Oh Ye of Little Faith: Delivery of Culturally Competent Mental Health Care to Evangelical Christians

Significance: Mental illnesses are leading causes of disability across industrialized countries. Although safe, effective treatments are available, many affected either delay or fail to seek treatment. Less than half of those individuals believed to benefit from formal health treatment seek it. Of those who do, less than half of those will continue treatment until symptoms are remitted. Under-diagnosed and un(der)treated mental illness contribute to increased morbidity and mortality. Reluctance to seek and/or engage formal mental health care systems may be due in part to different explanatory models of symptoms suggestive of emotional disturbances. A growing body of evidence suggests that people of faith may have differing and often conflicting explanatory models of symptoms suggestive of mental illness. These models may lead people of faith to prefer informal c strategies in lieu of formal health care. Objective: Describe Evangelical Christians different explanatory models of symptoms. Review how to identify and manage barriers to treatment adherence. Methods: 300 televised sermons were videotaped over 3 months on random days. 90 sermons were screened. Sermons containing references to physical or mental health (35) were transcribed verbatim, entered into Ethnograph to facilitate analysis. Using content analysis and constant comparison techniques, data clusters were isolated, aggregated to form categories, and combined to form overarching themes. Inter-rater reliability was established discussing instances of disagreement until consensus was reached. Preliminary Results: Etiologies of psychiatric symptoms were attributed to non-biological causes—demonic influence, negative thinking, negative talking, lack of faith. Spiritual coping strategies were encouraged to manage these symptoms.