%0 Journal Article %J Aging Ment Health %D 2010 %T Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults. %A Conner, Kyaien O %A Copeland, Valire Carr %A Grote, Nancy K %A Rosen, Daniel %A Albert, Steve %A McMurray, Michelle L %A Reynolds, Charles F %A Brown, Charlotte %A Koeske, Gary %K Adaptation, Psychological %K African Americans %K Aged %K Aged, 80 and over %K Aging %K Culture %K Depression %K Female %K Health Knowledge, Attitudes, Practice %K Health Services Accessibility %K Humans %K Interviews as Topic %K Male %K Mental Health Services %K Patient Acceptance of Health Care %K Pennsylvania %K Prejudice %K Qualitative Research %X

OBJECTIVE: Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services.

METHOD: A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data.

RESULTS: Thematic analysis of the interviews with African-American older adults is presented within three areas: (1) Beliefs about Depression Among Older African-Americans; (2) Barriers to Seeking Treatment for Older African-Americans; and (3) Cultural Coping Strategies for Depressed African-American Older Adults.

CONCLUSION: Older African-Americans in this study identified a number of experiences living in the Black community that impacted their treatment seeking attitudes and behaviors, which led to identification and utilization of more culturally endorsed coping strategies to deal with their depression. Findings from this study provide a greater understanding of the stigma associated with having a mental illness and its influence on attitudes toward mental health services.

%B Aging Ment Health %V 14 %P 971-83 %8 2010 Nov %G eng %N 8 %R 10.1080/13607863.2010.501061 %0 Journal Article %J J Community Psychol %D 2010 %T DEPRESSION STIGMA, RACE, AND TREATMENT SEEKING BEHAVIOR AND ATTITUDES. %A Brown, Charlotte %A Conner, Kyaien O %A Copeland, Valire Carr %A Grote, Nancy %A Beach, Scott %A Battista, Deena %A Reynolds, Charles F %X

This study examined the relationship between internalized and public stigma on treatment-related attitudes and behaviors in a community sample of 449 African American and white adults aged 18 years and older. Telephone surveys were administered to assess level of depressive symptoms, demographic characteristics, stigma, and treatment-related attitudes and behaviors. Multiple regression analysis indicated that internalized stigma mediated the relationship between public stigma and attitudes toward mental health treatment. Within group analyses indicated that the mediating effect of internalized stigma was significant for whites only. Among African Americans, internalized stigma did not mediate public stigma; it was directly related to attitudes toward mental health treatment. The internalization of stigma is key in the development of negative attitudes toward mental health treatment, and future research should focus on this aspect of stigma in both individual and community-based efforts to reduce stigma.

%B J Community Psychol %V 38 %P 350-368 %8 2010 Apr %G eng %N 3 %R 10.1002/jcop.20368 %0 Journal Article %J Am J Geriatr Psychiatry %D 2010 %T Mental health treatment seeking among older adults with depression: the impact of stigma and race. %A Conner, Kyaien O %A Copeland, Valire Carr %A Grote, Nancy K %A Koeske, Gary %A Rosen, Daniel %A Reynolds, Charles F %A Brown, Charlotte %K African Americans %K Aged %K Aged, 80 and over %K Attitude to Health %K Depression %K European Continental Ancestry Group %K Female %K Humans %K Male %K Mental Health Services %K Middle Aged %K Patient Acceptance of Health Care %K Stereotyping %X

OBJECTIVE: Stigma associated with mental illness continues to be a significant barrier to help seeking, leading to negative attitudes about mental health treatment and deterring individuals who need services from seeking care. This study examined the impact of public stigma (negative attitudes held by the public) and internalized stigma (negative attitudes held by stigmatized individuals about themselves) on racial differences in treatment-seeking attitudes and behaviors among older adults with depression.

METHOD: Random digit dialing was utilized to identify a representative sample of 248 African American and white older adults (older than 60 years) with depression (symptoms assessed by the Patient Health Questionnaire-9). Telephone-based surveys were conducted to assess their treatment-seeking attitudes and behaviors and the factors that impacted these behaviors.

RESULTS: Depressed older adult participants endorsed a high level of public stigma and were not likely to be currently engaged in or did they intend to seek mental health treatment. Results also suggested that African American older adults were more likely to internalize stigma and endorsed less positive attitudes toward seeking mental health treatment than their white counterparts. Multiple regression analysis indicated that internalized stigma partially mediated the relationship between race and attitudes toward treatment.

CONCLUSION: Stigma associated with having a mental illness has a negative influence on attitudes and intentions toward seeking mental health services among older adults with depression, particularly African American elders. Interventions to target internalized stigma are needed to help engage this population in psychosocial mental health treatments.

%B Am J Geriatr Psychiatry %V 18 %P 531-43 %8 2010 Jun %G eng %N 6 %R 10.1097/JGP.0b013e3181cc0366