MENTAL ILLNESS KNOWLEDGE, STIGMA, HELP-SEEKING BEHAVIORS, SPIRITUALITY AND THE AFRICAN AMERICAN CHURCH.
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) reports that the 2014 national average for any mental illness in the past year for adults was 18.1%, compared to 16.3% for African American adults (2014) .An estimated one in five people are affected by mental illness (Conley, 2012; National Alliance of Mental Illness [NAMI], 2015).In 2011, one in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression (U.S. Department of Health and Human Services, 2011).Asnaani and colleagues (2010) reported that 8.6% of African Americans suffer from Social Anxiety Disorder, 4.9% from Generalized Anxiety Disorder, and 3.8% from Panic Disorder. According to the CDC (2010) African-Americans have the highest rate of current depression (12.8%), followed by Hispanics (11.4%), and whites (7.9%). More specifically in African Americans the most common types of mental illness disorders include, major depression, attention deficit hyperactivity disorder, suicide, and posttraumatic stress disorder (Anxiety and Depression Association of America, 2015; NAMI, 2015).
Knowledge and Stigma
Jorm (2011) explained that public knowledge about mental disorders has received significantly less attention than physical diseases. Historically, the Black community has been reluctant to discuss mental health conditions. Many times the lack of knowledge leads this population to believe it is a sign of personal weakness (NAMI, 2015). Pickett-Schneck (2002) notes that distrust of health care providers and a lack of access to resources could contribute to low levels of knowledge in understanding the etiology of mental illness. However, there is a dearth of literature specific to differences in knowledge levels by race or ethnicity.
In 2007, Mental Health America reported that 63% of African-Americans believed depression was a "personal weakness", and only 31% of African-Americans thought depression was a health issue. "Five reasons a majority of the population withheld information on their illness included: concern of hurting the family, it would ruin their career, people might think they are crazy, they cannot afford to appear weak, and shame" (NAMI, 2009, np).
Spirituality & the Role of the Black Church
The church has long been documented as playing a significant role in the spirituality of the African American community (Abdullah, 1999; Jones, 1991) and that African-Americans attend church regularly, participate in private prayer, listen or watch religious programs, use encouragement, and religious coping messages [Chatters et al. (2009) noted in Chatters, Taylor, Lincoln, Nguyen, and & Joe (2011)]. Utsey et al. (2007) points out that involvement in spirituality by Blacks tends to correlate with better mental health and church related support provides vital networks to the African-American population by providing encouragement in physical and mental health (Taylor, Lincoln, & Chatters, 2005; Krause, 2008, as noted in Chatters et al. 2011).Historically, the Black church has served as a place of worship, a place of emotional expressiveness, educational endeavors, civic meetings, pastoral care, and counsel (Armstrong & Crowther, 2002). Further, the clergy are often the initial responders to mental health concerns among the Black culture. Kramer et al. (2007) suggest clergy provide a "cultural bridge between the formal healthcare system and recipients of care" (p. 124). However, a dearth of research was found on demographics of parishioners, beyond race, within the Black churches in relation to support of mental health help-seeking behaviors and thus should be further explored.
Mental Health Help-Seeking Behavior
African-Americans who had more positive attitudes toward mental health services were more likely to report feeling embarrassed if their friends or family knew they used these services and tend to cope with mental health concerns by utilizing support systems such as: church family, family, friends, neighbors, and coworkers rather than seeking medical attention (Matthews & Hughes, 2001; Woodward, Taylor, Bullard, Neighbors, Chatters, & Jackson, 2008). African Americans suppress topics of hardship, depression, and strategies to cope with mood or emotional life changes (NAMI, 2015), utilize mental health professional care assistance at half the rate of Whites(Agency for Healthcare Research and Quality, 2010),and are in general less likely than Whites to seek mental health counseling and instead seek assistance from their primary care physician (Pingitore, Snowden, Sansome, & Klinkman, 2001). Approximately one-quarter of Blacks seek mental health assistance compared to 40% of Whites (NAMI, 2015). Underrepresented groups have been reported to use prayer and spirituality as coping resources in lieu of counseling or psychotherapy (So, Gilbert,& Romero, 2006) and seek help from clergy first to manage mental illness (Young, Griffith, & Williams, 2003).
