This study investigated the utilization of outpatient mental health services by Puerto Rican women in the South Bronx, New York. The study was based on the assumption that ethnicity is a significant factor in the help-seeking behavior of mental health services users. It was hypothesized that the greater the ability to recognize symptoms of mental illness, the higher would be the frequency of utilization of mental health services. It was further hypothesized that Puerto Rican women with a higher degree of acculturation, a higher level of education, and longer residence in the United States would utilize mental health services more frequently. The population consisted of a convenience sample of 40 Puerto Rica-born women between the ages of 25 and 55 whose latency age children had been referred to an outpatient mental health clinic of a local community mental health center. The data were obtained by means of interviews. The ability to recognize symptoms of mental illness was measured by the Mental Illness Identification Scale (MIIS) derived from the 'Star Vignettes'. The behavioral acculturation scale developed and standardized by Szapocznik et al. was used to measure the degree of acculturation. The data do not support the hypothesis that the ability to recognize symptoms of mental illness is a significant factor in the utilization of outpatient mental health services. The evidence presented in this research indicates that acculturation to the dominant United States culture is the most significant variable of utilization of outpatient mental health services by Puerto Rican migrant women. Those exhibiting a higher frequency of utilization of mental health clinic services were found to have a higher level of education and longer residence in the United States. The findings further demonstrate that spiritualism is a significant source of support for the women regardless of their rate of utilization of mental health services. Spiritualists are consulted regarding conflicting relationships and nervous, mental, sexual, and health problems. A higher degree of acculturation does not seem to deter women from their belief in and utilization of spiritualism both as an alternative and a supplement to professional mental health services. The data show that regardless of Puerto Rican women's degree of acculturation, their perception of their children's problems differs from that of the clinic's psychiatrist as reflected in the diagnosis at the time of admission. The findings of this study suggest that having bicultural and bilingual staff is not sufficient to ensure culturally-relevant services when the overall mental health policies are not sensitive to ethnic differences of Puerto Rican patients. It appears that Puerto Rican women perceive mental health services as impersonal and as failing to take into consideration the Puerto Rican cultural values of personalism, kindness, charity, respect, and dignity.

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outpatient psychological aspect therapy health care utilization United States mental health