Clergy members have the unique opportunity to improve mental health treatment access and decrease the service need gap in rural communities. Very little is known about their role in referring older adults with depressive symptoms to mental health providers. The aim of this study was to examine predictors of rural, mainline Christian clergy members’ intentions to provide counseling to older congregants with depression/refer to another clergy member versus refer to a mental health provider. A cross-sectional, Internet-based survey was distributed to clergy in two rural states. Participants were presented with case scenarios depicting an older adult with mild-to-moderate and moderate-to-severe depressive symptoms. Predictors of intent to counsel or refer to a mental health provider were examined. Of the 101 clergy members who completed the survey, the majority referred to a mental health provider as opposed to providing counseling themselves or referring to another clergy member. Clergy with high depression knowledge and strong endorsement of an organic etiological model of depression were more likely to refer to a mental health provider, &khgr;2(11) = 28.56, p = .003. Qualitative findings suggested a complex approach to referral, including factors such as congregant characteristics. Interventions to enhance the clergy’s knowledge about late-life depression and mental illness etiology as well as skills to provide brief, evidence-based depression treatment to older congregants may improve mental health treatment access in rural communities. Likewise, programs that facilitate collaboration between clergy members and mental health providers may further support rural mental health care.

中文翻译：

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农村神职人员和老年抑郁症：提供咨询与参考心理健康提供者的预测因素。

神职人员拥有独特的机会来改善心理健康治疗的可及性并减少农村社区的服务需求差距。关于他们将有抑郁症状的老年人转介给心理健康提供者的作用知之甚少。本研究的目的是检查农村主流基督教神职人员向患有抑郁症的老年会众提供咨询/转介另一位神职人员与心理健康提供者的意图的预测因素。一项基于互联网的横断面调查已分发给两个农村州的神职人员。向参与者展示了描述具有轻度至中度和中度至重度抑郁症状的老年人的案例场景。检查了咨询或转介心理健康提供者的意图的预测因素。在完成调查的 101 名神职人员中，大多数人提及心理健康提供者，而不是自己提供咨询或提及另一位神职人员。具有高度抑郁症知识和强烈支持抑郁症有机病因模型的神职人员更有可能提到心理健康提供者，&khgr;2(11) = 28.56, p = .003。定性研究结果表明，转诊采用复杂的方法，包括诸如聚集性特征等因素。提高神职人员对晚年抑郁症和精神疾病病因学知识的干预，以及为老年会众提供简短的、以证据为基础的抑郁症治疗的技能，可能会改善农村社区的心理健康治疗机会。同样，促进神职人员和精神卫生提供者之间合作的计划可能会进一步支持农村精神卫生保健。