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Research on mental health outcomes among racial-ethnic, sexual, and gender minority young people indicates that they may be at increased risk for service use disparities when these identity statuses intersect. However, evidence of how having multiple minority identities is related to using mental health services is lacking. This dissertation used a mixed-methods, convergent design to explore and describe relationships between intersecting minority identities and mental health service use in the experiences of 31 Black and Hispanic, sexual and gender minority young adults. Consistent with an intersectional perspective, findings indicated that mental health service use was more strongly associated with minority identities collectively than with any single minority identity, and that experiences of intersecting minority identities could facilitate, as well as hinder, mental health service use among participants. A theoretical model was revealed in which participants negotiated multiple minority identities within four dimensions related to their service use: ethnic-racial culture, intersecting identities, family, and personal identities. Results suggested provider strategies that support intersecting minority identity strengths around culture, community belonging, and self-efficacy may encourage service use and engagement with treatment.

Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 346-364) and index.

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The need to arm targets, allies, and bystanders in the face of increased discrimination and political unrest is imperative to the well-being and mental health of minorities in the United States. Most recently, Sue and colleagues (2019) introduced “microinterventions” a taxonomy of anti-discrimination strategies that aim to disarm or counteract the experience of a microaggression and enhance overall psychological well-being (Sue, 2019). Utilizers of mental health services may seek treatment due to symptoms of depression, anxiety and/or PTSD related to repeated instances of microaggressions (Sue et al.,2007). The field of psychology must respond by sharing resources and providing identity affirming counseling to help clients process feelings of negative sense of self, helplessness, and internalized attitudes (Anderson & Stevenson, 2019; Miller et al., 2018). There is a significant gap in the psychological literature with regard to the effectiveness, benefits and associated outcomes of individual-level strategies and tactics to disarm and disrupt instances of microaggressions (Brondolo, Pencille, Beatty, Contrafa, 2009). The purpose of this study was to contribute to the multicultural and social advocacy literature by training individuals on microintervention tactics and utilizing qualitative methodology to evaluate participants experiences and outcomes. A pre and post design with short answer responses and a one month follow up was conducted using consensual qualitative research data analysis methods (CQR-M). The results of the study are discussed in terms of their applicability to multicultural workshops and trainings, clinical practice and future areas of microintervention and response strategy research.

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Multiracial people are the fastest growing population in the United States; yet despite their growing population size, they often experience prejudice, stigma, and discrimination (Pew Research Center, 2015). Research suggests that racist discrimination—both in its overt and covert forms—is associated with mental health concerns for multiracial people (e.g., Sue & Spanierman, 2020; Townsend et al., 2009; Tran et al., 2016). Currently, very few studies have assessed proximal stressors, or those related to subjective perceptions and appraisals, with samples of multiracial people. Research with other racial minority groups suggests that expectations of rejection and internalized racism are significant stressors for these populations (Chan & Mendoza‐Denton, 2008; Henson et al., 2013). While several measures currently exist that examine the race-based stressors multiracial people encounter, none of the scales adequately address proximal stressors (Franco & O’Brien, 2018; Salahuddin & O’Brien, 2011; Yoo et al., 2016). The purpose of the present study is to address the limitations of previous measures and develop a measurement of race-related proximal minority stressors for multiracial people. Based on a review of multiracial minority stressors (i.e., expectations of rejection, internalized monoracism, and concealment of multiracial identity) and psychological distress and well-being, a measure of minoritized multiracial stress was developed (the Minoritized Multiracial Stress Scale; MMSS). The proposed MMSS was evaluated by eight expert reviewers and a pilot study of 13 multiracial people. Items were modified based on their feedback and the scale was subsequently administered to a sample of 569 self-identified multiracial people. Exploratory and confirmatory factor analyses were conducted to determine and confirm factor structure. A four-factor structure model consisting of internalized monoracism, concealment and concealment motivation, expectations of rejection, and what appeared to be a pride construct, emerged from the exploratory factor analysis. The pride factor was not supported in the confirmatory factor analysis. The final model confirmed in the confirmatory factor analysis sample and supported in the full sample was composed of three factors: internalized monoracism, concealment and concealment motivation, and expectations of rejection. Convergent, concurrent, and discriminant validity were established. The present research proposes a valid and reliable measurement of proximal stressors for multiracial people. Implications of the MMSS, its limitations, and future directions for clinical and research work are discussed.

Multiracial people are the fastest growing population in the United States; yet despite their growing population size, they often experience prejudice, stigma, and discrimination (Pew Research Center, 2015). Research suggests that racist discrimination—both in its overt and covert forms—is associated with mental health concerns for multiracial people (e.g., Sue & Spanierman, 2020; Townsend et al., 2009; Tran et al., 2016). Currently, very few studies have assessed proximal stressors, or those related to subjective perceptions and appraisals, with samples of multiracial people. Research with other racial minority groups suggests that expectations of rejection and internalized racism are significant stressors for these populations (Chan & Mendoza‐Denton, 2008; Henson et al., 2013). While several measures currently exist that examine the race-based stressors multiracial people encounter, none of the scales adequately address proximal stressors (Franco & O’Brien, 2018; Salahuddin & O’Brien, 2011; Yoo et al., 2016). The purpose of the present study is to address the limitations of previous measures and develop a measurement of race-related proximal minority stressors for multiracial people. Based on a review of multiracial minority stressors (i.e., expectations of rejection, internalized monoracism, and concealment of multiracial identity) and psychological distress and well-being, a measure of minoritized multiracial stress was developed (the Minoritized Multiracial Stress Scale; MMSS). The proposed MMSS was evaluated by eight expert reviewers and a pilot study of 13 multiracial people. Items were modified based on their feedback and the scale was subsequently administered to a sample of 569 self-identified multiracial people. Exploratory and confirmatory factor analyses were conducted to determine and confirm factor structure. A four-factor structure model consisting of internalized monoracism, concealment and concealment motivation, expectations of rejection, and what appeared to be a pride construct, emerged from the exploratory factor analysis. The pride factor was not supported in the confirmatory factor analysis. The final model confirmed in the confirmatory factor analysis sample and supported in the full sample was composed of three factors: internalized monoracism, concealment and concealment motivation, and expectations of rejection. Convergent, concurrent, and discriminant validity were established. The present research proposes a valid and reliable measurement of proximal stressors for multiracial people. Implications of the MMSS, its limitations, and future directions for clinical and research work are discussed.