Decolonizing infant mental health: Black maternal mental health decision-making.

Over the last three decades (and maybe longer), studies have documented persistent race-based maternal mental health disparities, whereas Black mothers are more likely to experience mental health concerns, and least likely to access formal mental health services due to structural racism and other social determinants. Given the history of colonization and culturally grounded collective healing, it is essential that infant mental health practitioners support Black mothers and their intentional decision-making rather than problematizing or pathologizing healthy responses. This qualitative pilot study entailed analysis of in-depth interviews with 12 Black mothers between the ages of 20 and 39 in a US midwestern metropolitan context. Three interconnected themes emerged describing the decision-making process: changing contexts in maternal mental health and decision-making, assessing supports for mental health, and recommendations for supporting Black maternal mental health and decision-making in more helpful ways. Findings reveal that Black mothers engage in complex, culturally-grounded decision-making processes that extend beyond formal mental health services to include self-help, informal support, and community-based resources. The research contributes to a theoretical understanding of how intersecting identities and contextual factors influence mental health decision-making, offering practical recommendations for culturally responsive infant mental health practice and policy development that center on Black mothers' voices and experiences.