Community-Identified Needs, Barriers to Care, and Potential Solutions for Black Men's Mental Health in Detroit, MI

Background: Depression and suicide rates among Black men were on the rise before the pandemic and worsened after it (Stone et al., 2023; Thomeer et al., 2023). Despite pressing need, Black men face significant mental health treatment access disparities (Chandler, 2010; Hudson et al., 2018). These disparities are driven by barriers related to treatment availability, accessibility, and, importantly, acceptability. Black men are often overlooked in mental health discussions (Mitchell et al., 2017), a significant oversight given the need to address their mental health through lenses of racial discrimination, masculinity, and medical mistrust (Hankerson et al., 2015; Hudson et al., 2018). To fill these gaps, this community-based participatory research examines Black men’s mental health needs and treatment preferences in Detroit, Michigan. Given the Black church's prominent role in addressing community needs (Lewis and Trulear, 2008), this research focused on Black church leaders.

Methods: The research was led by a stakeholder team that included clergy, human service providers, and social work researchers. This team organized a community symposium on Black men’s mental health, featuring presentations on innovative programs designed to better engage and serve Black men. Attendees of the symposium were invited to complete web-based surveys about their perceptions of Black men’s mental health in their community, factors affecting mental health, treatment preferences, barriers, and potential solutions. The survey consisted of 18 items, including 14 open-ended and 4 closed-ended questions. Community members accessed the survey via a QR code available at the symposium. Data analysis included thematic analysis of open-ended questions and descriptive statistics of closed-ended questions.

Results: Of the 23 people who attended the symposium, 17 (74%) completed surveys. Nearly two-thirds (65%) identified Black men’s mental health as a significant issue in their community. The most common barriers to mental health care were high costs (71%), lack of insurance or coverage (65%), no transportation (59%), and concern about judgment (59%). Structural factors such as "poverty, unemployment, economics" were noted as contributors to mental health issues. Family and stigma were also highlighted as contributing factors. Respondents emphasized the importance of community connection and education as potential solutions. They suggested creating spaces for Black men to gather and discuss mental health, with one stating the need for “authentic spaces to discuss,” and another advocating for “training for Black men to counsel and care for one another.” Community education was another proposed solution, with calls for “educating kids and families/youth in schools” and promoting “transparency and awareness.” Churches and schools were identified as key locations for supporting Black men's mental health.

Implications: The findings highlight the need to center Black men’s voices in discussions about their mental health and treatment. Creating opportunities for Black men to engage in conversations about mental health within their lived experiences is crucial. Churches, schools, and other informal community spaces are seen as potential settings for this support. Although structural factors significantly influence Black men’s mental health, they are often overlooked in treatment. Addressing these in mental health care is essential for acknowledging and validating Black men’s lived experiences.