Mental Health in the U.S. among African American Men

Abstract:

Today, mental health in the U.S. has become the focus of a growing body of scholarship as researchers examine the antecedents to the nation’s current political polarization and increasingly violent responses to the multiple existential threats that confront humanity. The ongoing COVID-19 pandemic, for instance, has not only brought to the forefront the critical importance of public health but has also exposed the vulnerabilities in the nation\'s mental health infrastructure. Likewise, the looming threat of climate change and other existential challenges, such as global conflicts and economic instability, have raised concerns about the psychological impact of living in an era marked by uncertainty about the future. As a result, many people are grappling with a sense of existential anxiety and despair as they witness the environmental degradation and social disruptions caused by these global challenges. Indeed, the prolonged stress, fear, and uncertainty that are associated with the pandemic have exacerbated preexisting mental health issues and led to a surge in demand for mental health services. Against this backdrop, developing an improved understanding concerning the interplay between mental health, political polarization, and responses to existential threats has become imperative. Not surprisingly, already marginalized groups including most especially African American men are experiencing the adverse effects of these trends at an even greater rate than mainstream American society. Therefore, there is a corresponding growing need for cultural relevant health intervention competence raining among mental health workers in the United States, with a particular emphasis on reducing mental health disparities among African American men. To this end, the project aims to address the prevailing challenges in mental health care that disproportionately affect this demographic to identify current constraints and opportunities for improvement.

Thesis Statement:

The purpose of this cultural relevant health intervention project is to highlight the need to embrace cultural competence training targeting mental health workers to reduce cases of mental health problems in the U.S., especially among African American men.

Annotated Bibliography:

Allen, J. L., Szechy, K. A., Campbell, R. D., Nobile, J., & Huggins-Hoyt, K. Y. (2023). Swept under the rug and forgotten... A qualitative study exploring the lived experiences of four Black/African American men living with depression. Journal of Human Behavior in the Social Environment, 33(6), 793–809.

The authors report that the purpose of this qualitative study was to gain new insights concerning the manner in which African American men perceive, discuss, and manage their experiences of depression. The research context noted that while men, in general, are less likely to receive depression diagnoses compared to women, the experiences of African American men are frequently overlooked to an even greater extent. The study analyzed interviews with four African American men, which were part of a larger qualitative investigation into depression within the African American community. Qualitative content analysis techniques, including open coding, were used to identify recurring themes in the interviews that revealed commonalities in the participants\' experiences. The four key recurring themes that were identified in the study were: (1) depressive episodes as responses to traumatic life events; (2) the significance of family and paternal figures for African American men; (3) coping mechanisms such as substance use and sleeping; and, (d) the pervasive stigma surrounding depression as a major barrier to seeking help and utilizing services. The findings that emerged from this study indicate that African Americans experience depression within the framework described by the Diagnostic and Statistical Manual of Mental Disorders V, but they frequently adapt to these experiences, “soldier through” the emotional pain and tend to normalize their feelings as typical aspects of daily life as an African American male in the U.S. today. The paper concludes with recommendations for service providers working with African American men including most especially the importance of developing cultural competence and sensitivity when addressing depression within this population. The timeliness and relevance of this study make it a highly valuable resource for the proposed study.

Bauer, A. G., Christensen, K., Bowe-Thompson, C., Lister, S., Aduloju-Ajijola, N., & Berkley-Patton, J. (2020). “We Are Our Own Counselor”: Resilience, Risk Behaviors, and Mental Health Service Utilization among Young African American Men. Behavioral Medicine, 46(3/4), 278–289.

The authors emphasize that in spite of the increased risk of trauma, subsequent mental health issues, and poor health outcomes among young Black/African American men (YBM), they are less likely to receive mental health services compared to other racial/ethnic groups. While there is a growing body of research on resilience, there is limited information on how resilience relates to risk behaviors and the use of mental health services among YBM who have experienced trauma. This study aimed to investigate the relationships between resilience, trauma-related risk behaviors, and the utilization of mental health services among a sample of YBM who have experienced trauma. The research included focus groups and a brief survey involving 55 YBM who had been exposed to at least one traumatic event, such as witnessing violence or experiencing a serious injury or illness. Participants were primarily recruited from urban community settings like colleges, barbershops, and churches and had an average age of 23 years. The study found that trauma exposure was a significant predictor of risk factors but resilience did not significantly moderate this relationship. In addition, resilience did not predict the receipt of mental health services. Qualitative themes related to resilience included maintaining resilience independently, preferred coping methods like relying on friends and music, and adapting to adversity. This study has a high degree of relevance for the purposes of the proposed study since it underscores some of the multiple barriers to mental health treatment experienced by African American men in the U.S. today.

Bauer, A. G., Pean, K., Lalwani, T., Julien, L., & Shevorykin, A. (2022). Community Needs and Recommendations for Multilevel Mental Health Interventions Among Young Black Men with Previous Trauma Exposure. Journal of Consulting & Clinical Psychology, 90(10), 760–769.

