Being a Strong Black Woman and Willing to Seek Help

Abstract

The Strong Black Woman (SBW) schema is a race-gender specific schema that has been and continues to be used as a tool of survival for Black women. The SBW schema has also been linked to physical and mental health consequences. This study aims to investigate the role of the SBW schema on Black women’s willingness to seek mental health services. The present study addresses this gap by quantitatively examining the relationship among SBW endorsement, intentions to seek mental health services, stigma, and barriers using the Theory of Planned Behavior (Ajzen, 1991) as a framework. A sample of 439 Black females participated in an online survey where attitudes, subjective norms, perceived behavioral control, age, and religiosity were examined. The SBW schema was related to attitudes, subjective norms, and perceived behavioral control such that greater endorsement of the SBW schema was associated with more negative attitudes (Negative Perceived Value and Self-Stigma Associated With Seeking Help), more negative subjective norms (In-Group Stigma and Cultural Barriers), and less perceived behavioral control (Lack of Knowledge, Lack of Access, and Greater Discomfort with Emotions). However, the SBW schema was not correlated with intentions to seek help from a mental health professional for general distress or suicidal ideation. As predicted, Self-stigma and Discomfort with Emotions were associated with lower intention to seek help from a mental health professional for general distress and suicidal ideation. Contrary to predictions, Negative Perceived Value, Cultural Barriers, Lack of Knowledge, and Lack of Access was positively associated with intention to seek help from a mental health professional for general distress.

Then these relationships were considered using simple mediation, simple moderation, and moderated serial mediation analyses to examine the complex interplay between the variables. The relationships between SBW and intention to seek mental health care are no longer significant when the mediation of Self-stigma and Discomfort with Emotions through the moderation of Lack of Knowledge and Lack of Access is considered. Intentions to seek mental health services are affected by attitude, subjective norms, and perceived behavioral control. However, the SBW schema influence appears to be only a small part of intentions to seek from a mental health professional. The SBW schema has the potential to be a tool in increasing intentions to seek help from a mental health profession.