US Religious Leaders' Views on the Etiology and Treatment of Depression.

Importance: Religious leaders commonly provide assistance to people with mental illness, but little is known about clergy views regarding mental health etiology and appropriate treatment. Objective: To assess the views of religious leaders regarding the etiology and treatment of depression. Design, Setting, and Participants: This cross-sectional study used the National Survey of Religious Leaders, which is a nationally representative survey of leaders of religious congregations in the United States, with data collected from February 2019 to June 2020. Data were analyzed in September and October 2022. Main Outcomes and Measures: Views about causes of depression (chemical imbalance, genetic problem, traumatic experience, demon possession, lack of social support, lack of faith, and stressful circumstances) and appropriate treatments (seeing a mental health professional, taking prescribed medication, and addressing the situation through religious activity). Results: The analytic sample was limited to congregations' primary leaders (N = 890), with a 70% cooperation rate. Clergy primarily endorsed situational etiologies of depression, with 93% (95% CI, 90%-96%) endorsing stressful circumstances, 82% (95% CI, 77%-87%) endorsing traumatic experiences, and 66% (95% CI, 59%-73%) endorsing lack of social support. Most clergy also endorsed a medical etiology, with 79% (95% CI, 74%-85%) endorsing chemical imbalance and 59% (95% CI, 52%-65%) endorsing genetics. A minority of clergy endorsed religious causes: lack of faith (29%; 95% CI, 22%-35%) or demon possession (16%; 95% CI, 10%-21%). Almost all of the religious leaders who responded to the survey would encourage someone with depressive symptoms to see a mental health professional (90%; 95% CI, 85%-94%), take prescribed medication (87%; 95% CI, 83%-91%), and address symptoms with religious activity (84%; 95% CI, 78%-89%). A small but nontrivial proportion endorsed a religious cause of depression without also endorsing chemical imbalance (8%; 95% CI, 5%-12%) or genetics (20%; 95% CI, 13%-27%) as a likely cause. A similar proportion would encourage someone exhibiting depressive symptoms to engage in religious treatment without also seeing a mental health professional (10%; 95% CI, 5%-14%) or taking prescribed medication (11%; 95% CI, 8%-15%). Conclusions and Relevance: In this cross-sectional survey, the vast majority of clergy embrace a medical understanding of depression's etiology and treatment. When clergy employ a religious understanding, it most commonly supplements rather than replaces a medical view, although a nontrivial minority endorse only religious interpretations. This should encourage greater collaboration between medical professionals and clergy in addressing mental health needs.

Religious Congregations' Technological and Financial Capacities on the Eve of the COVID-19 Pandemic.

Background: The COVID-19 pandemic dramatically upended religious life and placed significant strain on religious congregations. However, the effects of the pandemic were likely not felt evenly across the religious landscape. Purpose: We used data from the fourth wave of the National Congregations Study, gathered on the eve of the coronavirus pandemic in 2018-19, to identify the kinds of congregations that may have been especially vulnerable to the challenges of the COVID-19 pandemic. Methods: Using bivariate and multiple regression analysis, we examined two aspects of congregations' preparedness for the pandemic: technological infrastructure and financial stability. Results: We found that, while many congregations were technologically and financially equipped for a time of social distancing and economic recession, there were stark inequalities in levels of preparedness among congregations on the basis of race, class, size, urban/rural location, religious tradition, and the age of congregations' parishioners. In particular, Catholic congregations and congregations with older attendees tended to lack streaming or online communication capacities, and both rural and small congregations had more limited technological infrastructure and less financial cushion. Somewhat surprisingly, predominantly Black congregations were more likely to have worship streaming systems set up prior to the pandemic, though these congregations were more likely to lack other kinds of technological and financial infrastructure. Conclusions and Implications: Though COVID-19's full impact on congregations will not be known for several years, these results highlight variations in congregations' readiness for the pandemic's challenges, and they show that COVID-19's impact likely has not been felt equally across the religious landscape.

Does disestablishment lead to religious vitality? The case of Switzerland.

Economists and sociologists of religion have claimed that religious establishment dampens religious vitality, leading to lower recruitment efforts, low attendance, declining membership within established congregations, and the 'crowding out' of non-established congregations. Conversely, these authors have told us, disestablishment will lead to more religious vitality. Remarkably, even though these claims rest on the connection between establishment and the organizational and membership behaviour of local religious congregations, no research has directly examined that connection. We use the 2008 Swiss National Congregations Study as well as historical data to assess the effect of different levels of religious establishment on both established and non-established congregations. We find that established congregations do indeed show less religious vitality than non-established congregations. Contrary to the claims of the economic literature, however, these covariations are not caused by differences in religious establishment on the cantonal level. Both our quantitative and historical analyses show that disestablishment has not led to religious vitality for either established or non-established congregations. The only clear effect of disestablishment is a dramatic decrease of income for established congregations. Based on quantitative and historical evidence, we suggest that differences between established and non-established congregations are produced by differences in religious tradition and immigration flows, not by differences in levels of establishment.

Proportion of US congregations that have people living with HIV.

Surveillance studies monitor the prevalence and incidence of HIV, and this information is used by policy makers to design prevention programs and facilitate care for people living with HIV (PLWHIV). Although most of these studies monitor the presence of PLWHIV in the general population or specific communities, some assess the presence of PLWHIV in organizations. One type of organization that has not been examined, yet could potentially play a large role in caring for PLWHIV, is the religious congregation. In this study, we estimate the proportion of US religious congregations that have PLWHIV and examine whether congregations that are in contact with populations with high HIV prevalence and incidence rates are more likely to have PLWHIV using data from a nationally representative sample of congregations and the 2000 Census. Over 10,000 congregations have PLWHIV, and congregations containing, open to, or located in areas with populations with high HIV prevalence and incidence rates are more likely to have them. This study offers new insight into the presence of HIV in the United States and provides information about which congregations may be amenable to serving as sites of HIV programs.