Moderating Effects of Stigma-related Barriers on Ethnic Identity Dimensions and Mental Health Service Utilization among Black Adults in the US.

BACKGROUND

Significant disparities in mental health service utilization persist, particularly among Black adults in the United States. We focused on ethnic identity dimensions of centrality and assimilation and addressed their distinction from the commonly used term of acculturation.

METHOD: This study utilized gamma regression to examine the relationship between ethnic identity and help-seeking behavior within a large sample of Black adults (N = 1,117) and investigated the moderating effects of stigma-related barriers on this relationship.

RESULTS

The findings revealed statistically significant differences in centrality (extent to which a person identifies with their race), and assimilation (desire for integration into the mainstream parts of society) across gender, ethnicity, and age groups. Participants aged 45-65 scored higher in centrality compared to those aged 25-44. In terms of assimilation, males scored higher than females, and African/Afro-Caribbean immigrants scored higher than African Americans. Stigma-related barriers, including stigma within the workplace and concerns about being perceived as an unfit parent were notable deterrents to seeking mental health care. Centrality and assimilation were negatively associated with help-seeking intentions, such that higher levels of centrality and assimilation were related to lower intentions to seek mental health care for personal/emotional issues and suicidal thoughts. Stigma-related barriers moderated the relationship between education and help-seeking behavior. As stigma-related barriers increased, Black adults with higher education levels experienced a 17% decrease in help-seeking likelihood for personal/emotional issues (RR = 0.83, p < .01) but a 16% increase in help seeking for suicidal thoughts (RR = 1.16, p < .05).

CONCLUSION

These findings highlight the moderating effect of stigma-related barriers in relationships between ethnic identity dimensions and mental health service utilization among Black adults, underscoring the need for targeted, culturally informed interventions.