The following research questions are thus posited: What relationship exists between mental illness knowledge, stigma, spirituality, and reported help seeking behaviors? And, what demographic differences (i.e. age, education, marital status, income, and employment) exist between African Americans who think the Black church should playa role in addressing mental illness versus those who do not?
Utilizing convenience and snowball sampling, African-American adult women and men were recruited from Baptist faith-based organizations. Participants for this study were recruited from two faith-based locations, one organization from the Midwest and one from the Southern part of the United States. Approximately 14,600 parishioners were invited to participate via a combination of newsletter ads and verbal announcements. A total of 350 paper surveys were distributed at church and 567 clicks on the survey link were recorded. In total, 114 paper surveys and 295 online surveys were completed. Resulting in an approximate participation rate of 44.6% (N=409).
The Institutional Review Board (IRB) from the University of Cincinnati (UC) reviewed and approved all aspects of the study. Several predominantly African American churches were invited to participate by reaching out to the local church administrations who were identified as gatekeepers to the membership. Two agreed to participate and survey data was collected from both locations. The Mental Health and Spirituality survey was distributed on paper and via an online portal.
A combination of existing, adapted, and novel questions were utilized to form the study questionnaire in order to measure: (1) knowledge of specific signs of symptoms, (2) stigma, (3) spirituality, (4) help-seeking, (5) role of the church, (6) and demographics.
Knowledge. The top five areas of mental illness are schizophrenia/psychotic disorders, depression, bipolar disorders, panic disorders, and anxiety disorders (Mayo Clinic, 2015). To assess knowledge of mental illness, the authors organized 50 signs and symptoms of these top 5 conditions into 3 sections (a. Feelings of ... b. Experiencing ... & c. Engaging in ...) and presented them to participants. Participants were asked to 'check all that apply'. Knowledge level was measured by adding up the number of signs and symptoms identified by participants (Cronbach's alph = .97).Additionally, four items assessed participant level of agreement with statements related to effectiveness of treatment, contagiousness, and level of effect on one's life related to mental illness, and the concept of being mentally ill equating to being 'crazy' (strongly agree-strongly disagree).
Stigma. A modified 30-item Stigma about Depression Questionnaire by Nieuwsma, Pepper, Maack, and Birgenheir (2011) was used. Nineteen items were selected due to their relevance to the present study. The selected items were then modified to reflect mental illness in general rather than depression specifically. Selected items included among others, feelings toward people living with mental illness, such as burden of society, mental illness patient reflections on society, and growing up in a household with a person who suffers from mental illness and the possibility of shame. Items were measured on a Likert-type scale from 1-4 (1 Strongly disagree--4 Strongly agree). Items 4, 10, 12, 16 and 19 were reverse coded so that agreement would be indicative of stigma. Higher scores indicated higher stigma. Scale scores were calculated by summing across items after reverse coding (Cronbach alpha = .637).
Spirituality. To assess spirituality, participants responded to three sections. First, they were asked how often they attend church (rarely- weekly) and to self-rate how spiritual they were (not at all- a great deal). Secondly, a 5-point Likert type scale (strongly agree-strongly disagree) with 14 items was used to measure spirituality. Thirteen items were adopted from Holt, Clark, and Klem (2007) and a 14th item was added for this study to assess comfort level in talking about personal issues with a person from their clergy. The Cronbach coefficient of reliability was reported as alpha=.81 by Holt, Clark, and Klem (2007) and measured .724 in the present study. A possible scale score between 14 and 70 was computed by summing across all items. Third, the 8-item Spiritual Centered Coping subscale by Utsey, Adams, and Bolden (2000) was used to measure participants' coping behaviors during certain life situations. The internal consistency Cronbach alpha coefficient was reported as .81 (2000) and measured .756 in the present study. A possible scale score between 8 and 32 was computed by summing across all items.
Role of the Church.To assess the perceived role of the church several questions were created. Specifically, participants were asked a) if they thought the church has a role in mental health awareness, b) if their church provides mental health services and c) if their church were to offer these services, would they use them?(yes/no). A fourth question asked their level of agreement with "Faith-based organizations should provide mental health services" (1 strongly disagree - 4 strongly agree). Lastly participants were asked the level at which their faith-based organization a) understood mental health, b) provides mental health support, c) openly discusses mental health, and d) provides mental health support (1 not at all -4 a great deal).
