Cited by 409Mental Health Treatment and AccessRacial and Ethnic Identity ResearchCultural Competency in Health Care

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Barriers to Effective Mental Health Services for African Americans

Snowden, Lonnie R.·2001·Mental Health Services Research

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Abstract

Many African Americans-especially the most marginal-suffer from mental health problems and would benefit from timely access to appropriate forms of care. However, few seek treatment from outpatient providers in the specialty mental health sector and those who do are at risk of dropping out. African Americans visit providers in the general medical sector, although they use another hypothesized alternative to specialty care, voluntary support networks, less than other groups. These help-seeking tendencies may reflect characteristic coping styles and stigma, as well as a lack of resources and opportunities for treatment. More should be learned about differences in need according to location, social standing, and cultural orientation so as to identify treatments and programs that are especially beneficial to African Americans.

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“, fatigue, anhedonia, concentration problems), 2) hectic parenting schedules as a result of being primary caregiver of children and other family members, 3) silence or stigma regarding psychiatric problems among African Americans [77] and 4) mistrust of research based on past injustices within the African American com…”
BackgroundInfluential
Afrocentricity and social work education
Hollingsworth, L. D., & Phillips, F. B. (2016) · Journal of Human Behavior in the Social Environment · doi:10.1080/10911359.2016.1259928 · Cited by 14
“African Americans have been found to have need for mental health services comparable to, or greater than, that of Caucasians (Snowden, 2001).”
Result
Culturally Adapted Cognitive-Behavioral Therapy in the Treatment of Panic Episodes and Depression in an African American Woman: A Clinical Case Illustration
Wallace, D. D., Carlson, R. G., & Ohrt, J. H. (2020) · Journal of Mental Health Counseling · doi:10.17744/mehc.43.1.03 · Cited by 18
Expanding the Psychological Wellness Threshold for Black College Women
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“…barriers, issues of shame and stigma, lack of information, and primary reliance on family and the religious community during times of distress (Alvidrez, Snowden, & Kaiser, 2008; Eisenberg et al., 2012; Grier-Reed, 2013; Nadeem, Lange, & Miranda, 2009; Snowden, 2001; Williams et al., 2007).”
Background
Benzodiazepine and unhealthy alcohol use among adult outpatients.
Hirschtritt, M. E., Palzes, V. A., Kline‐Simon, A. H., Kroenke, K., Campbell, C. I., & Sterling, S. (2019) · PubMed · Cited by 14
Advanced Generalist Practice
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Shannon, J. (2022) · Journal of Multicultural Counseling and Development · doi:10.1002/jmcd.12275 · Cited by 21
Parents' clinical depression and children's problem behaviors: A multi-level meta-analytic examination
Aaron, L., Kaplan, R. M., & Black, S. R. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.199 · Cited by 16
Probable posttraumatic stress disorder in a sample of urban jail detainees
Ruzich, D., Reichert, J., & Lurigio, A. J. (2014) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2014.02.018 · Cited by 12
“In addition, the stigma attached to mental illness in the African American community could have prevented the African American participants from answering the mental health questions honestly and openly (Snowden, 2001).”
Background
Mental Health Service Use Among African-American Emerging Adults, by Provider Type and Recency of Use
Williams, S.-L. L. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201300329 · Cited by 19
An exploration of mental health literacy among older African Americans
Stansbury, K. L., Peterson, T. L., & Beecher, B. (2012) · Aging & Mental Health · doi:10.1080/13607863.2012.724652 · Cited by 14
“Future research should also explore to what extent older African Americans report symptoms of mental distress and physical conditions (Snowden, 2001) in comparison to mental health disorders.”
Background
Predictors of Seeking Mental Health Treatment in Black Men: Therapy Fears and Expectations About Counseling
Turner, E. A., Douglas, C., & Haseeb, A. (2023) · Community Mental Health Journal · doi:10.1007/s10597-023-01183-1 · Cited by 19
“Previous studies have consistently demonstrated that Black Americans and men are less likely to utilize mental health services compared to other ethnic and racial groups and women (e.g., Cheng et al., 2013; Snowden, 2001; Turner et al., 2016; Vogel et al., 2011).”
