"the Load Is Heavier Than What We’Re Showing”: Black Men’s Perceptions of Barriers and Opportunities to Support Mental Health

Background:
Depression and suicide rates among Black men are increasing, yet Black men continue to face significant disparities in access to mental health care. They are also frequently sidelined in broader mental health discussions, despite the importance of understanding their experiences through the intersecting lenses of racial discrimination, masculinity, and medical mistrust. This study, conducted as part of a community-based participatory research (CBPR) project, explores Black men’s mental health treatment preferences and barriers to care to inform more accessible and culturally acceptable community-based supports.

Methods:
A community-university partnership involving clergy, human service providers, and social work researchers organized a symposium focused on Black men’s mental health and masculinity. Attendees were invited to complete a web-based, cross-sectional survey assessing perceptions of Black men’s mental health, treatment preferences, and barriers to care. The 17-item survey included 8 closed-ended and 9 open-ended questions. Descriptive statistics were used to analyze quantitative data, and thematic analysis was conducted on qualitative responses.

Results:
Forty-four Black men from the Metro Detroit area completed the survey. Over 70% of respondents (n=31; 71%) identified Black men’s mental health as a significant issue in their community. Half reported being emotionally impacted by racial tension and discrimination often (n=7; 16%) or very often (n=15; 34%). The most frequently endorsed barriers to care included a desire to handle problems privately (n=32; 73%), concern about judgment (n=32; 73%), lack of insurance (n=30; 68%), discomfort with available providers (n=27; 61%), and high cost (n=25; 57%).

Respondents identified several preferred supports, including peer support groups (n=41; 93%), mental health education and workshops (n=34; 77%), access to culturally responsive therapists (n=34; 77%), economic or employment support (n=32; 73%), and faith-based mental health programs (n=30; 68%).

Thematic analysis revealed two core themes: (1) the importance of peer support and (2) the need for safe spaces. Respondents emphasized the value of community-based dialogue, with suggestions such as “men’s group formation and conversation circles” and opportunities to “speak and interact with Black men.” Safe, trusted environments were described as essential for open discussion of mental health. Participants also highlighted the psychological burden of societal expectations, stereotypes, and judgment. As one respondent noted, “We exist in a society that requires us to be soldiers, but the battles we struggle with the most are in our own heads and often nobody knows we need help.”

Implications:
Findings underscore the importance of centering Black men’s voices in mental health research and intervention design. Black men are seeking opportunities to engage in informal, community-based spaces that allow for authentic dialogue grounded in shared lived experiences. Effective mental health supports must move beyond individual-level approaches to incorporate the broader social context, including racism, discrimination, and structural inequities, that shapes Black men’s mental health. Faith-based institutions, peer-led models, and culturally responsive care represent promising pathways for developing accessible and trusted interventions.