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Black History Month and Mental Health

This guide is dedicated to amplifying Black Voices

Physical titles on Black Mental Health

eBooks on Black Mental Health

Journal Articles on Mental Health in the Black Community

Triple Jeopardy: Complexities of Racism, Sexism, and Ageism on the Experiences of Mental Health Stigma Among Young Canadian Black Women of Caribbean Descent

 

This article explores how the intersection of race, gender, and age intertextually complicate and nuance the experience of mental health stigma among young Black women of Caribbean descent living in Canada. The Mental Health Commission of Canada acknowledged that mental health stigma continues to affect the help-seeking behavior of young adults. Some youth-serving agencies and many advocates within Black communities have become increasingly vocal about mental health stigma and the lackluster response to the needs of Black youth (e.g., no increase in funding for the Substance Abuse Program for African, Canadian, and Caribbean Youth-SAPACCY, since the program was established in the mid-1990s). The issue of mental health stigma within the African, Caribbean, and Black Canadian (ACB) communities is widely known and often discussed at public forums. Several recent mental health forums and mental health initiatives held in Toronto made it clear that mental health in Black communities is at a crisis point in the Greater Toronto Area (GTA) and possibly across Canada. Forum discussions also revealed that the issue is further compounded by the intersection of race, gender, and age. In addition, while research studies have also identified stigma as a barrier to accessing mental health services and/or supports, there is a paucity of research on how mental health stigma, when complicated by the experience of racism, sexism, and ageism, affects access to services among young Black women of Caribbean descent. This lack of research on Caribbean women's experience with mental illness limits insights into concepts, issues, and problems that directly impact broader issues related to mental health in Canada. This article engenders a discussion that strengthens the focus on mental health stigma campaigns and education on the mental health of young Black women in Canada. The lack of literature relating to this topic in the Canadian context, as previously noted, limits the extent to which this issue can be fully discussed within Canada. As such, insights into concepts and existing discussions on women's mental health throughout this paper will include references to literature from the U.S., U.K., and Australia, professional experiential knowledge, and personal insights from conversations with young Black women of Caribbean descent. The paper calls for more research on Caribbean women's mental health in Canada to provide better insights and understanding of the issue within a Canadian context.

“If You Prayed More, You Would Feel Better”: The Dual Nature of Religion and Spirituality on Black Youths’ Mental Health and Access to Care in Canada

This study explores Black Canadian youth’s relationship with religion and the impact religion has on their mental health and wellbeing. In addition, we probed promising practices for religious leaders and service providers who want to improve Black youth’s access to care. The results of this article draw from a larger study that aimed to explore the barriers and facilitators to mental healthcare for Black youth in Ontario, Canada. 128 (n = 66 youth, n = 35 service providers, n = 27 family and community members; 91% Black, 24% people of colour, 67% white) participants from six regions across Ontario were engaged in 23 qualitative focus groups held virtually between March 2020 and August 2021. Data were analyzed using thematic analysis. Three themes emerged from the data: The stigma and taboo nature of mental illness, the influence of religion and mental health and suggestions to improve care for Black youth. Mental illness is stigmatized in specific ways in Black communities and intergenerational differences exist in how mental illness is conceptualized. In addition, Black Two-Spirit, lesbian, gay, bisexual, transgender, queer/questioning and other diverse or marginalized sexual orientations and gender identities (2SLGBTQ+) youth face additional difficulties in relation to stigma. Religion and religious affiliation stigmatized mental illness yet, both were considered important for inclusion in traditional mental health supports. To improve access to care for Black youth, there is a need for community-practitioner partnerships, incorporating religion into traditional mental healthcare, and increasing mental health awareness in religious and community spaces. This study is among the first to explore the impact of religion on Black youth’s mental health, findings can contribute to increased access to affirming and responsive care for this population.

