Mental health: Black, Christian and struggling with mental health

The qualified and accredited psychotherapist explains that while mainstream services repeatedly fail to understand the unique needs and outlook of Christians from African and African-Caribbean backgrounds particularly, black-majority churches can often be superstitious about conditions of the mind and seldom have the expertise in place to help.

In this interview with the Evangelical Alliance, Dr Burrell – who has a track record of developing counselling services within education, the voluntary sector and churches – unpacks some of the challenges faced by BME Christians and says certain measures can be introduced to help believers who are struggling with mental health problems. 

You led a project entitled ​‘The black-majority church: Exploring the impact of faith and a faith community on mental health and wellbeing’. Why was it necessary to do this work?

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Black-majority churches (BMCs) have withstood changing political and social climates and have been a place of refuge and restoration for many members of the black community. Add to this, according to research by independent charity Christian Research (published in 2006), BMCs are the fastest-growing group of Christians in the UK. 

Yet, despite this huge contribution and growth, many congregants believe church leaders need to do more to provide a holistic approach to mental health concerns – one that encompasses both spiritual and psychological interventions. And, since black people are still overrepresented in the mental health system, something clearly doesn’t add up. 

For these reasons, I have taken the initiative to investigate the experiences of BME Christians who have mental health problems. The result has been a research report (a summary of which is available upon request) as well as a suite of much-needed resources, to help churches support congregants who are struggling with mental health problems.

You argue that individuals from BME backgrounds have a unique set of challenges that may make them susceptible to mental health problems. Can you explain what you mean?

There is a complex interplay of factors that can affect the mental health of ethnic minority communities. In addition to common everyday concerns such as money worries and work-related stress, African and African-Caribbean communities face further problems that can affect their mental health, such as sub-standard housing, unemployment and racism. 

Many BME groups, for example, experience higher rates of poverty than their white-British counterparts in terms of income, benefits use, unemployment, access to basic necessities, and area deprivation.

Additionally, as highlighted by the Mental Health Foundation in 2014, people who move from one country to another have a higher risk of mental illness. This is especially true for black people who move to predominantly white countries, and the risk is even higher for their children. Therefore, mental illness can be a serious problem for African and African-Caribbean communities living in the UK.

Other challenges you highlight are BME groups’ attitudes towards mainstream mental health care and how professional services perceive and treat BME communities. First, what do you think mainstream services are getting wrong?

Mainstream mental health services often fail to understand or provide services that are acceptable and accessible to BME communities, particularly when it comes to their cultural or religious needs. For instance, BME communities face significant barriers to accessing psychological therapies as often many local areas lack culturally sensitive and tailored services which meet the diverse needs of the local population.

The We Need to Talk coalition’s ​‘We still need to talk’ report (2014) on access to psychological therapies revealed that people from BME communities have long been under-served in primary mental health services and are much less likely than other groups in the UK to be referred to psychological therapies.

Yet, in general, people from BME communities are more likely to be diagnosed with mental health problems. They’re also more likely to be diagnosed and admitted to hospital, more likely to experience a poor outcome from treatment, and they’re more likely to disengage from mainstream mental health services, which leads to social exclusion and a deterioration in their mental health.

How do the actions of BME communities, or lack thereof, add to the issues seen within mainstream services? 

It is likely that mental health problems go unreported and untreated because people in some ethnic minority communities are reluctant to engage with mainstream health services. So great is the fear of misunderstanding and misdiagnosis within services, that users avoid them, leading to further deterioration and crisis point.

According to the Mental Health Foundation (2014), BME communities have a higher propensity towards receiving an over-diagnosis — being deemed schizophrenic and sectioned under the Mental Health Act. And, since 2009, they’re more likely to be placed on community treatment orders. 

Dr Fernando A. Wagner, a professor at the University of Maryland School of Social Work, wrote in 2012 that black people are more likely than any other group to be deemed both ​‘mad’ and ​‘bad’, detained in psychiatric institutions and neither referred to nor accepted for counselling or psychotherapy. While his research pertained to the US, I’d argue that the experiences of black people in Britain are similar. 

While you say local churches are a valuable source of support for Christians who have mental health problems, you highlight that many aren’t equipped to offer adequate help. First, why do you believe churches can help people who have mental health problems?

With regards to the role of the church in helping individuals with mental health distress, researchers have found that, historically, churches have provided a range of help and support to such individuals, though churches’ efforts in this area have often been undervalued and overlooked.

Focusing on black-majority churches (BMCs) specifically, they appear to have a holistic approach to meeting the spiritual, educational, social and economic aspirations of BME communities. In recent years, some of the interventions undertaken by BMCs have been commended by political figures, who have recognised their contributions to community development and cohesion. 

A typical example is the social engagement of Evangelical Alliance member Jesus House, which is in active collaboration with the Prince’s Trust, a charity that supports 11 to 30 year olds who are unemployed or at risk of being expelled from school. Prince Charles commended the London-based church’s work during his 59^th birthday celebrations at Jesus House in November 2007. 

Similarly, the Evangelical Alliance member church where I serve on the leadership team, Ruach City Church, also based in London, has received visits from various political figures including former UK prime minister Tony Blair, former Labour Party leader Ed Milliband, incumbent London mayor Sadiq Khan, Diane Abbott MP, the current shadow home secretary, and various local officials, who celebrated its work around mental health and community initiatives. 

So, if the work of BMCs is being recognised and commended by political leaders, and even a member of the monarchy, what do you think is lacking in the support they offer congregants? 

My research project, ​‘The black-majority church: Exploring the impact of faith and a faith community on mental health and well-being’, examined and interpreted some of the problems, coping strategies and help-seeking behaviour of black Christians attending black-majority churches. 

My findings suggest that while music, prayer, activities around the Bible, and belonging to a church provide a positive sense of wellbeing, a lack of understanding of mental health issues within the church, plus distrust, ignorance and inadequate training and qualifications among leadership teams, contribute to a negative impact on mental health and wellbeing.

Participants recovering from, or living with, mental health difficulties stressed that leaders should be better equipped to deal with the congregants’ mental health concerns. Additionally, they voiced a wish to be respected, to be treated with kindness, to receive a warm welcome when they attend church services, and to be contacted regularly. 

A culture of acceptance, openness and destigmatising mental health problems, rather than spiritualising and demonising them, was emphasised. Participants pointed out that a culture such as this could only exist where church leaders themselves take good care of their own spiritual growth and wellbeing. 

What steps have you and colleagues taken to remedy some of these problems?

In direct response to concerns raised by participants in my study, I have worked with others to develop a range of resources, including: 

• Sozo Therapeuo, a mental health resource to promote, improve and maintain good mental health within churches;
• a therapist directory of qualified Christian counsellors and psychotherapists; 
• bespoke training packages and workshops designed to meet the needs of individual churches; 
• training manuals for pastors, entitled ​‘Mental Health Awareness for Churches and Counselling Skills’;
• clinical supervision for pastors; and
• a church-based therapy forum and a mental health champions training programme.

It seems like a significant shift in church culture is required to bring about meaningful and effective change.

Overall, there remains a need to create supportive and respectful church cultures in which everyone is aware that mental health and the need to take care of it are both universal and essential considerations, regardless of faith or ethnicity.

To create an inclusive, supportive and safe church environment for those experiencing mental health distress requires: 

• every individual to invest in their own mental health;
• churches positioning themselves as information hubs, promoting health and wellbeing through partnerships with community organisations; 
• churches utilising skills and expertise within their congregations; and 
• greater emphasis on mental health awareness training for leadership teams and members in general. 

For more information and to check out the resources listed above, visit the Sozo Therapeuo website.