The MHISTREET: Barbershop Embedded Education Initiative

The United States (US) is in the midst of a mental health crisis. More than one in four (26.2%) adults experience a diagnosable mental health disorder each year, and 46% of the population will do so in their lifetime. Collectively, mental health disorders are a leading cause of disability and account for one-third of all years lived with disability and premature mortality. Black Americans constitute about 12% of the US population, but they make up more than 18% of the population affected by mental disorders. Black men are 30% more likely than non-Hispanic white men to report having a mental illness but are less likely to receive proper diagnosis and treatment. Black adults are 20% more likely to report serious psychological distress than white adults. Despite this, many Black people do not seek mental health care for various reasons. Causes of higher morbidity and non-care seeking behavior in Black people and Black men in particular include racism, discrimination, stigma, and distrust of the healthcare system. Across the District of Columbia (DC), Black Americans are twice as likely as other ethnicities to report a serious mental disorder, especially if they live in poverty and did not complete high school. In the project service area of Ward 8 in Southeast DC, 92% of the population is Black, 30.7% live in poverty, and only 85% of the population age 25+ completed high school. Evidence shows common mental health disorders are distributed according to a gradient of economic disadvantage across society; the poor and disadvantaged suffer disproportionately from common mental health disorders. In Southeast DC, this negative impact on mental health is compounded by the geographic concentration of underemployment, lack of economic opportunity, poverty, and underutilization of mental health services. Improving mental health literacy is a non-systemic intervention shown to increase mental health care-seeking behaviors. Mental health literacy is the knowledge of, attitude about, and behavior toward mental health issues and mental health services. The goal of the Mental Health Improvement through Study, Teaching, Rebranding, Embedded Education, and Technology or (MHISTREET) initiative is to improve mental health in Black men through embedded education in non-traditional spaces such as barbershops.