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BackgroundStudies suggest that despite a high prevalence of mental health conditions among African immigrants in Western countries, they tend to underuse mental health services, compared with native-born people. This study explored the reasons for underuse of conventional mental health services among African immigrants in Canada.MethodThe study participants were 280 African immigrants who had experienced depressive symptoms but did not use conventional mental health services. They were presented with a questionnaire that contained 50 statements referring to reasons for not using conventional mental health services while experiencing depressive symptoms. They were asked to indicate their degree of agreement with each of the statements on a scale of 0-10. Responses were then analyzed using factor analysis.ResultsA eight-factor structure of reasons was found: "Symptoms underestimation and perceived self-efficacy" (important for 61% of the sample), "Relying on community support" (56% of the sample), "Cost and waiting time" (45% of the sample), "Influence of significant others" (34% of the sample), "Denying competence" (32% of the sample), "Fear of stigmatization" (23% of the sample), "Nature of the consultation" (10% of the sample) and "Social models" (8% of the sample). Scores on these factors were related to participants’ demographics. ConclusionThese findings strongly suggest that strategies to promote the use of mental health services among African immigrants must be multifaceted rather than focused on one single barrier. When implementing these strategies, policymakers should put more emphasis on increasing mental health literacy among African immigrant communities, as well as providing them with culturally sensitive mental healthcare.