Conceptualizing Black Boys' Mental Health Help-Seeking Behaviors As a Social Process

Background: Most current literature fails to thoroughly examine how Black boys’ unique intersectional identity plays into their help-seeking process, accounting for sociocultural barriers, unique forms of informal mental health support, and systemic barriers to formal mental health service use. Black Boys are in a unique intersection of Blackness, Maleness, and Adolescence. Each of these groups mentioned above has been found to underutilize formal mental health supports, partake in many unhealthy and deleterious coping behaviors, avoid explicit acts of vulnerability, and are at increased risk of experiencing depressive symptoms, suicidal ideation, and anxiety. The unique intersection calls for a sociocultural perspective to examine help-seeking behaviors and understand mental health help-seeking as a social process significantly influenced by specific sociocultural factors.

Methods: This study uses 15 in-depth semi-structured interviews with Black boys from four high schools in Southeast Michigan to explore their mental health help-seeking behaviors as components of a complex social process. Interviews were collected from March 2020 through January 2021. A constructivist grounded theory approach with a three-cycle coding process was employed to explore the participants' help-seeking behaviors and how they navigated their experiences with depressive symptoms and mental distress. Constructivist grounded theory (CGT) was chosen as the analytical method for this study because of its unique ability to identify social processes via its systematic approach to data analysis while being sensitive to researcher positionality.

Results: Findings from this study showed that the participants navigated through several stages in their help-seeking process. Each stage was triggered by the progression or worsening of depressive symptoms. As the participants' experiences with depressive symptoms progressed, they described making key decisions about how to seek support from both formal and informal resources. In their decision-making process, the participants described the importance of maintaining independence and addressing depressive symptoms.The participants in this study attempt to maintain independence by initially addressing their needs on their own, having control over whom they seek help from when they seek external help, and controlling how much they reveal to those they seek help from. The participants' descriptions of their help-seeking process revealed the importance of maintaining cognitive and physical independence related to feelings when Black boys need or seek mental health support.

Discussion: This study builds on previous literature that views help-seeking as a dynamic interaction between social interactions and cognitive decision-making as part of a larger complex social process. It provides a framework that considers important sociocultural factors to aid practitioners and researchers in examining Black boys’ mental health help-seeking and supporting their positive help-seeking behaviors.