Gaps in Service Utilization by Mexican Americans With Mental Health Problems

Vega, William A.; Kolody, Bohdan; Aguilar‐Gaxiola, Sergio; Catalano, Ralph

doi:10.1176/ajp.156.6.928

Cited by 302 publications

(232 citation statements)

References 23 publications

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“…More than 40% are foreign born, and 75% are immigrants or children of immigrants (25). Acculturation, “the process by which individuals adopt the attitudes, values, customs, beliefs, and behaviors of another culture” (26), has been found to have mixed health, including mental health, effects for Latinos (27–29); Latinos who are less acculturated have lower prevalence rates of psychiatric disorders, but those with a disorder are less likely to receive mental health treatment (30, 31). Given these health and acculturation relationships, acculturation could potentially affect adherence via, for example, physician/patient communication or health literacy.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

View full text Add to dashboard Cite

show abstract

“…In this wave, studies, such as the Epidemiological Catchment Area (ECA) Study (Robins & Regier, 1991), the National Comorbidity Study (NCS; Kessler et al, 1994), and the Mexican American Prevalence and Service Survey (MAPSS; Vega, Kolody, Aguilar-Gaxiola, & Catalano, 1999) among others, have used state-of-the-art methodologies (e.g., structured diagnostic interviews, probability community samples) to document disparities in mental health care among Latino adults living in the community. Findings from these influential studies have served as a major platform to inform future directions of mental health services, policy, and research.…”

mentioning

confidence: 99%

Latino Adults’ Access to Mental Health Care: A Review of Epidemiological Studies

Cabassa

Zayas

Hansen

2006

Adm Policy Ment Health

311

177

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Since the early 1980s, epidemiological studies using state-of-the-art methodologies have documented the unmet mental health needs of Latinos adults in the U.S. and Puerto Rico. This paper reviews 16 articles based on seven epidemiological studies, examines studies methodologies, and summarizes findings about how Latino adults access mental health services. Studies consistently report that, compared to non-Latino Whites, Latinos underutilize mental health services, are less likely to receive guideline congruent care, and rely more often on primary care for services. Structural, economic, psychiatric, and cultural factors influence Latinos' service access. In spite of the valuable information these studies provide, methodological limitations (e.g., reliance on cross-sectional designs, scarcity of mixed Latino group samples) constrict knowledge about Latinos access to mental health services. Areas for future research and development needed to improve Latinos' access and quality of mental health care are discussed.

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“…service use for Panic Disorder module questions among those participants who met criteria for that disorder). This is sometimes referred to as diagnosis-specific service use (Kessler et al, 1998;Olfson et al, 1998;Vega et al, 1999). Because of the multiple comparisons, we discuss only differences at the p < 0.01 level for these analyses.…”

Section: Methodsmentioning

confidence: 99%

“…In the second approach, questions regarding service utilization are located at the end of specific diagnostic modules. Through both context and wording, these questions are linked explicitly to the psychiatric symptomatology elicited by that diagnostic module (Kessler et al, 1998;Kessler and Ustun, 2004;Olfson et al, 1998;Vega et al, 1999;Wang et al, 2005a). Interestingly, some studies have included both separate service utilization modules and diagnosis-specific service utilization questions (Kessler et al, 1997a;Kessler et al, 1998;Kessler et al, 1999;Kessler, 2000;Kessler and Ustun, 2004;Olfson et al, 1998; US Department of Health and Human Services, 2000;Wang et al, 2005a;Wang et al, 2005b;Wang et al, 2006;Wu et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Methods for measuring utilization of mental health services in two epidemiologic studies

Novins

Beals

Croy

et al. 2008

Int J Methods Psych Res

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Objectives of Study-Psychiatric epidemiologic studies often include two or more sets of questions regarding service utilization, but the agreement across these different questions and the factors associated with their endorsement have not been examined. The objectives of this study were to describe the agreement of different sets of mental health service utilization questions that were included in the American Indian Service Utilization Psychiatric Epidemiology Risk and Protective Factors Project (AI-SUPERPFP), and compare the results to similar questions included in the baseline National Comorbidity Survey (NCS).Methods-Responses to service utilization questions by 2878 AI-SUPERPFP and 5877 NCS participants were examined by calculating estimates of service use and agreement (κ) across the different sets of questions. Logistic regression models were developed to identify factors associated with endorsement of specific sets of questions.Results-In both studies, estimates of mental health service utilization varied across the different sets of questions. Agreement across the different question sets was marginal to good (κ = 0.27-0.69). Characteristics of identified service users varied across the question sets.Limitations-Neither survey included data to examine the validity of participant responses to service utilization questions.Recommendations for Further Research-Question wording and placement appear to impact estimates of service utilization in psychiatric epidemiologic studies. Given the importance of these estimates for policy-making, further research into the validity of survey responses as well as impacts of question wording and context on rates of service utilization is warranted.

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Gaps in Service Utilization by Mexican Americans With Mental Health Problems

Cited by 302 publications

References 23 publications

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

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

Latino Adults’ Access to Mental Health Care: A Review of Epidemiological Studies

Methods for measuring utilization of mental health services in two epidemiologic studies

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