摘要：Objectives. We have presented nationally representative data on the prevalence and correlates of mental illness and mental health service use among African American and Caribbean Black (US-born and foreign-born) fathers in the United States. Methods. We have reported national estimates of lifetime and 12-month prevalence rates of mental illness, correlates, and service use among African American (n = 1254) and Caribbean Black (n = 633) fathers using data from the National Survey of American Life, a national household survey of Black Americans. We used bivariate cross-tabulations and Cox proportional hazards regression approaches and adjusted for the National Survey of American Life's complex sample design. Results. The prevalence of mental illness, sociodemographic correlates, and service use among Black fathers varied by ethnicity and nativity. US-born Caribbean Black fathers had alarmingly high rates of most disorders, including depression, anxiety, and substance disorders. Mental health service use was particularly low for African American and foreign-born Caribbean Black fathers. Conclusions. These results demonstrate the need for more research on the causes and consequences of mental illness and the help-seeking behavior of ethnically diverse Black fathers. Limited empirical evidence exists regarding national prevalence rates of mental illness, the correlates of such illness, and service use among fathers. 1 Although scarce, community-based studies have shown that rates of particular mental illnesses differ between fathers and nonfathers, 1 and some evidence has been found for race-based mental health disparities among fathers. For example, the rate of 12-month depressive symptoms is 1.5 times higher among urban Black fathers than among the general population. 2 Urban Black fathers’ rates of comorbid anxiety and substance use are also disproportionate. 2 Fathers who experience a mental illness may have impairments in parenting practices 3–6 that place their children at increased risk for mental illness and poor functioning. 7–19 Therefore, more research is needed on fathers’ mental health, particularly among racial and ethnic populations who have known risk factors for mental disorders. Black fathers are more likely than are fathers of different racial or ethnic backgrounds to experience adverse social circumstances associated with mental illness, such as high unemployment levels, discrimination, poverty, 20–24 and disruptions in family functioning (e.g., separations). 25,26 The nonmarital birth rate is high among Blacks, 27,28 and many Black fathers are nonresidential. However, in the United States Black fathers are just as involved with their children as, and sometimes more involved than, White and Hispanic fathers, even when they are no longer romantically involved with the child's mother. 29–31 Among nonresidential Black fathers, depressive symptoms are associated with less contact and closeness, lower monitoring, and increased conflict with their children. 32 Given the centrality of the provider role among Black fathers, 33,34 their ability to provide for their children may be impeded by symptoms of mental illness, and their inability may exacerbate those symptoms. Despite noted racial disparities among fathers, little is known about differences in rate of mental illness and patterns of service use among Black fathers. The existing literature has focused primarily on depressive symptoms and has been based on information collected from special populations (e.g., nonresidential fathers, low-income fathers). Moreover, little nationally representative information has been available regarding disparities among Black fathers based on ethnic heterogeneity (e.g., African American vs Caribbean Black fathers). We have contributed to the sparse yet growing mental health profile of Black fathers by presenting nationally representative data from the National Survey of American Life (NSAL) on the prevalence of a range of mental illnesses, prevalence of mental health service use, and correlates of mental illness among African American and Caribbean Black (US-born and foreign-born) fathers. Creating a mental health profile of US fathers is consistent with the growing interest in men's physical and psychological health and the role of fathers in family life. Fatherhood status may either increase or decrease risk for mental illness among men, 35 as evidenced by community studies. 1 However, to our knowledge no existing study has provided national estimates of the prevalence of mental illness, service use, and the correlates of mental illness among fathers.