Prevalence and correlates of anxiety symptoms among Black people in Canada: A significant role for everyday racial discrimination and racial microaggressions

 

Anxiety disorders are highly prevalent worldwide but vary significantly by country and ethnoracial background. Minimal published data exist on the prevalence of clinically significant anxiety among Black people in Canada and none using validated measures. Therefore, this study sought to establish the frequency of clinically significant anxiety symptoms among a sample of Black people living in Canada as well as examine the association with two forms of racism (racial discrimination and racial microaggressions). Data collected from the Black Community Mental Health project in Canada was analyzed. Participants provided (N= 845) sociodemographic information and completed measures assessing anxiety symptomology (GAD-7), everyday racial discrimination, racial microaggressions, and resilience. Prevalence of anxiety symptomatology was determined across sociodemographic variables as well as categories of everyday racial discrimination and racial microaggressions. Two regression models were conducted to examine the relationship between anxiety symptoms and the two forms of racism controlling for sociodemographic factors. Overall, nearly a third of participants endorsed clinically significant levels of anxiety symptoms, with higher rates observed among men, unemployed people, those with higher education, people who are separated, and those with no reported family history of mental health problems. Logistic regression models demonstrated that, except for those reporting the greatest frequency of racial discrimination, there is a general linear trend such that those experiencing higher levels of racial discrimination or racial microaggressions are increasingly more likely to present with anxiety symptoms when compared to those reporting low levels of discrimination or microaggressions. Psychological resilience afforded nominal protection but only against exposure to racial microaggressions. Rates of clinically significant anxiety are higher among Black people in Canada than reported previously. Both racial discrimination and racial microaggressions predicted higher rates of anxiety symptoms. The results are discussed in relation to previous findings from the US that report similar findings. •Black people in Canada experience high levels of racial discrimination and microaggressions.•One third of the Black people surveyed reported clinically significant anxiety symptoms.•Increasing levels of racial discrimination and microaggressions were associated with higher rates of anxiety.•Psychological resilience modestly protects against microaggressions but not racial discrimination.

Prevalence and correlates of depression among Black individuals in Canada: The major role of everyday racial discrimination

Depression is a common mental health problem causing significant disability globally, including in Canada. Prevalence estimates for depression within Black communities in Canada are unknown. This study determined the prevalence of depression in a sample of Black Canadians and the association between everyday racial discrimination experiences and depression. Methods We analyzed data collected from the Black Community Mental Health project in Canada. Participants provided sociodemographic information and completed measures assessing depressive symptomology, everyday racial discrimination, and social support. The prevalence of depressive symptomatology was computed across sociodemographic variables and categories of everyday racial discrimination. Different regression models were conducted to examine the relationship between depressive symptoms and everyday racism controlling for sociodemographic factors. Results In total, 65.87% of participants reported severe depressive symptoms, with higher rates among women, those who are employed, and those born in Canada. The linear regression models showed that everyday racial discrimination is the best predictor of depressive symptoms, with a final model explaining 25% of the variance. A logistic regression model demonstrated that those experiencing a high level of racial discrimination are 36.4 more likely to present severe depressive symptoms when compared to those reporting a low level of discrimination. Conclusions Rates of depressive symptoms among Black individuals are nearly six times the 12‐month prevalence reported for the general population in Canada. Racial discrimination, which significantly predicts greater depressive symptomatology, is consistent with earlier studies in the United States and suggests that Canadian colorblind policies may inadvertently reinforce racial discrimination with detrimental effects on mental health.

Prevalence and determinants of depression, anxiety, and stress symptoms among Black individuals in Canada in the context of the COVID-19 pandemic

The COVID-19 pandemic has disproportionately affected Black communities in Canada in terms of infection, hospitalizations, and mortality rates. It exacerbated social, economic, and health disparities that can impact their mental health. We investigated the prevalence and predictors of symptoms of depression, anxiety, and stress in Black individuals in Canada. A community-representative weighted sample of 2002 Black individuals (51.66% women) aged 14 to 94 years old (Mean age 29.34; SD = 10.13). Overall, 40.94%, 44.50%, and 31.36% of participants were classified as having clinically meaningful anxiety, depression, and stress levels, respectively, based on DASS scores. Men (45.92%) reported a higher prevalence of anxiety than women (36.27%), χ2 (1) = 19.24, p<.001, but similar symptoms of depression and stress. The progression of the prevalence of anxiety, depression, and stress symptoms were consistent with the progression of the prevalence of everyday racial discrimination. After controlling for socio-demographic variables, regression models showed that everyday discrimination (B = 0.14, p=.001, B = 0.14, p= .006, B = 0.18, p< .001), major experiences of racial discrimination (B = 0.30, p=.046, B = 0.34, p= .033, B = 0.35, p=.024), and COVID-19 traumatic stressors (B = 0.43, p<.001, B = 0.43, p< .001, B = 0.44, p< .001) were positively associated with anxiety, while community resilience (B= -0.02, p= .039, B= -0.04, p= .001, B= -0.03, p= .014) was negatively associated with anxiety, depression, and stress, respectively. This study demonstrates the need to address racial discrimination in implementing prevention and intervention programs among Black individuals and to consider intersectional factors related to age, birthplace, language spoken, and province of residence.