Background
Self‐reported antidepressant use among depressed, low‐income homebound older adults: class, type, correlates, and perceived effectiveness
Choi, N. G., BRUCE, M. L., Sirrianni, L., Marinucci, M. L., & Kunik, M. E. (2012) · Brain and Behavior · doi:10.1002/brb3.48 · Cited by 11
“…have found that in general, racial/ethnic minority older adults were less likely than their non-Hispanic White peers to use formal mental health services, but more likely to use traditional self-care regimens and prayer and to turn to their informal support networks and to clergy (Snowden 2001).”
Background
Therapeutic Engagement of Adolescents with Emotional and Behavioral Disorders
DiCroce, M., Preyde, M., Flaherty, S., Waverly, K., Karki-Niejadlik, N., & Kuczynski, L. (2015) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-015-0419-z · Cited by 17
Relationship Between Symptoms of Depression, Functional Health Status, and Chronic Disease Among a Residential Sample of African Americans
Larson, C. O., BeLue, R., Schlundt, D. G., & McClellan, L. H. (2006) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200604000-00006 · Cited by 10
“…areas are less likely to seek treatment for depression, including counseling and medications, than would be by other races (Cooper et al., 2003; Snowden 2001; Snowden & Pingitore, 2003; Wells et al., 2001) and have greater unmet treatment needs for depression (Harmon et al., 2004; Ialongo et…”
Background
Development of a Faith-Based Stress Management Intervention in a Rural African American Community
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“In terms of specific service providers, research also indicates that racial–ethnic minority groups tend to visit general healthcare providers rather than specialty mental health providers to treat their mental health problems (Chapa 2004; Snowden 2001).”
Background
Trends in Suicidal Behaviors Among US Adults 2015–2018
Yockey, R. A., King, K. A., & Vidourek, R. A. (2020) · Crisis · doi:10.1027/0227-5910/a000732 · Cited by 12
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“Substantial disparities and patient-, provider-, and delivery system-level barriers means survivors are unlikely to follow-through with referrals nor receive adequate treatment when they do (Nobles, Valentine, Gerber, Shtasel, & Marques, 2016; Snowden, 2001; Williams & Rucker, 2000).”
Background
Organizational Climate and Treatment Outcomes for African American Clients Receiving Services at Community Mental Health Agencies
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“surgeon general’s 2001 report on race, culture, and ethnicity in mental health further underscored the limited amount of research regarding predictors of disparate treatment outcomes for African American clients receiving services at CMHAs (Snowden, 2001; USDHSS, 2001).”
Background
Examining the effect of discrimination and stigma on utilization of mental health services among college students
Singh, S., Melendez, K., & Sezginis, N. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1970561 · Cited by 12
Examining eating disorder pathology and self-stigma of help-seeking behaviors in a community sample of sexual minority adults: an intersectional investigation of race and gender
Miller, M. G. B., Denning, D. M., Alvarez, J. C., Lebron, J. C., Bakoyema, S., & Brown, T. A. (2024) · Eating Disorders · doi:10.1080/10640266.2024.2355699 · Cited by 10
“This aligns with literature suggesting that BIPOC adults and AAPI young adults seek mental health services at lower rates than White counterparts (Choi & Miller, 2014; Snowden, 2001).”
Factors That Contribute to the Mental Health of Black Youth during COVID-19 Pandemic
Salami, B. O., Maduforo, A. N., Aiello, O., Osman, S., Omobhude, O. F., Price, K., Henderson, J. L., Hamilton, H. A., Kemei, J., & Mullings, D. V. (2024) · Healthcare · doi:10.3390/healthcare12121174 · Cited by 9
“However, systemic barriers, like inadequate access to culturally relevant mental health services, persist [7].”
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Delayed Healthcare Due to Cost Among Adults with Multimorbidity in the United States
Azubuike, C. D., & Alawode, O. A. (2024) · Healthcare · doi:10.3390/healthcare12222271 · Cited by 10
A Study on the Psychometric Properties of Conners Comprehensive Behavior Rating Scales-Self Report Scores in African Americans with Juvenile Court Contact
Andretta, J. R., Thompson, A. D., Ramirez, A. M., Kelly, J. C., Barnes, M. E., & Woodland, M. H. (2014) · Journal of Forensic Psychology Practice · doi:10.1080/15228932.2014.863051 · Cited by 9
“For example, Snowden (2001) argued that African Americans are more likely to report on overall distress rather than symptoms associated with specific diagnoses, and attempts to operationalize this hypothesis are needed.”
