A Conceptual Model of Help-Seeking by Black Americans After Violent Injury: Implications for Reducing Inequities in Access to Care

Abstract

Many inequities exist in serving and supporting Black survivors of violent crime. A key question in reducing inequities in care after victimization is whether police first responders and other formal system providers identify the victim as an “offender” and/or someone who is “undeserving” of supports. These labels and associated biases can directly reduce access to supports through a variety of mechanisms that include police withholding information about one’s rights as a victim, among other direct and indirect barriers to social and health services. Unaddressed financial, mental, and physical health consequences of victimization contribute to poorer health outcomes later in life. This paper seeks to bring together the extant research on help-seeking, discrimination in criminal legal system functioning, and barriers to victim services by synthesizing these discrete threads into a theoretically and empirically informed conceptual model that captures the range of factors that shape Black Americans’ decision to report their victimization to the police and subsequent help-seeking. Qualitative and quantitative data from a purposive sample of 91 Black victims of community violence is used to ground the developing model. The conceptual model can help lay the foundation for research that seeks to remedy the marked mismatch between the prevalence of violent victimization and help-seeking among Black Americans. Research findings can be applied to guide policies and programming to reduce inequities in care for victims of violence.

Commentary for Special Issue on Advancing Health Equity Among Black Communities: Implications for Research Funders (and Researchers)

“…Funders’ requests for proposals frame how we understand and respond to health problems and what questions researchers prioritize. For example, each study in this issue makes clear that racism has been and continues to be a source of stress for Black communities, but despite the clearly documented consequences of this structural factor (Barbarin et al, 2022 ; Summers-Gabr, et al, 2023 ), most interventions have focused on individuals and families (Boyd et al, 2023 ; Ray et al, 2023 ); a smaller number have focused on the access and quality of supportive systems (Roman, 2022 ); and a rare few have studied structural factors or racism itself (Hassen et al, 2021 ; NIH Advisory Committee, 2021 ). This is due in part to the prevailing frame that guides research funders’ investments in prevention science, which focuses on individuals, specifically on supporting and enhancing the skills of those targeted by racism and discrimination.…”

“…A more asset-based lens is evident in several articles in this special issue, although disparities and challenges to health and mental health still anchor the research. For example, Berkel et al ( 2022 ); Roman ( 2022 ); and Dinizulu and colleagues ( in press ) present findings from evaluations of interventions that reduce the consequences of stress from racism and discrimination by bolstering individual and family skills and practices. They argue for and pursue this research through a cultural lens and leverage assets in individuals and families while also responding to needs.…”

Engagement With Mental Health Services Among Survivors of Firearm Injury

“…People who break the code may be susceptible to physical injury themselves . The antisnitching code has been largely applied to speaking with the police and victim’s services offered within police departments . Survivors often perceive blurred lines between medical professionals and police at the time of their firearm injury .…”

“… 32 The antisnitching code has been largely applied to speaking with the police and victim’s services offered within police departments. 32 , 33 , 34 , 35 Survivors often perceive blurred lines between medical professionals and police at the time of their firearm injury. 36 , 37 Our findings demonstrate the antisnitching code also extends to mental health practitioners and is a crucial barrier to survivors of firearm injury seeking potentially helpful mental health services.…”