African American Mental Health Treatment Preferences: Understanding the Role of Religion, Mastery, and Psychopathology
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There has been much attention paid to the gap between mental health need and mental health treatment. Research has broadly shown that whereas individuals with a mental disorder underutilize mental health services, African-Americans, as a whole, utilize these services even less than other groups (National Institute of Mental Health, 2014). Whereas African-Americans are more likely to report psychological concerns than Whites, they receive mental health treatment at a lower rate than Whites (Meyer, Saw, Cho, & Fander, 2015; Office of Minority Health, 2014). Although research has identified stigma, mistrust of health professionals, and lack of access to care as contributing barriers to the decreased mental health treatment in African Americans (Barksdale & Molock, 2009; Broman, 2012; Hines-Martin, 2002), there is less information regarding those who do seek such care and why. Emerging evidence has noted a preference for African-Americans, as a group, towards informal, non-professional resources (e.g., social networks, clergy) for mental health care (Chatters et al., 2011; Dupree, Watson, & Schneider, 2005). Culturally salient factors including religiosity, community-based social support, and coping mechanisms might illuminate the care path African-Americans take and why. Religious participation and employing active coping mechanisms that emphasize control, resilience, and determination have been demonstrated to be protective factors for emotional and psychological well-being in African-Americans (Chatters et al., 2008; Ward, Mengesha, & Issa, 2013). In order to close the gap in African-American mental health care treatment it is important to understand how religious participation, coping strategies, and psychological distress influence decision making.
The present study will analyze data from the National Study of American Life: Coping with Stress in the 21st Century (NSAL), a national representative study conducted between February 2001 and March 2003 of African-Americans, Caribbean descent Blacks, and non-Hispanic Whites 18 years or older in the U.S. (Heeringa et al., 2004; Jackson et al., 2004). Mastery, psychological distress, religious participation, and mental health treatment provider type are the variables I will examine. Mastery is an active coping strategy that relates to an individual’s appraisal of his/her ability to control or influence outcomes. (Pearlin, Menaghan, Lieberman, & Mullen, 1981). Psychological distress is measured by the Kessler Psychological Distress scale, a 6-item measure of global distress (Kessler et al., 2002). Religious participation is a measure of both organized and non-organized religious activities such as religious service attendance, prayer, and watching or listening to religious programming. The proposal will examine the extent to which mastery, psychological distress, and religious participation are associated with African-Americans decision making in regards to mental health treatment preference. Specifically, this study will look at the extent to which these factors are significant predictors of one’s propensity to seek informal versus formal mental health care among African-Americans in need of mental health treatment by utilizing logistical regression analysis.