English language proficiency and mental health service use among Latino and Asian Americans with mental disorders

Amy M Bauer ¹, Chih-Nan Chen , Margarita Alegría

Affiliations

¹ Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA 02143, USA. abauer@challiance.org

PMID: 21063226
35 References
45 citations

Abstract

Objective: The impact of language proficiency as a potential contributor to ethnic disparities in mental health care has received less attention than other factors. Data from the National Latino and Asian American Study were examined to assess the impact of limited English proficiency (LEP) on access to and quality of mental health care for community-dwelling Latino and Asian Americans with mental disorders.

Methods: English-proficient (EP) and LEP individuals with mental disorders were compared on lifetime use of healthcare services for a mental disorder, duration of untreated disorders, receipt of minimally adequate care, and barriers to treatment (eg, lack of identification of need for treatment, language barriers, and embarrassment or discomfort related to treatment).

Results: Compared with EP individuals, LEP individuals with mental disorders were significantly less likely to identify a need for mental health services, experience longer duration of untreated disorders, and use fewer healthcare services for mental disorders, particularly specialty mental health care. Receipt of minimally adequate care did not differ significantly by language proficiency. Embarrassment and discomfort were not more common among LEP individuals. Perceived need for treatment predicted lifetime mental healthcare use, whereas embarrassment and discomfort did not.

Conclusions: Among Latino and Asian Americans with mental disorders, LEP contributes to disparities in access to care and longer duration of untreated disorders. Potential disparities in quality of care were difficult to detect in the context of low overall rates of mental healthcare use and quality of care among both LEP and EP individuals.

