Since the Welfare Reform Act of 1996, citizenship status has become an important consideration in mental health service utilization due to the restrictions on federal healthcare benefits for noncitizens living in the U.S. Using a nationally representative sample of Latinos and Asians, we examined the extent to which U.S. citizenship status was related to rates of mental health service utilization. We also identified several predictors of mental health service utilization among noncitizens. Noncitizens were about 40% less likely than U.S.-born citizens to use any mental health services. Findings are discussed in the context of healthcare policy and recent healthcare reform.
[Show abstract][Hide abstract] ABSTRACT: This study examined the extent to which a criminal history is associated with the use of various mental health services as well as related service use predictors among people with serious mental illness (SMI). Data were obtained from the National Comorbidity Survey Replication. The sample consisted of 1,588 adults with SMI, including major depressive disorder (n = 1,398) and bipolar disorder (n = 190). Chi square tests were conducted to compare respondent characteristics based upon the presence/absence of a criminal history. Logistic regression analyses were conducted to examine various mental health services usage among respondents while controlling for predisposing, enabling, and need factors. Approximately 30 % of respondents reported a criminal history. Those with a criminal history were more likely to use specialty mental health services (OR = 1.42, p < 0.05). Findings suggest that the criminal justice system may be serving as a substantial referrer to mental health services or that there is higher morbidity among people with SMI who have been justice involved.
[Show abstract][Hide abstract] ABSTRACT: Objective:
This study examined the factors associated with service utilization for mental health conditions among Latino and Asian non-U.S. citizens in the United States by service type and race.
Data were obtained from the National Latino and Asian American Study (NLAAS). The sample for this study was 849 Latino and 595 Asian non-U.S. citizens between ages 18 and 64 (N=1,444). Mental health services obtained through three types of service providers were examined: specialty mental health services, general medical services, and other services. Guided by the modified Andersen health behavioral model, analyses involved logistic regression models conducted with penalized maximum likelihood estimation.
Although having a psychiatric disorder increased mental health service use in both groups, only 32% of Latino and 52% of Asian non-U.S. citizens with psychiatric needs reported using mental health services during the past 12 months. Overall, noncitizen Latinos and Asians were more likely to use mental health services from general health care providers and other providers than from specialty mental health providers. Several significant predisposing, enabling, and need factors, such as age, health insurance, and having psychiatric conditions, also interacted with race.
Findings of the study suggest that there are ethnoracial variations in mental health service use between Latino and Asian non-U.S. citizens. Mental health professionals should consider developing tailored mental health interventions that account for cultural variations to enhance access to services for these vulnerable subgroups of Latinos and Asians. Further research should examine ethnic disparities in mental health service use among various non-U.S. citizen racial-ethnic subgroups.
[Show abstract][Hide abstract] ABSTRACT: As a community partner and an academic researcher, we experienced the direct and extended benefits of a relatively small-scale, community-engaged informed consent process that developed in an immigrant occupational health study, Assessing and Controlling Occupational Health Risks for Immigrant Populations in Somerville, Massachusetts. The practice of human participants research played a positive role in the community, and both community partners and researchers, as well as the larger academic community, reaped unexpected benefits during the five-year project (2005-2010), which continue into the present. Lessons learned from our experience may be helpful for wider application. (Am J Public Health. Published online ahead of print October 17, 2013: e1-e4. doi:10.2105/AJPH.2013.301517).
American Journal of Public Health 10/2013; 103(12). DOI:10.2105/AJPH.2013.301517 · 4.55 Impact Factor
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