americans. Ethnic minorities, however, are less likely to utilize mental health services, specifically outpatient services, than White Americans (DHHS, 2001). Wells, Klap, Koike, and Sherboume (2001) found that among Americans with perceived or actual clinical needs, Whites were more likely to be receiving active treatment than both Hispanics and African Americans. Underutilization by minorities is particularly evident among minority groups from rural areas (New Freedom Commission on Mental Health, 2003). This disparity in treatment utilization has become a focus of mental health policy and research.;To better understand the underlying factors that influence the decision of rural African Americans to utilize or not utilize mental health treatment, this mixed method study was designed to elucidate the relationship between religious coping, religious beliefs, religious attitudes and mental health utilization behavior and beliefs. Investigating the association between the influence of religious behaviors and attitudes and mental health service behavior and attitudes is important for three reasons; (1) this association may inform observed patterns of underutilization of mental health services among rural African Americans, (2) this association may, in part, explain the evidence for mental health resilience among African Americans (Breslau et al., 2005; Williams, et al., 2007) and (3) this association could help to inform interventions designed to increase appropriate utilization of mental health services.;Employing qualitative and quantitative methods, data were collected from 110 African Americans living in rural communities. Qualitative results revealed that perceptions and attitudes regarding the necessity and usefulness of mental health treatment were linked to religious beliefs within the rural African American community. Quantitative survey findings revealed significant relationships between mental health service attitudes and intent to utilize services. Further, analyses revealed relationships between several religious indices (i.e. collaborative religious coping and Acceptance God Image) and mental health service attitudes, but no direct relationship between religious indices and intent to utilize. Possible interpretations of findings and future study directions are discussed.