University of Windsor Scholarship at UWindsor Electronic Theses and Dissertations Theses, Dissertations, and Major Papers 7-19-2018 Explaining Intentions to Seek Mental Health Services among Black Canadians Renee Taylor University of Windsor Follow this and additional works at: https://scholar.uwindsor.ca/etd Recommended Citation Taylor, Renee, "Explaining Intentions to Seek Mental Health Services among Black Canadians" (2018). Electronic Theses and Dissertations. 7579. https://scholar.uwindsor.ca/etd/7579 This online database contains the full-text of PhD dissertations and Masters’ theses of University of Windsor students from 1954 forward. These documents are made available for personal study and research purposes only, in accordance with the Canadian Copyright Act and the Creative Commons license—CC BY-NC-ND (Attribution, Non-Commercial, No Derivative Works). Under this license, works must always be attributed to the copyright holder (original author), cannot be used for any commercial purposes, and may not be altered. Any other use would require the permission of the copyright holder. Students may inquire about withdrawing their dissertation and/or thesis from this database. For additional inquiries, please contact the repository administrator via email ([email protected]) or by telephone at 519-253-3000ext. 3208. Explaining Intentions to Seek Mental Health Services among Black Canadians By Renee E. Taylor A Thesis Submitted to the Faculty of Graduate Studies through the Department of Psychology in Partial Fulfillment of the Requirements for the Degree of Master of Arts at the University of Windsor Windsor, Ontario, Canada 2018 © 2018 Renee Taylor Explaining Intentions to Seek Mental Health Services among Black Canadians by Renee E. Taylor APPROVED BY: ______________________________________________ J. Grant Faculty of Social Work ______________________________________________ R. Menna Department of Psychology ______________________________________________ K. Soucie Department of Psychology ______________________________________________ B. Kuo, Advisor Department of Psychology June 6, 2018 DECLARATION OF ORIGINALITY I hereby certify that I am the sole author of this thesis and that no part of this thesis has been published or submitted for publication. I certify that, to the best of my knowledge, my thesis does not infringe upon anyone’s copyright nor violate any proprietary rights and that any ideas, techniques, quotations, or any other material from the work of other people included in my thesis, published or otherwise, are fully acknowledged in accordance with the standard referencing practices. Furthermore, to the extent that I have included copyrighted material that surpasses the bounds of fair dealing within the meaning of the Canada Copyright Act, I certify that I have obtained a written permission from the copyright owner(s) to include such material(s) in my thesis and have included copies of such copyright clearances to my appendix. I declare that this is a true copy of my thesis, including any final revisions, as approved by my thesis committee and the Graduate Studies office, and that this thesis has not been submitted for a higher degree to any other University or Institution. iii ABSTRACT The aim of this present study was to test the ability of the theory of planned behaviour (TPB) model (Ajzen, 1991) in explaining psychological help-seeking intention in a sample of 387 community-based Black Canadians. This study further examined: a) an expanded TPB psychological help-seeking model that includes self-stigma and public stigma; and b) a culturally-expanded TPB model of psychological help-seeking that includes cultural variables unique to Black Canadians (e.g., cultural mistrust and afrocultural beliefs). The results showed that TPB was not an adequate fitting model for the data. Furthermore, the addition of stigma and culturally-relevant variables did not improve the TPB’s ability to explain Black Canadian help-seeking intention. However, a final respecified model was found to be a good fit for the data. An open-ended question was also included to gain a greater understanding of how Black Canadians would improve utilization of mental health services in their community. Participants emphasized making mental health services more available and accessible to Black Canadians; educating Black Canadians more about mental health and mental illness; and reducing the stigma surrounding the use of mental health services. Overall, the findings of this study revealed the important roles of perceived behavioural control, self-stigma, and afrocultural strength beliefs as the antecedents to help- seeking intention. It is hoped that the study’s findings might help better inform mental health initiatives that are designed to address the issues of underutilization of psychological services and mental illness stigma among Black Canadians, and to help encourage Black Canadians to access mental health services. iv ACKNOWLEDGEMENTS Completing a master’s thesis project is a challenging task - one that cannot be accomplished without support. I would first like to acknowledge my research supervisor, Dr. Ben Kuo. His guidance was tremendously helpful in making this endeavour a reality. I would also like to acknowledge my family, friends and loved ones, as they provided me with perspectives and feedback that greatly improved the quality of my thesis. I could not have accomplished this on my own, and I am very grateful to all the people who got me this far. v TABLE OF CONTENTS DECLARATION OF ORIGINALITY .............................................................................. iii ABSTRACT ....................................................................................................................... iv ACKNOWLEDGEMENTS .................................................................................................v LIST OF TABLES ............................................................................................................. ix LIST OF FIGURES .............................................................................................................x LIST OF APPENDICES ................................................................................................... xii CHAPTER 1 INTRODUCTION .........................................................................................1 Mental Health Service Use among African Americans................................................................ 3 Demographics of the Black Population in Canada ..................................................................... 4 Mental Health Service Use of Black Canadians .......................................................................... 6 Accessibility of Mental Health Services ....................................................................................... 7 Critical Psychological Variables Related to Help-Seeking Intentions ...................................... 10 Theoretical Models for Psychological Help-Seeking ................................................................. 11 The Theory of Reasoned Action ............................................................................................. 12 The Theory of Planned Behaviour ......................................................................................... 12 The Theory of Planned Behaviour and Psychological Help-Seeking ........................................ 16 The TPB and Factors Commonly Associated with Psychological Help-Seeking....................... 19 Mental Illness Stigma ................................................................................................................. 20 Public Stigma ......................................................................................................................... 20 Self-Stigma ............................................................................................................................. 21 Mental Illness Stigma and the Black Community .................................................................. 22 Culturally-Specific Variables ..................................................................................................... 24 Afrocultural Beliefs ................................................................................................................ 25 Cultural Mistrust .................................................................................................................... 29 vi CHAPTER 2 PRESENT STUDY ......................................................................................32 Research Questions .................................................................................................................... 32 Hypothesized Path Models ......................................................................................................... 33 Hypothesized Path Model 1 ................................................................................................... 34 Hypothesized Path Model 2 ................................................................................................... 35 Hypothesized Path Model 3 ................................................................................................... 37 CHAPTER 3 METHODS ..................................................................................................39 Recruitment Procedures............................................................................................................. 39 Participants ...............................................................................................................................