Help-Seeking. Another section measured the participant's attitude toward mental health help-seeking. A selection of 10 items from Fischer and Turner's (1970) Attitudes toward Seeking Professional Help Scale was modified for this study. The selected items assessed level of agreement with statements reflecting if participants received past counseling for emotional issues, the advice they might give to a friend or family member, if they would consider getting aid if the need erupted, and an individual's thoughts on getting help from a mental health specialist among other help seeking behaviors (1 strongly disagree--4 strongly agree). The modified scale had an acceptable Cronbach alpha coefficient of .78. Reverse coding was conducted for items 2, 3, 5, and 7 so that higher scores were indicative of healthier help seeking behaviors. Scale scores were computed by summing across item values and had a possible range of 0 to 40.
Lastly, a series of demographic items were also included in the instrument. These measured age, sex, years of school completed, marital status, employment status, occupation, approximate household income and number of people in household.
Descriptive statistics were used to assess count, percent, and central tendency. The data was cleaned and assessed for skewness and kurtosis. It was identified that the sample included significantly more females than males and thus non-parametric statistics were used. Spearman Rho correlations were used to assess the relationship between variables and Chi Square was used to compare observed and expected frequencies of selected variables. All data was analyzed using the Software Package for the Social Sciences (v23).
About the Participants
As seen in Table 1, the average age of participants was 44.8 years (SD=12.748). Most were female, married, and worked full time. The average household size was 2.44 (SD=1.408) people with an income mean above $60,000, nearly one third had graduated college and over 40% held a graduate or professional degree. All participants self-identified as African-American.
Results for symptom and sign recognition showed that after summing across all 50 items, participants had an average score of 33.95 (SD=13.98). Over half (52%, n=205)correctly identified at least 70% of the 50 signs and symptoms. Some of the top symptoms identified were anxiety, hopelessness, suicidal thoughts or behaviors, and withdrawal from family members and friends. As seen in Table 2, more than 15% agreed mental illness was infectious, 31% agreed mental illness was the same as craziness, 90% agreed mental illness affects one's whole life, and 72% agreed mental illness can be treated completely.
Stigma toward Mental Illness
The stigma scale results showed an average stigma score of 33.5 (SD=5.142) with a range of scores between 19 and 57(n=352). Higher scores indicate higher stigma. The median score was 33.0 and the mode was 30.0. Table 3 shows detailed data for the 13 stigma laden items. Over half (68%) of the respondents had scores above the mode indicating existing stigma toward mental illness. The three statements with the highest percent of respondents in agreement included "had I received treatment in a mental hospital, I would not feel that it ought to be "covered up or hidden" (49.4%), "there is something admirable in the attitude of a person who is willing to cope with his/ her conflicts and fears without resorting to professional help" (33.6%), and "Having a mental illness reflects poorly on a person and their family" (24.5%).
Mental Health Help-Seeking Behavior
Mental Health Help-Seeking scale scores averaged 32.42 (SD=4.602) and ranged between 0 and 40 (n=375). The most frequent score was 30 and 53.6% scored below the median of 32.The scale scores appear to indicate that participants, as a group, had negative attitudes toward mental health help-seeking behaviors. Individual item analysis shows that more than 83% of respondents stated they would feel uneasy going to a mental health provider because of what some people would think. Another 87% felt that the investment in counseling was not a promised healing aid fortheir emotional problem. Most respondents believed that considering the time and cost involved with seeking mental health help, it would have very little value (86.6%). Almost 92% stated they would rather live with certain mental conflicts than go through mental health treatment. The results also showed that 80% of the adults would rather be advised by a close friend than a specialist for an emotional problem. Only 30% believed they might consider counseling at some point in the future (see table 4).
The scale mean score was 40.38 (SD=4.998) with a range of 14 to 56 (n=375). Higher scores were indicative of higher levels of spirituality. The most frequently occurring score was 39 and 45.6% of participants scored below the median of 40. The Role of Spirituality responses revealed that 65% (n=253) of the participants usually or always have had spirituality play a role in difficult life situations. More than three-fourths of the respondents believed that through their faith in God, they would stay healthy. Just over 70% believed that relying on God is what keeps them healthy (see table 5). However, the majority of the participants acknowledged that though they trust God will take care of them, it is also their responsibility to take care of themselves. More than 97% also believed that God works through medical doctors' skills to help heal the sick. The majority of the respondents believe that it is both God's will and personal responsibility to take care of them, and that strength to care for oneself comes from God.
