title: Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care.
abstract: Little is known about the prevalence or predictors of seeking help for depression and PTSD from spiritual counselors and clergy. We describe openness to and actual help-seeking from spiritual counselors among primary care patients with depression. We screened consecutive VA primary care patients for depression; 761 Veterans with probable major depression participated in telephone surveys (at baseline, 7 months, and 18 months). Participants were asked about (1) openness to seeking help for emotional problems from spiritual counselors/clergy and (2) actual contact with spiritual counselors/clergy in the past 6 months. At baseline, almost half of the participants, 359 (47.2%), endorsed being "very" or "somewhat likely" to seek help for emotional problems from spiritual counselors; 498 (65.4%) were open to a primary care provider, 486 (63.9%) to a psychiatrist, and 409 (66.5%) to another type of mental health provider. Ninety-one participants (12%) reported actual spiritual counselor/clergy consultation. Ninety-five (10.3%) participants reported that their VA providers had recently asked them about spiritual support; the majority of these found this discussion helpful. Participants with current PTSD symptoms, and those with a mental health visit in the past 6 months, were more likely to report openness to and actual help-seeking from clergy. Veterans with depression and PTSD are amenable to receiving help from spiritual counselors/clergy and other providers. Integration of spiritual counselors/clergy into care teams may be helpful to Veterans with PTSD. Training of such providers to address PTSD specifically may also be desirable.
authors.affiliation: VA Puget Sound Geriatric Research, Education and Clinical Center (GRECC) and Health Services Research & Development (HSR&D), GRECC-S-182, 1660 S. Columbian Way, Seattle, WA 98018, USA. Laura.bonner@va.gov
authors.forename: Laura M
authors.initials: LM
authors.lastname: Bonner
authors.forename: Andy B
authors.initials: AB
authors.lastname: Lanto
authors.forename: Cory
authors.initials: C
authors.lastname: Bolkan
authors.forename: G Stennis
authors.initials: GS
authors.lastname: Watson
authors.forename: Duncan G
authors.initials: DG
authors.lastname: Campbell
authors.forename: Edmund F
authors.initials: EF
authors.lastname: Chaney
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Rubenstein
mesh_terms: D000368:Aged; D002977:Clergy; D015897:Comorbidity; D003376:Counseling; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D012069:Religion and Psychology; D026443:Spiritual Therapies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*