'Sharing things with people that I don't even know': help-seeking for psychological symptoms in injured Black men in Philadelphia

Ethn Health. 2020 Aug;25(6):777-795. doi: 10.1080/13557858.2018.1455811. Epub 2018 Apr 1.

Abstract

Objectives: Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. Design: A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Results: Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Conclusions: Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.

Keywords: Black men; Help-seeking; Philadelphia; injuries; mental health; mental health services; trauma; urban health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • Cohort Studies
  • Health Services Accessibility
  • Help-Seeking Behavior*
  • Humans
  • Interviews as Topic
  • Male
  • Mental Health Services
  • Patient Acceptance of Health Care* / ethnology
  • Patient Acceptance of Health Care* / psychology
  • Philadelphia
  • Qualitative Research
  • Stress, Psychological / psychology*
  • Trauma Centers
  • Wounds and Injuries / psychology*