Title: Analyzing the Influence of Cultural Nuances and Contextual Factors on Mental Health and Well-being Perceptions Among Residents Aged 18-34 in Dare County, NC

 

Authors | Affiliations:

Marie Lina Excellent, MD, MPH | Samira Zahedrozegar, DDS, MPH Candidate | Kelly Nettnin Fleming, MPA | LaTonia Clark Chalmers, DNP, APRN, PMHNP-BC, NC-BC | Sheila F. Davies, PhD | Michelle Wagner, BA | Judy A. Schmidt, Ed.D., CRC, LCMHCA | Lori A. Evarts, MPH PMP CPH MBTI

University of North Carolina at Chapel Hill, USA | Gillings School of Global Public Health

Dare County Department of Health & Human Services

Breaking Through Task Force

University of North Carolina at Chapel Hill, USA | Nursing School

University of North Carolina at Chapel Hill, USA | School of Medicine

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Background:

The 2021-2022 Dare County Community Health Needs Assessment (CHNA) identified mental health as a key factor contributing to mortality rates in the community. The report highlighted suicide as the second leading cause of death among individuals aged 20-34, while Alzheimer’s disease was noted for those aged 85 and older. Dare County's suicide rate (19.3) surpasses the North Carolina state average (13.4). In response to this pressing issue, we have dedicated to exploring ways to enhance mental health awareness, improve literacy, and reduce stigma. In collaboration with Dare County Department of Health & Human Services & Breaking Through Task Force, this project aims to investigate how cultural and contextual factors influence perceptions of mental health and well-being among residents aged 18-34 in Dare County, NC by May 2025. Understanding these influences will provide valuable insights to inform targeted interventions and support systems for better mental health outcomes within the community. Our community-academic research initiative, funded by the 2024 Tar Heel Bus Tour Grant through Carolina Across 100, seeks to establish a lasting partnership with Dare County DHHS and the Breaking Through Task Force Team.
 
Methods:
The study comprises three key components: surveys, interviews, and focus groups. Data from 4,363 survey participants analyzed through Stata captures demographic details, mental health status, stress levels, and access to mental health services. Additionally, interviews with seven individuals and two focus group sessions offer qualitative insights into the primary challenges and barriers faced by Dare County residents. A code book was developed. Thematic analysis of interviews and focus groups transcripts using NVivo software revealed multifaceted aspects of the challenges.

 

Results:
The key findings reveal notable racial and gender disparities in mental health perceptions and service access. White and Black respondents report higher stress levels and face more difficulties accessing mental health support compared to other racial groups. Males generally report better mental health and greater confidence in managing stress than females. Despite available resources, significant gaps in mental health support persist, with stigma around mental health being widespread in the community. Participants emphasized the need for greater awareness and enhanced support for mental health concerns. Qualitative findings underscored barriers to accessing services, including financial constraints, transportation difficulties, cultural perceptions, and a shortage of local therapists. Additionally, the study identifies systemic obstacles, including financial constraints, transportation issues, and cultural beliefs, that limit access to mental health services. Future efforts should focus on expanding mental health resources and support within the community, increasing awareness about mental health issues, and continuing to engage with Dare community members to address their unmet needs more efficiently.
 
Conclusions/Next steps:
Our community-academic study provides a comprehensive analysis of mental health perceptions and challenges faced by young adults in Dare County. The findings underscore the importance of addressing mental health and well-being among residents aged 18-34 years in Dare County. The project highlights the need for increased mental health resources, support, and awareness to combat stigma and improve community well-being. The data also emphasizes the significance of cultural and contextual factors in shaping mental health perceptions and access to care. Further research and in-depth interviews could provide additional insights into the specific challenges and opportunities for improving mental health among residents. Additionally, implementing targeted interventions to address financial, transportation, and cultural barriers will be crucial for enhancing access to mental health services.