A Qualitative Grounded Theory Study of Black Canadian Mental Health Service Use

Background: Black Canadians are less likely than White Canadians to willingly use mental health services despite the social and economic challenges we experience that negatively affect our mental health. It has been found that Eurocentric theoretical models of psychological help-seeking do not adequately explain how Black Canadians decide whether or not to use mental health services. Research Question: How do Black Canadians decide whether we want to seek help from a mental health professional?Purpose: Generate a theory of psychological help-seeking that is empirically grounded in data collected from a diverse sample of Black Canadians. Methods: I employed the Corbin and Strauss (2007) version of grounded theory (Straussian grounded theory) to construct a theory that includes causal explanations of Black Canadian mental health service use. The sample consisted of 30 Black males (n=15) and females (n=15) who resided in various regions in Canada (e.g., Ontario, British Columbia, Alberta, Quebec, and Nova Scotia). The participants completed hour-long online interviews. The data was analyzed using techniques specific to Straussian grounded theory (e.g., theoretical sampling, open coding, selective coding, analyzing for context, analyzing for process, etc.). Results: Broadly speaking, Black Canadians' willingness to use mental health services relied most on the degree to which using mental health services deviated from or aligned with the individual's cultural norms. When the act of accessing mental health services opposed a participant’s cultural norms, then that individual reported less willingness to use mental health services. This divergence between cultural norms and mental health service utilization led to various consequences. These included, but were not limited to, Black Canadians’ anticipation of a) being misunderstood by the mental health practitioner; b) being treated unfairly by the mental health practitioner; c) negative judgment from oneself and others; and d) feelings of discomfort, shame, and pessimism around using mental health services. Whereas when the act of accessing mental health services was in line with a participant’s cultural norms, then that individual reported more willingness to use mental health services. This is because the individual would be more likely to expect understanding, fair treatment, self-acceptance about seeking help, and feelings of comfort, pride, and optimism when engaging in mental health services. It is important to note one additional factor. That is, that the degree to which the divergence between help-seeking and cultural norms impacted an individual Black Canadian’s willingness to use mental health services depended on the extent to which the individual internalized or conformed to their cultural norms. Black Canadians who routinely acted in line with cultural norms tended to be less willing to use mental health services compared to those who did not act in line with cultural norms. Conclusions: The results of this study expand the current knowledge about Black Canadian mental health service use and have implications for making mental health services more accessible to Black Canadians.

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