The Role of the Church
The majority of the participants thought the church should have a role in focusing attention on mental health awareness (93.6%, n=381). The majority of participants state their church provides some source of information on mental health (62.6%, n=238). And, if their church offered services such as counseling, psychology, or referrals, the majority of the sample (70.5%, n=272) would utilize those services.
After analysis of the Kurtosis and Skewness statistics for demographic variables values outside the -2 to +2 were discovered for Kurtosis of the Age variable. According to George and Mallery (2003) it can thus be assumed that the sample is not normally distributed. Therefore Spearman's Rho was utilized instead of Pearson R correlational analysis.
Research question 1. What relationship exists between mental illness knowledge, stigma, spirituality, and reported help seeking behaviors? The Spearman's correlation was utilized to measure the strength of association that exists between mental illness knowledge, stigma, spirituality, and mental health help seeking behaviors scale scores. A Bonferoni correction was utilized to minimize type one error given that 4 variables were compared simultaneously (alpha = .0125).Three significant correlations were identified. First, knowledge was positively correlated with mental health help seeking behaviors (r=.227, alpha <.001) indicating that as knowledge scores increased, mental health help seeking behavior scores increased. Second, knowledge was negatively correlated with stigma (r=-.272, alpha <.001) indicating that as knowledge scores increased, stigma scores decreased. Third, stigma was negatively correlated with mental health help seeking behaviors (r=.440, alpha<.001) indicating that lower stigma is correlated with more positive mental health help seeking behaviors. There were no statistically significant correlationsbetween knowledge, help-seeking, or stigma and spirituality scale scores (see table 6).
Research question 2. Are there demographic differences between African Americans who think the Black church should play a role in addressing mental illness and those who do not? Chi Square tests were utilized to compare the observed frequencies between participants. There were no statistically significant differences between the age, sex, education, marital status, income, or employment of participants and whether they thought the church should be involved in addressing mental illness.
Respondents were highly educated (nearly two in ten had a bachelor's degree or higher) and from high-income households (median just over $50,000). This is in contrast to the national numbers from the U.S. Census Bureau that show less than two in ten had a bachelor's degree (2014) and the national median household income was just over $35,000 for black households (DeNavas-Walt & Proctor, 2015). Further, most were women, and worked full time.
All participants were African American and attended church at least monthly. Researchers have previously reported high levels of spirituality, church attendance and prayer among Black communities (Neighbors et al., 1998; Chatters & Taylor, 1989). More recently, the Pew Research Center (2018), reported that 47% of African-Americans confirm they attend religious services at least once per week. Results show that although many participants correctly identified signs and symptoms, nearly one in three could not recognize half of the signs and symptom of mental illness presented. Similarly, Jorn (2011) reported a need for more mental health literacy among minorities and African American communities. Further, Corrigan, Druss, and Perlik (2014) found that knowledge significantly moderated stigma toward mental illness. In the present study, over half of participants agreed with stigma laden statements, a majority showed reluctance toward mental help-seeking, and higher knowledge was positively correlated with increased help-seeking behaviors and negatively correlated with lower stigma. These findings warrant important consideration since it has been documented that minorities are "disproportionately deterred" from seeking mental health services by stigma (Clement, et al., 2015, p.11).
Similar to the findings of Clement, et al. (2015) and Corrigan, Druss, and Perlik (2014), the present study found a negative correlation between stigma and attitudes toward help seeking in that participants who had lower stigma were more likely to have positive attitudes toward mental health help-seeking behaviors. This further supports the need to decrease stigma in order to improve attitudes toward seeking mental health services among African Americans. The church is known to be an integral part of health education in African American communities (Chatters et al., 2011; Roberts, 2007; Saunders, et al., 2015; Young, Griffith, & Willimas, 2003) and can be an effective partner in providing mental health awareness and services (Kramer et al., 2007).
