Mental Health and African Pentecostalism: Unpacking the Two Sides of the Coin

There is a gap in understanding how beliefs in demonic forces affect perceptions and therapeutic methodologies. This study, therefore, examined the tensions that exist in dealing with mental health matters in African Pentecostal churches. This paper used social constructionism as a theoretical framework. Data for this study were collected through qualitative desktop analysis. The research revealed a prevalent tendency among African Pentecostal pastors to attribute mental disorders primarily to supernatural influences, including demonic possession and spiritual attacks. This perspective significantly influences mental health care approaches within these churches, often leading to excessive reliance on spiritual practices such as prayer, anointing with oil, and exorcisms. The key findings suggest that excessive spiritualization may lead to the stigmatisation of individuals with mental illness and could obstruct access to professional mental health services. This paper concludes that there is tension between neurophysiological interpretations and Pentecostal faith-based perspectives on mental health concerns. The paper recommends collaboration between the spiritual support provided by Pentecostal churches and mental health practitioners to deliver more comprehensive and culturally sensitive mental health care practices in African communities. The paper enhances scholarship by elucidating evolving African Pentecostal perspectives on mental health, underscoring the necessity for collaboration between clergy and professionals to create culturally attuned, comprehensive mental health therapies. Keywords: Mental Health, African Pentecostalism, Psychiatry, Over-Spiritualisation, Spirituality, Religion.

Opportunities in mental health services research.

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

Pentecostal scholarship in and about Africa is a vibrant arena in world Christianity, with an upswing in the proliferation of scholarly works on Pentecostal Churches and its centrality in the political and social fabric of African societies. Pentecostalism has been hailed for revival of Christian conservatism in Sub-Saharan Africa, predominated by the nominal Roman Catholics and Protestant Christianity. While some authors have studied African Pentecostalism with prejudgments based on other Christian traditions, some have hailed the theological innovations in healing and evangelism. The study of the Pentecostal end of year worship festivals unravels one of the innovations that justifies the uniqueness of African Pentecostalism, promulgating theologies and traditions on the one hand, and reinventing Judeo-Christian practices in African perspectives, which in a sense give African Pentecostal Churches a claim to divine originality, on the other. In another way, theologies, traditions, and practices emerging from the observance of the annual Pentecostal worship festivals place African Pentecostal Churches among the towering African Christian traditions, which then borrow rather than debunk such Pentecostal theological innovations. This article therefore discusses the Pentecostal Church reinvention of the ancient Jewish Passover festival to mirror the lives of African Christians in contemporary contexts. The 'contextual theology' analysis is employed to reflect on both the Jewish Passover and annual Pentecostal worship festivals, with a view of establishing how Passover (non-)parallels and reinventions have produced African Pentecostal theologies, traditions, and practices defining the uniqueness of African Pentecostalism.

In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

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Previous analyses demonstrated an elevated occurrence of perceived unmet need for mental health care among persons with co-occurring mental and substance use disorders in comparison with those with either disorder. This study built on previous work to examine these associations and underlying reasons in more detail. Secondary data analyses were performed on a subset of respondents to the 2002 Canadian Community Health Survey (unweighted N=4,052). Diagnostic algorithms classified respondents by past-year substance dependence and selected mood and anxiety disorders. Logistic regressions examined the associations between diagnoses and unmet need in the previous year, accounting for recent service use and potential predisposing, enabling, and need factors often associated with help seeking. Self-reported reasons underlying unmet need were also tabulated across diagnostic groups. Of persons with a disorder, 22% reported a 12-month unmet need for care. With controls for service use and other potential confounders, the odds of unmet need were significantly elevated among persons with co-occurring disorders (adjusted odds ratio=3.25; 95% confidence interval=1.96-5.37). Most commonly, the underlying reason involved a preference to self-manage symptoms or not getting around to seeking care, with some variation by diagnosis. The findings highlight potential problems for individuals with mental and substance use disorders in accessing services. The elevated occurrence of perceived unmet need appeared to be relatively less affected by contact with the health care system than by generalized distress and problem severity. Issues such as stigma, motivation, and satisfaction with past services may influence help-seeking patterns and perceptions of unmet need and should be examined in future work.

Notes of a traveller

The Robert Wood Johnson Foundation (RWJF) Program on Chronic Mental Illness has come to an end. Launched in December 1986, it was the foundation’s first multisite national venture into mental health care. The program sought to establish improved systems of care for persons with serious and long-term mental disorders in nine major cities across the country. Now, almost six years later, the grant period has ended, and it is time to take stock. The nine demonstration programs are still intact, with more than 250 staff in place at the sites. Throughout the program’s lifetime it received $22.5 million in RWJF grant funds, $9 million in foundation loan funds to stimulate housing development, and 1,200 Section 8 housing certificates, issued by the U.S. Department of Housing and Urban Development (HUD). One view of the impact of this program is offered by Howard Goldman and his colleagues, based on a formal evaluation funded by RWJF and a consortium of federal agencies.’ But there is another view of the program’s impact: the subjective impressions of the national program office staff and the staff at the nine demonstration sites. This perspective has been enriched by RWJF’s style of grant management, which is to fund a partnership between the national program office (typically in a university) and the demonstration sites. Instead of awarding the grant and coming back later to assess the results, RWJF requires that each demonstration site develop its program in collaboration with the national program staff. The national office maintains constant contact with the sites to monitor progress and solve immediate problems and carries out numerous site visits, with special conferences among the sites and other direct contact as needed. This management style affords the national program staff an intimate view of the demonstration sites and an opportunity to compare them as they face common situations.

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