Maintaining Balance: Examining Mental Wellness in Black Women During the Menopausal Transition

Black women experience menopause earlier and with more severe symptoms than other racial groups, placing them at heightened risk for mental health challenges during midlife. Despite this vulnerability, they remain underrepresented in mental health care utilization. This research investigates the attitudinal, cultural, lifestyle, and behavioral factors that influence how Black women perceive, seek, and access mental health care during the menopausal transition. Using a mixed-methods approach, the research integrates qualitative interviews (n = 23) and a segmentation analysis (n = 231) to uncover nuanced insights into the lived experiences of Black women and their mental health decision-making. Qualitative findings reveal key themes related to emotional suppression, stigma, cultural expectations, structural barriers, and the role of self-care. The segmentation analysis, performed using K-means clustering, identified four distinct groups-Reluctant Avoidants, Evolving Discerners, Practical Engagers, and Steady Seekers-each with unique orientations toward mental health care. Based on these profiles, this research proposes targeted engagement strategies for enhancing access to care. The findings contribute to a deeper understanding of the interplay between cultural identities and mental health behavior and highlight the need for improving care delivery for underserved populations.