Depression is one of the most common, costly, and debilitating psychiatric disorders in the United States. One of the most persistent mental health disparities is the underutilization of treatment services among African American men with depression. Little is known about appropriateness or acceptability of depression care among African American men. The purpose of this study was to examine perceptions of depression and determine barriers to depression treatment among African American men. A series of four focus groups were conducted with 26 African American men. The average age of the sample was 41 years and most participants reported that they had completed high school. Nearly half of the participants reported that they are currently unemployed and most had never been married. The most common descriptions of depression in this study were defining depression as feeling down, stressed, and isolated. A small group of participants expressed disbelief of depression. The majority of participants recognized the need to identify depression and were supportive of depression treatment. Nonetheless, most men in this sample had never sought treatment for depression and discussed a number of barriers to depression care including norms of masculinity, mistrust of the health care system, and affordability of treatment. Men also voiced their desire to discuss stress in nonjudgmental support groups. Research findings highlight the need to increase the awareness of symptoms some African American men display and the need to provide appropriate depression treatment options to African American men.
Black emerging adults ages 18–29, particularly those residing in predominantly black urban communities, are at risk for community violence exposure (CVE). This potentially traumatic event may induce traumatic stress reactions for black emerging adults that contribute to their engagement in violence perpetration, substance use and/or sexual risk-taking behaviors as a way to cope with their experiences. To address these identified concerns and make recommendations for future research, this article identifies and synthesizes results from studies that have examined CVE and its association with violence perpetration, substance use, and sexual risk-taking behaviors among black emerging adults. We use the term “black” throughout the article to refer to a socially constructed racial group or identity and recognize that this group, like all other racial groups in the United States, are ethnically heterogeneous. A systematic review of the literature was conducted to identify studies that (1) included a measure of CVE (2) included a measure of violence perpetration, substance use, or sexual risk-taking behaviors, and (3) included primarily black emerging adults. Results showed CVE rates as high as 83% for black emerging adults. CVE was significantly associated with substance use, but findings on the association of CVE with violence perpetration and sexual risk-taking behaviors were mixed. Also, there was a lack of consistency in measures used to assess CVE, suggesting that future research should seek to identify “gold standard” measures and consider whether they have been examined with black emerging adults or similar populations and whether they capture the experiences of this unique population. Furthermore, studies investigating factors that might moderate and/or mediate the relationship between CVE, violence perpetration, substance use, and sexual risk-taking behaviors among black emerging adults are warranted.
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