Gaps in service utilization by Mexican Americans with mental health problems

Am J Psychiatry. 1999 Jun;156(6):928-34. doi: 10.1176/ajp.156.6.928.


Objective: The purpose of this study was to ascertain the degree of underutilization of services for mental health problems among urban and rural Mexican American adults.

Method: A probability sample (N = 3,012) was used to represent the Mexican American population of Fresno County, California, and face-to-face interviews were conducted with the use of the Composite International Diagnostic Interview. Bivariate and multivariate analyses were used to analyze the data on diagnosis and service utilization.

Results: Among the respondents with DSM-III-R-defined disorders, only about one-fourth had used a single service or a combination of services in the past 12 months, and Mexican immigrants had a utilization rate which was only two-fifths of that of Mexican Americans born in the United States. Overall use of mental health care providers by persons with diagnosed mental disorders was 8.8%, use of providers in the general medical sector was 18.4%, use of other professionals was 12.7%, and use of informal providers was only 3.1%. According to logistic regression analyses, factors associated with utilization of mental health services included female sex, higher educational attainment, unemployment, and comorbidity.

Conclusions: Immigrants are unlikely to use mental health services, even when they have a recent disorder, but may use general practitioners, which raises questions about the appropriateness, accessibility, and cost-effectiveness of mental health care for this population. Several competing hypotheses about the reasons for low utilization of services need to be examined in future research.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • California / epidemiology
  • Community Mental Health Services / economics
  • Community Mental Health Services / statistics & numerical data*
  • Cost-Benefit Analysis
  • Female
  • Health Services Accessibility
  • Health Services Research
  • Humans
  • Male
  • Medically Underserved Area
  • Mental Disorders / economics
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Mexican Americans / statistics & numerical data*
  • Regression Analysis
  • Sampling Studies