Mental health disparities among young Black men aged 18 to 25 have reached crisis levels in the United States, evidenced by a 47% increase in suicide rates between 2010 and 2020 and persistent underutilization of mental health services. Existing theoretical frameworks remain inadequate, as traditional approaches treat race, gender, and age as separate risk factors, failing to capture how multiple forms of marginalization intersect to create distinct patterns of risk and service disengagement. This conceptual review proposes a four-dimensional intersectional framework integrating gendered racism, masculinized health stigma, anti-Black misandry, and delayed adulthood, four mutually reinforcing forces operating synergistically during the critical period of emerging adulthood, offering clinicians, researchers, and policymakers a comprehensive model for understanding and addressing mental health disparities affecting young Black men.

PURPOSE:Community-based organizations (CBOs) are increasingly providing violence prevention programming and services. However, researchers have found that many of these organizations struggle to implement evidence-based practices or face administrative burdens of managing the grants that fund the organization. The current study sought to further explore facilitators and barriers of CBOs receiving state funding. MATERIALS AND METHODS:Participants included 29 individuals who led grant writing or implementation efforts at a CBO receiving at least one violence prevention grant from a large state agency. Online focus groups were held, and reflexive thematic analysis was conducted. RESULTS:We divided the major themes into two categories: facilitators and barriers. Facilitators included: 1) these grants were a financial lifeline for organizations providing violence prevention services, helping expand organizations' capacity; and 2) grantees expressed satisfaction with the funder when there was clear and regular communication. Barriers included: 1) rigid application, reporting and budgeting requirements; 2) delays in reimbursement that hindered grants administration; and 3) an under-resourced state agency impacting the overall grant process. Grantees discussed the importance of and recommended fostering community and collaboration among violence prevention organizations. DISCUSSION:These results have implications for funders to consider when administering funds, supporting organizations, building community, and reporting requirements for violence prevention efforts. Recommendations for funders are provided, including streamlining budget requirements, providing training and technical assistance, and creating more opportunities for collaboration. CONCLUSION:As more community-based organizations are funded to implement violence prevention services, funders need to review procedures to ensure equity throughout grant applications and implementation.

Background: Hospital-based violence intervention programs (HVIPs) aim to disrupt cycles of violence by providing trauma-informed, client-centered care to survivors of violent injury. Project HEAL, a HVIP established in 2021 at Jersey Shore University Medical Center, offers case management, mental health support, and connections to legal, housing, and employment resources for individuals impacted by violence in Monmouth and Ocean Counties, New Jersey. Methods: This qualitative study explored the lived experiences of Project HEAL clients (N = 9). Semi-structured interviews were conducted, and transcripts were analyzed using thematic analysis by a team of three coders. The coding process was iterative, with oversight from senior researchers to ensure analytic rigor. Results: Participants described Project HEAL as effective in reducing barriers to care and providing personalized, compassionate case management. The program was valued for its role in supporting mental health and fostering empowerment. However, clients also identified persistent unmet needs, particularly in areas such as youth opportunities, housing, employment, and social services—needs that extend beyond the program’s reach. The findings highlight Project HEAL’s essential but partial role within a fragmented ecosystem shaped by structural inequities. Conclusion: Project HEAL demonstrates the strengths and limitations of HVIPs in addressing the complex needs of survivors of community violence. While the program effectively reduces immediate barriers and fosters supportive relationships, broader systemic challenges persist. These results underscore the need for a sustained coordinated community response and policy advocacy to address structural barriers that HVIPs alone cannot overcome.

This study analyzes the relationship between anticipatory community and police violence and health outcomes including mental and physical well-being, sleep problems, and functional disability. Using data from a nationally representative survey of 3015 self-identified Black and African American adults in the USA collected in 2023, findings from a series of regression analyses reveal that anticipating community violence is linked to poorer self-rated health and increased sleep problems. Anticipatory police violence is associated with poorer physical health and sleep disturbances. These associations persist even after accounting for previous experiences of violence. The results underscore the potential health consequences of anticipating violence, suggesting that the fear of personal victimization can adversely influence health. Addressing anticipatory violence through trauma-informed public health policies and practices is critical for improving health outcomes and reducing disparities in violence-exposed communities. Future research should explore longitudinal impacts and extend analyses to additional racial groups and health outcomes.