In contradiction with the original prediction that differences in demographic characteristics might exist between those supporting the role of the church in addressing mental health awareness and providing services, the present study did not find this to be true. Most participants thought their church should play a role in addressing mental health. This is not surprising given the long history and established role of the church as a social service provider for the African American community (Hays, 2015). As Brown and McCreary (2014) noted, addressing disparities in mental health care seeking is vital and the use of mental and social resources within the church venue may assist. As presented by Beck et al. (2007), partnerships of bringing awareness to myths, perceptions, knowledge, and negative attitudes or behaviors are important, but may play a specifically critical role to addressing mental health awareness.
There are inherent limitations to be considered when interpreting the results of this study. The study utilized self-report data, and as such results could be influenced by a social desirability bias. Further, it is possible that participants misunderstood the questions, had recall bias or other limitations inherent with survey research. Additionally, this study utilized a small convenience sample from only two regions and is not representative of all African Americans who regularly attend church. The majority of the population surveyed reported to have obtained graduate or professional degrees, there could be differences in populations with lower socio-economic status (SES) and lower educational attainment. It is also plausible that spirituality, religiosity, or denomination could have impacted responses. Lastly, given that the sample was composed of a large proportion of women, it is important to consider these findings within that context.
Faith-based empowerment that lies in the foundational spirituality of Black culture is a vital part of their communities. The results of this study add to our understanding of the relationship between knowledge, stigma and help-seeking behaviors through the church and of the important role the church can play in increasing mental health awareness. Clergy, mental health specialists, and faith-based organizations could partner and focus on community-based health education interventions. Additionally, it is vital to continue investigating the continuing need for mental illness awareness and help-seeking in the Black church and to emphasize the health-promoting resources.
Future research should be conducted with a more representative sample and further investigate the relationship between stigma, knowledge and mental help-seeking behaviors. Specifically, we recommend research to assess the feasibility and efficacy of health education awareness campaigns and mental health service provision in the African American church in developing increased awareness that leads to earlier detection, accurate diagnosis and effective treatment. Any such effort should be culturally appropriate and relevant and include the church community in its development, implementation and evaluation.
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Shameka Y. Neely-Fairbanks, PhD
Liliana Rojas-Guyler, PhD, CHES
Laura Nabors, PhD, ABPP
Otomatayo Banjo, PhD
Corresponding author: Liliana Rojas-Guyler, PhD, ESGF, CHES, University of Cincinnati Health Promotion & Education School of Human Services, CECH, PO Box 21068 (ML0068) TDC 460B Email: email@example.com.
Table 1. Demographics Variable N % Age 18-29 52 13.0 30-49 214 53.5 50-69 125 31.3 70+ 9 2.3 Total 409 100.0 Gender Male 42 10.4 Female 363 89.6 Total 405 100.0 Marital Status Married 146 36.2 Widowed 10 2.5 Divorced 84 20.8 Separated 9 2.2 Never married 154 38.2 Total 403 100.0 Education Some High school 3 0.7 High school or GED 22 5.4 Some college/Technical school 89 22.0 Bachelor's 128 31.6 Graduate/Professional degree 163 40.2 Total 405 100.0 Employment Working full-time 286 70.8 Working part-time 31 7.7 Not currently working 28 6.9 Homemaker 4 1.0 Fulltime student 13 3.2 Not in work force (retired, disabled, 42 10.4 or other) Total 404 100.0 Note-Missing data excluded. Table 2: Knowledge Statements Rate your level of agreement Strongly Disagree or disagreement with the Disagree following statements. n % n % Mental illness cannot be treated 123 30.3 168 41.4 completely. Mental illness is not infectious or 27 6.6 37 9.0 contagious. Mental illness is not the same as 27 6.6 100 24.4 "craziness." Mental illness affects one's whole life. 20 4.9 20 4.9 Rate your level of agreement