Pathways to Mental Health Recovery among Black Adults with Serious Mental Illness

Abstract
Black adults are disproportionately impacted by serious mental illness (SMI) and have been
found to underutilize formal mental health services and seek support and help outside the
formal setting to manage their mental health, creating unique pathways to mental health
recovery. The recovery processes among Black adults with SMI are understudied, contributing
to a lack of understanding of the recovery processes among Black adults with SMI and how they
experience recovery through formal care (therapy, medication), informal support (peer, family,
faith-based) and personal recovery (self-management). Despite the objective need for formal
treatment, Black adults may still experience recovery from their mental health when help-
seeking from multiple pathways. Multiple pathways to recovery exist, but less is known about
the key mechanisms of recovery that Black adults specifically utilize to achieve recovery. The
goal of this study is to understand how Black adults with SMI navigate the process of finding
and then deciding to use formal services, informal supports, both or personal recovery, and
which mechanisms within these unique pathways are critical to promoting recovery. It is
grounded in the CHIME personal recovery framework, which encompasses five recovery
processes, including Connectedness, Hope, and optimism about the future, Identity, Meaning in
Life, and Empowerment, to deepen our understanding of how Black adults with SMI
conceptualize the recovery process in relation to the CHIME framework and understand how
service use (formal care, informal supports, or both, and personal recovery) promote and
interact with the CHIME recovery processes. A qualitative phenomenological research design
will be used to address the following aims: Aim 1: To explore how the dimensions of the
recovery process (Connectedness, etc.) are experienced by Black adults with SMI, explore
whether there are additional dimensions of recovery specific to Black adults with SMI, and to
examine which of these dimensions are most salient for this population and Aim 2: To identify
how formal and informal pathways of mental health supports facilitate the dimensions of the
recovery process and what specific aspects of these supports facilitate recovery in Black adults
with SMI. A purposive-convenience sampling approach will be used to recruit Black adults with
SMI (n=40) from two groups – those who are involved in formal services or have used them in
the last year (n=20) and those who have not sought formal services but engaged with informal
and personal approaches to recovery within the last year (n=20). Data collection includes one
semi-structured interview and interpretive phenomenological analysis will guide data analysis.

Grant Number: 5R36MH136771-02
NIH Institute/Center: NIH
Principal Investigator: Marcus Brown