Determinants of the need for homophily in referral criteria: the case of clergy referrals to mental health professionals in Singapore.

Homophily, the tendency to seek out those who are similar, is a powerful force in structuring the relations that people have in a variety of social settings including the selection of partnerships. Despite this, attitudinal homophily has seldom been discussed in relation to referral practices, an important consideration in health care delivery. In this paper Christian clergy in Singapore are examined as to the extent they impose homophily as a selection criteria for referrals to mental health professionals. This is an important consideration as clergy are popular sources of help though they seldom refer their clients to mental health professionals due to the competition between health sectors. This study based on survey data collected from a representative sample of Singaporean clergymen predicts that those who expect referral partners to be homophilous include those with greater Christian conservatism, professional ideology and beliefs in clergy competence in handling emotional and mental problems. These ministers tended to come from smaller congregations and had more psychological education. In essence clergy who value homophily in referral partners are concerned about the relational risk involved in the referral process and use homophily in the hope that they can find referral partners who do not undermine their authority or jeopardize laymen's faith.