Agree Strongly or disagreement with the Agree following statements. n % n % Mental illness cannot be treated 88 21.7 27 6.7 completely. Mental illness is not infectious or 117 28.6 228 55.7 contagious. Mental illness is not the same as 144 35.2 138 33.7 "craziness." Mental illness affects one's whole life. 118 28.9 251 61.4 Note: Missing data excluded Table 3: Stigma Scale Stigma laden items Strongly Disagree Disagree n % n % Having a mental illness reflects 174 43.0 132 32.6 poorly on a person and their family. People with a mental illness 203 50.2 160 39.6 should only tell family members about their depression. People with a mental illness 286 71.1 106 26.4 should keep it to themselves. I tend to think less of someone 239 59.5 141 35.1 with mental illness. Mental illness reflects badly on 198 49.3 149 37.1 one's character. I would feel ashamed if a close 258 63.7 111 27.4 family member suffered from a mental illness. Strong people do not suffer from 302 74.9 85 21.1 mental illness. Having been a mental health 96 24.6 95 24.4 patient carries with it a burden of shame. Mental patients are a burden to 196 49.0 161 40.3 the society. The idea of talking to a mental 253 63.1 118 29.4 health provider is a poor way to get rid of emotional conflicts. A person should work out his/ 283 70.6 95 23.7 her own problems; getting mental health counseling would be a last resort. Had I received treatment in a 60 15.5 135 35.0 mental hospital, I would not feel that it ought to be "covered up or hidden." There is something admirable in 103 25.8 162 40.6 the attitude of a person who is willing to cope with his/her conflicts and fears without resorting to professional help. Although there are clinics for 138 34.4 201 50.1 people with mental troubles, I would not have much faith in them. Stigma laden items Agree Strongly Agree n % n % Having a mental illness reflects 72 17.8 27 6.7 poorly on a person and their family. People with a mental illness 21 5.2 20 5.0 should only tell family members about their depression. People with a mental illness 5 1.2 5 1.2 should keep it to themselves. I tend to think less of someone 13 3.2 9 2.2 with mental illness. Mental illness reflects badly on 48 11.9 7 1.7 one's character. I would feel ashamed if a close 29 7.2 7 1.7 family member suffered from a mental illness. Strong people do not suffer from 6 1.5 10 2.5 mental illness. Having been a mental health 154 39.5 45 11.5 patient carries with it a burden of shame. Mental patients are a burden to 30 7.5 13 3.3 the society. The idea of talking to a mental 11 2.7 19 4.7 health provider is a poor way to get rid of emotional conflicts. A person should work out his/ 15 3.7 8 2.0 her own problems; getting mental health counseling would be a last resort. Had I received treatment in a 126 32.6 65 16.8 mental hospital, I would not feel that it ought to be "covered up or hidden." There is something admirable in 81 20.3 53 13.3 the attitude of a person who is willing to cope with his/her conflicts and fears without resorting to professional help. Although there are clinics for 47 11.7 15 3.7 people with mental troubles, I would not have much faith in them. Note: Missing data excluded Table 4: Mental Health Help-Seeking Scale Items Rate the following statements about Strongly Disagree seeking help. (Circle your response) Disagree n % n % If a good friend asked my advice about a 7 1.7 15 3.7 mental problem, I might recommend that he/she see a mental health specialist. I would feel uneasy going to a mental 18 4.5 50 12.4 health provider because of what some people would think. Considering the time and expense involved 12 3.0 42 10.5 in seeking mental health help, it would have doubtful value for a person like me. I would willingly confide intimate matters 15 3.8 17 4.3 to an appropriate professional if I thought it might help me or a member of my family. I would rather live with certain mental 11 2.8 22 5.5 conflicts than go through the ordeal of getting mental health treatment. If I believed I was having a mental 24 6.0 66 16.5 breakdown, my first inclination would be to get professional attention. I would rather be advised by a close 14 3.5 66 16.5 friend than a mental health provider, even for an emotional problem. If I were experiencing a serious emotional 17 4.3 44 11.0 crisis at this point in my life, I would be confident that I could find relief in mental health therapy. At some future time I might want to have 33 8.4 87 22.2 mental health counseling. If I thought I needed mental health help, 10 2.5 36 9.0 I would get it no matter who knew about it. Rate the following statements about Agree Strongly