This project is part of AcademyHealth’s efforts to better understand and address disparities in diagnosis with funding from the Gordon and Betty Moore Foundation. The goal of the study is to refine how we understand, diagnose, and treat Black men in need of mental health services. While Black men have lower rates of depression and anxiety than White men and Black women, their morbidity and mortality from illnesses associated with stress and depression (e.g., heart disease, cancer, COVID-19), and the persistence of misdiagnosis and underdiagnosis of their mental health needs warrants attention. The team notes that Black men have a uniquely dubious history of anti-Black gendered structural racism, medical experimentation, misdiagnosis, and mistreatment in health care that have critical implications for diagnostic equity. This project would: (1) explore the ways that Black men understand, experience, and describe distress; (2) identify structural and systemic drivers and social influences of distress in Black men; (3) examine the social, psychological, and emotional coping strategies Black men use in response to distress; and (4) examine how well measures of depression capture the dimensions of distress salient to Black men who are young adults, middle-aged or older adults. Deliverables will include a project work plan, narrative and financial reports, and a range of products to reach clinicians, policymakers and other audiences for study findings.