OBJECTIVE: The purpose of this study was to ascertain the degree of underutilization of services for mental health problems among urban and rural Mexican American adults. METHOD: A probability sample (N = 3,012) was used to represent the Mexican American population of Fresno County, California, and face-to-face interviews were conducted with the use of the Composite International Diagnostic Interview. Bivariate and multivariate analyses were used to analyze the data on diagnosis and service utilization. RESULTS: Among the respondents with DSM-III-R-defined disorders, only about one-fourth had used a single service or a combination of services in the past 12 months, and Mexican immigrants had a utilization rate which was only two-fifths of that of Mexican Americans born in the United States. Overall use of mental health care providers by persons with diagnosed mental disorders was 8.8%, use of providers in the general medical sector was 18.4%, use of other professionals was 12.7%, and use of informal providers was only 3.1%. According to logistic regression analyses, factors associated with utilization of mental health services included female sex, higher educational attainment, unemployment, and comorbidity. CONCLUSIONS: Immigrants are unlikely to use mental health services, even when they have a recent disorder, but may use general practitioners, which raises questions about the appropriateness, accessibility, and cost-effectiveness of mental health care for this population. Several competing hypotheses about the reasons for low utilization of services need to be examined in future research.
OBJECTIVE: The purpose of this study was to ascertain the degree of underutilization of services for mental health problems among urban and rural Mexican American adults. METHOD: A probability sample (N = 3,012) was used to represent the Mexican American population of Fresno County, California, and face-to-face interviews were conducted with the use of the Composite International Diagnostic Interview. Bivariate and multivariate analyses were used to analyze the data on diagnosis and service utilization. RESULTS: Among the respondents with DSM-III-R-defined disorders, only about one-fourth had used a single service or a combination of services in the past 12 months, and Mexican immigrants had a utilization rate which was only two-fifths of that of Mexican Americans born in the United States. Overall use of mental health care providers by persons with diagnosed mental disorders was 8.8%, use of providers in the general medical sector was 18.4%, use of other professionals was 12.7%, and use of informal providers was only 3.1%. According to logistic regression analyses, factors associated with utilization of mental health services included female sex, higher educational attainment, unemployment, and comorbidity. CONCLUSIONS: Immigrants are unlikely to use mental health services, even when they have a recent disorder, but may use general practitioners, which raises questions about the appropriateness, accessibility, and cost-effectiveness of mental health care for this population. Several competing hypotheses about the reasons for low utilization of services need to be examined in future research.
Authors: May Yeh; Kristen McCabe; Michael Hurlburt; Richard Hough; Andrea Hazen; Shirley Culver; Ann Garland; John Landsverk Journal: J Behav Health Serv Res Date: 2002-02 Impact factor: 1.505
Authors: Bradley D Stein; Sheryl Kataoka; Lisa H Jaycox; Marleen Wong; Arlene Fink; Pia Escudero; Catalina Zaragoza Journal: J Behav Health Serv Res Date: 2002-08 Impact factor: 1.505
Authors: Kathleen Ell; Betsy Vourlekis; Jan Nissly; Deborah Padgett; Diana Pineda; Olga Sarabia; Virginia Walther; Susan Blumenfield; Pey-jiuan Lee Journal: Community Ment Health J Date: 2002-08