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Communities about mental illness in general however

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communities about mental illness, in general. However, our results suggestthat Black women appear to be aware of the serious nature of depression andhold favorable attitudes pertaining to depression treatment but may decline toseek treatment due to past individual and collective negative experienceswith the mental health care system. This finding is concerning and impliesthat the mental health care community should actively work to increase out-reach and promote positive images of mental health treatment (Thompsonet al., 2004). As researchers have found that Black people in general typicallyview mental health providers as disconnected from the contextual and cul-tural realities of their experience (Poleshuck et al., 2013; Thompson et al.,2004), it is important for providers to be particularly attuned to facilitatingtreatment engagement.Two thirds of the participants indicated that they would seek help fordepression. This result, in part, was reflected in the theme,Self-care, despitewhat others may say. This theme reflects help-seeking for depressiongrounded in the need for self-care, despite family attitudes against treatmentseeking. Participants discussed personal positive experiences of therapy,including resisting the notion to keep family business, in particular, theirmental health private. Justifiably, family concerns about privacy and themental health care system are not atypical among Black people, given the
278Journal of Black Psychology 46(4)historical context of enslavement, medical experimentation, and stigmatoward help-seeking (Whaley, 2001). However, for some Black women withmental health conditions (e.g., depression, bipolar disorder), treatment seek-ing may be a form of both self-care and resistance of messages that Blackwomen do not experience depression (Beauboeuf-Lafontant, 2009).Although two thirds of participants endorsed help-seeking for depres-sion, some of the conditions for treatment seeking warrant increased atten-tion. That is, many participants in this group acknowledge that they wouldseek help only after informal sources of care were exhausted and the situ-ation was serious. The theme,Do I really need to go and see somebody,reflects the perspective that extreme circumstances (e.g., comorbidity ofmental health conditions, substance use, and significant traumatic experi-ences) are required before it would be acceptable to seek professionalmental health services. Therefore, this finding is consistent with previousresearch that suggests that Black women do seek treatment for depression,but their symptoms tend to be more severe, debilitating, and often lessdetected (Borowsky et al., 2000; Lawson, 2002). Furthermore, Blackwomen continue to report negative experiences and perceived risk inengaging in the therapeutic process (Poleshuck et al., 2013). Moreover,our findings demonstrate the need to conceptualize help-seeking as a pro-cess informed by myriad factors, including Black women’s previous expe-riences with mental health treatment.

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