Black–White Health Inequalities in Canada

 

Little is known about Black–White health inequalities in Canada or the applicability of competing explanations for them. To address this gap, we used nine cycles of the Canadian Community Health Survey to analyze multiple health outcomes in a sample of 3,127 Black women, 309,720 White women, 2,529 Black men and 250,511 White men. Adjusting for age, marital status, urban/rural residence and immigrant status, Black women and men were more likely than their White counterparts to report diabetes and hypertension, Black women were less likely than White women to report cancer and fair/poor mental health and Black men were less likely than White men to report heart disease. These health inequalities persisted after controlling for education, household income, smoking, physical activity and body-mass index. We conclude that high rates of diabetes and hypertension among Black Canadians may stem from experiences of racism in everyday life, low rates of heart disease and cancer among Black Canadians may reflect survival bias and low rates of fair/poor mental health among Black Canadian women represent a mental health paradox similar to the one that exists for African Americans in the United States.

Biological Embedding of Racism Can Impact Mental Health Inequities Among Black Women

Black women in the U.S. are faced with unrelenting chronic stressors that are often driven by racism and oppression to influence mental health inequities. Similar to common U.S. societal views of Black women, ideological values about Black women’s lives also permeate psychiatry and neuroscience research to prevent likely impactful research that fully examines the role of social power structures in the biological embedding of racism. The proposed presentation aims to highlight the most urgent areas to address in mental health inequities utilizing a Black feminist lens.

"That Stuff Can Be Ugly:" Black Women in Sport, Stigma, and Public Mental Health Disclosures

 

This research investigates Black women athletes' long-form public mental health disclosures (LFPMHDs). We conducted a phenomenological thematic analysis and drew from Orbe's co-cultural theory to illuminate the communicative practices and orientations that Black WNBA players rely on as co-cultural group members. We argue that the LFPMHDs in the current study confront multiple layers of stigma related to race, gender, and mental illness while confronting limitations of the "mental health conversation" within and outside of sport. Our phenomenological thematic analysis revealed that Black WNBA players used LFPMHDs to: (a) communicate self and model the risks of intimate social contact with mental illness; (b) educate others by retelling their story, claiming agency over mediated appropriations of their self-disclosure narratives; and (c) narrate triggers and breaking points that coincide with their past adoption of nonassertive communication approaches.

Community needs and recommendations for multilevel mental health interventions among young Black men with previous trauma exposure

 

To report on multilevel strategies for addressing community mental health disparities among young Black/African American men, who are at increased risk for trauma exposure yet have a lower likelihood of receiving mental health care compared to other young adults. This was a secondary data analysis from a larger mixed-methods study that was conducted in two phases, using an exploratory sequential design. Participants in Phase 1 were 55 Black men aged 18-30 years old (M = 22.55, SD = 3.9), who had experienced one or more lifetime traumatic events. Relevant for the present study, participants completed focus groups that elicited community needs and recommended strategies for promoting community mental health. The social-ecological model (including individual, interpersonal, organizational, community, and public policy levels) was used to guide interpretation of these qualitative findings. Focus groups recommended intervention strategies from individual/interpersonal levels (e.g., educational resources, fostering social support) to organizational and community approaches (e.g., resource fairs; tools for schools, churches, and broader community settings) and policy changes (e.g., increased funding to improve access). Qualitative findings have potential to provide the foundation for culturally relevant interventions to improve access to mental health care and engagement in services.

