Witnessing for Black mental health: Formative steps for designing a community-based mental health education intervention

Objectives: Following the May 2022 racially motivated mass shooting in Buffalo, New York, mental health care was found to be the most frequently endorsed unmet need among local Black community members surveyed. In response, a community-university partnership formed in pursuit of developing culturally tailored mental health programming. To inform program development, the partnership conducted community-engaged research to understand diverse stakeholders’ relevant concerns, beliefs, and preferences. Methods: In Study 1, community health workers (n=13; 92% Black; 100% women; 23–78 years old, Mage=52) participated in one-on-one semi-structured interviews. In Study 2, community members (n=54; 100% Black; 63% women, 31% men, 6% gender not reported; 18–91 years old) participated in focus groups. In both studies, transcripts were coded using descriptive, semantic, realist thematic analysis. Member checks were conducted with organizational leadership, study participants, and broader members of the community. Results: Across both studies, participants described cultural (e.g., stigma) and material (e.g., insurance) barriers to care; systematic (e.g., poverty) and interpersonal (e.g., lack of social support) mental health risks; willingness to discuss mental health (e.g., increasing over time); and preferences for mental health education and services (e.g., provider authenticity). Individual study results and convergences and divergences across studies are detailed. Conclusions: Results informed the development of a pilot mental health education program, “Witnessing for Mental Health.” The community health worker–delivered program addresses participant-identified cultural, tangible, and systemic barriers to mental health care and leverages increasing community openness and interest in discussing mental health.