The Recognition and Referral of Mental Disorders within Religious Congregations

描述（由申请人提供）：宗教团体通常是帮助心理健康问题的第一个也是唯一的联系点。作为社区的守门人，宗教团体可以在将个人与所需的心理健康治疗联系起来方面发挥强大的作用。然而，宗教团体往往不知道何时、如何或在何处与心理健康提供者进行咨询。因此，尽管宗教团体被认为是连接非正式和正式护理系统的宝贵对应方，但它们仍然是一种尚未开发的资源，特别是对于服务不足的少数民族人口来说，他们在获得、使用和精神卫生保健质量方面存在重大差距。需要一个更加标准化的程序，以加强宗教团体对精神障碍的认识，并与精神卫生提供者合作。作为第一步，拟议的研究旨在为加强围绕心理健康筛查，转诊和咨询的会众实践的干预奠定基础。这项拟议中的研究将与一个以信仰为基础的合作伙伴西洛杉矶基督上帝教会合作进行，该教会拥有24 000多名会众，是全国最大的黑人“巨型教会”之一。西洛杉矶位于南洛杉矶，与健康，社会福利和社区组织有广泛的互动，并提供80多个项目，以提高社区。西洛杉矶寻求建立其他教会的能力，以参与类似的合作关系，并帮助领导基于信仰的社区合作，一个由300多个当地宗教教会组成的网络。拟议的研究有以下具体目标：（1）描述解决精神障碍的会众实践范围（2）确定与宗教会众接受精神健康筛查，转诊和咨询相关的因素（3）制定初步协议，以提高宗教会众参与精神健康筛查，转诊和合作的能力。我们会从具不同组织特色的宗教团体中，选取有针对性的样本，与主要持份者进行焦点小组讨论。对于目标2，我们将与协作组织一起进行一项调查，以检验关于心理健康筛查、转诊和协作接受性预测因素的假设。对于目标3，协作小组的一个子集将召集会议，根据目标1和目标2的结果以及关于质量改进协作护理心理健康干预措施的文献，制定一项初步干预措施，旨在加强驻地协调员的心理健康筛查、转诊和咨询。使用经过修改的德尔菲方法，协作将审查初步计划，提供反馈，进行修改，并就最终的一套建议达成共识，这些建议将在利益相关者反馈会议上提出，为未来的大规模实施工作做准备。 公共卫生相关性：宗教团体通常是帮助精神障碍的第一个也是唯一的联系点。作为社区的守门人，宗教团体可以发挥强大的作用，将个人与所需的治疗联系起来，特别是对那些在获得和利用精神卫生保健方面仍然存在重大差距的少数民族。然而，宗教团体仍然是严重未开发的资源，因为他们很少转介，咨询或与心理健康提供者合作。这项拟议的研究将为初步干预奠定基础，旨在提高宗教团体参与精神健康筛查、转诊和合作的能力。开发的干预措施将作为如何成功地弥合信仰和心理健康社区的模式，并可能对估计1.404亿美国宗教会众成员产生重大影响。

DESCRIPTION (provided by applicant): Religious congregations are often the first and only point of contact for help with mental health problems. As community gatekeepers, religious congregations can play a powerful role in linking individuals to needed mental health treatment. However, religious congregations often do not know when, how, or where to consult with mental health providers. Thus, although recognized as invaluable counterparts that can connect informal and formal systems of care, religious congregations remain a grossly untapped resource, particularly for underserved ethnic minority populations for whom there are significant disparities in access, use, and quality of mental health care. A more standardized process on how to enhance religious congregations' recognition of mental disorders and collaboration with mental health providers is needed. As an initial step, the proposed study aims to lay the foundation for an intervention that enhances congregational practices around mental health screening, referral, and consultation. The proposed study would be carried out in collaboration with a faith-based partner, West Angeles Church of God in Christ, which has over 24,000 congregants and is one of the largest Black "mega-churches" in the nation. Situated in South Los Angeles, West Angeles has extensive interactions with health, social welfare, and community organizations and provides more than 80 programs to enhance the community. West Angeles seeks to build the capacity of other congregations to engage in similar collaborative relationships and helps lead the Faith-based Community Collaborative, a network of over 300 local religious congregations. The proposed study has the following specific aims: (1) Describe the range of congregational practices in addressing mental disorders (2) Identify factors associated with religious congregations' receptivity to mental health screening, referral, and consultation (3) Develop a preliminary protocol to enhance the capacity of religious congregations' engagement in mental health screening, referral, and collaboration For Aim 1, we will conduct focus groups with key stakeholders from a purposeful sample of religious congregations with varying organizational characteristics. For Aim 2, we will conduct a survey with the Collaborative to test hypotheses about predictors of receptivity to mental health screening, referral, and collaboration. For Aim 3, a subset of the Collaborative will convene as a workgroup to develop a preliminary intervention aimed at enhancing RCs mental health screening, referral, and consultation, based upon findings from Aims 1 and 2 and from the literature on quality improvement collaborative care mental health interventions. Using adapted modified Delphi methods, the Collaborative will review the preliminary plan, provide feedback, make revisions, and obtain consensus on a final set of recommendations that will be presented at stakeholder feedback sessions in preparation for future wide-scale implementation efforts. PUBLIC HEALTH RELEVANCE: Religious congregations are often the first and only point of contact for help with mental disorders. As community gatekeepers, religious congregations can play a powerful role in linking individuals to needed treatment, particularly for ethnic minorities who continue to experience significant disparities in mental health care access and utilization. However, religious congregations remain grossly untapped resources given that they rarely refer, consult, or collaborate with mental health providers. The proposed study would lay the groundwork for a preliminary intervention aimed at enhancing religious congregations' capacity to engage in mental health screening, referral, and collaboration. The developed intervention would serve as a model on how to successfully bridge faith and mental health communities and could yield significant impact for the estimated 140.4 million Americans who are members of a religious congregation.