Mental health knowledge and service utilization among black adults: Moderation by mental illness stigma

Black adults delay treatment seeking and use mental health services at significantly lower rates than white adults, often resulting in more severe and chronic mental illness. Understanding the complex relationship between mental health knowledge, stigma, and service utilization is critical. This study examines how general and specific mental health knowledge are associated with willingness to engage in help-seeking behaviors and the moderating role of stigma. A cross-sectional survey of Black adults across the United States (N = 1117) assessed mental health knowledge, health service utilization, and the effects of mental illness stigma using tailored instruments. Gender differences emerged, with black females showing significantly higher specific mental health knowledge of depression, bipolar disorder, and drug addiction, while Black males had greater knowledge about stress (p_s < 0.01). Gamma regression analyses revealed that participants with greater mental health knowledge about depression, schizophrenia, bipolar disorder, and drug addiction were more likely to report willingness to seek help from a mental health professional for personal/emotional problems and suicidal thoughts, controlling for demographic factors. Furthermore, future intended stigma behavior significantly moderated the association between specific knowledge (i.e., depression, bipolar disorder) and help seeking behavior (RRs: 0.94 to 0.97, p_s < 0.05). Culturally tailored education programs and community-based outreach initiatives may aim to enhance Black men's knowledge of specific conditions like depression, bipolar disorder, and drug addiction. Additionally, future interventions should focus on improving both general and specific mental health knowledge while mitigating the negative effects of stigma on help-seeking behavior for Black adults.