Utilization of mental health services among Black African immigrants in the US: Integrative literature review

<b>Background:</b> Black African immigrants–individuals born in sub-Saharan Africa who now reside in the United States, irrespective of citizenship status–represent one of the nation’s fastest‐growing immigrant groups. Although they contend with migration stress, racism, cultural dislocation, and socioeconomic hardship, they remain among the least likely to seek or receive mental-health services. This persistent under-utilization, coupled with scant empirical attention, leaves their distinct needs largely invisible in mental-health research and policy.<br /> <b>Purpose:</b> This integrative review examines multilevel factors influencing mental health service (MHS) utilization specifically among Black African immigrants in the United States, foregrounding structural, cultural, and psychosocial barriers.<br /> <b>Methods:</b> Following integrative review methodology [1], 19 peer-reviewed studies published between 2000 and 2025 were analyzed using thematic synthesis and constant comparative analysis. A conceptual framework grounded in intersectionality, Stigma and race-related stressors, and structural competency guided the review.<br /> <b>Results:</b> Five major themes emerged: (1) underutilization despite need, (2) structural barriers and systemic exclusion, (3) cultural and religious interpretations of mental illness, (4) stigma and silence within communities, and (5) the role of acculturation and identity. These themes highlight the complex interplay of stigma, systemic racism, and sociocultural dynamics influencing help-seeking behaviors.<br /> <b>Conclusion:</b> MHS underutilization among Black African immigrants is shaped by interlocking individual, cultural, and structural barriers. Culturally and structurally responsive interventions are urgently needed to improve access and engagement. The review underscores the importance of population-specific research, disaggregated data, and community-partnered models of care.