“It’s Finding the Time to Prioritize Ourselves”: Using the Theory of Planned Behavior to Explore Young Black Women’s Attitudes, Norms, and Beliefs Toward Mental Health Care

Across the United States, Black women are likely to have unmet mental health needs, with greater personal, social, and structural barriers to mental health treatment compared to other groups. The Theory of Planned Behavior (TPB) may help to conceptualize young Black women’s mental health beliefs and help-seeking behaviors. The current study aimed to use the TPB framework and a concurrent mixed methods approach to explore behavioral, normative, and control beliefs toward seeking mental health care among a sample of young Black women from community settings. The sample consisted of 33 Black women with an average age of 28 years old (SD = 3.58). Participants were predominately heterosexual, and no participants identified as transgender. Most participants (n = 26, 79%) reported seeing a mental health provider at least once. In focus groups, participants identified behavioral beliefs regarding positive outcomes from mental health services, mixed expectations from mental health providers, and mental health stigma. Normative referents included immediate family members, friends, colleagues, religious and/or faith communities. Control beliefs pertained to personal and social factors (e.g., self-confidence, reducing stigma, mistrust of providers), the therapeutic relationship, and access to care. Comprehensive strategies are needed to promote young Black women’s mental health while recognizing their strength, balancing informal and professional supports, and integrating peers. Collective efforts should include organizational and structural interventions across the mental health workforce, with funding and policy changes to improve social determinants of health and expand prevention of mental health symptoms across communities.