Exploring Mental Health Screening and Linkage to Care among Young African American Men

Abstract

Young Black/African American men are at greater risk for trauma compared to young non-Hispanic White males, which increases the risk of mental health concerns and risk behaviors. However, young Black/American men are less likely to seek mental health screening and linkage to care (LTC) services than other racial/ethnic groups. The purpose of the current study was to use a Theory of Planned Behavior (TPB)-guided framework to qualitatively explore attitudes, norms, control beliefs, and intentions related to seeking mental health screening/LTC among Black/African American men aged 18-30, who had experienced trauma. Participants (N = 55) had an average age of 23 years (SD = 3.9) and had experienced an average of two to three traumatic events (SD = 2.2), most commonly being threatened with a weapon and loss of a loved one. Focus groups elicited behavioral beliefs that there is a need to normalize mental health, services can be effective, and mental health providers can provide an objective perspective. However, participants also strongly believed that to engage in screening/LTC required individual effort and there is no guarantee that providers can help. Key normative referents were significant others, family, friends and peer groups, faith-based organizations, and employers. Participants endorsed greater motivation to seek screening/LTC with the support of others. Control beliefs ranged from individual and interpersonal facilitators and barriers (e.g., knowledge of where to go, establishing a therapeutic relationship) and more systemic factors (e.g., availability of providers, cost, lack of access, disparities in incarceration). Findings have potential to inform development of culturally tailored, relevant intervention to promote engagement in mental health services among high-risk young adults. This study also could be a valuable resource for researchers and clinicians seeking to more effectively address trauma-related outcomes among urban youth.