Race-Related Stress, Racial Identity Attitudes, and Mental Health Among Black Women

This study examined whether racial identity attitudes moderate the relationship between racist stress events, racist stress appraisal, and mental health. One hundred eighteen African American and 144 self-identified Caribbean women completed the Cross Racial Identity Scale, the Schedule of Racist Events, the Rosenberg Self-Esteem Scale, and the Center for Epidemiologic Studies Depression Scale. Hierarchical regression analyses revealed that multicultural identity attitudes moderated the relationship between racist stress appraisals and depression, as well as the relationship between racist stress events and depression. Compared with participants with multicultural identity attitude scores 1 standard deviation below the mean, those with multicultural identity attitude scores 1 standard deviation above the mean were somewhat protected from the impact of racist stress events and racist stress appraisals. The primary conclusion is that multicultural identity attitudes are somewhat protective against the impact of race-related stress on mental health. Implications for mental health practitioners and future research in the field of Black psychology are discussed.

The relationship between work and mental health outcomes in Black men after serious injury

For black men who survive serious injuries, work-related factors are associated with mental health recovery.•Men who had not returned to work had twice the odds of poor mental health than men who had returned to work.•Experiences of racism and health insurance status were also associated with mental health outcomes after injury. To explore the association between return to work (RTW) and mental health outcomes in Black men in Philadelphia recovering from serious traumatic injuries. We analyzed data from 498 Black men aged ≥ 18 years living in Philadelphia who were admitted to a Level I trauma center for injury between January 2013 and June 2017. We used multivariable logistic regression to estimate the association between pre-injury occupation, RTW and depression or PTSD 3 months after hospitalization. In adjusted analyses, men who had not RTW at follow-up had higher odds of poor mental health outcomes than men who had RTW (OR: 2.7, 95% CI: 1.8, 4.2). Additional significant factors included: younger age, lack of or public health insurance and higher lifetime experiences of racism. The mental health recovery trajectory of injured Black men living in Philadelphia is associated with RTW and other factors that can influence financial stability and economic resources. Programmatic strategies that seek to optimize recovery after injury in Black men should include consideration of key structural factors such as employment, financial stability, and the impact of racism-related exposures.

Social Media Contributions to Strong Black Woman Ideal Endorsement and Black Women’s Mental Health

Although research findings highlight the complex dualities of the Strong Black Woman ideal and demonstrate its effects on Black women’s mental health and well-being, there is less understanding of the role that social media may play in Black women’s negotiation of this ideal. To what extent might Black women’s engagement with race-related social media, such as the use of Black-oriented blogs and hashtags, contribute to their well-being and potentially buffer contributions of the Strong Black Woman ideal? To investigate this question, we tested 412 Black women who completed online survey measures assessing their general social media use, Black-oriented blog and hashtag use, mental health, and self-esteem. Correlational and regression analyses revealed that, as expected, both greater endorsement of the Strong Black Woman ideal and higher levels of general social media use was associated with adverse mental health and lower self-esteem. Contrary to our expectations, Black-oriented blog use was also associated with more symptoms of depression and anxiety and did not moderate effects of Strong Black Woman endorsement on well-being. Clinicians, instructors, parents, and media activists should be mindful of how the use of both traditional and race-related social media may be both liberating for, and detrimental to, Black women’s well-being.

“Is it Okay Not to be Okay?”: A Critical Literature Review of Barriers to Mental Health Treatment for Black Men

 

Black men reportedly have a high prevalence of mental illness with little to no counseling engagement. While there have been studies to determine potential influences on their lack of counseling utilization, the lack of impact toward progress and the scarcity of such literature in the counseling field proves the need for continued exploration. Many of these studies have been conducted by scholars in other social science disciplines with few done by counseling scholars. A review of research concerning Black men and counseling utilization is presented using BlackCrit as a theoretical framework. Racism and masculinity are highlighted as barriers to mental health treatment which require further exploration in counseling literature. Recommendations for improving future research and advocacy efforts are provided for counselors and other mental health professionals.

