Sources of Care for Alcohol and Other Drug Problems: The Role of the African American 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.

Project overview of the Restoration Center Los Angeles: steps to wholeness--mind, body, and spirit

OBJECTIVES

Unmet needs for depression and substance abuse services are a concern in urban communities. This article summarizes the design and recommendations of the Restoration Center Planning Project to better address depression and substance abuse while promoting resiliency and wellness for persons of African descent in South Los Angeles.

DESIGN

A partnered participatory planning process during 18 months involving community members, faith-based and service agency leaders, and investigators from academic organizations was implemented. Leaders formulated a set of principles to address diversity of the group, hosted community conferences and working groups, while developing recommendations.

RESULTS

The community-academic partnership recommended the establishment of restoration centers in Los Angeles (RCLAs) that would serve as a one-stop shop for holistic services addressing depression, substance abuse, related social and spiritual needs, and coordinated care with a network of existing community-based services. Specific recommendations included that the RCs would aim to: 1) support community resilience and improve outcomes for depression and substance abuse; 2) be one-stop shops; 3) promote cultural competency; 4) facilitate ongoing community input and quality review; 5) assure standards of quality within centers and across the broader network; and 6) support the enterprise through a multi-stakeholder community-based board dedicated to RCLA goals.

CONCLUSION

A community-academic partnered planning process acknowledged the importance of respect for diversity and formulated plans for the Restoration Center network including the integration of health, social, cultural, and faith-based approaches to services with a multi-agency network and community leadership board. The feasibility of the plan will depend on the subsequent implementation phase.

Addressing unmet mental health and substance abuse needs: a partnered planning effort between grassroots community agencies, faith-based organizations, service providers, and academic institutions

OBJECTIVE

To conduct a process evaluation of the Restoration Center Los Angeles, a community-academic partnered planning effort aimed at holistically addressing the unmet mental health and substance abuse needs of the Los Angeles African American community.

DESIGN

Semi-structured interviews with open-ended questions on key domains of partnership effectiveness were conducted with a random stratified sample of participants varying by level of involvement.

PARTICIPANTS

Eleven partners representing grassroots community agencies, faith-based organizations, service providers, and academic institutions.

MEASURES

Common themes identified by an evaluation consultant and partners relating to partnership effectiveness, perceived benefits and costs, and future expectations.

RESULTS

Findings underscore the importance of considering the potential issues that may arise with the increasing diversity of partners and perspectives. Many of the challenges and facilitating factors that arise within academic-community partnerships were similarly experienced between the diverse set of community partners. Challenges that affected partnership development between community-to-community partners included differences in expectations regarding the final goal of the project, trust-building, and the distribution of funds. Despite such challenges, partners were able to jointly develop a final set of recommendations for the creation of restoration centers, which was viewed as a major accomplishment.

CONCLUSIONS

Limited guidance exists on how to navigate differences that arise between community members who have shared identities on some dimensions (eg, African American ethnicity, Los Angeles residence) but divergent identities on other dimensions (eg, formal church affiliation). With increasing diversity of community representation, careful attention needs to be dedicated to not only the development of academic-community partnerships but also community-community partnerships.