A Longitudinal Study of the Use of Mental Health Services by Persons With Serious Mental Illness: Do Spanish-Speaking Latinos Differ From English-Speaking Latinos and Caucasians?

Folsom, David P.; Gilmer, Todd; Barrio, Concepción; Moore, David J.; Bucardo, Jesús; Lindamer, Laurie A.; Garcia, Piedad; Hawthorne, William; Hough, Richard L.; Patterson, Thomas L.; Jeste, Dilip V.

doi:10.1176/appi.ajp.2007.06071239

Cited by 60 publications

(53 citation statements)

References 44 publications

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“…Particular attention should be paid to including these when comparing ethnic groups, because ethnic differences in adherence have been found to disappear when, for example, income was accounted for (73). As previously noted (56, 65), preferred language may be a better predictor of health patterns than ethnicity. It is essential to include adequate numbers of Spanish-speaking as well as bilingual and English-speaking patients and clinicians in future research to better understand these relationships.…”

Section: Discussionmentioning

confidence: 51%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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Section: Discussionmentioning

confidence: 51%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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“…We propose an additional path between English proficiency and services use [22, 23]. That is, we expect that the set of cultural and social factors associated with English proficiency will have an independent effect on hospitalizations and costs beyond their effects on medication adherence.…”

Section: Methodsmentioning

confidence: 99%

“…Consistent with our prior research, we use a client’s preferred service language as a proxy for limited English proficiency status [22, 23]. Clients report their preferred language for receiving services at admission to each service, and we use a client’s revealed preference for service language as a proxy for English proficiency.…”

Section: Methodsmentioning

confidence: 99%

Adherence to Antipsychotics Among Latinos and Asians With Schizophrenia and Limited English Proficiency

Gilmer

Ojeda²,

Barrio³

et al. 2009

Psychiatric Services

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OBJECTIVES We examined the relationship between preferred English, Spanish, or an Asian language for mental health services and adherence to treatment with antipsychotic medication and Medi-Cal beneficiaries with schizophrenia in San Diego, California. METHODS Data included 31,560 person-years from 1999–2004. Pharmacy records were analyzed to assess adherence to antipsychotic medication, based on the medication possession ratio (MPR). Clients were defined as nonadherent (MPR<0.5), partially adherent (0.5<=MPR<0.8), adherent (0.8<=MPR<=1.1), or as an excess filler (MPR>1.1). Regression models were used to examine adherence, hospitalization, and costs by race/ethnicity and language status. RESULTS Limited English proficient Latinos were more likely to be adherent to antipsychotic medications than English proficient Latinos (40.8% vs. 35.9%, P<0.001). Limited English proficient Latinos were less likely to be excess fillers than English proficient Latinos (15.1% vs. 20.4%, P<0.001). Limited English proficient Asians were less likely to be adherent than English proficient Asians (40.1% vs. 45.1%, P=0.034). Compared to English proficient Asians, limited English proficient Asians were more likely to be nonadherent (28.7% vs. 22.0%, P<0.001) and less likely to be excess fillers (12.5% vs. 17.4%, P=0.004). Controlling for adherence and comorbidities, limited English proficient clients had lower rates of hospitalization and health care costs than English proficient and white clients. CONCLUSIONS Adherence to antipsychotic medications varies among and within ethnic groups by English proficiency. Policies supporting the training of bilingual and multicultural ethnic minority providers, and interventions that capitalize on existing social support networks, may improve adherence to treatment among linguistically diverse populations.

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“…This contrasts with previous work which has shown that individuals with poor language proficiency have higher rates of depression, anxiety, and substance abuse compared to those with good to excellent language proficiency. [2][3][4] However, in these studies participants had at least limited English skills and data collection took place in the United States where there is a pre-eminence of English as an "official language". In contrast, the current study was unable to assess English or French language proficiency and took place in Canada where two official languages exist.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, some linguistic minority groups have been shown to have an increased risk for poor mental health. [2][3][4] However, it should be noted that the relationship between language and mental health outcomes has been inconsistent. [5][6][7][8] This may be attributed to the fact that research occurring in Canada and the United States has almost exclusively focused on visible minority groups or immigrants as a proxy for language use.…”

mentioning

confidence: 99%

Official Language Minority Communities in Canada: Is Linguistic Minority Status a Determinant of Mental Health?

Puchala

Leis

Lim

et al. 2013

Can J Public Health

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A Longitudinal Study of the Use of Mental Health Services by Persons With Serious Mental Illness: Do Spanish-Speaking Latinos Differ From English-Speaking Latinos and Caucasians?

Abstract: This study suggests that for Latinos, preferred language may be more important than ethnicity in mental health service use. Future studies comparing mental health use may need to differentiate between Spanish- and English-speaking Latinos.

Cited by 60 publications

References 44 publications

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Adherence to Antipsychotics Among Latinos and Asians With Schizophrenia and Limited English Proficiency

Official Language Minority Communities in Canada: Is Linguistic Minority Status a Determinant of Mental Health?

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