title: Addressing Mental Health Needs: Perspectives of African Americans Living in the Rural South.
abstract: OBJECTIVE
  Rural African Americans are disproportionately affected by social stressors that place them at risk of developing psychiatric disorders. This study aimed to understand mental health, mental health treatment, and barriers to treatment from the perspective of rural African-American residents and other stakeholders in order to devise culturally acceptable treatment approaches.
  
  
  METHODS
  Seven focus groups (N=50) were conducted with four stakeholder groups: primary care providers, faith community representatives, college students and administrators, and individuals living with mental illness. A semistructured interview guide was used to elicit perspectives on mental health, mental health treatment, and ways to improve mental health in rural African-American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data.
  
  
  RESULTS
  Stressful living environments (for example, impoverished communities) and broader community-held beliefs (for example, religious beliefs and stigma) had an impact on perceptions of mental health and contributed to barriers to help seeking. Participants identified community-level strategies to improve emotional wellness in rural African-American communities, such as providing social support, improving mental health literacy, and promoting emotional wellness.
  
  
  CONCLUSIONS
  Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and provision of mental health education to the general public may improve use of services in this population.
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Tiffany F
authors.initials: TF
authors.lastname: Haynes
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Cheney
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: J Greer
authors.initials: JG
authors.lastname: Sullivan
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Keneshia
authors.initials: K
authors.lastname: Bryant
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Curran
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Mary
authors.initials: M
authors.lastname: Olson
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Naomi
authors.initials: N
authors.lastname: Cottoms
authors.affiliation: Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: tfhaynes@uams.edu ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas.
authors.forename: Christina
authors.initials: C
authors.lastname: Reaves
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001131:Arkansas; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008875:Middle Aged; D011203:Poverty; D036301:Qualitative Research; D012424:Rural Population; D057545:Social Stigma; D012944:Social Support; D055815:Young Adult
keywords: African Americans; Mental illness & alcohol/drug abuse; Research/psychiatric