“I Know What I Need”: A Mixed Methods Study of Mental Health-Seeking Behaviors in Formerly Incarcerated Black Men

Background Black men in the United States experience disproportionate rates of incarceration, contributing to adverse mental health outcomes. Yet, research on mental health-seeking behaviors of formerly incarcerated Black men (FIBM) remains limited, often focusing on formal mental health services, leaving knowledge gaps about coping strategies, support networks, and the influence of incarceration experiences on health-seeking behaviors. Purpose The purpose was to describe how incarceration shapes FIBM’s health-seeking behaviors for mental health needs. Methods This convergent mixed methods study collected and analyzed data from semi-structured interviews and surveys with 29 FIBM. Reflexive thematic analysis and descriptive statistics were used; integrated data analysis examined the relationship between qualitative findings and quantitative measures. Results Five themes described how incarceration shaped health-seeking behaviors for FIBM: (1) “I know what I need” reflected self-assessment of mental health needs; (2) “You learn to depend on yourself” described self-reliance and coping strategies; (3) “Trying to express myself” reflected efforts to engage social support; (4) “How can you put your trust in that?” highlighted mistrust in carceral mental health services due to historical and personal experiences of harm; and (5) “It’s not normal for guys like us” described how participants’ navigate stigma and additional barriers in seeking community-based mental healthcare. Integrated data analysis revealed a nuanced understanding of how FIBM expressed their mental health needs compared to their scores on mental health measures. Conclusion This study shows how FIBM identify and address mental health needs across individual, social, and structural contexts, providing insights for improving mental health outcomes.