Factors Related to Mental Health Stigma Among Church-Affiliated African Americans

Abstract

African Americans make up 13% of the U.S. population, yet represent nearly 20% of persons diagnosed with a mental illness. Studies suggest African Americans experience higher levels of mental health related stigma (MHS) than whites. In addition, African Americans have the highest rate of church attendance compared to all other racial/ethnic groups, and they are more likely to seek counsel from religious leaders. Although there is a growing body of research on MHS with African Americans, few studies have explored MHS predictors among church-affiliated African Americans – a population that may be important to examine given studies have shown that African American churches have great influence on health behaviors and beliefs among their members. This study used the Health Stigma and Discrimination Framework’s key constructs (e.g., domains, facilitators, stigma marking, manifestations) to guide examination of predictors (e.g., mental health fear, awareness, and social support, cultural and social norms, access to mental health services, demographics, mental health conditions, and mental health-related stigma beliefs) of MHS among an African American church-affiliated population. Baseline survey data from the religiously-tailored Healthy Actions to Impact Mind and Soul (Healthy AIMS) pilot intervention study, which focused on mental health screening and linkage to care services and took place in four African American churches (N=200 participants) in Kansas City, MO, was used to determine potential predictors of mental health stigma for examination. Most participants were female (79.5%), church members (78.5%) and an average age of 53 (SD = 17). Participants endorsed moderate to high levels of MHS (M = 39.03; SD = 6.8; range 11-55). Results indicated that social support (support from others and beliefs), collaborative and self-directive religious coping, and engaging in religious activities (e.g., thinking of God, meditating, praying) were significantly related to MHS. Linear regression analysis indicated that self-directive religious coping was a positive predictor of MHS. African Americans may engage in self-directive religious coping due to negative beliefs about the connection between having a mental illness and religiosity/spirituality. Future interventions may consider addressing MHS through providing tailored education and offering screening in a trusted setting, such as African American churches.