ABSTRACT In the United States, Hispanics have the same prevalence of mental illness as any other group however researchers have found that they are less likely to seek mental health services. This population’s lack of mental health utilization is due to various barriers hindering the population’s need for help, a substantial for social work practitioners. To better understand the factors that lead up to that, the current study explored and identified perceptions toward seeking and receiving mental health services among Hispanic members. Using a qualitative data collection, ten participants were interviewed to elicit their perceptions about mental health services ranging from what they believed addressed their lack of seeking services and what they thought about services. Data analysis revealed five core themes among the participants’ responses: Closeness to Family as a reason for people not seeking professional help. Another theme found was environment as a reason for Mental Illness making them feel that there is no need to seek services since they can simply remove the environmental stressor and the illness will seize to exist. Existing support systems were found such as involvement in church as a form of therapy, they talked about their faith providing them a form of support for stressors. Shared culture was a theme that was found to be a necessity for therapy, they felt they did not seek services because they felt mental health practitioners would not validate their culture. The final theme was access and that theme encompassed : not knowing mental health services existed in their community, to lack of Spanish speaking clinicians. The recognition of these themes could potentially guide social work practitioners’ when they are trying to engage the Hispanic community to receive mental health services. Social workers can be aware of the obstacles toward engaging this population into professional therapy, by having an understanding of what they believe about therapy and helping to alleviate or use some of those perceptions as a form of engagement and validating existing strengths that the population has causing them to feel professional services are not needed.

This study sought to understand why college students of Mexican origin underutilize mental health services (i.e., university counseling services). Previous research has identified several potential reasons for the underutilization of mental health services by Mexican Americans. These reasons can be grouped into one of three categories: (1) negative attitudes toward mental illness and mental health services, (2) greater use of alternative, informal resources, and (3) barriers. To examine these factors in the context of help-seeking behavior, Ajzen’s theory of planned behavior (TPB) was used. The TPB assumes that the best predictor of a certain behavior is an individual’s intention to perform that specific behavior. This model includes three determinants of the intent to perform a certain behavior: (1) attitudes toward the behavior, (2) subjective normative beliefs about performing the behavior, and (3) perceived behavioral control of performing the behavior. The primary aim of this study was to examine the meditating effects of culture on the TPB and investigate the unique factors contributing to help-seeking behavior in college students of Mexican origin reporting anxious and/or depressive symptoms. Results showed that the TPB was effective in predicting help-seeking behavior, with attitudes and subjective normative beliefs as the strongest predictors. Acculturation and cultural values did not mediate the TPB model as originally predicted, however the TPB determinants differed in predictability between help-seekers and non help-seekers. Specifically, among help-seekers, attitudes predicted intent to seek psychological services; among non help-seekers, subjective normative beliefs predicted intent. Help-seekers also reported more ease than non help-seekers on a few of the steps toward help-seeking. Lastly, qualitative measures supported findings based on the TPB and provided additional support for the strong stigmatizing views among college students of Mexican origin. These findings suggest that non help-seekers are a complex group and other variables, such as acculturative stress, perceived social support, and screening participants on perceived symptom distress and impairment, need to be addressed. In addition, subjective normative beliefs need to be considered in the development of psychoeducational interventions which encourage seeking psychological services for individuals of Mexican origin experiencing significant anxious or depressive symptoms. / text

Disruptive behavior disorders consist of oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder. These disorders account for about 40 percent of child referrals to mental health services. This study aims to evaluate how socioeconomic status, ethnicity, prior help-seeking behaviors, and gender relate to the attitudes that participants with symptoms of disruptive behavior disorders have toward mental health service. The study found that females have a more positive attitude regarding mental health service than males. Minorities with lower disruptive behavior have more positive attitudes about mental health than Caucasians with lower and higher disruptive behavior as well as minorities with high disruptive behavior, with this group viewing mental health most negatively. Results indicated that individuals who received mental health services view them more positively than individuals who have not received mental health services, and individuals with lower SES may be exposed to receiving more services compared to individuals with higher SES.

INTRODUCTION: To address a lack of population-level studies that examine the association between ambulatory care utilization and cardiovascular outcomes among Asian Americans, this study examined 1) ambulatory care utilization among different racial/ethnic groups and 2) the association between ambulatory care utilization and cardiovascular outcomes. METHOD: This was a retrospective analysis of 2009–2012 Medicare fee-for-service data. Primary outcomes were 1) hospitalization for angina, an ambulatory care sensitive condition, and 2) inpatient AMI mortality. Intermediate outcomes of interest were ambulatory care utilization. First, a descriptive analysis of patients’ predisposing and enabling factors was performed, and then bivariate association between these predisposing and enabling factors and ambulatory care utilization was examined. Lastly, using multivariate logistic regression models I estimated the association between ambulatory care utilization and cardiovascular outcomes, adjusting for socio-demographic and geographical characteristics. RESULTS: There were 999,999 people in the analytic sample, drawn from 21.6 million Medicare fee-for-service enrollees. In 2009, there were significant differences in racial/ethnic ambulatory care utilization. Significantly lower percentage of Asians had frequent ambulatory care visits (>30 visits) and outpatient cardiology clinic visits (>30 visits) (both p-values<0.01), after adjusting for predisposing and enabling factors. Asians had the highest observed inpatient mortality (15.9%) and low ambulatory utilization was associated with increased odds (OR=1.85 [1.11–3.08]) of inpatient AMI mortality. CONCLUSION: Among Medicare fee-for-service enrollees, Asians had fewer ambulatory clinic visits. Low ambulatory care utilization was associated with increased odds of AMI mortality. Further research is needed to understand the causal relationship between ambulatory care utilization and cardiovascular outcomes. / 2018-11-08T00:00:00Z

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Background Migrants in many European countries including Germany tend to utilize preventive measures less frequently than the majority population. Little is known about the dental health of migrants as well as about their oral health behaviour, particularly in the adult population. The aim of this study was to examine differences in the uptake of annual dental check-ups in adult migrants and non-migrants in Germany. Methods We used data from the cross-sectional survey ‘German Health Update 2010’ conducted by the Robert Koch Institute (n = 22,050). Data from 21,741 German-speaking respondents with information on the use of dental check-ups was available, of which 3404 (15.7%) were migrants. Multiple logistic regression models were applied to adjust for demographic and socioeconomic confounders, including the place of residence as well as type of health insurance. Results Migrants were generally younger, had a lower socioeconomic status and showed a lower utilization of dental check-ups. The unadjusted odds ratio (OR) for utilization was 0.67 (95%-CI = 0.61–0.73). After adjusting for demographic and socioeconomic confounders the chance only increased slightly (adjusted OR = 0.71; 95%-CI = 0.65–0.77). Conclusions The analysis shows that migration status is associated with a reduced chance of attending dental check-ups, independently of demographic and socioeconomic factors. The influence of other factors, such as type of health insurance and place of residence had also no influence on the association. Migrants are exposed to different barriers in the health care system, comprising the patient, provider and system level. Further studies need to examine the relevant barriers for the uptake of preventive dental services in order to devise appropriate migrant- sensitive measures of dental prevention.