Mental health service research has insufficiently examined young Black men’s (YBM; ages 18–25) mental health care consumption patterns, obscuring their unmet mental health needs. Concurrently, the literature indicates YBM face unmet service needs that impede their ability to address numerous negative social determinants of health (e.g., high adverse childhood experiences, low socioeconomic status, etc.). Because preventing or treating mental health issues at or near onset can dramatically improve outcomes, this study utilizes thematic analysis to elucidate the factors most consequential to YBM’s experiences as mental health service consumers. Eight YBM ( M age = 21.1 years) were purposively recruited to participate in semi-structured interviews to discuss attitudes regarding mental health care and cultural attitudes, gender-based attitudes, structural racism, and transition to adulthood. Of the eight participants, five had active health insurance, six had received mental health services before age 18 years, and three were currently receiving mental health services. Participants were attuned to their mental health needs and rejected stigmatizing attitudes about mental illness. Most participants reported hesitation about taking psychiatric medications. Participants had limited resources and encountered structural barriers to accessing mental health services. Most participants did not perceive racism as a source of mental distress. Culturally informed, consumer-oriented research is critical to tailoring and strengthening YBM’s mental health care. Future research should employ a population health approach to promote YBM’s mental health service uptake in adulthood.

Exploring the post-injury lives of those who have survived gunshot wounds is essential to understanding the entire scope of firearm violence. The lives of Black male firearm violence survivors are transformed in various ways due to their injuries both visible and invisible. This study explored how Black men who suffer from disabilities via a firearm negotiated their masculine identities. Semi-structured, qualitative interviews were conducted with 10 violently injured Black men participating in a hospital-based violence intervention program. Survivors expressed their thoughts on how their injuries impacted their manhood and masculinities. Three themes emerged: (1) perceptions of manhood, (2) loss of independence and burden on others, and (3) and mobility. These themes highlighted and described how their lives were impacted post-injury and characterized their psychological and physical experience of recovery. The research findings suggest the need for more qualitative studies to further explore the relationship between firearm injury, Black masculinity, and perceptions of manhood. While Black men are understudied in health research and invisible in disability research, they continue to be hyper-invisible when discussing violently acquired disabilities.

Black children in the United States disproportionately experience early childhood adversity and toxic stress, which can lead to long-term negative physical and mental health outcomes. Mothers are traditionally enrolled in intervention programs to help address this while fathers typically are not. This study assessed Black fathers' perspectives about early childhood adversity and toxic stress to begin to understand this public health concern through their lens. Sixteen self-identified Black fathers watched a six-minute animation about toxic stress, neurodevelopment, and resilience, and engaged in focus group discussions. Fathers identified unique and culture-specific contributors to early childhood adversity and toxic stress, as well as their inherent strengths and needs to help protect children. Implications for social work practice, particularly related to Black father engagement in early childhood prevention and intervention programs, are discussed.

Self-appraisal after a life-altering event is a critical process for individuals, often comprised by assigned labels that may not align with an individuals' perceptions of themselves or of their situation. Existing research within this victim-survivor dichotomy largely rests in the interpersonal violence space, with a victim assuming legal recourse and wrongdoing, and a survivor associating with positive personal characteristics like grit and resilience. Much existing literature on self-appraisal after interpersonal injury is heavily concentrated within the sexual violence literature, and this study applies these concepts to a sample of Black men injured by firearms. Ten Black men enrolled in a hospital-based violence intervention program (HVIP) were interviewed to understand how they label their experience of firearm injury, and if their perceptions aligned with common labels seen among other populations and/or in other areas of study (e.g., cancer, domestic violence). Each participant assigned themselves their own label, with three labels emerging: survivor, victim and survivor, and neither victim nor survivor. The results illustrate the nuance of experiences beyond the victim-survivor dichotomy, and how labels and personal identities may shift following injury into new terms and considerations of resilience and trauma processing. More research is warranted to understand the factors that shape self-labeling within this population, including influences of masculine norms, racialized stereotypes, community context, and availability of services. Findings support public awareness campaigns to reframe surviving violence as a strength, and for community partners and practitioners to increase access to culturally competent and trauma-informed mental healthcare.