seeking help. (Circle your response) Agree n % n % If a good friend asked my advice about a 176 43.9 203 50.6 mental problem, I might recommend that he/she see a mental health specialist. I would feel uneasy going to a mental 156 38.7 179 44.4 health provider because of what some people would think. Considering the time and expense involved 175 43.8 171 42.8 in seeking mental health help, it would have doubtful value for a person like me. I would willingly confide intimate matters 153 38.4 213 53.5 to an appropriate professional if I thought it might help me or a member of my family. I would rather live with certain mental 143 35.8 223 55.9 conflicts than go through the ordeal of getting mental health treatment. If I believed I was having a mental 145 36.2 166 41.4 breakdown, my first inclination would be to get professional attention. I would rather be advised by a close 170 42.5 150 37.5 friend than a mental health provider, even for an emotional problem. If I were experiencing a serious emotional 178 44.6 160 40.1 crisis at this point in my life, I would be confident that I could find relief in mental health therapy. At some future time I might want to have 175 44.6 97 24.7 mental health counseling. If I thought I needed mental health help, 164 41.1 189 47.4 I would get it no matter who knew about it. Note: Missing data excluded Table 5: Spirituality Scale Items Rate each statement below by Strongly Disagree selecting your level of agreement Disagree or disagreement. n % n % Through my faith in God, I can 9 2.2 68 16.8 stay healthy. If I lead a good spiritual life, I will 24 6.0 155 38.7 stay healthy. If I stay healthy, it is because I am 56 13.9 161 39.9 right with God and I take care of myself. I rely on God to keep me in good 18 4.5 102 25.2 health. Even though I trust God will take 2 0.5 5 1.2 care of me, I still need to take care of myself. God works through doctors to 2 0.5 8 2.0 heal us. Living the way the Lord says I am 8 2.0 28 6.9 supposed to live means I have to take care of myself. Prayer is the most important 5 1.2 54 13.4 thing I do to stay healthy, as well as exercise. If I stay well, it is because of the 10 2.5 57 14.2 grace of the good Lord and eating a balanced diet. It is ok not to seek medical attention 254 62.9 117 29.0 because I feel that God will heal me. There is no point in taking care 303 75.0 87 21.5 of myself when it is all up to God anyway. God and I share responsibility for 21 5.2 42 10.4 my health. God gives me the strength to take 4 1.0 15 3.7 care of myself. It is difficult to talk about my 101 25.0 158 39.1 personal health with clergyman or people of the church. Rate each statement below by Agree Strongly selecting your level of agreement Agree or disagreement. n % n % Through my faith in God, I can 184 45.4 144 35.6 stay healthy. If I lead a good spiritual life, I will 145 36.2 77 19.2 stay healthy. If I stay healthy, it is because I am 113 28.0 74 18.3 right with God and I take care of myself. I rely on God to keep me in good 179 44.3 105 26.0 health. Even though I trust God will take 92 22.7 307 75.6 care of me, I still need to take care of myself. God works through doctors to 143 35.1 254 62.4 heal us. Living the way the Lord says I am 127 31.4 242 59.8 supposed to live means I have to take care of myself. Prayer is the most important 163 40.5 180 44.8 thing I do to stay healthy, as well as exercise. If I stay well, it is because of the 177 44.1 157 39.2 grace of the good Lord and eating a balanced diet. It is ok not to seek medical attention 18 4.5 15 3.7 because I feel that God will heal me. There is no point in taking care 10 2.5 4 1.0 of myself when it is all up to God anyway. God and I share responsibility for 148 36.8 191 47.5 my health. God gives me the strength to take 163 40.4 221 54.8 care of myself. It is difficult to talk about my 85 21.0 60 14.9 personal health with clergyman or people of the church. Note: Missing data excluded Table 6: Spearman Results for Correlations Scale Scores Knowledge Help Spirituality Stigma Seeking Knowledge r 1.000 .227 ** .004 -.272 ** Sig. . .000 .939 .000 n 394 361 363 341 Help Seeking r -- 1.000 .037 -.440 ** Sig. -- . .490 .000 n -- 375 352 332 Spirituality r -- -- 1.000 -.056 Sig. -- -- .309 n -- -- 375 335 Stigma r -- -- -- 1.000 Sig. -- -- -- . n -- -- -- 352 Note: Missing data excluded
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|Author:||Neely-Fairbanks, Shameka Y.; Rojas-Guyler, Liliana; Nabors, Laura; Banjo, Otomatayo|
|Publication:||American Journal of Health Studies|
|Date:||Sep 22, 2018|
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