Psychiatric Services
Volume 58, Issue 12, 2007, Pages 1547-1554

Does stigma keep poor young immigrant and U.S.-born black and Latina women from seeking mental health care? (Article)

Nadeem E.* , Lange J.M. , Edge D. , Fongwa M. , Belin T. , Miranda J.
  • a Health Services Research Center, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd., Los Angeles, CA 90024, United States
  • b Health Services Research Center, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd., Los Angeles, CA 90024, United States
  • c Faculty of Medical and Human Sciences, University of Manchester, United Kingdom
  • d School of Nursing, University of California, Los Angeles, CA, United States
  • e Department of Biostatistics, School of Public Health, University of California, Los Angeles, CA, United States
  • f Health Services Research Center, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd., Los Angeles, CA 90024, United States

Abstract

Objective: 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. Methods: 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. Results: 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). Conclusions: 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.

Author Keywords

[No Keywords available]

Index Keywords

controlled study female major clinical study depression immigrant psychiatric treatment ethnicity mental health service lowest income group stigma mental health care Article race difference help seeking behavior human
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-38049052644&doi=10.1176%2fps.2007.58.12.1547&partnerID=40&md5=dc6e176b9bacf19ccfbf496cb08303b3
DOI: 10.1176/ps.2007.58.12.1547
ISSN: 10752730
Cited by: 197
Original Language: English