Mental Health Stigma and Service Use Among Black American Youth: A Systematic Review

• Published in: American journal of orthopsychiatry 2024-01, Vol.94 (6), p.655-667
• Main Authors: Fields-Oriogun, Danae, Foley-Nicpon, Megan, Thornburg-Suresh, Michael
• Format: Article
• Language: English
• Subjects: Adolescent; Black or African American - psychology; Black People; Caregivers; Caregivers - psychology; Child; Health Care Utilization; Human; Humans; Mental Disorders - ethnology; Mental Disorders - psychology; Mental Disorders - therapy; Mental Health Services - statistics & numerical data; Mental Health Stigma; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Social Stigma; White
• ISSN: 0002-9432; 1939-0025; 1939-0025
• DOI: 10.1037/ort0000749

Past research has found that Black children do not obtain mental health services at a rate commensurate with their needs. Additionally, they overall have lower rates of service utilization in comparison to other groups, even when factors such as socioeconomic status are considered. This systematic review aimed to examine the impact of mental health stigma on service utilization within Black families. We conducted a review of qualitative and quantitative studies published from 1990 to 2020 that examined the relationship between mental health stigma and service use and included disaggregated data of Black American youth and/or caregivers as the participants. Twelve articles (six quantitative, four qualitative, and two mixed methods) met the inclusion criteria. We used a narrative synthesis approach to organize and assess the extracted data. Youth reported stigmatizing beliefs about mental health treatment, although their attitudes did not contribute to caregivers' decisions about seeking treatment for them. Caregivers reported an awareness of stigmatizing views being held by others in their communities, but they did not consistently describe these views as impacting their service use decisions. Findings suggest a need for additional research to determine which factors most strongly impact the service use decisions of Black American caregivers. Public Policy Relevance Statement The review indicates the presence of perceived mental health stigma by Black American caregivers, though it does not consistently impact their service use decisions. The findings of this review suggest that Black youth report more stigmatizing views than caregivers, though their views did not contribute to caregivers' treatment decisions. Whether this is a protective response related to racism or other factors is unclear. Results from this review can provide considerations to clinicians when discussing mental health care options with Black American families.