Sources of Care for Alcohol and Other Drug Problems

The Role of the African American Church

Published in: Journal of Religion and Health [Epub May 2017]. doi: 10.1007/s10943-017-0412-2

Posted on RAND.org on June 06, 2017

by Eunice C. Wong, Kathryn Pitkin Derose, Jeremy N. V. Miles

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Research Questions

  1. How are problems with alcohol and other drug (AOD) use identified within congregations?
  2. What types of support are offered, and what barriers do congregations experience in offering support?
  3. What factors are associated with referrals from congregations to formal AOD services, outside the church?

African Americans experience significant disparities in treatment access, retention, and quality of care for alcohol and drug use (AOD) problems. Religious congregations, often the first point of contact for help with AOD problems, can play an integral role in improving access to treatment. However, little is known about the role of African American churches in addressing AOD problems. We administered a survey to a faith-based collaborative of 169 African American churches in Los Angeles to examine how AOD problems are identified in congregations, the types of support provided, barriers to providing treatment referrals, and factors associated with the provision of treatment referrals. Seventy-one percent of churches reported caring often for individuals with AOD problems. AOD problems came to the attention of congregations most commonly via a concerned family member (55%) and less frequently through individuals with AOD problems directly approaching clergy (30%). In addition to providing spiritual support, a substantial proportion of churches reported linking individuals to AOD services through referrals (62%) and consultation with providers (48%). Barriers to providing treatment referrals included lack of affordable programs (50%), stigma (50%), lack of effective treatments (45%), and insufficient resources or staff (45%). The likelihood of providing treatment referrals was greater among mid-sized versus smaller-size congregations (OR 3.43; p < .05) and among congregations with clergy that had attended seminary (OR 3.93; p < .05). Knowing how to effectively coordinate informal sources of care provided by African American churches with the formal service sector could make a significant impact on AOD treatment disparities.

Key Findings

  • Many African American churches in the Los Angeles area in the study provide support that would be classified as recovery supports and services.
  • Churches with more than 100 but less than 500 members were the most likely to provide referrals to providers—three times more likely than churches with fewer than 99 members.
  • A significant number of congregations actively connect individuals to formal AOD treatment through referrals to providers and encourage individuals to stay in treatment.
  • Despite active involvement with individuals, barriers to care include individuals avoiding treatment due to shame or stigma, inability to connect with an effective provider, and lack of cultural or religious sensitivity among providers.
  • Family members, church members, or church leaders often help identify individuals in need of treatment.

Recommendation

Integrating education on AOD issues with seminary or clergy training could help churches address the needs of individuals who struggle with AOD disorders.

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