Strengths and Weaknesses of the Young Black Men, Masculinities, and Mental Health (YBMen) Facebook Project

The Young Black Men, Masculinities, and Mental Health (YBMen) project is a Facebook-based intervention that provides mental health education and social support to young Black men. The YBMen project was created to better understand and address the pressures and needs of young Black men, particularly with regard to issues related to their conceptualization of masculinity and mental healthBlack men from a 2-year liberal arts college in the Midwest (United States) enrolled in the YBMen pilot project. The purpose of this study is to report what participants in the YBMen pilot project liked and disliked about the intervention, along with their suggestions for improvement. Qualitative results from the 8 Black men who actively participated in the YBMen Facebook intervention and completed the postintervention interview are reported. A systematic analysis identified 9 subthemes that described participants' reactions to different components and characteristics of the Facebook intervention. Results indicated that opportunities for relationship building and connectivity, coupled with engaging popular culture references used in the intervention encouraged young Black men to actively participate in the YBMen Facebook intervention. The YBMen project has potential to improve the health and well-being of young Black men by providing nontraditional resources that are easily accessible, culturally sensitive, and gender-specific. Implications of the YBMen project as an effective Internet-based program that promotes mental health and increases social support among young Black men are discussed.

Black Mental Health Matters: Addressing Post-COVID Mental Health Needs of Black Americans

As our nation and our world appear to have turned a corner after the height of the disastrous COVID-19 pandemic, many thoughtful writers have called attention to the racial inequities and injustices that were glaringly exposed (e.g., Ross, 2021). In this editorial, I focus specifically on the situation of Blacks in America, during and after the biggest outbreak of COVID-19 in the world. 

Soul work: Black practitioners’ perceptions of Black clients’ mental health needs

Most empirical investigations with Black clients have focused on the multicultural competence of practitioners who work with them. Little attention has been given to the needs of Black clients. This phenomenological inquiry explored Black practitioners’ perceptions of Black clients’ mental health needs and identified five common themes: (a) mental health literacy, (b) family and parenting counseling, (c) advocacy, (d) trauma and grief work, and (e) self‐efficacy enhancement. Implications for counseling and future research are discussed.

The (Black) Struggle That Must Be: Black Masculinity, Black College Athletes, and Black Mental Health Through a Looking Glass

In this article, the author describes their mental health struggles tied to Black Masculinity as a (former) Black athlete. In particular, the author focuses on the stigma surrounding mental health in the Black community and the ways in which Blackness, Black masculinity, and mental health battles emulate the (Black) struggle that must be. The author attempts to highlight the complicated nature of mental health struggles, specifically the ways in which suicide is handled in the world of sport and the ways in which the narrative can have juxtaposed racial frameworks. The author moves into and through their own personal experiences with mental health as a Black man, both in present tense and including personal journal entries, to make sense of “the (Black) struggle that must not be ignored.”

Actions needed to promote health equity and the mental health of Canada's Black refugees

 

The overall goal was to synthesize knowledge on actions that need to be taken to promote health equity and the mental health of Black refugees in Canada. Group concept mapping systems were applied to generate and organize action-oriented statements related to the different social determinants of health. A total of 174 participants from the cities of Calgary and Edmonton with experience working with Black Canadians participated in four focus groups: (a) 2 focus groups that engaged 123 participants in brainstorming 84 statements guided by the following focus prompt: 'A specific action that would improve the mental health equity of Black refugees living in Canada is ... ' and (b) 2 focus groups of 51 participants who sorted the generated statements and rated them by order of 'importance' and 'ideas seen in action.' Data was further computed and analysed by the research team and a select advisory group from the participants. A 10-cluster map generated included the following clusters: (1) promoting cultural identity, (2) promoting ways of knowing, (3) addressing discrimination and racism, (4) addressing the criminalization of Black Canadians, (5) investing in employment for equity, (6) promoting equity in housing, (7) facilitating self-determination, (8) improving (public) services, (9) promoting appropriate and culturally relevant mental health services, and (10) working with and addressing faith and belief related issues. Clusters 4 and 9 ranked as the most important clusters in promoting health equity and the mental health of Black Canadians. Addressing the criminalization of Black Canadians through a range of rehumanizing interventions at institutional levels will provide a platform from which they can participate and engage others in developing appropriate and culturally relevant mental health services.

