All ETDs from UAB

Advisory Committee Chair

Teneasha Washington

Advisory Committee Members

Larrell L Wilkinson

Jessica T Chambliss

Sara N Lappan

C Nicole Swiner

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Introduction: Strength is indoctrinated into the cultural tapestry of Black women, dating back to slavery, and passed down through intergenerational socialization. The incessant need for Black women to be strong diminishes their psychological health leading to poorer quality of life. Further, historical injustices and unethical practices in mental healthcare continue to perpetuate the need for Black women to perform in strength. The performance of strength is one explanation for the grave mental health disparities among Black women offering an opportunity to better understand their mental health needs. This project aims to center Black women within the cultural contextualization of the Strong Black Woman/Superwoman (SBW/SW) schema employing established public health models to frame our understanding about mental health treatment utilization in a region highly impacted by poverty and inequality which are primary risk factors for mental health disorders. Methods: Qualitative in-depth interviews were conducted with Black women living in the Deep South to explore their lived experiences as it relates to mental health, help-seeking, and treatment utilization. Topics included defining the SBW/SW schema, awareness of mental healthcare and treatment utilization, experiences related to endorsement of the SBW/SW and mental health, barriers to mental health treatment utilization, and suggestions for improvement. Interviews were conducted virtually, and iv audio recorded. Audio-recordings were transcribed, and transcripts were analyzed using thematic analysis. Results: Interviews were completed with 13 Black women living in the Deep South exploring mental health treatment utilization and the unique factors that impact help-seeking and decision making. The first manuscript provides a theoretical conceptualization of the literature about the mental health needs of Black women and factors that may impact treatment utilization. The second manuscript describes the qualitative approach taken and the protocol developed to conduct the current study. The third manuscript reports findings related to the mental health needs of Black women and factors impacting mental health treatment utilization. Conclusions: Results from this study helped established an understanding of how to support the mental health needs of Black women providing implications for the development of targeted interventions that address barriers to treatment utilization, provider training, and educational and promotion strategies to dismantle stigma. For example, we found that positive experiences such as compassionate person-centered care in the therapeutic setting increased desire to utilize mental health treatment services. Therefore, culturally responsive provider training may improve mental health treatment utilization among Black women over time.

Included in

Public Health Commons



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