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Articles   |    
Racial-Ethnic Variation in U.S. Mental Health Service Use Among Latino and Asian Non-U.S. Citizens
Sungkyu Lee, Ph.D.; Laurel Laiewski, M.S.S.W.; Sunha Choi, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200430
View Author and Article Information

The authors are with the College of Social Work, University of Tennessee, Knoxville (e-mail: slee90@utk.edu).

Copyright © 2014 by the American Psychiatric Association

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.

Methods  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.

Results  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.

Conclusions  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.

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Table 1Sample characteristics of Latino and Asian non-U.S. citizens responding to the 2002–2003 NLAAS surveya
Table Footer Note

a NLAAS, National Latino and Asian American Study

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b Rao-Scott chi square test

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*p<.05, **p<.001

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Table 2Predictors of mental health service use among 1,444 Latino and Asian non-U.S. citizens, by provider typea
Table Footer Note

a Multivariate logistic regression models used penalized maximum likelihood estimation. Summary statistics: any mental health services, b=–6.03, pseudo-R2=.252; specialty care, b=–9.12, pseudo-R2=.448; general medical care, b=–5.32, pseudo-R2=.222; and other services, b=–6.02, pseudo-R2=.339

Table Footer Note

b A variable for age at immigration was excluded from the models because of multicollinearity.

Table Footer Note

*p<.05, **p<.01, ***p<.001

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