Is John Henryism a Health Risk or Resource?: Exploring the Role of Culturally Relevant Coping for Physical and Mental Health among Black Americans

Research shows that John Henryism, a high-effort, active coping style, is associated with poor physical health, whereas others suggest it may be psychologically beneficial. As such, it is unclear whether John Henryism represents a health risk or resource for black Americans and whether its impact varies across sociodemographic and gender groups. The present study used data from a representative community sample of black Americans (n = 627) from the Nashville Stress and Health Study (2011–2014) to clarify the physical and mental health consequences of John Henryism by assessing its relationship with depressive symptoms and allostatic load (AL). Results indicate that John Henryism is associated with increased AL scores and fewer depressive symptoms. Additionally, the association between John Henryism and AL is conditional on socioeconomic status. Study results underscore the importance of evaluating both physical and mental health to clarify the health significance of John Henryism among black Americans

The Discipline’s Escalating Whisper: Social Work and Black Men’s Mental Health

 

Objective: Though sparse in previous years, research on the mental health of Black men has recently experienced a gradual increase in social work journals. This article systematically organizes and critically examines peer-reviewed, social work evidence on the mental health of Black men. Methods: Twenty-two peer-reviewed articles from social work journals were examined based on their contribution to social work research and practice on the mental health of Black men. Results: The social work evidence on Black men’s mental health can be grouped into one of four categories: psychosocial factors; mental health care and the role of clinicians; fatherhood; and sexual orientation, HIV status, and sexual practices. Conclusions: This representation of the social work literature on Black men’s mental health neglects critical areas germane to social work research and practice with this population. Implications include ways to extend current social work research and practice to improve the health for Black men.

I Don't See Color: Barriers to Black American Mental Health

 

Understanding historical trauma and “seeing color,” that is, acknowledging a client’s race, is important to adequately address mental health within the Black American community. Whereas many practitioners have tended to embrace the idea of a “colorblind” society, this article explores how it can be harmful for human services practitioners to approach services with Black American clients in a manner that does not address the racial trauma they continue to endure. The term “Black American,” as used for this article, refers to Black American descendants of American slavery. However, Black Americans are not a monolith and there is cultural variation within the population. This article aims to encourage human services practitioners to adjust their approach to Black American and other non-White clients of color in a manner that is culturally sensitive.

Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program

Poor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks. Black adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant. Among 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and - 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS. The Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity.

Becoming Strong: Sociocultural Experiences, Mental Health, & Black Girls' Strong Black Woman Schema

This study examines the precedents and consequences of Black girls' Strong Black Woman schema (SBW) endorsement. Hierarchical regression analyses revealed that, among Black girls (N= 308), racial discrimination experiences and racial barrier socialization messages were positively associated with SBW endorsement. However, there was no significant interaction between racial discrimination and racial barrier messages in predicting SBW endorsement. Our analyses also revealed that SBW was not directly associated with internalizing symptoms (e.g., anxiety and depression symptoms). Furthermore, there was no significant interaction between racial discrimination and SBW endorsement in predicting internalizing symptoms. Findings provide evidence of and clarity on how sociocultural experiences shape SBW develop.

“I’m a Strong Independent Black Woman”: The Strong Black Woman Schema and Mental Health in College-Aged Black Women

The Strong Black Woman Schema (SBWS) is a cultural expectation for Black women to unfailingly display signs of strength and caretaker qualities, while suppressing their emotions. Although this schema is a purported source of strength for Black women, quantitative explorations of its psychological impact have been limited. In the present study, we examined associations between endorsement of the SBWS and several indicators of mental health and resilience in Black women. We analyzed responses from 212 college-aged, Black women assessing psychological distress, suicidal behaviors, resilience, and SBWS endorsement. Findings indicated that endorsement of the SBWS was positively related to both psychological distress and self-reported suicidal behaviors. In addition, the SBWS’ link to suicidal behaviors was mediated by psychological distress. Lastly, results from moderated mediation analysis supported a buffering effect of resilience. That is, when resilience was high, the association between psychological distress and suicidal behaviors, as well as the conditional indirect effects of the SBWS, was lessened. Implications of these findings suggest that prevalent endorsement of SBWS within Black communities may be harmful to Black women’s mental health. We call for additional research and provide recommendations on how the media, mental health professionals, and community leaders can mitigate its negative effects.