Other Links

Free PMC article
Full text on Medical care

References
Cited By

References
Disparity in depression treatment among racial and ethnic minority populations in the United States. Margarita Alegría, Pinka Chatterji, +5 authors, Xiao-Li Meng. less Psychiatr Serv, 2008 Oct 31; 59(11). PMID: 18971402 Free PMC article. Highly Cited.
Depression in US Hispanics: diagnostic and management considerations in family practice. Roberto Lewis-Fernández, Amar K Das, +2 authors, César Alfonso, Myrna M Weissman, Mark Olfson. less J Am Board Fam Pract, 2005 Jul 05; 18(4). PMID: 15994474 Review.
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? David P Folsom, Todd Gilmer, +8 authors, Dilip V Jeste. less Am J Psychiatry, 2007 Aug 03; 164(8). PMID: 17671279
Social networks and patterns of use among the poor with mental health problems in Puerto Rico. B A Pescosolido, E R Wright, M Alegría, M Vera. Med Care, 1998 Jul 23; 36(7). PMID: 9674623
Collaborative management to achieve treatment guidelines. Impact on depression in primary care. W Katon, M Von Korff, +5 authors, J Russo. less JAMA, 1995 Apr 05; 273(13). PMID: 7897786 Highly Cited.
Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. K B Wells, C Sherbourne, +6 authors, L V Rubenstein. less JAMA, 2000 Jan 14; 283(2). PMID: 10634337 Highly Cited.
Correlates of past-year mental health service use among Latinos: results from the National Latino and Asian American Study. Margarita Alegría, Norah Mulvaney-Day, +3 authors, Meghan Woo, Maria Torres, Shan Gao, Vanessa Oddo. less Am J Public Health, 2006 Dec 02; 97(1). PMID: 17138911 Free PMC article.
Gaps in service utilization by Mexican Americans with mental health problems. W A Vega, B Kolody, S Aguilar-Gaxiola, R Catalano. Am J Psychiatry, 1999 Jun 09; 156(6). PMID: 10360134
County-level estimates of mental health professional supply in the United States. Alan R Ellis, Thomas R Konrad, Kathleen C Thomas, Joseph P Morrissey. Psychiatr Serv, 2009 Oct 03; 60(10). PMID: 19797370
The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Ronald C Kessler, Patricia Berglund, +7 authors, National Comorbidity Survey Replication. less JAMA, 2003 Jun 19; 289(23). PMID: 12813115 Highly Cited.
Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study. Jennifer Abe-Kim, David T Takeuchi, +6 authors, Margarita Alegría. less Am J Public Health, 2006 Dec 02; 97(1). PMID: 17138905 Free PMC article. Highly Cited.
Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics. C Annette DuBard, Ziya Gizlice. Am J Public Health, 2008 Sep 19; 98(11). PMID: 18799780 Free PMC article. Highly Cited.
Stigma and help seeking for mental health among college students. Daniel Eisenberg, Marilyn F Downs, Ezra Golberstein, Kara Zivin. Med Care Res Rev, 2009 May 21; 66(5). PMID: 19454625 Highly Cited.
Initiation and use of public mental health services by persons with severe mental illness and limited english proficiency. Todd P Gilmer, Victoria D Ojeda, +3 authors, Dilip V Jeste. less Psychiatr Serv, 2007 Dec 01; 58(12). PMID: 18048556
Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). Steven G Heeringa, James Wagner, +3 authors, Patricia Berglund. less Int J Methods Psychiatr Res, 2005 Feb 22; 13(4). PMID: 15719530 Free PMC article. Highly Cited.
Risk for psychiatric disorder among immigrants and their US-born descendants: evidence from the National Comorbidity Survey Replication. Joshua Breslau, Sergio Aguilar-Gaxiola, +3 authors, Ronald C Kessler. less J Nerv Ment Dis, 2007 May 01; 195(3). PMID: 17468677 Free PMC article.
National patterns in antidepressant treatment by psychiatrists and general medical providers: results from the national comorbidity survey replication. Ramin Mojtabai, Mark Olfson. J Clin Psychiatry, 2008 Apr 11; 69(7). PMID: 18399725