Background
Religiosity and Stigmatization Related to Mental Illness Among African Americans and Black Immigrants: Cross-Sectional Observational Study and Moderation Analysis
Pederson, A. B., Earnshaw, V. A., Lewis‐Fernández, R., Hawkins, D., Mangale, D. I., Tsai, A. C., & Thornicroft, G. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001576 · Cited by 11
“We Have Closed Our Eyes and Sealed Our Lips”: Black Women’s Accounts of Discussing Suicide within the Black Community
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“The fact that blacks are more inclined to seek support from religious figures or friends and family members in lieu of therapy (Snowden 2001) makes having the conversation all the more essential.”
Background
Racial Disparities in Pediatric Psychiatric Emergencies: A Health Systems Approach
Das, A., Singh, P., & Bruckner, T. A. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200006 · Cited by 9
“Our results speak to larger system-and individual-level factors contributing to mental health racial disparities in the US, including health care operations, provider-patient communications, and help-seeking preferences [52,54].”
BackgroundResult
Mental Health Screening Needs and Preference in Treatment Types and Providers in African American and Asian American Older Adults
Lee, M., Lu, W., Mann-Barnes, T., Nam, J.-H., Nelson, J., & Grace, X. (2021) · Brain Sciences · doi:10.3390/brainsci11050597 · Cited by 9
“Data from a survey of Baltimore residents aged 18 or older indicated that 22% of African Americans sought informal mental health care from spiritual leaders, social service organizations, and family members; this rate was similar to the rate of people who utilized formal mental health services [12].”
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‘Should I really be here?’ Exploring therelationship between black men’sconceptions of well-being, subject positionsand help-seeking behaviour
Myrie, C. V., & Gannon, K. N. (2013) · UEL Research Repository (University of East London) · Cited by 9
Reconceptualizing church-based mental health promotion with African Americans: A social action theory approach
Hays, K. (2018) · Journal of Religion & Spirituality in Social Work Social Thought · doi:10.1080/15426432.2018.1502643 · Cited by 9
“Concerning treatment for mental disorders, African Americans have been found to have lower rates of professional help seeking than other ethnic groups (Barrio et al., 2003; Snowden, 2001; Wang et al., 2005).”
Background
Psychotic experiences in the context of mood and anxiety disorders and their associations with health outcomes among people of color in the United States
Oh, H. Y., Waldman, K. E., Stubbs, B., & Koyanagi, A. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.01.004 · Cited by 10
Exploring Patient and Provider Level Variables That May Impact Depression Outcomes Among African American Adolescents
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ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems
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The Recurring Victimization of Individuals with Mental Illness: A Comparison of Trajectories for Two Racial Groups
Policastro, C. N., Teasdale, B., & Daigle, L. E. (2015) · Journal of Quantitative Criminology · doi:10.1007/s10940-015-9271-8 · Cited by 8
Inside the therapy room: A case study for treating African American men from a multicultural/feminist perspective.
Carr, E. R., & West, L. M. (2013) · Journal of Psychotherapy Integration · doi:10.1037/a0031422 · Cited by 8
Suicidal Ideation and Sense of Community in Faith Communities
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“For example, African-American men have been shown to be more likely than White men to visit or be visited by friends and to attend church or other group functions (Snowden 2001).”
Background
Barriers to Mental Health Treatment Utilization in Wards 7 and 8 in Washington, DC: A Qualitative Pilot Study
Ganz, O., Curry, L. E., Jones, P., et al. (2018) · Health Equity · doi:10.1089/heq.2017.0051 · Cited by 8
Primary Care Practice Redesign: Challenges in Improving Behavioral Health Care for a Vulnerable Patient Population
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Trauma Survivors' Emotional Distress and Barriers to Early Psychological Intervention in an Inner-City Acute Surgical Trauma Service
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“Fears of hospitalizations and mistreatment have been documented among African Americans and Hispanic Americans (Copeland, 2005; Snowden, 2001).”
Background
Service Patterns of Adult Survivors of Childhood Versus Adult Sexual Assault/Abuse
Grossman, S. F., Lundy, M., Bertrand, C., Ortiz, C., Tomas-Tolentino, G. H., Ritzema, K., & Matson, J. (2009) · Journal of Child Sexual Abuse · doi:10.1080/10538710903317265 · Cited by 8
“It is possible that underutilization by survivors of color could be related to greater feelings of stigma (for a discussion, see Kaukinen, 2004; Shaw et al., 2001; Snowden, 2001; West, Kantor, & Jasinski, 1998).”
