The Black Church Is a First Stop for Mental Health Support. Pastors Need Partners.

Many Black churchgoers turn to their pastors first when they are struggling. Strong bridges to culturally humble professional care could help close a persistent treatment gap.

By EEW Magazine Online Health & Wellness Editors

For many Black believers, the church is the first place they turn in times of distress. (Credit: EEW Magazine)

For generations, Black churches have served as trusted places for people experiencing grief, family difficulties, emotional distress and personal crises. When the weight becomes too much, many Black believers take it to the pastor first. A 2022 study highlighted by Rice University found that Black and Latino congregants often sought mental health support from pastors rather than clinicians.

Researchers also found that pastors frequently lacked the resources, time and professional referral networks needed to address those concerns.

“Regardless of whether they want to be or not, pastors are on the front lines of this mental health crisis,” said Rice researcher Dan Bolger, whose team held focus groups with 14 pastors and interviewed 20 congregants in Houston.

That trust creates an opportunity to connect people with professional mental health services. It also places the church at the center of a larger question about America’s mental health system: What happens when someone finds the courage to seek help but struggles to find a professional she can trust?

According to the Substance Abuse and Mental Health Services Administration’s 2024 National Survey, just 38.5% of Black adults experiencing mental illness received treatment that year, compared with 57.9% of White adults. Hispanic adults received treatment at a rate of 44.1%, while Asian adults had the lowest rate among those four groups, at 32.5%. The disparities persisted even after researchers accounted for demographic and geographic differences.

The figures reflect a complicated problem involving insurance, affordability, provider availability, stigma and other barriers. They also invite closer examination of what patients experience when they finally enter the mental health system.

A young Black woman, identified in a research study by the pseudonym Kay, needed someone to talk to after being diagnosed with triple-negative breast cancer. All the fears of being diagnosed with an aggressive form of the disease weighed on her. She sought mental health treatment, but the bond she needed never developed.

“I met with a therapist one time. I didn’t connect with him,” she recalled. The therapist was a middle-aged White man, she explained, and she did not feel like talking to him.

Her experience is documented in a study conducted by SHARE Cancer Support and researchers at the University of South Carolina. Kay made it to the therapist’s office, and the care still did not take hold. For a pastor making a referral, that is the risk waiting on the other end.

A clinician may understand the symptoms of depression, anxiety or post-traumatic stress disorder but know relatively little about the cultural experiences shaping a patient’s life. For some Black women, those experiences include racial discrimination, family expectations, religious beliefs and the pressure to remain strong while managing enormous personal responsibilities.

A woman who has learned to conceal emotional distress may struggle to describe what she is feeling. Another may hesitate to discuss her religious beliefs out of concern that a clinician will misunderstand them. Someone who has previously experienced discrimination in health care may enter treatment uncertain whether her concerns will be taken seriously.

Cultural humility asks clinicians to listen, ask questions and keep learning from each patient.

These experiences call for a therapist willing to listen, ask questions and acknowledge the limits of personal knowledge. This approach is known as cultural humility.

The concept was introduced in a widely cited 1998 paper by pediatricians Melanie Tervalon and Jann Murray-García. They argued that effective cross-cultural care requires continuing self-examination, awareness of power imbalances and respectful partnerships with patients and communities. Under that approach, a clinician keeps learning from each patient, however many years of training she brings to the room.

Black therapists can misunderstand Black patients, just as clinicians from other backgrounds can build strong, trusting relationships with them. In either case, the relationship depends on a provider’s ability to recognize individual experiences and respond with sensitivity and skill.

As of December 2025, approximately 137 million Americans lived in federally designated mental health professional shortage areas. According to KFF’s analysis of federal workforce data, available providers met only about 27% of the estimated need in those areas.

The profession also remains unevenly represented. A 2022 report by the Association of Black Psychologists cited figures indicating that Black professionals accounted for approximately 4% of psychologists and 2% of psychiatrists in the United States.

Expanding the pipeline of Black mental health professionals is important. So is ensuring that clinicians of every background receive meaningful training in culturally responsive care.

Patients should have opportunities to ask questions, express discomfort, discuss cultural or religious concerns and request another provider when a therapeutic relationship is unsuccessful. Health systems, meanwhile, must look further than the initial referral to assess whether patients can get timely appointments, afford continued treatment, feel respected, and keep coming back.

Pastors and ministry leaders are often the first to hear when a congregant is struggling.

Congregations can help by identifying qualified counselors, sharing information about affordable treatment and preparing ministry leaders to recognize signs of psychological distress. Pastors can also address misconceptions about therapy and psychiatric medication, particularly among some believers who have been taught to interpret mental illness primarily as a spiritual problem.

For churches encouraging people to pursue professional care, cultural humility matters on both sides of that referral. Ministry leaders need to respect the expertise of mental health professionals, while clinicians need to recognize the important role faith may play in a patient’s identity, relationships and recovery.

Micah 6:8 calls believers “to do justly, and to love mercy, and to walk humbly with thy God” (KJV). That call to humility has practical implications for anyone entrusted with another person’s well-being.

Addressing disparities in mental health care requires coordinated action from medical institutions, training programs, policymakers and community organizations.

Empowering Everyday Women Ministries is contributing to that effort through the American Alliance for Black Mental Wellness, a mental health advocacy initiative co-founded by EEW founder Dianna Hobbs and her husband, Kenya Hobbs. Under the banner “Healing Our Community. Empowering Our Future,” the initiative advocates for accessible, compassionate, stigma-free mental health support across Black communities.

The broader challenge is to ensure that people who seek help can find professionals equipped to understand their concerns and provide appropriate treatment.

For patients like Kay, the first appointment was an important step. Yet her experience illustrates how easily the promise of care can fall short when a patient feels disconnected from the person providing it.

A successful mental health system makes room for patients to be heard. Getting someone through the door is the beginning, and what happens after she sits down matters just as much. For pastors who are often the first to hear a congregant’s pain, that means making sure every referral leads to someone ready to listen.