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Understanding Barriers to Mental Health Care for Urban Black Men Who Experience Traumatic Injury

Psychological distress is common in the aftermath of a traumatic injury. Symptoms of depression and post-traumatic stress can make it harder to re-establish one’s social and family life, work performance, and wellbeing after injury.

Despite the prevalence and impact of psychological symptoms, United States trauma systems do not routinely integrate psychological evaluation and mental healthcare as a mainstay of post-injury care. This shifts the responsibility for help-seeking to injured people who must identify their symptoms and find mental health support and services. This gap is especially troubling for populations disproportionately affected by traumatic injuries, like black men, who are less likely to use mental healthcare after physically and psychologically traumatic events.

A new study from the University of Pennsylvania School of Nursing (Penn Nursing) has explored how injured black men in Philadelphia perceived their psychological symptoms after injury and the factors that guided their decisions to seek professional mental health help. The study, ‘Sharing things with people that I don’t even know’: help-seeking for psychological symptoms in injured Black men in Philadelphia,’ has recently been published in the journal Ethnicity & Health.

“Our focus on urban black men is intended to bring greater attention to a population highly vulnerable to trauma, injury, and suboptimal outcomes after injury,” explains the study’s senior author, Therese S. Richmond, PhD, FAAN, CRNP, the Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation.

“By understanding help-seeking in urban Black men and others at high-risk  for psychological challenges after injury, we are better positioned to create individually-responsive programs that can be seeded within the continuum of trauma care,” noted the study’s lead-author Sara F. Jacoby, PhD, MPH, MSN, an Assistant Professor in Penn Nursing’s Department of Family and Community Health. “What we learned from study participants was that despite suffering from often severe psychological symptoms in the months that followed hospitalization, very few men would seek professional mental healthcare citing both personal and system-based barriers like lack of health insurance, as well as preference for informal or faith-based support.”

This study suggests the need for research to identify interventions that will 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 who live in recovery environments like Philadelphia.

This study was co-authored by John A. Rich, MD, MPH, of Drexel University’s Dornsife School of Public Health and Jessica L. Webster, MS, LPC, of Penn Nursing, and was funded by a National Institutes of Health/National Institute of Nursing Research grant R01NR013503 to Dr. Richmond.