Background
From efficacy to effectiveness: the trajectory of the treatment literature for children with PTSD
Nikulina, V., Hergenrother, J. M., Brown, E. J., Doyle, M. E., Filton, B., & Carson, G. S. (2008) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.8.8.1233 · Cited by 7
The use of leverage in community mental health: Ethical guidance for practitioners
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“There is evidence, for example, that people from black and ethnic minority groups perceive mental health services to be unresponsive to their cultural norms and values (e.g. Keating & Robertson, 2004; Leong & Lau, 2001; Moffat, Sass, McKenzie, & Bhui, 2009; Snowden, 2001), and that these perceptions have resulted in i…”
Background
An Introduction to Parenting and Mental Health Services Utilization Among African American Families: The Role of Racial Socialization
Rodriguez, J., Cavaleri, M. A., Bannon, W. M., & McKay, M. M. (2008) · Social Work in Mental Health · doi:10.1080/15332980802031997 · Cited by 7
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Black Women and Sickle Cell Disease
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“Furthermore, Snowden (2001) suggests that in general, African Americans tend to deny the threat of mental illness and strive to overcome mental health problems through self reliance and determination.”
Background
Caregiver-relevant perspectives from a multi-stakeholder collaborative advisory board on adapting a child mental health intervention to be delivered in child-welfare settings
Hooley, C., Winters, A. M., Pisciotta, C., & Gopalan, G. (2020) · Journal of Public Child Welfare · doi:10.1080/15548732.2020.1724238 · Cited by 7
“…experiences with the CW system or service providers themselves may discourage parents from engaging in other traditional service delivery systems (Kerkorian et al., 2006; Palmer, Maiter, & Manji, 2006), as can stigma and negative perceptions about seeking care (Alvidrez, 1999; Snowden, 2001).”
Background
Racial Disparities in Healthcare Utilization Among Individuals with Cardiometabolic Risk Factors and Comorbid Anxiety Disorder
Dark, T., Rust, G. S., Sehres, G., & Harman, J. S. (2020) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-020-00748-0 · Cited by 6
Chapter 3. Mental Health Care Policy
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The current status and impact of US National Policy on the help-seeking behavior of adolescents
Lippman, A. D. P. (2010) · Children and Youth Services Review · doi:10.1016/j.childyouth.2010.01.020 · Cited by 7
ALCOHOL AND OTHER DRUG DISORDERS, COMORBIDTY and VIOLENCE IN RURAL AFRICAN AMERICAN WOMEN
Boyd, M. B., Mackey, M. C., Phillips, K. D., & Tavakoli, A. S. (2006) · Issues in Mental Health Nursing · doi:10.1080/01612840600943622 · Cited by 6
“Some researchers found that African Americans have higher levels of psychological distress (Fiscella & Franks, 2000; Snowden, 2003; Thompson, 2002; Vega, Kolody, Porter, & Noble, 1997).”
Background
Exploring the Relationship between Access and Retention among Substance Abuse Treatment Admissions
Brucker, D. L. (2010) · Journal of Drug Issues · doi:10.1177/002204261004000302 · Cited by 7
Children's mental health services in fee-for-service Medicaid.
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Mind the Gap: Unraveling Mental Health Disparities in America’s Diverse LandscapePreprint
Fischer, M., Swint, J., Zhang, W., & Zhang, X. (2024) · medRxiv · doi:10.1101/2024.07.28.24311109 · Cited by 9
Antiracist mental healthcare training and development of multicultural awareness, knowledge and skills among school mental health providers in Canada
Cénat, J. M., Farahi, S. M. M. M., Dalexis, R. D., Kogan, C. S., Noorishad, P., & Williams, M. T. (2025) · Transcultural Psychiatry · doi:10.1177/13634615251379440 · Cited by 7
“Racialized patients may experience a lack of understanding or empathy from poorly trained and untrained mental health professionals, which can lead to miscommunication and a breakdown in trust between patient and provider (Snowden, 2001).”
Influential
Permissiveness of firearm laws, pro-gun culture, and suicides by firearm in the U.S., 2000–2016
Das, A., Singh, P., & Bruckner, T. A. (2021) · Public Health in Practice · doi:10.1016/j.puhip.2021.100218 · Cited by 6
“Race/ethnic groups differ in their access to behavioral health treatment, levels of income inequality, as well as other societal factors [22,23].”
