MENTAL HEALTH AND HEALTH-SEEKING BEHAVIORS IN FORMERLY INCARCERATED BLACK MEN

This dissertation investigated the impact of incarceration on mental health, health-related quality of life, and health-seeking behaviors in formerly incarcerated Black men (FIBM). Recognizing the disproportionate effects of incarceration on Black men and the scarcity of research on their mental health needs, this work aims to address gaps in understanding needed to improve mental health outcomes, contributing to broader efforts for health equity and social justice, particularly within nursing. This dissertation included a systematic mixed studies review that synthesized the state of scientific knowledge on mental health outcomes of FIBM followed by a convergent mixed method (QUAL+ quan) research study that examined the experiences of 29 FIBM including their incarceration history, mental health, health-seeking behaviors, and engagement in mental health services. Using data from in-depth interviews and surveys, this study examined FIBM’s perceptions of mental health in relation to their lived experiences and elucidated how incarceration shapes health-seeking behaviors. Reflexive thematic analysis, descriptive statistical analysis, and integrated analysis approaches addressed study aims. Results demonstrated that FIBM experience worse mental health outcomes compared to never-incarcerated Black men. Participants’ perceptions of mental health are context-dependent, shaped by the trauma of incarceration and its persistent and pervasive impact on FIBM’s overall context including their relationships and engagement with their physical environment. Incarceration often contributed to participants distrusting and disregarding formal mental health evaluation, diagnostic, and treatment processes. Considering this, participants became self-assured in their ability to identify and address their mental health needs, but also sought support from friends and family. Descriptions of participants’ mental health status, especially in comparison to their mental health symptom severity scores, demonstrated the complexity in evaluating their mental health needs. Their mental health needs were inadequately or inappropriately addressed across lifetime mental health treatment experiences. Overall, this dissertation underscores the complex role of incarceration in shaping the mental health and health-seeking behaviors of FIBM, offering insights for tailored interventions to improve the mental health of this population.

Author dc:creator

• Addison, Helena, Afua-Mansa

Advisor dc:contributor.advisor

• Jacoby, Sara, F

• Nursing

Language dc:language.iso

en

Repository record dc:identifier.uri

https://repository.upenn.edu/handle/20.500.14332/60238

OAI identifier oai:identifier

oai:repository.upenn.edu:20.500.14332/60238