Abstract

Pastoral concern for young people in African-diaspora churches may not translate into professional mental health care. Existing research does not adequately connect congregational conditions, gatekeepers’ referral decisions, and completed service contact. This article develops a framework to explain that gap and guide ethically bounded referral practice. A critical integrative review and theory synthesis examined literature published from 2000 to 18 August 2026, retaining earlier foundational sources. Iterative searches of PubMed/MEDLINE, Google Scholar, publisher platforms, and citation chains informed a concept matrix comparing populations, contexts, mechanisms, and outcomes. The synthesis indicated that faith and family relationships can support or delay care. Favorable referral intentions do not guarantee action, and service barriers can prevent initial contact after referral. Integrating the social-ecological model, theory of planned behavior, and organizational readiness theory produced the Pastoral Gatekeeping-to-Linkage Framework and eight testable propositions. The framework distinguishes referral intention, enacted warm referral, completed initial linkage, and continued engagement. These are conceptual outputs, not empirically validated causal findings. The article recommends defined non-clinical roles, competency-based training, safeguarding and privacy protocols, trusted provider partnerships, practical access support, and consent-based follow-up. Spiritual accompaniment should complement, not replace, qualified care. The framework provides a basis for youth-centered church–health service partnerships and prospective evaluation of referral completion, cultural safety, and equity.

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