At 20 years old, Yashi Brown began feeling depressed. A few years later, she started having delusions. Manic highs followed. Then thoughts of suicide.
It became clear she needed treatment. Her family, who were practicing Jehovah’s Witnesses, helped her seek therapy and medication.
But not everyone in the faith community understood the support she needed.
“Just pray,” one person said, “and Jehovah will take care of everything.”
That alone wouldn’t help, said Brown, now 40 and a mental-health advocate in Los Angeles. “I was in the throes of a manic episode. I didn’t even have the tools to say a prayer.”
Some religious traditions, coupled with a misunderstanding of mental illness, can stop people from getting mental-health care. Individuals may be told to pray the illness away or trust in God to heal them, psychologists and social workers say.
The impact is especially profound for the African American community, research shows. For complex reasons, including greater exposure to violence, racism, and other trauma, African Americans are 20 percent more likely to report serious psychological distress than their white counterparts. But they are less likely to seek mental-health treatment, even if they have equal financial means.
That is in part due to a lack of trust in government and medical institutions with a history of mistreating African Americans.
But many in the community also accept mental trauma as a normal part of life for generations, said Meagan McLeod, a pastor and spiritual care director for Friends Hospital, a psychiatric hospital in Northeast Philadelphia.
“The idea is if prayer worked for our ancestors when we were in slavery, then prayer has to be able to work now,” she said.
While research shows religion can aid in recovery from mental illness, it’s not always enough, McLeod said.
For Brown, the strict rules of religion and the fear of condemnation from God became too much. “It seemed to be exacerbating my symptoms,” she said.
She drew away from faith.
Ten years later, she would rediscover her spirituality at a crucial moment.
Carter Patterson has worked with several families who saw their child’s mental illness as punishment from God. He saw it first as a teacher, then as a case manager, and now as a board member of the Urban Mental Health Alliance in New Jersey.
One family refused to allow treatment for their daughter’s mental illness because they believed God would heal her, he said. The girl died by suicide while still in her teens.
When people are reluctant to seek medical care, clergy often become first responders. Yet they are not always formally trained for that.
Some have experience in professional counseling. Others will connect people to resources at local clinics. But some, often out of a lack of understanding, will think they can talk someone out of the mental illness, McLeod said. They’ll suggest simply looking at things a different way or coming to church more often.
“That’s not enough,” she said.
And it can leave people with lasting distrust.
At Friends Hospital, African American patients tend to be more wary of McLeod. “It may be because they’re used to the judgment in the African American religious community" they’ve come from, she said.
If patients do speak with her, McLeod will ask if they’d like their pastor from home to join in the conversation. The answer is almost always an unequivocal no.
Instead, patients ask McLeod a question she fields three to four times a day: “Is God angry with me?”
Around the time Brown turned 30, she was in a nearly unbearable depression. Her medications weren’t working.
“I was crying nonstop,” she said. “I was very suicidal.”
Not knowing what else to do, she returned to the way of seeking help she’d learned as a child: prayer.
This time, it wasn’t in a church. She didn’t follow a religious text. It was just her and God.
“A very real physical feeling of peace and comfort started to come over me,” Brown said.
Now she calls spirituality the cornerstone of her healing. It’s as much a part of her routine as therapy and medication.
“It allows me the ability to surrender and elevate my thoughts to something much higher,” she said. “I just had to find it on my own.”
Faith and mental-health treatment can — and often should — work together, mental-health professionals and clergy alike insist. Research suggests higher levels of religiosity or spirituality are associated with lower rates of depression, anxiety, substance-use disorder, and suicidal thoughts. Prayer can have the same calming effects as meditation, such as lowering blood pressure and respiratory rate.
“Religion can serve as a sustainer of mental health,” said Karriem Salaam, a psychiatrist and medical director of the adolescent unit at Friends Hospital.
Many mental-health disorders are chronic, with episodes triggered by stress. “Religion can help you not be as vulnerable to stressors,” said Salaam, who attributes much of his ability to handle stressful work to his faith.
Studies have shown that incorporating religious approaches into mental-health care may be especially helpful in engaging African Americans in treatment.
Loren Johnson-Rosa sees this often in her work as a licensed clinical social worker serving clients with mental illness across New Jersey.
Sometimes parents say it’s God’s will for their child to have a mental illness. But Johnson-Rosa, a practicing Christian, counters that God created the human mind, which led to the development of medication and therapy. “They can all work together,” she says.