The purpose of this study was to address mental health disparities in the young African American male community, a group at elevated risk of trauma exposure and less likely to receive mental health care compared to their peers. The authors used a secondary data analysis from a larger mixed-methods study conducted in two phases, employing an exploratory sequential design. During the first phase of the research, 55 African American men aged 18–30 years old, who had experienced one or more lifetime traumatic events, participated in focus groups. These focus groups aimed to identify community needs and recommend strategies for enhancing community mental health. The analysis of these findings was guided by the socioecological model, which considers various levels of influence, including individual, interpersonal, organizational, community, and public policy levels. The results of the focus groups yielded a range of recommended intervention strategies, spanning from individual and interpersonal levels (e.g., educational resources and fostering social support) to organizational and community approaches (e.g., resource fairs, tools for schools and churches, and broader community settings) and even policy changes (e.g., increased funding to enhance access to care). The authors conclude by suggesting these qualitative findings have the potential to serve as a foundation for culturally relevant interventions aimed at improving access to mental health care and encouraging engagement in mental health services within the young African American male community. The study highlights the importance of researchers collaborating with communities to address mental health disparities and promote equitable access to care. This research is of significant public health importance and therefore relevance for the purposes of the study proposed herein since it amplifies the real-life voices and empirical observations of young African American men who have experienced trauma and underscores their preferences, needs, and priorities for community-based interventions.

Donadio, M., Valera, P., & Sinangil, N. (2022). Understanding attachment styles, adverse childhood events, alcohol use, and trauma in Black and Latino Men with criminal justice histories. Journal of Community Psychology, 50(5), 2260–2272.

The authors report that the purpose of this study was to investigate the relationships between trauma, adverse childhood experiences, alcohol use, and adult attachment styles in a sample of 248 Black and Latino men with experiences of incarceration. The majority of the respondents reported being single and never married (61.3%), earning an annual income of less than $10,000 (84.3%), and having been in a state prison facility during their last incarceration (60.9%). The findings that emerged from the data analysis indicated that a majority of the men scored above average in attachment anxiety (mean = 5.14, standard deviation = 1.34) and attachment avoidance subscales (mean = 5.35, standard deviation = 1.08). In addition, nearly one-quarter (about 23%) of the participants self-reported hazardous drinking behavior. With respect to trauma, the mean trauma score was 2.85 (standard deviation = 2.97), suggesting that participants reported experiencing minimal trauma. These findings suggest that African American and Latino men with incarceration experiences exhibit high rates of insecure attachment styles that are strongly associated with traumatic childhood experiences. Therefore, in order to better support this population, mental health treatment both during incarceration and in the community should focus on enhancing attachment security as a key component of their well-being and cultural competence. Given the inordinately high percentage of African American men that are currently incarcerated or who have been incarcerated in the past, these findings are highly relevant for the purposes of the proposed study.

McNeish, R., Simmons, C., Watson, J., & Tran, Q. (2021). Perceptions of emotional and physical wellness among African American men as predictors of perceived overall health. Ethnicity & Health, 26(4), 600–613.

The authors make the point that African Americans are at risk for adverse emotional health, but due to the intersection of their racial and gender identities, which often emphasizes masculinity, emotional well-being is not always given priority for these men. This study sought to investigate the relationship between emotional and physical health and overall wellness among African American men. This study was an exploratory cross-sectional study with a convenience sample of 115 African American men. Participants were asked to provide self-reported responses regarding their emotional and physical health, which were assessed using the Wellness Self-Perception Questionnaire (WSPQ), a 15-item scale. Overall health was evaluated through a single-item measure. The majority of the study participants reported a positive perception of their overall health. Linear regression analyses indicated that both emotional and physical wellness were predictors of better overall wellness, even when controlling for factors like education and income. This study is especially relevant for the purposes of the proposed study since it is the first of its kind to examine emotional and physical wellness as predictors of overall health specifically among African American men.

Stare, B. G., & Fernando, D. M. (2019). Black American Men’s Treatment Experiences in Mental Health Court: A Phenomenological Analysis. Journal of Addictions & Offender Counseling, 40(1), 17–35.

Emphasizing that African American men are at disproportionately greater risk a wide array of mental health disorders as well as suffering from a fundamental lack of access to mental health resources compared to any other race in the U.S. today. The purpose of this qualitative study drawing on the life experiences of 14 participants was to assess the perceptions of young adult African American men concerning their treatment in mental health diversion programs to identify specific barriers and opportunities for improvements. The most effective approach for delivering psychoeducational information to African American clients was found to be one that is nonthreatening and reassuring. In the study, many participants viewed mental health and counseling treatment modalities positively, considering them as positive experiences within a system they perceived as oppressive. These experiences helped mitigate feelings of mistrust and powerlessness. In addition, the participants frequently reported that the quality of their therapeutic relationship with their mental health treatment providers played a significant role in their level of engagement with treatment formats and adherence to medication. They also noted shifts in trust and motivation over time, primarily through meaningful relationships developed with members of the treatment team. While some participants initially entered mental health counseling with comparatively low levels of motivation for change and concerns about mandated medications, further interactions with participants revealed that mistrust tended to decrease with time spent in the program. These findings underscore the challenges that are involved in encouraging young and old African American men to seek mental health support when they need it as well as the barriers to progress they may experience when and if they do seek such support, making these findings highly relevant for the purposes of the study proposed herein.