Seeking Care for Obsessive-Compulsive Symptoms Among African Americans: Findings From the National Survey of American Life

Behav Ther. 2025 Jan;56(1):1-15. doi: 10.1016/j.beth.2024.08.002. Epub 2024 Aug 20.

Abstract

Although obsessive-compulsive disorder (OCD) is associated with clinically significant distress, many OCD patients do not seek treatment. Studies show that Black Americans with OCD are even less likely to obtain treatment due to differences in access. This study explored demographic and symptom outcomes associated with mental health service use for obsessions and compulsions among a nationally representative sample of African American adults (n = 3,570). The analytic sample for this analysis is African Americans who endorsed either obsessions (n = 435) or compulsions (n = 543). Few respondents sought care from their doctor for obsessions (14.25%, n = 62) and even fewer sought care for compulsions (7.55%, n = 36). Respondents were significantly more likely to seek care for obsessions if they had poorer self-rated mental health and perceived impairment due to obsessions-however, they were significantly less likely to seek care for obsessions if they had a high school education or less. Additionally, respondents were more likely to seek care for compulsions if they had poorer self-rated mental health. Our findings suggest that demographic factors, such as level of education, can impact care-seeking behaviors and, therefore, treatment outcomes for African Americans with obsessive-compulsive symptoms. Knowledge of factors associated with OCD care-seeking behavior can help inform potential barriers to treatment and strategies to ensure equity in access to mental health care for this population. Clinical implications and future directions are discussed.

Keywords: African Americans; barriers to treatment; care-seeking behavior; demographic factors; obsessive-compulsive disorder.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • Female
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Obsessive-Compulsive Disorder* / ethnology
  • Obsessive-Compulsive Disorder* / psychology
  • Obsessive-Compulsive Disorder* / therapy
  • Patient Acceptance of Health Care* / ethnology
  • Patient Acceptance of Health Care* / psychology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • United States
  • White
  • Young Adult