Black Women’s Mental Health Service Needs: The Possibilites of Peer Support

Background and Purpose: Black women in the United States occupy a precarious social
location, experiencing compounded oppression at the intersection of race, class, and gender.
These experiences have been linked to a host of poor physical health and mental health
outcomes. Related to mental health outcomes, women experience depression at twice the rate of
men. However, Black women with depression are less likely to seek treatment in formal mental
health settings. The study centers the lived experiences of urban dwelling Black women to
advance understanding of their mental health experiences, barriers to care and mental health
service needs. This study specifically elicits Black women’s perspectives on the feasibility and
desirability of models of mental wellness care using peer support.
Methods: A total of 18 Black adult women participated in one of two semi-structured focus
groups conducted in January 2024. One focus group occurred virtually/online while the other
was in-person. Participants were recruited via electronic flyers, email listserves and social media.
Drawing on a phenomenological approach to qualitative research within a Black feminist
theoretical framework, we used descriptive and thematic analysis to interpret raw data and text
on the lived experiences and mental health needs of Black women. Of note, this study was part
of a larger community-based participatory research approach in which the research questions,
research design, recruitment, data collection and data analysis were all developed and /or
conducted in collaboration with community partners to inform the development and
implementation of a peer support intervention.
Findings:
Preliminary data analysis reveals that in the context of mental health services Black women want
to be authentic, feel seen, safe and heard. Many women described the importance of vulnerability
to engage in mental health treatment. However, women noted several challenges to showing up
authentically in traditional therapeutic spaces including stigma, lack of education about mental
health conditions, and a lack of cultural humility from therapist. Black women also described a
deep desire to engage in authentic connections with other Black women in spaces that felt non-
judgemental. When asked specifically about their perspectives on peer support models of care
they expressed excitement about the prospect of forming connections with other Black women in
a way that felt less formal and easier to access than traditional therapy or counseling.
Observations of the participants’ interactions and engagement with each other during the focus
group suggested an important sense of collectivity, empowerment, agency and excitement when
given the space to imagine mental wellness for Black women.
Conclusion and Implications: This study provides comprehensive and current evidence of the
mental health service needs of Black women including barriers to access and perspectives on
peer support models of care. Findings also provide insight into how Black women imagine and
make meaning of mental wellness and wellbeing for themselves and other Black women. These
findings alongside the community-engaged and collaborative approach to the research can help
to inform social work research, science and practice concerned with the development of
innovative approaches achieve mental health equity for Black women.