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The purpose of this study was to explore the perceptions of African community leaders, on factors that influence substance use and mental health status of Sub-Sahara African immigrants living in the northeast region of the USA.

A social constructionist approach to grounded theory was used to understand social life’s complexity in the African community. Data analysis consisted of initial coding and focused coding, which led to the emerging of the following mid-range theories.

The following mid-range theories are developed: the work culture of Sub-Sahara African immigrants may influence substance-use behaviors, impact treatment for mental health and contribute to interpersonal conflicts related to marriage and parenting; there may be a relationship between the culture of privacy and spirituality because the church is often a place of comfort, and many may not seek treatment for mental health for fear of losing that community; Sub-Sahara African immigrants’ mental health and substance-use behaviors are influenced by unique factors that stem from balancing living in the new culture while also preserving their unique cultural norms.

The analysis of perceptions of African community leaders underscored “On the go” as a metaphor for describing Sub-Sahara African immigrants.