WITHDRAWN: Barriers to School-Based Mental Health Resource Utilization Among Black Boys

Background:

Despite increased attention to students’ mental health needs in K-12 settings, Black boys are among the least likely groups to use available mental health resources (MHR) provided by their school. This issue is urgent given that injury from suicide attempts by Black boys rose by 122% over the past 30 years and Black boys with depressive symptoms are often misdiagnosed. There is a distinct need to examine potential barriers to Black boys’ MHR use in schools so that school staff can better screen for and address those in mental distress, including those at significant risk for self-harm and suicide.

Methods:

Secondary data for 172 Black boys was utilized from a baseline mental health needs assessment conducted by a large school district in Southeast Michigan. Logistic regression was employed to examine the predictive power of select internal and external barriers on school-based MHR utilization. Internal barriers included self-reliance, I feel embarrassed, I am concerned about privacy, I don’t think it will help, and I already tried it didn’t help. External barriers included, no transportation, not enough time, no insurance, and parents will not let me. Participants ranged from 13 to 19 years old (mean age=15, SD=1.01) and the majority were in 9^th and 10^th grade (n=108).

Results:

The PHQ9-A measure was used to assess depressive symptoms and the average participant score was 5.87, meeting criteria for mild depression. Nearly 50% of participants reported mild to severe depression and 56% used at least one school-based MHR when experiencing mental distress. There was no significant relationship between depression and school MHR use (P>.005) in the bivariate analysis. In the first model, no external barriers significantly predicted school resource use (x²=6.0, P=.429). A second model (x²=20.06, P<.05) examining internal barriers found that self-reliance (OR=.23; P=.006; CI; .06-.54) and embarrassment (OR=3.83; P=.029; CI: 1.15-12.80) were both statistically significant predictors. Of note, boys who identified a desire to rely on themselves to address their mental health symptoms were 70% less likely to use available MHR in their school. When embarrassment was reported as a barrier to using MHR, participants were nearly four times more likely to use a school-based MHR. This unanticipated finding is worthy of further exploration.

Conclusion and Implications:

This study identifies key barriers that shape school MHR utilization patterns in a sample of school-age Black boys, including that Black boys in this sample underutilized school MHR. These findings speak to potential protective factors in schools that make Black boys feel safer in seeking formal mental health support in school. Additional research will be critical to ensuring that the Black boys in mental health distress have access to and reach out to utilize the school-based MHR that can enhance their wellbeing.