Mental health literacy. Public knowledge and beliefs about mental disorders. A F Jorm. Br J Psychiatry, 2000 Nov 04; 177. PMID: 11059991 Highly Cited. Review.
Association between language proficiency and the quality of primary care among a national sample of insured Latinos. Jennifer R Pippins, Margarita Alegría, Jennifer S Haas. Med Care, 2007 Dec 01; 45(11). PMID: 18049341 Free PMC article.
Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Ronald C Kessler, Wai Tat Chiu, +2 authors, Olga Demler, Kathleen R Merikangas, Ellen E Walters. less Arch Gen Psychiatry, 2005 Jun 09; 62(6). PMID: 15939839 Free PMC article. Highly Cited.
Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Philip S Wang, Patricia Berglund, +3 authors, Ronald C Kessler. less Arch Gen Psychiatry, 2005 Jun 09; 62(6). PMID: 15939838 Highly Cited.
Considering context, place and culture: the National Latino and Asian American Study. Margarita Alegria, David Takeuchi, +14 authors, Fong Gong. less Int J Methods Psychiatr Res, 2005 Feb 22; 13(4). PMID: 15719529 Free PMC article. Highly Cited.
The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Ronald C Kessler, T Bedirhan Ustün. Int J Methods Psychiatr Res, 2004 Aug 07; 13(2). PMID: 15297906 Free PMC article. Highly Cited.
Prevalence and treatment of mental disorders, 1990 to 2003. Ronald C Kessler, Olga Demler, +6 authors, Alan M Zaslavsky. less N Engl J Med, 2005 Jun 17; 352(24). PMID: 15958807 Free PMC article. Highly Cited.
Help seeking for mental health care among poor Puerto Ricans: problem recognition, service use, and type of provider. M Vera, M Alegría, +3 authors, D H Freeman, R Robles, B Pescosolido, M Peña. less Med Care, 1998 Jul 23; 36(7). PMID: 9674622
Depression in the planet's largest ethnic group: the Chinese. G Parker, G Gladstone, K T Chee. Am J Psychiatry, 2001 Jun 01; 158(6). PMID: 11384889 Review.
Mental health literacy as a function of remoteness of residence: an Australian national study. Kathleen M Griffiths, Helen Christensen, Anthony F Jorm. BMC Public Health, 2009 Mar 31; 9. PMID: 19327161 Free PMC article.
Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Philip S Wang, Michael Lane, +3 authors, Ronald C Kessler. less Arch Gen Psychiatry, 2005 Jun 09; 62(6). PMID: 15939840 Highly Cited.
Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Philip S Wang, Sergio Aguilar-Gaxiola, +19 authors, J Elisabeth Wells. less Lancet, 2007 Sep 11; 370(9590). PMID: 17826169 Free PMC article. Highly Cited.
Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. H Herrman, D L Patrick, +4 authors, D P Buesching. less Psychol Med, 2002 Aug 13; 32(5). PMID: 12171383
The impact of medical interpreter services on the quality of health care: a systematic review. Glenn Flores. Med Care Res Rev, 2005 May 17; 62(3). PMID: 15894705 Highly Cited. Systematic Review.
Identification of limited English proficient patients in clinical care. Leah S Karliner, Anna M Napoles-Springer, +2 authors, Eliseo J Pérez-Stable. less J Gen Intern Med, 2008 Jul 12; 23(10). PMID: 18618200 Free PMC article.
Access to mental health treatment by English language proficiency and race/ethnicity. Tetine Sentell, Martha Shumway, Lonnie Snowden. J Gen Intern Med, 2007 Nov 28; 22 Suppl 2. PMID: 17957413 Free PMC article.
Delays in initial treatment contact after first onset of a mental disorder. Philip S Wang, Patricia A Berglund, Mark Olfson, Ronald C Kessler. Health Serv Res, 2004 Mar 23; 39(2). PMID: 15032961 Free PMC article.
Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Ramin Mojtabai, Mark Olfson, David Mechanic. Arch Gen Psychiatry, 2002 Jan 12; 59(1). PMID: 11779286 Highly Cited.

