This study examined the extent to which stigma-related concerns about mental health care account for the underuse of mental health services among low-income immigrant and U.S.-born black and Latina women.
Participants included 15,383 low-income women screened for depression in county entitlement services who were asked about barriers to care, stigma-related concerns, and whether they wanted or were getting mental health care.
Among those who were depressed, compared with U.S.-born white women, each of the black groups were more likely to report stigma concerns (African immigrants, odds ratio [OR]=3.28, p=.004; Caribbean immigrants, OR=6.17, p=.005; U.S.-born blacks, OR=6.17, p=.06). Compared with U.S.-born white women, immigrant African women (OR=.18, p<.001), immigrant Caribbean women (OR=.11, p=.001), U.S.-born black women (OR=.31, p<.001), and U.S.-born Latinas (OR=.32, p=.03) were less likely to want treatment. Conversely, compared with U.S.-born white women, immigrant Latinas (OR=2.17, p=.02) were more likely to want treatment. There was a significant stigma-by-immigrant interaction predicting interest in treatment (p<.001). Stigma reduced the desire for mental health treatment for immigrant women with depression (OR=.35, p<.001) to a greater extent than it did for U.S.-born white women with depression (OR=.52, p=.24).
Stigma-related concerns are most common among immigrant women and may partly account for underutilization of mental health care services by disadvantaged women from ethnic minority groups.
"In addition, African Americans with high levels of stress are more likely to use mental health services than Latinos with high levels of stress, which suggests the need to further investigate racial disparities in terms of services utilization. Earlier research has shown that \9 % of U.S. born Latinos seek mental health services (Nadeem et al. 2007; Vega et al. 1999). Latinos have the lowest rate of health insurance coverage, which is a major reason why Latinos are not utilizing mental health services (Vega and Lopez 2001). "
[Show abstract][Hide abstract] ABSTRACT: Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.
American Journal of Community Psychology 07/2015; 56(1-2). DOI:10.1007/s10464-015-9738-7 · 1.74 Impact Factor
"The lower utilization of mental health services among minorities is a concerning public health issue (Bhugra, 2004; Bhui et al., 2003; Juang & Cookston, 2009; Lindert et al., 2008; van der Stuyft et al., 1989; Miranda et al., 2008). The low up-take of mental health services is thought to refl ect cultural and linguistic barriers during the help-seeking process (Nadeem et al., 2008; Shim et al., 2009). There is a need for more knowledge about high-risk groups including ethnic minorities, and about culturally specifi c conceptualizations of suicide, as well as help-seeking and pathways to receive care (Bhui, 2010; Canetto, 2008; Hjelmeland, 2011; Lester, 2012). "
[Show abstract][Hide abstract] ABSTRACT: Abstract Background: The Turkish community living in Europe has an increased risk for suicidal ideation and attempted suicide. Online self-help may be an effective way of engagement with this community. This study will evaluate the effectiveness of a culturally adapted, guided, cognitive behavioural therapy-based online self-help intervention targeting suicidal ideation for Turkish adults living in the Netherlands and in the UK.
This study will be performed in two phases. First, the Dutch online intervention will be adapted to Turkish culture. The second phase will be a randomized controlled trial with two conditions: experimental and waiting-list control. Ethical approval has been granted for the trials in London and Amsterdam. The experimental group will obtain direct access to the intervention, which will take 6 weeks to complete. Participants in the waiting-list condition will obtain access to the modules after 6 weeks. Participants in both conditions will be assessed at baseline, post-test and 3 months post-test follow-up. The primary outcome measure is reduction in frequency and intensity of suicidal thoughts. Secondary outcome measures are self-harm, attempted suicide, suicide ideation attributes, depression, hopelessness, anxiety, quality of life, worrying and satisfaction with the treatment.
International Review of Psychiatry 02/2015; 27(1):72-81. DOI:10.3109/09540261.2014.996121 · 1.80 Impact Factor
"Given that help-seeking attitudes are multifaceted, there has been increased focus on understanding (a) individuals' stigma concerns associated with seeking professional psychological services, (b) individuals' comfort with acknowledging personal psychological problems, and (c) individuals' willingness to seek help from professionals , as they may each play a unique role in psychological distress. Fear of stigma may be a particularly salient concern among African American women (Diala et al., 2001; Nadeem et al., 2007). Given African American women's double minority status, the stigma associated with seeking professional psychological services may create an additional unwanted burden. "
[Show abstract][Hide abstract] ABSTRACT: The Strong Black Woman (SBW) race-gender schema prompts African American women to use self-reliance and self-silence as coping strategies in response to stressors. Utilizing the coping strategies associated with the SBW race-gender schema could trigger anxiety and depression symptoms that may intensify when coupled with negative attitudes toward professional psychological help. The present study investigated whether African American women's endorsement of the SBW race-gender schema predicted increased symptoms of anxiety and depression and whether attitudes toward professional psychological help-seeking intensified psychological distress. Data were collected from 95 participants ranging in age from 18 to 65. Hierarchical regression analysis demonstrated significant main effects for the SBW race-gender schema and greater anxiety and depression, respectively. Greater indifference to stigma, 1 dimension of help-seeking attitudes, predicted lower levels of anxiety. African American women's attitudes toward professional help-seeking did not moderate the associations between endorsement of the SBW race-gender schema and anxiety or depression, respectively. Finally, endorsement of the SBW race-gender schema was inversely and significantly associated with 2 facets of help-seeking attitudes: (a) psychological openness and (b) help-seeking propensity. Taken together, these findings provide empirical support for the role of cultural factors, like the SBW race-gender schema, in African American women's experience of psychological distress and potential underutilization of mental health services. Future research directions are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Cultural Diversity and Ethnic Minority Psychology 01/2015; DOI:10.1037/cdp0000015 · 1.36 Impact Factor
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