# Maintaining Balance:: Examining Mental Wellness in Black Women during the Menopausal Transition

## TL;DR

This study explores how Black women in midlife perceive and access mental health care during menopause, highlighting cultural and structural challenges.

## Contribution

The research introduces a mixed-methods approach to identify distinct mental health care engagement profiles among Black women.

## Key findings

- Qualitative interviews revealed themes like emotional suppression, stigma, and cultural expectations affecting mental health care.
- Quantitative analysis identified four distinct groups with unique mental health care orientations.
- The study proposes targeted strategies to improve mental health care access for Black women.

## Abstract

Black women begin the menopausal transition at an earlier age than other women and experience more severe menopausal symptoms such as depression and anxiety. The “Strong Black Woman Schema” (SBWS) is a cultural expectation that these women portray strength and caretaker qualities, while suppressing their emotions. This research had two aims (1) what factors influenced how Black women in midlife perceive, seek, and access mental health care and (2) how these factors could enhance mental well-being. Using a mixed-methods approach, the research integrated qualitative interviews (n = 23) and a segmentation analysis (n = 231) to uncover nuanced insights into the lived experiences of Black women and their mental health decision-making. In the qualitative component the participants ranged from 42–60 in age; the mean age was 49. Approximately 60% of the participants sought mental healthcare. Qualitative findings revealed key themes related to emotional suppression, stigma, cultural expectations, structural barriers, and the role of self-care. In the next phase a survey was distributed online to a pre-established national consumer panel of self-identified Black women using a market research firm in the United States. The quantitative segmentation analysis (N = 231), performed using K-means clustering, identified four distinct groups—Reluctant Avoidants, Evolving Discerners, Practical Engagers, and Steady Seekers—each with unique orientations toward mental health care. Based on these profiles, this research proposes targeted engagement strategies for enhancing access to care. These insights into how Black women navigate mental health care may assist in identifying effective strategies for improving access and support to women.