Behavioral Health Initiative (BHI) Behavioral Health Challenges in African American Communities: Referral Process and Treatment Specifications

Many research studies have shown that underuse of mental health services among African Americans remains a serious concern. Even when seeking treatment, African Americans are more likely to be treated with medications rather than psychotherapy or interpersonal therapy. Data further shows that untreated behavioral health challenges among African Americans tend to be more chronic, disabling, and an indication of under-utilization of available mental health services. Our Behavioral Health Initiative (BHI) breaks from this conventional approach in three ways: (a) it considers behavioral health challenges as both communal and individual problems; (b) it uses an Indaba process to bring communities together in addition to ‘clinical' solutions; and (c) it promotes holistic solutions that include body (nutrition and exercise), mind (behavioral interventions and social support), and spirit (faith-based). Special attention is focused on the central role black churches played in initially identifying behavioral health challenges as problematic and deploying community resources to address these challenges holistically. BHI developed and implemented the following eight strategies to engage churches in making holistic referrals: persisting, responding, muscling, resourcing, praying, observing, reciprocating and personalization. Results show these strategies were successful in significantly increasing the number of referrals made from churches. A total of 40 church referrals were generated within 5 months (June - November 2009). This successful implementation of BHI demonstrated that church leadership can effectively engage in the referral process and can help facilitate holistic interventions for behaviorally-challenged members and non-members of their congregations.