BACKGROUND:Adverse childhood experiences have been associated with future outcomes; however, Felitti's 1998 ACEs questionnaire fails to capture the experiences of Black populations living in disinvested neighborhoods making it necessary to expand the ACEs questionnaire to examine the life experiences of violently injured Black men.OBJECTIVE:The aim of the study was to advance the understanding of ACEs among Black male firearm violence survivors using the ACEs questionnaire and semi-structured interviews.PARTICIPANTS AND SETTING:Ten Black male firearm violence survivors were recruited from an urban HVIP. Case managers conducted recruitment using the HVIP's REDcap database; active and previous HVIP participants were eligible for the study.METHODS:A qualitative study design was used to understand the childhood experiences of Black male firearm violence survivors using Felitti's ACEs questionnaire and a semi-structured interview examining perceptions of their childhood experiences. Due to the COVID-19 pandemic, recruitment and interviews were conducted over the phone.RESULTS:All participants experienced at least one ACE. Three themes arose from the interviews: youth incarceration, family separation and loss, and housing transition. Men at risk for violent injury experience ACEs beyond those measured in the current instrument.

This study investigated the relationship between youth violence exposures (i.e., peer and neighborhood) and early sexual initiation. It also explored whether caring relationships with teachers might moderate this relationship and whether results differed for heterosexual versus non-heterosexual African American youth. The study sample (N = 580) comprised 475 heterosexual and 105 non-heterosexual youths, 319 female and 261 male, ages 13 to 24 years (M age = 15.8). Students were assessed for peer and neighborhood violence, relationship with teachers, early sexual initiation, sexual orientation, and socioeconomic status. Major results indicated a positive relationship between exposure to peer and neighborhood violence and early sexual initiation for heterosexual youth but not those who identified as non-heterosexual. Further, identifying as female (vs. male) was significantly associated with later sexual initiation for both heterosexual and non-heterosexual youth. In addition, caring teachers moderated the relationship between exposure to peer violence and age of sexual initiation among non-heterosexual youth. Programs and interventions to curtail violence sequelae would need to consider the unique effects of various types of youth violence exposures and the significance of sexual orientation.

Objectives: To examine whether heightened vigilance partially explains associations between police brutality, depressed mood, and generalized anxiety among Black adults. Method: We used data from the cross-sectional Survey of the Health of Urban Residents (SHUR) in the United States (N = 623). Controlling for sociodemographic and health characteristics, we regressed depressed mood and generalized anxiety on police brutality. To assess whether heightened vigilance mediates the relationship between police brutality and mental health, we computed the direct effects of police brutality and indirect effects (through heightened vigilance) on depression and anxiety. Results: Over half of the sample reported experiencing police brutality. Both police brutality and heightened vigilance were associated with depressed mood and generalized anxiety. Heightened vigilance explained 11% of the total effect of police brutality on depressed mood and 21% of the total effect of police brutality on generalized anxiety. Conclusions: Police brutality is associated with negative mental health outcomes among Black people. As clinicians work to provide assessment, diagnosis, and treatment services, they should be aware that Black patients might face increased risk for depression and anxiety because of heightened vigilance and police brutality. Addressing how to manage these kinds of stressors is important, as is building a society where hypervigilance is unnecessary for the survival of Black people. Advocating for broad policy actions to reimagine policing is important for the mental health of Black adults.

The present study examined the types of drugs likely to be used by bullies, victims, and bully/victims. Participants comprise African American adolescents from three high schools, one youth church group, two community youth programs, and four public venues in low-income communities in Chicago's Southside. A series of logistic regression analyses and latent class analyses were employed. Victims are likely to use alcohol, marijuana, and lean/krokodil. Bullies were likely to use alcohol and marijuana. Bully/victims were not at risk of any of the substances. Our LCA findings revealed a lower occurrence of substance use among victims although 30% used alcohol and marijuana; more than half of bullies showed high levels of alcohol, marijuana, and lean/krokodil use; a diverse pattern of drug use was shown among bully/victims although their lean/krokodil and crack/cocaine use was higher than other subgroups of bullying. The drugs of choice for African American bullies, victims, or bully/victims are variable.

