3 - (SYM 77) Exploring Mental Health Treatment Engagement Among Black Individuals: The Role of Race-specific Factors

Suicide results in over 47,000 annual U.S. deaths (CDC, 2021). Mental health (MH) treatment is crucial for mitigating suicide risk; yet, few high-risk people engage in care, including those identifying as Black (Sheehan et al., 2018) and those with past suicide ideation (Hom et al., 2015). Few studies have aimed to clarifying MH care utilization among Black individuals and how prior experiences of suicidality and race-specific factors impact this. To address this gap and expand on prior work (i.e., Sheehan et al., 2018), we compared MH care utilization across Black, white, and Hispanic individuals. To elucidate correlates of care utilization among Black people, we also examined how suicide risk history, race-related cultural stress, and their interaction were related to MH care engagement.

Participants were 2299 people recruited online who identified as Hispanic (24.5%), white/non-Hispanic (51.1%), or Black/non-Hispanic (24.4%). They answered questions about MH care utilization. Black participants answered questions about lifetime suicide risk and cultural racism (i.e., Index of Race-Related Stress-Brief; Chapman-Hilliard et al., 2020).

 Analyses probed the relationship between race and 5 mutually exclusive care history groups: (1) no MH care, (2) therapy, (3) psychiatric medication, (4) medication and therapy, and (5) psychiatric hospitalization. People were grouped by highest reported care intensity. Among Black people, we also examined relationships among MH engagement and suicide risk and race-related stress.

Chi-square analyses showed Black (vs. white and Hispanic) people were more likely to report no lifetime MH care. Black people were less likely than: Hispanic people to report engaging in therapy and hospitalization, white people to report medication use, and Hispanic and white people to report therapy and medication, (x² (10, N = 2287) = 90.105, p< .001). Among Black people, three ordinal regressions showed suicide risk, race-related stress, and the suicide risk by race-related stress interaction predicted care level such that higher suicide risk (x² (1, N = 392) = 69.65, p < .001; McFadden’s R² = 0.10), higher race-related stress (x² (1, N = 392) = 50.27, p < .001; McFadden’s R² = 0.07), and their interaction (x² (1, N = 392) = 69.65, p < .001; McFadden’s R² = 0.10) predicted more intensive care.

Results support prior work revealing disparities in MH care utilization across minoritized individuals. Further, race-specific factors should be considered when addressing barriers to care engagement among Black individuals.