Black men, mental health & the national health service

This paper emerged from a talk delivered to the community and members of the Tower Hamlets African and Caribbean Mental Health Organisation (THACMHO) for Black History Month in October 2022. A growing body of evidence exposes the persistence of racism and inequality within health service provision and the psychological professions. This has led to a commitment across all professional bodies to address as a significant matter. This paper explores the links between racism and intergenerational trauma and the consequences on Black men's mental health. The author probes the gaps in services and inequalities using a psychoanalytic lens. Men from Africa and the Caribbean face disproportionate rates of mental health diagnoses and poor care provision. However, little or no consideration is given to intergenerational trauma and cultural factors. At the heart of the paper sits the question: What happens to Black men in the mental health system and why? The author considers whether cultural insensitivity might be a barrier to accessing mental health care and explores the differential treatment options, outcomes, and possible reasons and solutions for the future.

Experiences of mental health services for ‘black’ men with schizophrenia and a history of disengagement: A qualitative study

Whilst mental disorders can be disabling they are also treatable, yet engagement with services is often poor and disengagement from treatment is a major concern for mental health nurses. Participants were service users typically perceived as the most disengaged from mental health services, yet they were willing to engage in the research interviews. The seven participants were all male with a diagnosis of schizophrenia, a history of disengagement from mental health services and described their ethnicity as ‘black’. Participants were under the care of Assertive Outreach Teams and were recruited after the researcher was introduced to them by clinicians who were working with them. After ethical approval, in‐depth, semi‐structured interviews were used to elicit the experiences of participants. Through interpretative phenomenological analysis, themes were developed. Interpretative Phenomenological analysis generated four themes: (i) “People just keep hounding me”, (ii) Antipathy to Medication, (iii) Choice and the value of services, (iv) Stigmatisation and identity. By rigorously examining how service users with schizophrenia make sense of their experience of their relationship with mental health services, there is potential to give voice to the experiences of the recipients of mental health services. This study uncovered the complex nature of disengagement and in view of this there may never be a straightforward mechanism developed to engage all people with schizophrenia with mental health services. When the participants’ experiences are considered in a broader social context it may be possible to reflect on how services can be adapted to facilitate better engagement.

Black Mental Health: Patients, Providers, and Systems

Novel in its approach and unique in its scope, Black Mental Health: Patients, Providers, and Systems examines the role of African Americans within American psychiatric health care from distinct but interconnected perspectives. The experiences of both black patients and the black mental health professionals who serve them are analyzed against the backdrop of the cultural, societal, and professional forces that have shaped their place in this specialized health care arena. The volume opens with the singular, first-person accounts of five senior black psychiatrists--including Dr. Altha J. Stewart, president of the American Psychiatric Association--who describe their individual journeys to the top of their field, not shying away from discussing the racism and discrimination that have challenged their paths to leadership. The book's second part focuses on the complexities of and opportunities for delivering mental health care to various subsets of the African American population, including children, women, elderly patients, and LGBTQ individuals. System design strategies, biological therapies, and church-based mental health promotion initiatives are all considered as methods for reducing racial and ethnic disparities in access to effective treatment. Part III examines the training of black mental health professionals and their representation in psychiatry, particularly in the face of discrimination and implicit bias. A chapter on historically black colleges and universities discusses the importance of their role in the delivery of psychiatric services and research development for African Americans. The fourth part builds on this discussion, addressing research that is relevant to the care of the black population. A concluding chapter highlights the key themes that emerged from each of the previous four parts, providing a holistic view of the place of black patients and providers in American psychiatry. With its blend of scholarship, clinical insight, and training analysis, Black Mental Health is compulsory reading both for trainees--as care delivery to minority groups is of ever greater importance--and practicing clinicians, who will glean useful information from the chapters on research advances and treatment modalities. Additionally, policy makers, educators, and historians, among others, will gain a better understanding of the challenges and necessity of developing integrated approaches to the care of nondominant groups.