The internalization of the Strong Black Woman (SBW) schema is associated with negative psychological outcomes. However, not much is known about the mechanisms through which this schema leads to poor health. We examined the direct associations between the SBW schema and depression, anxiety, and loneliness. We also tested four mediators—maladaptive perfectionism, self-compassion, and two Africultural coping strategies of collective coping and spiritual coping—between the schema and psychological outcomes. Moreover, we examined serial mediation effects. A total of 222 African American women participated in an online survey. Structural equation modeling was conducted, and after controlling for age, family income, and level of education, the direct associations were supported, and the mediator roles of maladaptive perfectionism, self-compassion, and collective coping but not spiritual coping were supported. For serial mediation effects, the SBW schema was first positively associated with maladaptive perfectionism, which was associated with low self-compassion and low use of collective coping, which in turn were correlated with negative psychological outcomes. Racial, economic, and structural inequalities that maintain the SBW schema need to be examined and removed. Clinical interventions should focus on reducing maladaptive perfectionism and increasing self-compassion and collective coping among those who have internalized the schema. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684319883198