Factors critical for implementing a sustainable depression intervention in faith-based settings.

Abstract

Background: There is an adverse circuitous relationship between intimate partner violence (IPV) victimization, depression, and femicide, disproportionately affecting depressed Black women IPV survivors, hereafter referred to as "depressed survivors", who lack access to culturally responsive care. The Black church has long-been a trusted resource and may be a viable pathway for depression care delivery.

Purpose: Plan for implementing a sustainable mental health intervention for depressed survivors help-seeking in faith-based organizations.

Methods: We conducted individual, in-depth interviews with 10 Black women IPV survivors, hereafter referred to as "survivors," 10 women clergy or lay ministry leaders and 10 mental health providers. The integrated sustainability framework (ISF) guided interview protocol development and analysis. Inductive-deductive thematic analysis was employed.

Results: Factors were found in five ISF domains: (i) outer/community context, (ii) inner/church context, (iii) processes, (iv) intervention characteristics, and (v) interventionist/lay provider characteristics. The funding environment and sociopolitical context emerged as critical outer/community contextual factors. Within the inner/church context, clergy- and lay ministry leader-participants highlighted the need for pastoral support, program champions, and organizational resources/funding. Among processes, the need for stepped care with community partners for crisis referrals as needed, as well as training and supervision were identified. Intervention characteristics included perceived need, adaptability, and contextual fit. As it relates to interventionist/lay provider characteristics, survivor-participants emphasized the demand for discreet, psychologically healthy, and proficient lay health providers.

Conclusion: Findings point to the elements critical for developing and implementing sustainable solutions for depressed survivors help-seeking in the Black church. Fundamental to achieving mental health equity is employing collaborative approaches that respond to the nuanced needs and cultural preferences of this historically marginalized community of depressed survivors.