A few years ago I tried to reconnect with a friend from college. After a few attempts I spoke to a family friend who indicated my classmate was struggling with a mental illness. I finally spoke to him but I didn’t feel comfortable asking him if he was seeing a therapist or taking medication. He never brought up the issue, and I still feel guilty not finding out what, if anything, I could do to help.

My apprehension is part of a bigger problem among Black men; far too many brothers are struggling in silence. According to Dr. F. Abron Franklin, epidemiologist and director of treatment and prevention services, Volunteers of America, Oregon, “African American men are socialized by a definitional architecture of manhood that promotes the integrity of a man or manhood is premised on a man’s level of resources to address his own issues and not to ask the help of others. Therefore, out a fear of appearing weak or infirm, African-American men are less motivated to utilize mental health services.”

Refusing to discuss mental health or seek out treatment can cause lives to spiral out of control. However, the reasons Black men do not trust the healthcare system is influenced by historical events.

For example, from 1932 to 1972 hundreds of Black men with syphilis went untreated as part of a study known as the Tuskegee Experiment. The story is still discussed in Black barbershops and beauty salons throughout the United States. Convincing Black men to talk about mental illnesses including schizophrenia and bipolar disorder is an uphill battle but barbershops provide the perfect environment.

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Ensuring Black men understand there are services available is important. Unfortunately there are a variety of visible and hidden obstacles that prevent Black men from seeking support. Dr. Franklin explains: “The barriers that impede or prevent access to mental health services among African-American men are complex and, sometimes, interdependent. Systemic issues such as structural inequalities; provider availability; culturally responsive assessment and treatment modalities; and either a lack of or inadequate insurance coverage also deter access.”

Increasing self-help behaviors among Black men is important. A study from the Office of Minority Health suggests that deaths related to suicide for Black men are nearly four times higher than the rate for Black women. For this reason, community based organizations, schools, religious institutions, local and state entities should consider the following:

Creating Safe Spaces for Black Men to discuss Mental Health

Mental illness is a taboo subject that Black men do not discuss in classrooms, sporting events, conferences or at home. Organizing peer and mentorship groups that allow Black men to talk about topics regardless of their sexual orientation, gender expression, gender identity, socio-economic background or religious affiliation is critical. Meetings should be moderated by professionals with similar experiences to ensure Black men feel comfortable discussing personal issues.

Safe spaces allow therapists to provide educational materials, critical feedback and support services that are not available in most communities. Creating a support network would extend into the local community where men in crisis have someone to talk to during difficult times.

Coordinate with Local Institutions to Promote Programs

Frequently, federal and state officials develop and/or fund programs without input from the local community. Teaming up with nonprofit organizations, religious institutions, schools and clubs would prevent duplicate programs that fail to properly address specific issues. For instance, programs have to be tailored to the needs of communities struggling with high unemployment, drug abuse or homelessness. Failing to invest in established organizations is counterproductive and costly.

Developing partnerships creates synergy between local, state and national organizations that seek to address mental health. Convincing Black men to attend individual or group sessions requires a coordinated effort that utilizes social media, barbershops, academic and athletic competitions. Local organizations have established relationships with the community, which is essential to addressing mental illness among Black men.

Mental illness is an issue that affects Americans from diverse backgrounds. However, Black men require support from therapists with similar backgrounds because of stress from community, family and peer relationships. Increasing self-help behaviors among Black men should include an understanding of how historical events affect perceptions and attitudes. Increasing funding to community-based programs that understand the barriers Black men encounter is critical to addressing this important issue. It is vital that fathers, sons, uncles, friends, fraternity brothers and cousins work together to support Black men in their darkest hours.

*This is excerpted from an article originally on EBONY.com in October 2015.