Background Police brutality towards racially minoritized populations is structural racism. Even though most of the research on the health impacts of police brutality centers the experiences of men, women are also harmed by this structural violence. Objectives We identify factors associated with the anticipatory stress of police brutality among women and examine its relationship with depressed mood across ethno-racial categories. Methods Data came from the cross-sectional Survey of the Health of Urban Residents in the United States (N = 2796). Logistic regressions were used to identify factors associated with odds of always worrying about the possibility of becoming a victim of police brutality and to examine its association with depression among Latinas, Black, and White women. Results Odds of always worrying about police brutality were greater among Black women and Latinas compared to White women. Household history of incarceration was associated with anticipation of police brutality among Black women and Latinas but not among White women. Black women and Latinas with constant anticipation of police brutality and history of incarceration of a household member during their childhood had elevated odds of depressed mood. Conclusion Although police brutality harms all women, the stressful anticipation of police brutality does not burden all women equally. Structural racism in communities of color continues to be associated with the anticipatory stress of police brutality and it harms the mental health of women of color. Developing policies to eliminate structural racism and for the allocation of resources to persons who are strongly impacted by these injustices is important.

To help address the disproportionate rates of early childhood adversity within the Black community, this study set out to assess African American fathers' knowledge and attitudes about toxic stress, its effect on neurodevelopment, and resilience factors, as well as their receptivity to engaging in research that addresses mental health disparities associated with early childhood. Sixteen self-identified Black adult males (mean age: 39 years) with children 18 years old or younger watched a 6-minute animated video about toxic stress, neurodevelopment, and resilience, and engaged in focus groups to assess their attitudes about these topics. Pre- and postsurvey questionnaires were used to quantify knowledge gained. Participants additionally completed the original and expanded Adverse Childhood Experiences (ACE) and Benevolent Childhood Experiences (BCE) questionnaires. All participants experienced at least 1 ACE (M: 3.5), one expanded ACE (M: 6.3), and 1 BCE (M: 8.5). Confidence in being able to explain toxic stress and its effects to others increased (M = 2.8, SD = 0.98 vs M = 3.5, SD = 0.82; p = 0.036), as did knowledge that genes, environment, and experiences together affect child cognitive, social, and emotional development (M = 10.44, SD = 1.8 vs M = 12.3, SD = 1.4; p = 0.002). Qualitative themes related to toxic stress included the perpetuation of historical and intergenerational trauma, parental stress of managing systemic barriers (ie, racial discrimination, financial inequities, incarceration), and challenges within co-parenting relationships. Protective themes included the need for early parental education about the effects of toxic stress, positive imagery of Black fatherhood, and the resilience of Black fathers and the Black community as a whole. This study yielded insights into Black fathers' perspectives about culturally specific contributors and protective factors of childhood toxic stress that are not currently addressed by evidence-based practices. These data, and the paucity of purposeful inclusion of fathers in early childhood prevention and intervention programs, represent gaps in current program design and implementation, and highlight the need for more father engagement and community-partnered participatory collaborations to improve mental health outcomes of children.

Purpose: Male youths living in neighborhoods with concentrated disadvantage are exposed to high levels of violence, which increases the risk for violence victimization and perpetration and shapes identify formation. We explored male youths' conceptions of manhood, influences on manhood, and intersections with interpersonal violence in the context of a community-partnered sexual violence prevention study. Methods: We conducted semistructured interviews with predominantly Black males, aged 14-19 years, participating in a gender-transformative sexual violence prevention study. We used an iterative coding process to identify developing themes around youths' definitions of manhood, influences on manhood, and intersections with racial identity and racism. Results: Participants outlined visions of manhood that included many traditionally masculine attributes and also offered nuance and subversion of traditional masculinity. Participants' definitions of manhood centered on themes of responsibility while also acknowledging the importance of emotional expression. Many participants described growing into manhood as a journey toward becoming a moral agent. Participants identified three predominant influences on their conceptions and experiences of manhood: (1) family and community connections; (2) interpersonal and structural racism; and (3) racial pride. Family, particularly fathers and other father figures, emerged as invaluable in understanding manhood and navigating racial identities. Conclusions: These stories suggest that the process of entering manhood comes with unique challenges for adolescents who do so in the context of community violence and racism. Being mindful of intersections between masculinity and racial injustice can inform violence prevention programs that address the lived experiences of minority male youths in neighborhoods with concentrated disadvantage. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.