Citedby
Mental health service use by persons of Asian ancestry with DSM-IV mental disorders in the United States. Su Yeon Lee, Silvia S Martins, Katherine M Keyes, Hochang B Lee. Psychiatr Serv, 2011 Oct 05; 62(10). PMID: 21969644 Free PMC article.
Are patient characteristics associated with quality of depression care and outcomes in collaborative care programs for depression? Amy M Bauer, Vanessa Azzone, +3 authors, Richard G Frank. less Gen Hosp Psychiatry, 2011 Oct 25; 34(1). PMID: 22018769 Free PMC article.
Prevalence of physical symptoms and their association with race/ethnicity and acculturation in the United States. Amy M Bauer, Chih-Nan Chen, Margarita Alegría. Gen Hosp Psychiatry, 2012 Mar 31; 34(4). PMID: 22460006 Free PMC article.
Associations of physical symptoms with perceived need for and use of mental health services among Latino and Asian Americans. Amy M Bauer, Chih-Nan Chen, Margarita Alegría. Soc Sci Med, 2012 Jun 15; 75(6). PMID: 22694987 Free PMC article.
Telepsychiatry services for Korean immigrants. Jiali Ye, Ruth Shim, +3 authors, George Ruth. less Telemed J E Health, 2012 Dec 14; 18(10). PMID: 23234426 Free PMC article.
Transcultural psychiatry made simple--asynchronous telepsychiatry as an approach to providing culturally relevant care. Peter M Yellowlees, Alberto Odor, +8 authors, Donald Hilty. less Telemed J E Health, 2013 Mar 05; 19(4). PMID: 23451812 Free PMC article.
Collaborative care for the treatment of depression in primary care with a low-income, spanish-speaking population: outcomes from a community-based program evaluation. Katherine Sanchez, Toni Terling Watt. Prim Care Companion CNS Disord, 2012 Jan 01; 14(6). PMID: 23585998 Free PMC article.
Stress, depression and coping among Latino migrant and seasonal farmworkers. Sloane Burke Winkelman, Elizabeth H Chaney, Jeffrey W Bethel. Int J Environ Res Public Health, 2013 May 07; 10(5). PMID: 23644829 Free PMC article.
Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients. Lonnie R Snowden, Sean R McClellan. Am J Public Health, 2013 Jul 20; 103(9). PMID: 23865663 Free PMC article.
The impact of patient-provider communication and language spoken on adequacy of depression treatment for U.S. women. Abiola O Keller, Ronald Gangnon, Whitney P Witt. Health Commun, 2013 Oct 24; 29(7). PMID: 24147987 Free PMC article.
Comorbid mental and physical health and health access in Cambodian refugees in the US. S Megan Berthold, Sengly Kong, +3 authors, Todd Franke. less J Community Health, 2014 Mar 22; 39(6). PMID: 24651944
Factors associated with mental health service use among Latino and Asian Americans. Hyunkag Cho, Isok Kim, Daniel Velez-Ortiz. Community Ment Health J, 2014 Mar 25; 50(8). PMID: 24659219
Race/ethnicity and other social determinants of psychological well-being and functioning in mental health clinics. Trina E Chang, Anthony P Weiss, +7 authors, Albert S Yeung. less J Health Care Poor Underserved, 2014 Aug 19; 25(3). PMID: 25130249 Free PMC article.
Lifetime Prevalence of Mental Disorders among Asian Americans: Nativity, Gender, and Sociodemographic Correlates. Seunghye Hong, Emily Walton, Emi Tamaki, Janice A Sabin. Asian Am J Psychol, 2015 Jan 27; 5(4). PMID: 25621123 Free PMC article.
Emergency department and inpatient health care utilization among patients who require interpreter services. Jane W Njeru, Jennifer L St Sauver, +4 authors, Mark L Wieland. less BMC Health Serv Res, 2015 May 30; 15. PMID: 26022227 Free PMC article.
Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States. Susan Caplan, Steven Buyske. Int J Environ Res Public Health, 2015 Sep 08; 12(9). PMID: 26343691 Free PMC article.
Mental Health Service Use Among Immigrants in the United States: A Systematic Review. Amelia Seraphia Derr. Psychiatr Serv, 2015 Dec 24; 67(3). PMID: 26695493 Free PMC article. Systematic Review.
Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital. April K Wilhelm, Debra J Jacobson, +5 authors, Deborah H Boehm. less J Community Health, 2016 Feb 05; 41(4). PMID: 26841899
The Healthcare Needs of Latinos with Serious Mental Illness and the Potential of Peer Navigators. Patrick W Corrigan, Alessandra Torres, +2 authors, Juana L Lara, Lindsay Sheehan, Jonathon E Larson. less Adm Policy Ment Health, 2016 May 30; 44(4). PMID: 27236458 Free PMC article.
Perceived Discrimination in Health Care and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites. Vickie M Mays, Audrey L Jones, +2 authors, Susan D Cochran. less Med Care, 2016 Oct 19; 55(2). PMID: 27753743 Free PMC article.
Diabetes Outcome and Process Measures Among Patients Who Require Language Interpreter Services in Minnesota Primary Care Practices. Jane W Njeru, Deborah H Boehm, +4 authors, Mark L Wieland. less J Community Health, 2017 Feb 24; 42(4). PMID: 28229264
Racial/ethnic differences in perception of need for mental health treatment in a US national sample. Joshua Breslau, Matthew Cefalu, +4 authors, Rebecca L Collins. less Soc Psychiatry Psychiatr Epidemiol, 2017 May 28; 52(8). PMID: 28550518 Free PMC article.
Usual Course of Treatment and Predictors of Treatment Utilization for Patients With Posttraumatic Stress Disorder. Carrie J Nobles, Sarah E Valentine, +3 authors, Luana Marques. less J Clin Psychiatry, 2017 Jun 02; 78(5). PMID: 28570794 Free PMC article.
Measurement, Education and Tracking in Integrated Care (METRIC): use of a culturally adapted education tool versus standard education to increase engagement in depression treatment among Hispanic patients: study protocol for a randomized control trial. Katherine Sanchez, Brittany H Eghaneyan, +2 authors, Michael O Killian, Leopoldo Cabassa, Madhukar H Trivedi. less Trials, 2017 Aug 05; 18(1). PMID: 28774339 Free PMC article.
Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges. Eunice C Wong, Rebecca L Collins, +2 authors, Jennifer Cerully, Rachana Seelam, Beth Roth. less Rand Health Q, 2017 Aug 29; 6(2). PMID: 28845344 Free PMC article.
Qualitative Evaluation of a Peer Navigator Program for Latinos with Serious Mental Illness. Lindsay Sheehan, Alessandra Torres, +6 authors, Patrick W Corrigan. less Adm Policy Ment Health, 2017 Nov 24; 45(3). PMID: 29168016 Free PMC article.
Collaborative Care for Depression among Patients with Limited English Proficiency: a Systematic Review. Maria E Garcia, Lisa Ochoa-Frongia, +2 authors, Nathalie Moise, Adrian Aguilera, Alicia Fernandez. less J Gen Intern Med, 2017 Dec 20; 33(3). PMID: 29256085 Free PMC article. Systematic Review.
Diabetes Mellitus Management Among Patients with Limited English Proficiency: A Systematic Review and Meta-Analysis. Jane W Njeru, Mark L Wieland, +5 authors, M Hassan Murad. less J Gen Intern Med, 2017 Dec 20; 33(4). PMID: 29256089 Free PMC article. Systematic Review.
Limited English Proficiency and Trajectories of Depressive Symptoms Among Mexican American Older Adults. Giyeon Kim, Minjung Kim, +2 authors, Soohyun Park, Daniel E Jimenez, David A Chiriboga. less Gerontologist, 2018 Apr 25; 59(5). PMID: 29688320 Free PMC article.
Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. Veronica Lopez, Katherine Sanchez, Michael O Killian, Brittany H Eghaneyan. BMC Public Health, 2018 May 24; 18(1). PMID: 29788998 Free PMC article.
Prioritizing the healthcare needs of Latinos with mental illness. Patrick W Corrigan, Alessandra Torres, +3 authors, Latino Health Disparities Consumer Research Team. less Int J Cult Ment Health, 2017 Jan 01; 10(1). PMID: 30505348 Free PMC article.
Diversity and Inclusion in Psychiatry: The Pursuit of Health Equity. Francisco A Moreno, Jasleen Chhatwal. Focus (Am Psychiatr Publ), 2020 Feb 13; 18(1). PMID: 32047391 Free PMC article. Review.
Pilot randomized controlled trial of a Spanish-language Behavioral Activation mobile app (¡Aptívate!) for the treatment of depressive symptoms among united states Latinx adults with limited English proficiency. Jennifer Dahne, Anahi Collado, +6 authors, Matthew J Carpenter. less J Affect Disord, 2019 Mar 15; 250. PMID: 30870770 Free PMC article.
Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack. Winnie W Kung, Xiaoran Wang, +2 authors, Xinhua Liu, Emily Goldmann, Debbie Huang. less Int J Environ Res Public Health, 2019 Apr 14; 16(7). PMID: 30979006 Free PMC article.
Unmet Mental Health Need Among Chinese and Latino Primary Care Patients: Intersection of Ethnicity, Gender, and English Proficiency. Maria E Garcia, Ladson Hinton, +3 authors, Leah Karliner. less J Gen Intern Med, 2019 Nov 02; 35(4). PMID: 31667737 Free PMC article.
A Framework for Translating an Evidence-Based Intervention from English to Spanish. Ané M Maríñez-Lora, Maya Boustani, Cristina T Del Busto, Christine Leone. Hisp J Behav Sci, 2016 Feb 01; 38(1). PMID: 32694881 Free PMC article.
Perceived Need for Mental Health Care: The Intersection of Race, Ethnicity, Gender, and Socioeconomic Status. Alice P Villatoro, Vickie M Mays, Ninez A Ponce, Carol S Aneshensel. Soc Ment Health, 2018 Mar 01; 8(1). PMID: 31413888 Free PMC article.
Correlates of Mental Health Treatment Receipt Among Asian Americans with Perceived Mental Health Problems. Minsun Lee, Aisha Bhimla, Wenyue Lu, Grace X Ma. J Behav Health Serv Res, 2020 Apr 30; 48(2). PMID: 32347427 Free PMC article.
Associations of Sociodemographic Factors With Health-Related Social Networks Among Premigration Filipinos. Dale Maglalang, A Butch de Castro, +3 authors, David T Takeuchi. less Soc Work Public Health, 2020 Oct 06; 35(8). PMID: 33016242 Free PMC article.
Technology Enabled Clinical Care (TECC): Protocol for a Prospective Longitudinal Cohort Study of Smartphone-Augmented Mental Health Treatment. Natali Rauseo-Ricupero, John Torous. JMIR Res Protoc, 2020 Dec 10; 10(1). PMID: 33296869 Free PMC article.
Primary Care Physician Recognition and Documentation of Depressive Symptoms Among Chinese and Latinx Patients During Routine Visits: A Cross-Sectional Study. Maria E Garcia, Ladson Hinton, +4 authors, Leah Karliner. less Health Equity, 2021 May 04; 5(1). PMID: 33937610 Free PMC article.
Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement. Ana-Marija Tomasi, Shameran Slewa-Younan, Renu Narchal, Pilar Rioseco. Int J Environ Res Public Health, 2022 Feb 16; 19(3). PMID: 35162916 Free PMC article.
Limited English Proficiency and Screening for Cervical, Breast, and Colorectal Cancers among Asian American Adults. Zhigang Xie, Guanming Chen, +3 authors, Ryan Suk, Brittney Dixon, Ara Jo, Young-Rock Hong. less J Racial Ethn Health Disparities, 2022 Mar 18;. PMID: 35297497
Effectiveness of Mental Health Literacy and Stigma Interventions for Latino/a Adults in the United States: A Systematic Review. Nancy Jacquelyn Pérez-Flores, Leopoldo J Cabassa. Stigma Health, 2022 Apr 05; 6(4). PMID: 35368243 Free PMC article.
Predictors of Mental Health Help-Seeking During COVID-19: Social Support, Emotion Regulation, and Mental Health Symptoms. Rachel R Tambling, Beth S Russell, Michael Fendrich, Crystal L Park. J Behav Health Serv Res, 2022 Apr 16;. PMID: 35426011 Free PMC article.

BioKDE: Biomedical Knowledge Discovery Engine

Abstract

Other Links