Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults

Abstract

Objective: Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services.

Method: A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data.

Results: Thematic analysis of the interviews with African-American older adults is presented within three areas: (1) Beliefs about Depression Among Older African-Americans; (2) Barriers to Seeking Treatment for Older African-Americans; and (3) Cultural Coping Strategies for Depressed African-American Older Adults.

Conclusion: Older African-Americans in this study identified a number of experiences living in the Black community that impacted their treatment seeking attitudes and behaviors, which led to identification and utilization of more culturally endorsed coping strategies to deal with their depression. Findings from this study provide a greater understanding of the stigma associated with having a mental illness and its influence on attitudes toward mental health services.

Keywords:

• depression
• beliefs/attitudes
• health service use
• stigma
• aging

Acknowledgments

The authors thank the men and women who shared their personal experiences in our interviews and to Michelle McMurray, LSW for assisting in the conduct of the semi-structured interviews. Funding for this study was provided by the John A. Hartford Foundation Dissertation Fellowship (K.O. Conner), UCSUR, University of Pittsburgh, Steven Manners Faculty Development Award (C. Brown), Center on Race and Social Problems, University of Pittsburgh School of Social Work (C. Brown), Advanced Center for Interventions and Services Research on Late Life Mood Disorders (P30MH71944; PI: C.F. Reynolds, III), and the Commonwealth of Pennsylvania Department of Health (C.F. Reynolds, III).

No conflicts to report.