Because they not educated about it, you know how important it is … I don’t think they’re informed. People don’t tell them. Just like this program. I’m for as long as I’ve been in Pittsburgh. I never heard about this program’ (Ms Y, a 94-year-old woman). Barriers to seeking treatment Participants’ experiences dealing with depression as an African-American and living in a predominantly low-income African-American community seemed to have an impact on their treatment seeking. Not surprisingly, these experiences and beliefs created factors that inevitably became barriers to treatment for African-American older adults with depression. Out of the 37 African-Americans interviewed, all had experienced moderate-to-severe depressive symptoms at some point during their lifetime, yet none were currently in mental health treatment for depression and only 6 reported they had ever been in mental health treatment. The lack of engagement in mental health treatment was partially due to the powerful obstacles that deterred them from help seeking, despite perceived need and experiencing significant depressive symptoms. Some of the most prevalent barriers acknowledged were lack of faith in mental health treatment, lack of access to treatment, mistrust, ageism, lack of recognition, and stigma. Questions asked during the qualitative interview to gain insight into barriers to seeking treatment included: (1) Have you had negative experiences in treatment or in your attempting to seek mental health treatment that you believe are due to your depression, your race, or your age; (2) What were barriers to getting help for your depression; and (3) Has stigma affected your decisions about whether or not to seek treatment. Experiences of stigma In this study sample, experiences of stigma were prevalent among African-American older adults with depression and were identified by a number of participants as a barrier to seekingAging Ment Health. CPI-455 web Author manuscript; available in PMC 2011 March 17.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptConner et al.Pagemental health treatment. Out of the 37 participants interviewed, 35 believed that people negatively stereotype individuals with depression and 32 believed that people with depression are stigmatized in society. Participants identified a number of negative stereotypes about individuals with depression. When asked what stereotypes exist about people who are experiencing depression, one participant get HS-173 stated the following: They’re dangerous. They can get violent. They pass on their genes to their children. That, they’re completely … they’re crazy … When a person’s depressed, they’re crazy’ (Ms E. a 67 year-old woman). Ms A. a 72-year-old woman, discussed similar stereotypes about people with depression. She stated that people with depression are often described as being: `Crazy, listless, lifeless, and opinionated.’ One participant stated that he experienced being stereotyped when he was going though a depression: `Think they ain’t trustworthy, you know. This whole thing like, “You crazy or something.” You ain’t crazy, but they think you’re crazy, because you might act different … They think you’re going to harm them or something like that or … Dangerous or something like that’ (Mr W. a 75 year-old man). The experience of being an African-American older adult with depression impacted experiences with stigma. Of the 37 participants, 35 believed that stereotypes about depression were more se.Because they not educated about it, you know how important it is … I don’t think they’re informed. People don’t tell them. Just like this program. I’m for as long as I’ve been in Pittsburgh. I never heard about this program’ (Ms Y, a 94-year-old woman). Barriers to seeking treatment Participants’ experiences dealing with depression as an African-American and living in a predominantly low-income African-American community seemed to have an impact on their treatment seeking. Not surprisingly, these experiences and beliefs created factors that inevitably became barriers to treatment for African-American older adults with depression. Out of the 37 African-Americans interviewed, all had experienced moderate-to-severe depressive symptoms at some point during their lifetime, yet none were currently in mental health treatment for depression and only 6 reported they had ever been in mental health treatment. The lack of engagement in mental health treatment was partially due to the powerful obstacles that deterred them from help seeking, despite perceived need and experiencing significant depressive symptoms. Some of the most prevalent barriers acknowledged were lack of faith in mental health treatment, lack of access to treatment, mistrust, ageism, lack of recognition, and stigma. Questions asked during the qualitative interview to gain insight into barriers to seeking treatment included: (1) Have you had negative experiences in treatment or in your attempting to seek mental health treatment that you believe are due to your depression, your race, or your age; (2) What were barriers to getting help for your depression; and (3) Has stigma affected your decisions about whether or not to seek treatment. Experiences of stigma In this study sample, experiences of stigma were prevalent among African-American older adults with depression and were identified by a number of participants as a barrier to seekingAging Ment Health. Author manuscript; available in PMC 2011 March 17.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptConner et al.Pagemental health treatment. Out of the 37 participants interviewed, 35 believed that people negatively stereotype individuals with depression and 32 believed that people with depression are stigmatized in society. Participants identified a number of negative stereotypes about individuals with depression. When asked what stereotypes exist about people who are experiencing depression, one participant stated the following: They’re dangerous. They can get violent. They pass on their genes to their children. That, they’re completely … they’re crazy … When a person’s depressed, they’re crazy’ (Ms E. a 67 year-old woman). Ms A. a 72-year-old woman, discussed similar stereotypes about people with depression. She stated that people with depression are often described as being: `Crazy, listless, lifeless, and opinionated.’ One participant stated that he experienced being stereotyped when he was going though a depression: `Think they ain’t trustworthy, you know. This whole thing like, “You crazy or something.” You ain’t crazy, but they think you’re crazy, because you might act different … They think you’re going to harm them or something like that or … Dangerous or something like that’ (Mr W. a 75 year-old man). The experience of being an African-American older adult with depression impacted experiences with stigma. Of the 37 participants, 35 believed that stereotypes about depression were more se.