Superwoman Schema, Stigma, Spirituality, and Culturally Sensitive Providers: Factors Influencing African American Women's Use of Mental Health Services.

Many African American women are heavily burdened by unmet mental health needs yet underuse mental health services. The superwoman schema (SWS) conceptual framework provides a new culturally sensitive framework to enhance researchers', providers', and educators' understanding of the barriers to mental health service use among this group. The "superwoman" role involves perceived obligations to (1) project strength, (2) suppress emotions, (3) resist feelings of vulnerability and dependence, (4) succeed despite limited resources, and (5) prioritize caregiving over self-care. In this study, the SWS framework guided a secondary qualitative analysis of data from eight focus groups comprised of 48 African American women from the southeastern United States and a broad range of age and educational backgrounds. Results suggest that the major components of SWS, as well as perceived stigma, religious and spiritual concerns, and the desire for culturally sensitive providers influenced participants' perceptions and use of mental healthcare. Understanding how SWS operates in African American women may (1) enable researchers to better understand and develop interventions to mitigate disparities in mental health service use; (2) help healthcare professionals to engage and treat this population more effectively; and (3) equip health professions educators to improve the cultural sensitivity of the next generation of providers.