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Mapping Trajectories of Behavioral and Emotional Risk Among Predominately African American Youth Across the Middle School Transition
Naser, S. C., & Dever, B. V. (2019) · School Psychology Review · doi:10.17105/spr-2018-0054.v48-4 · Cited by 5
“In general, African American youth are less likely than their White peers to access mental health supports (Caldwell et al., 2016; Snowden, 2001).”
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Why U.S. science and engineering undergraduates who struggle with mental health are left without role models
Busch, C. A., Barstow, M., Brownell, S. E., & Cooper, K. M. (2024) · PLOS mental health. · doi:10.1371/journal.pmen.0000086 · Cited by 7
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Meeting the Physical, Psychological, and Social Needs of African Americans Following a Disaster
Carswell, S. B., & Carswell, M. A. (2007) · International and cultural psychology/International and cultural psychology series · doi:10.1007/978-0-387-73285-5_3 · Cited by 5
A community–academic partnership develops a more responsive model to providing depression care to disadvantaged adults in the US
Dobransky-Fasiska, D., Nowalk, M. P., Cruz, M., McMurray, M. L., Castillo, E. G., Begley, A. E., Pyle, P., Partners, R.-C., Pincus, H. A., Reynolds, C. F., et al. (2011) · International Journal of Social Psychiatry · doi:10.1177/0020764010396406 · Cited by 4
“Elders, especially African Americans with mental illness, are more likely to be misdiagnosed, lack resources and lack access to a regular source of care (Neighbors et al., 2008; Snowden, 2001).”
BackgroundResult
Measurement of Acculturation Strategies for People of African Descent (MASPAD): An emic conceptualization of acculturation as a moderating factor between psychological distress and mental health seeking attitudes
Obasi, E. M. (2005) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 5
Key stakeholder perspectives on the use of research about supported employment for racially and ethnically diverse patients with mental illness in the United States
Zhen‐Duan, J., Chary, A. N., NeMoyer, A., Fukuda, M., Markle, S. L., Hoyos, M., Zhang, L., Fuentes, L., Pérez, G., Chambers, V., et al. (2022) · Health Services Research · doi:10.1111/1475-6773.13905 · Cited by 5
Evaluating Treatment Outcomes for African American and White Clients Receiving Treatment at a Community Mental Health Agency in the Rural South
Larrison, C. R., Schoppelrey, S. L., Nowak, M. G., Brantley, J. F., Leonard, M., Crooke, D., Barrett, D., & McCollum, A. (2004) · Research on Social Work Practice · doi:10.1177/1049731503257874 · Cited by 5
“Snowden (2001) stated: “At present we know disconcertingly little about effectiveness and cost-effectiveness of programs and treatments as they are routinely practiced in the community.”
Background
Willingness to Seek Professional Psychological Help Among Canadians of African Descent: a Culturally Based Help-Seeking Model
Joseph, J. (2010) · Scholarship at UWindsor (University of Windsor) · Cited by 5
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Wu, S., Liu, Y., Mo, H., Li, L., Li, Z., & Ying, Y. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1494629 · Cited by 5
“These vulnerabilities are exacerbated by persistent social exclusion and identity struggles, as evidenced by Snowden and Hannah’s frameworks on minority mental health (37, 38).”
Life Events, Barriers to Care, and Outcomes Among Minority Women Experiencing Depression
Tieu, L., Walton, Q. L., Sherbourne, C. D., Miranda, J. M., Wells, K. B., Tang, L., Williams, P., Anderson, G. L., Booker-Vaughns, J., Pulido, E., et al. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001496 · Cited by 5
“These barriers to mental health care (Hines-Martin et al., 2003a; Hines-Martin et al., 2003b; Snowden, 2001) have been well-characterized in crosssectional studies and impact depression outcomes (Wells et al.”
