Black American psychological help-seeking intention: An integrated literature review with recommendations for clinical practice.

Abstract

Cumulative research has indicated that Black Americans underutilize voluntary mental health services. This review article adopts the theory of planned behavior (TPB; Ajzen, 1991) model as an organizing conceptual framework to demonstrate how a variety of factors contribute to Black Americans' reluctance to seek psychological help. These factors include perceived negative consequences associated with seeking help (i.e., mental illness stigma); social pressure against psychological help-seeking (i.e., endorsement of beliefs, such as "Black people do not get mental illness," "Black people must be strong," and/or "Black people who seek professional help have less faith in God"); and perceived difficulties associated with seeking professional help (e.g., cultural mistrust, microaggressions in therapy). This article then suggests approaches that practitioners can use to encourage mental health service use in this population, such as reducing mental illness stigma through psychoeducation; discussing the influences of race/ethnicity and culture in therapy; and preventing and addressing microaggressions in therapy. Finally, the article discusses directions for future research to further investigate how to better understand and encourage psychological help-seeking intention in the Black community.

Mental health, well‐being, and help‐seeking in schools among black adolescents: The role of discrimination in high‐achieving academic settings

“…Past research utilizing the Theory of Planned Behavior has shown that Black Americans may not hold positive perceptions of traditional mental health services. Taylor and Kuo (2018) state that stigma against mental health is a prominent theme influencing help‐seeking generally but is especially significant within the Black community. Double Stigmatization—an individual faces prejudices and discrimination as part of an ethnic and racial group and based on stereotypes and prejudice of being seen as mentally ill—is hypothesized as a significant contributor to stigma within the Black community (Gary, 2005; Taylor & Kuo, 2018).…”

“…Taylor and Kuo (2018) state that stigma against mental health is a prominent theme influencing help‐seeking generally but is especially significant within the Black community. Double Stigmatization—an individual faces prejudices and discrimination as part of an ethnic and racial group and based on stereotypes and prejudice of being seen as mentally ill—is hypothesized as a significant contributor to stigma within the Black community (Gary, 2005; Taylor & Kuo, 2018). Furthermore, normative beliefs encouraging strength, independence, resilience, and faith may be salient within the Black community, thus decreasing intentions for engaging in traditional mental health services (Taylor & Kuo, 2018).…”

“…The Theory of Planned Behavior also suggests that an individual's history and past experiences influence their perception of the feasibility or utility of engaging in a behavior and have a role in assessing possible barriers. Perceived behavioral control can influence Black American's decision to seek help for their mental health needs based on the types of services utilized, cultural ideals within the therapeutic dynamic, or lack of Black mental health providers (Taylor & Kuo, 2018). Barriers can also be a result of systemic racism placing Black Americans with limited resources at a disadvantage, including insurance and financial factors, transportation issues, or difficulty navigating systems.…”

“…Barriers can also be a result of systemic racism placing Black Americans with limited resources at a disadvantage, including insurance and financial factors, transportation issues, or difficulty navigating systems. Finally, decisions to engage in help‐seeking can be influenced by cultural mistrust or previous negative experiences with psychological services, often due to experiences of discrimination and microaggressions (Sue et al, 2007; Taylor & Kuo, 2018). While all of the elements of the Theory of Planned Behavior are essential contributors in predicting intent within Black communities, experiences of school‐based discrimination could impact adolescents' views of engaging in mental health services at school.…”

“…This study will also begin the exploration into adolescents' willingness to seek mental health support at school. Culturally unresponsive practices, including discrimination, have been established as barriers to mental health treatment in traditional settings within Black communities (Sue et al, 2007; Taylor & Kuo, 2018). However, cultural barriers to treatment in schools, specifically experiences of school discrimination, have not been well examined.…”