TRIBUTE for Bereavement in Communities of Color

Highlights

• Black Americans experience higher rates of chronic illness, lower rates of health utilization, and shorter life expectancy compared to white Americans.
• There are few culturally responsive programs for bereavement and loss, designed to reduce risks of mental health problems.
• The TRIBUTE Program – Training Religious Leaders In Bereavement Counseling to Upskill Treatment Experiences – expands mental health services to reduce racial health disparities by training clergy and healthcare paraprofessionals in communities of color.
• TRIBUTE trains in Interpersonal Psychotherapy (IPT), an evidence-based approach that can reduce depression and anxiety symptoms related to bereavement.
  

Problem

The sudden loss of a loved one (particularly trauma related to COVID-19) increases the likelihood of prolonged grief disorder, mourning that does not resolve with time. This is related to sustained emotional problems, including anxiety, depression, social isolation, and post-traumatic stress disorder. Rates of prolonged grief disorder are higher in people of color than in whites.

Effective treatment for bereavement may decrease the risk of prolonged grief disorder and stress-related health problems.

However, there are not enough resources for individuals to access bereavement counseling, as the COVID-19 pandemic has stretched the demand for mental health services. There are also significant systemic barriers that impede individuals in communities of color from accessing mental health treatment and bereavement counseling, including concerns about being misunderstood or experiencing microaggressions.

Many people of color want to access services in the communities where they live with providers who are connected to these communities. While clergy and paraprofessionals, such as nursing assistants and healthcare aides, provide support for grieving individuals in communities of color, most do not have formal training in mental health.

Solution

Bereavement is a mental health need in black communities and has been highlighted in the Homewood Comprehensive Plan (2020) as a less stigmatizing point of entry for individuals to access and engage in mental health treatment.

Interpersonal Psychotherapy (IPT) is a long-established, evidence-based intervention to reduce depression related to bereavement. Partnering with clergy and health paraprofessionals who already provide counseling support can help address barriers, increase access to and enhance outcomes for mental health services in communities of color.

People of color are willing to seek out mental health services from faith-based organizations, so to increase access and utilization of mental health services for bereavement, we need to adapt existing evidence-based treatments for communities of color. TRIBUTE will work to train clergy and paraprofessionals within these communities to provide these services, and deliver these services through churches and community centers.

Path to Impact Plan

Black residents of Pittsburgh (22% of the Pittsburgh population) experience significant disparities in health and well-being, with rates of fetal deaths twice the rate of those seen in whites, mortality rates higher than those seen in similar sized cities, and cardiovascular disease death rates as being considerably higher compared to Black residents in other cities.

The TRIBUTE Program will create a training program for teaching and supervising clergy and other paraprofessionals to provide group IPT, an evidence-based intervention that can reduce depression related to bereavement.

We propose to build capacity for training by empowering investigators as future culturally-responsive IPT trainers, develop a large-scale standard training platform for clergy and paraprofessionals, and evaluate the clinical outcomes (depressive symptoms, stress).

While our work will focus on Homewood community in Pittsburgh, this research on the effectiveness of training clergy and paraprofessionals and the clinical outcomes of their services will provide a model for large-scale adoption by communities of color across the country.

Team

• Laura J. Dietz, PhD (Pitt Clinical Rehabilitation & Mental Health Counseling) is a clinical and developmental psychologist, a certified trainer in IPT, and has expertise in developing, adapting, and evaluating evidence-based psychotherapies.
• Channing L. Moreland, EdD (Pitt Health and Rehabilitation Sciences & Office of Equity, Inclusion and Community Engagement) is the Director of the Pitt Wellness Pavilion.
• Quiana Golphin, PhD (Pitt Assistant Professor, Clinical Rehabilitation & Mental Health Counseling) is an ordained minister at Deliverance Baptist Church in Wilkinsburg, PA.
• Khavah Murray, LCSW is Director of Behavioral Health & Social Services at the Alma Illery Medical Center, the only community health provider in Homewood that offers behavioral health services.
• Dr. Jonathon Counts, D.Min, LCSW is Pastor of the Homewood AME Zion Church.
• Lena Verdeli, PhD (Columbia University Clinical Psychology) is a technical advisor for the WHO on global dissemination of psychosocial treatments by paraprofessionals.