Background
Brief Adjustment Scale–6 for Measurement-Based Care: Psychometric Properties, Measurement Invariance, and Clinical Utility
Ko, H., Shin, J. H., & Cooper, L. D. (2022) · Assessment · doi:10.1177/10731911221115144 · Cited by 4
“It is meaningful that these race/ethnic groups were equally included in this study, considering the underrepresentation of those individuals as research participants other than the White/non-Hispanic group, especially in the mental health field including assessment and measurement (Alegria et al., 2002; Snowden, 2001;…”
Background
White matter correlates of dissociation in a diverse sample of trauma-exposed women
Kondas, A., McDermott, T. J., Ahluwalia, V., Haller, O. C., Karkare, M. C., Guelfo, A., Daube, A., Bradley, B., Powers, A. D., Stevens, J. S., et al. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.116231 · Cited by 4
Asperger syndrome in the African American community: Barriers to diagnosis
Theus, F. C. (2008) · Advances in special education · doi:10.1016/s0270-4013(08)18006-0 · Cited by 4
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Hackett, J. R. (2014) · SOPHIA (St. Catherine University) · Cited by 4
The Unique Coping Strategies of African American Families With a Loved One With Schizophrenia: The Use of the Family Crisis Oriented Personal Evaluation Scale
Guada, J. M. (2012) · Journal of Family Social Work · doi:10.1080/10522158.2012.675625 · Cited by 4
“Thus, intervention models targeting such communities must include cultural specific family components to support and maintain ongoing treatment for such individuals (Esterberg & Comptom, 2006; Snowden, 2001).”
Background
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Williams, L., & Washington, G. J. (2018) · IEEE International Conference on Healthcare Informatics (ICHI) · doi:10.1109/ichi.2018.00055 · Cited by 4
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Spikes, P., Willis, L. A., & Koenig, L. J. (2010) · Springer eBooks · doi:10.1007/978-0-387-78321-5_6 · Cited by 4
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Coustasse, A., Singh, K. P., & Treviño, F. M. (2007) · Hospital Topics · doi:10.3200/htps.85.1.27-34 · Cited by 4
“treatment system biases, and reliance on voluntary support networks hamper treatment access (Dana 2002; Kales et al. 2000; Snowden 2001).”
BackgroundInfluential
A nationwide assessment of asthma-mental health nexus among veterans
Becerra, M. B., Becerra, B. J., & Safdar, N. (2015) · Journal of Asthma · doi:10.3109/02770903.2015.1086785 · Cited by 4
“However, the lower odds for adverse mental health outcomes among Black/African Americans should be interpreted with some caution as researchers have noted that mental illness diagnoses may be lower among minorities due to limited resources, stigma or perceived discrimination [42,45–48].”
Background
Psychosocial and healthcare experiences among women with pre-pregnancy mental health concerns
Phan, J., Liu, H. H., Yasui, M., & Liu, C. H. (2019) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2019.01.007 · Cited by 4
“are less likely to seek and have access to mental health services in general as a result of barriers including, but not limited to: low socioeconomic status, distrust of mental health providers, lack of culturally-appropriate services, cultural differences in conceptualizing mental illness, and stigma (Clement et al.,…”
Minority Mental Health and Wellness: A Perspective from Health Care Systems
Koroukian, S. M. (2008) · Springer eBooks · doi:10.1007/978-0-387-75659-2_6 · Cited by 4
“For example, because of injustices committed toward their ancestors and sometimes persisting discrimination, African Americans and Indian Americans tend to deny mental health problems and/or mistrust the good that may be offered by the dominant culture (Johnson & Cameron, 2001; Snowden, 2001 ).”
BackgroundInfluential
Ethnic Differences in the Prevalence of Mental Health Disorders Among Individuals with Diabetes: A Systematic Review and Meta-analysis
Ezinne, N. E., Agho, K., Doyle, A. K., Lee, M., Jung, S.-B., & Osuagwu, U. L. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02656-7 · Cited by 4
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Hawkins, J., Schwenzer, C., Hecht, H. K., Jones, L. M., Ortiz, D. V., Lee, J., Ahmedani, B. K., & Piatt, G. (2019) · Health Education and Care · doi:10.15761/hec.1000163 · Cited by 3
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Frierson, W., & Erving, C. L. (2024) · Sociological Focus · doi:10.1080/00380237.2024.2431218 · Cited by 5
“Mental health providers should avoid overgeneralization when treating African Americans and consider how socioeconomic status impacts their clients’ lives (Snowden 2001).”
