Depression is one of the most common mental disorders in the United States and affects an estimated 17 million people each year. Projections about depression have generated concern on both the domestic and global levels because of its impact on health outcomes and quality of life. We examined and summarized published research focusing on depression among African American men with the goal of identifying prevalence of depression, risk factors, treatment-seeking behaviors, and treatment-seeking barriers. In the use of a systematic review, inclusion criteria were studies focused on depression among African American or Black men, separated analysis by race and gender, and conducted in the United States. Each study was critically reviewed to identify depression prevalence, risk factors, treatment-seeking behaviors, and barriers. Only 19 empirical studies focusing on depression among African American men were identified in a 25-year time span. Findings suggest the prevalence of depression among African American men ranges from 5% to 10%, they face a number of risk factors, yet evidence low use of mental health services. Consequently, depression among African American men needs to be at the forefront of our research, practice, and outreach agendas. A focus on this group has the potential to reduce mental health disparities experienced by African American men.

Little is known about older African American women’s lived experiences with depression. What does depression mean to this group? What are they doing about their depression? Unfortunately, these questions are unanswered. This study examined older African American women’s lived experiences with depression and coping behaviours. The common sense model provided the theoretical framework for present study. Thirteen community-dwelling African American women aged 60 and older (M =71 years) participated. Using qualitative phenomenological data analysis, results showed the women held beliefs about factors that can cause depression including experiences of trauma, poverty, and disempowerment. Results also indicated the women believed that depression is a normal reaction to life circumstances and did not see the need to seek professional treatment for depression. They coped by use of culturally-sanctioned behaviours including religious practices and resilience. It appears these women’s beliefs about depression and use of culturally-sanctioned coping behaviours might potentially be a barrier to seeking professional mental health care, which could result in missed opportunities for early diagnosis and treatment of depression among this group. Implications for research, educational and clinical interventions are discussed.

A growing body of research focusing on African Americans' mental health is showing that this group relies heavily on their religious/spiritual beliefs and practices to cope with mental health issues including depression. Unfortunately, the psychotherapy literature provides little guidance on how to incorporate religion/spirituality into psychotherapy with African American women. With the growing cultural diversity of the U.S. population, there has been more emphasis on providing patient-centered culturally sensitive care, which involves providing care that is respectful of, and responsive to, individual patient preferences, needs, and values. This paper provides a synthesis of literature that psychotherapists could use to become more culturally sensitive and patientcentered in their clinical practices; that is, to recognize and integrate religion/spirituality into their work with African American women experiencing depression, and possibly other groups with similar needs.

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