Journal of Counselor Practice, 11(1):1–33, 2020 DOI: 10.22229/afa1112020 Copyright © Ohio Counseling Association 1 African Americans’ Perceptions of Mental Illness and Preferences for Treatment Janeé R. Avent Harris 1 East Carolina University Loni Crumb East Carolina University Allison Crowe East Carolina University Jasmine Garland McKinney East Carolina University Historically, African Americans have lower rates of help seeking as negative perceptions of mental illness and treatment have persisted. Previous researchers identified stigma as an important factor in these attitudes and behaviors. In this current study, 210 African American participants responded to open-ended survey questions assessing these topics. We conducted a qualitative content analysis to identify themes. The themes that emerged included: 1) Stigma: Feeling ashamed and being shamed, (2) Violence/danger, (3) Perceptions of ability, (4) Indicator of weakness, (5) Dismissing mental health issues, and (6) Religion and spirituality. Keywords: African Americans, mental health, stigma, perceptions, treatment African Americans use mental health services at about half the rate of Caucasian and Asian Americans (Substance Abuse and Mental Health Services Administration, __________________________________ 1 Correspondence may be sent to: Janeé R. Avent Harris, Department of Interdisciplinary Professions (IDP), East Carolina University (ECU), Ragsdale Hall 225A Mail Stop 121, Greenville, NC 27858, aventj16@ecu.edu, 252-737-1255.