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Harris, A. L. (2012) · Journal of Bioresource Management · Cited by 3
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Huguet, N., Kaplan, M. S., & McFarland, B. H. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2012.0081.x · Cited by 3
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Mental illness etiology beliefs among African American men with serious mental illness and their social support networks
Hack, S. M., Larrison, C. R., Bennett, M. E., Klingaman, E. A., & Peeples, A. (2016) · Social Work in Mental Health · doi:10.1080/15332985.2016.1188194 · Cited by 3
“…2012), microaggressions (Gómez, 2015), treatment disparities (Hankerson, Suite, & Bailey, 2015), service use (Holden, McGregor, Blanks, & Mahaffey, 2012), policy implications (Snowden, 2001), cultural mistrust (Whaley, 2001), and cultural lived experience (Williams & Williams-Morris, 2000).”
Background
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Woodcock, K. M. (2007) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 3
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Lowe, T. B., Hopps, J. G., & See, L. A. (2006) · Journal of Ethnic & Cultural Diversity in Social Work · doi:10.1300/j051v15n03_03 · Cited by 3
“, family, friends, church) to mediate their behavioral needs (Levin, 1986; Neighbors & Jackson, 1984; Snowden, 2001).”
Background
Learning and Instruction in the Clinical Process
de Anda, D. (2008) · Social Work in Mental Health · doi:10.1300/j200v06n03_01 · Cited by 3
“Prior studies add to the list of barriers facing minority groups, and have revealed that African American adults often perceive racist or hostile systems of care that deter them from seeking mental health care or lead to termination of services ( Snowden, 1999 ; Snowden, 2001 ; U.”
Background
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Siegel, C., & Chambers, E. D. (2002) · Cited by 3
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“Research highlights considerable stigma surrounding mental illness (see Pescosolido, 2013) and suggests that stigma is a significant barrier to help-seeking among minorities (Gary, 2005; Snowden, 2001; U.S. Department of Health and Human Services, 2001).”
Background
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Factor Structure and Psychometric Properties of the Thoughts About Psychotherapy Survey in a Parent Sample
Turner, E. A. (2018) · Community Mental Health Journal · doi:10.1007/s10597-018-0248-6 · Cited by 3
“1 3 Similar to research on help-seeking in adult populations, studies (Harrison et al. 2004; McMiller and Weisz 1996; Snowden 2001; Turner and Mohan 2016) show that variables that predict parental help-seeking include previous experience with mental health services, attitudes toward mental health professionals, stigma…”
BackgroundMethod
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Discrimination experiences and mental health outcomes among African American homeless smokers
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Disclosing psychiatric diagnosis to close others: a cultural framework based on older Latin@s participating in a depression trial in Los Angeles county
Fuentes, D., & Aranda, M. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1506738 · Cited by 3
“…in help-seeking and mental health services use (Conner, Koeske, & Brown, 2009; Eisenberg, Downs, Golberstein, & Zivin, 2009; Gary, 2005; Interian, Martinez, Guarnaccia, Vega, & Escobar, 2007; Jang, Chiriboga, Herrera, Tyson, & Schonfeld, 2011; Sirey, et al. 2001; Snowden, 2001; Ting & Hwang, 2009).”

Authors: Snowden, L. R.
Affiliations: University of California, Berkeley (US)
Corresponding author: Snowden, Lonnie R.
ORCID: Snowden, Lonnie R.
Venue: Mental Health Services Research
Publisher: Springer Science and Business Media LLC
Published: 2001-12
Volume: 3
Issue: 4
Pages: 181-187
ISSN: 1522-3434 (ISSN-L)
1573-6636
DOI: 10.1023/a:1013172913880
OpenAlex: W1570230786
Semantic Scholar: cee44c38d282c0452637f2b965812ca6f4567ccc
Cited by: 409
References: 44
Citations by year: 2026: 6 · 2025: 17 · 2024: 18 · 2023: 10 · 2022: 14 · 2021: 6 · 2020: 17 · 2019: 15 · 2018: 18 · 2017: 16 · 2016: 20 · 2015: 21 · 2014: 35 · 2013: 20 · 2012: 29
FWCI: 9.87
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Mental Health Services Research (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5p50mh043694-13)
National Institute of Mental Health (MH43694-13)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
Keywords: African Americans, mental health services, help-seeking, barriers to treatment, general medical care, treatment discontinuation, stigma, coping styles, cultural factors in mental health
MeSH terms: Adaptation, Psychological, Mental Disorders, Black or African American, Culture, Health Services Accessibility, Health Services Research, Humans, Mental Health Services, Patient Acceptance of Health Care, United States

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Barriers to Effective Mental Health Services for African Americans

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