Abstract

The United States (US) is in the midst of a mental health crisis. More than one in four (26.2%) adults experience a diagnosable mental health disorder each year, and 46% of the population will do so in their lifetime. Collectively, mental health disorders are a leading cause of disability and account for one-third of all years lived with disability and premature mortality. Black Americans constitute about 12% of the US population, but they make up more than 18% of the population affected by mental disorders. Black men are 30% more likely than non-Hispanic white men to report having a mental illness but are less likely to receive proper diagnosis and treatment. Black adults are 20% more likely to report serious psychological distress than white adults. Despite this, many Black people do not seek mental health care for various reasons. Causes of higher morbidity and non-care seeking behavior in Black people and Black men in particular include racism, discrimination, stigma, and distrust of the healthcare system. Across the District of Columbia (DC), Black Americans are twice as likely as other ethnicities to report a serious mental disorder, especially if they live in poverty and did not complete high school. In the project service area of Ward 8 in Southeast DC, 92% of the population is Black, 30.7% live in poverty, and only 85% of the population age 25+ completed high school. Evidence shows common mental health disorders are distributed according to a gradient of economic disadvantage across society; the poor and disadvantaged suffer disproportionately from common mental health disorders. In Southeast DC, this negative impact on mental health is compounded by the geographic concentration of underemployment, lack of economic opportunity, poverty, and underutilization of mental health services. Improving mental health literacy is a non-systemic intervention shown to increase mental health care-seeking behaviors. Mental health literacy is the knowledge of, attitude about, and behavior toward mental health issues and mental health services. The goal of the Mental Health Improvement through Study, Teaching, Rebranding, Embedded Education, and Technology or (MHISTREET) initiative is to improve mental health in Black men through embedded education in non-traditional spaces such as barbershops.

Highlights

  • 1.1 Mental Health in the United StatesThe United States (US) is in the midst of a mental health crisis [1–7]

  • The authors were invited by the chair of the council to create a mental health sub-committee charged with promoting and enhancing policies and practices that increase access to mental and behavioral health services, decreasing stigma associated with mental health disorders, promoting mental health wellness, and improving mental health literacy and outcomes for individuals living in Ward 8

  • Healthcare providers, and community stakeholders in the local Southeast District of Columbia (DC) community has proven to be of great benefit toward achieving the aim of this initiative, which is to provide a non-traditional, non-healthcare platform for black men to share and hear stories of mental health resilience, encourage mental health-related conversations among barbershop clients, and serve as a bridge to mental health services

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Summary

Mental Health in the United States

More than one in four (26.2%) adults experience a diagnosable mental health disorder each year, and 46% of the population will do so in their lifetime [1, 2]. Available care services are often underutilized because mental health disorders impair one’s ability to seek and adhere to care, delaying the receipt of effective treatment. Early detection, and effective ongoing treatment of mental health disorders can have a positive impact on the quality and quantity of life. This often does not occur; many people experience their introduction to mental health treatment in emergency settings at a late stage in the course of the disease. Elements influencing mental health treatment-seeking behaviors include systemic factors, knowledge, beliefs, attitudes, and stigma [4]

Mental Health in black Americans
Racial discrimination, stress, and trauma
Stigma
Distrust of the health care system
Bias and lack of cultural sensitivity
Inadequate mental health literacy
Poverty
Mental Health in Black American men
The Initiative’s service area
Approach
CBPR principles
Original project design
Current project design
Formation of a mental health sub-committee of the Ward 8 Health council
Pre-implementation data collection
Selection of mental health literacy as core intervention
Selection of anchor institution
Use of the black barbershop for increasing mental health literacy
Use of embedded education for increasing mental health literacy
Barbershop embedded education (BEE) curriculum development
BEE training
Program redesign
Number of barbers and community members trained
3.4.10 Use of storytelling for mental health literacy
3.4.11 Program expansion - barbershop embedded education squad
Resident/patient survey
Provider survey
GIS mapping
Service inventory
Community engagement
Barbershop embedded education training
Social media
Outputs
Outcomes
Reaction: what learners thought or felt about the training
Learning: to what degree learners acquired intended knowledge, behavior, and attitudes
Result: effects resulting from learners’ performance
Discussion
Building trust
Partnerships and networks across sectors
Flexibility and patience
Findings
Full Text
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