The Effects of Racial Identity and Racial Discrimination on Black Mental Health Service Use

Abstract Growing diversity in the Black Diaspora and increases in mental health concerns among Black people indicate a need for exploring the factors that influence the mental health practices of Black people. Racial identity and racial discrimination may be significant predictors of mental health service use; however, variability in Black historical context and experiences in the U.S. suggest that these factors may operate differently by Black ethnic group. In this dissertation, data from the National Survey of American Life (NSAL) was used to examine how racial identity and racial discrimination influence mental health support-seeking behavior among African Americans and Caribbean Blacks. In the first study, we identified classes of racial identity and examined whether these classes determine mental health service use. Racial identity characterized by a strong sense of racial pride, centrality of race, and social and political autonomy of Black people (Pride-Nationalist) is associated with lower odds of mental health service use. In contrast, racial identity characterized by the belief that people of other races have positive perceptions of Blacks was associated with more mental health service use. In the second study, we identified three distinct mental health support classes (Family-Friends/Clergy, Informal Support, and All Supports) and examined whether racial identity predicts class membership. High private regard is associated with a greater likelihood of being in the Family-Friends/Clergy class than the other two classes among African Americans and Caribbeans. On the other hand, high racial ideology was associated with a greater likelihood of being in the All Supports class among Caribbean Blacks. In the third study, we examined the moderating role of racial identity on the association between racial discrimination and mental health. More experiences with racial discrimination was associated with more mental health service use. Among Caribbean Blacks with high centrality, racial discrimination was associated with a lower likelihood of mental health service use. Collectively our findings fill a gap in our understanding of how racial identity influences Black mental health support-seeking behavior. Furthermore, our results highlight the significance of informal support sources for Black mental well-being.