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The literature has documented the contention that economic, cultural, and structural barriers have led to lower utilization of mental health services by Latinos when compared to other ethnic groups. With the growth of older Hispanics, the number of people affected by the barriers to health care will grow. Despite barriers, a small number of older Latinos access mental health services. A gap exists in the literature to explain how some older Latinos access mental health treatment. Using qualitative exploration, this dissertation answers the central question what factors influence help-seeking behavior and mental health service utilization of older Mexican Americans. The researcher used a purposive sample and interviewed 20 older Mexican Americans, who completed outpatient mental health services located in Texas. Green’s (1999) Adapted help-seeking behavior model guided the ethnographic content analysis. Respondents experienced a multiplicity of stressors and behavioral signs of mental distress. Among labels used for the problem were depression or depresion, anxiety, nervios or ansiosa, also soledad, tristeza and coraje. The meaning of the language respondents used was important; often times had multiple meanings. Factors that influenced respondents’ help-seeking behavior and mental health service use included family with the daughter being most instrumental. Community factors doctors, nurses, social workers, support groups, and housing authority. An overarching theme was the significant relationships with the interaction of these factors. The relationships were characterized as close, family like. The physician was central to the respondents. Agency staff and the group members helped with utilizing services, resolving their problem, and continuing treatment. Other themes included challenges such as lack of education of mental illness and mental health services, language preference, costs of medication, and stigma of mental illness. Recommendations include expanding the workforce of bilingual/bicultural providers and Spanish-speaking providers; community education of mental illness and reduce the cultural distance between older Hispanics and health care providers. Future research should focus on exploring the relationship with the primary care physician, and the language that research and treatment programs use, attitudinal barriers to the treatment of depression among ethnic minorities, effective culturally competent interventions and improving treatment adherence with older Latinos. / text

The intent of this study was to examine the perceived resources and obstacles which were related to the utilization of mental health services by chronically mentally ill Mexican American clients. Specifically, the study identified resources and obstacles encountered by six chronically mentally ill clients and six family members as they accessed various mental health services. The study was conducted in the fall of 1985 from clients currently receiving services from La Frontera Center, Inc., Tucson, Arizona. Data were interpreted through content analysis to conceptualize and categorize client and family member responses. Chronically mentally ill clients relied heavily on individuals such as friends, therapist and priest as resources for mental health service support. In contrast, family members focused primarily on institutions for resource support. Financial resources, institutional policies, denial, and the lack of personal direction were listed as obstacles to seeking mental health services by clients and family members. Study results suggested that the perceptions of traditional and nontraditional obstacles and resources by Mexican American clients and family members continue to strongly influence utilization of mental health services In particular, the issue of "stigma" and the personal qualities and abilities of the therapist emerged as significant descriptors in client and family member self statements.

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The problem with which this investigation was concerned was that of determining the relationship between the variables of acculturation, imagery, self-concept, anxiety, stress, and seriousness of disease in Mexican-Americans. The purposes of this study were 1) to determine the statistical predictive efficiency of stress and its relation to disease, 2) to determine if a combination of anxiety, acculturation, self-concept, imagery, along with stress, would increase the statistical predictive efficiency concerning seriousness of disease, and 3) to provide information that may help to develope a theoretical base concerning the above variables and disease in Mexican-Americans.

This study seeks to examine the influence of key cultural values like machismo, familism, traditionalism, and religiosity on self-efficacy in reducing HIV risk among Mexican-origin IDUs. The purpose of this examination hinges on the importance of including cultural concepts/values not only to facilitate process, but also to add a cultural dimension to an HIV/AIDS intervention that may facilitate attitudinal and behavioral change as well. The findings suggest that culturally innovative approaches can facilitate HIV/AIDS risk reduction among male Mexican-origin drug injectors. The importance of key cultural values like machismo is underscored by its association with HIV risk reduction for both sexual and injection related risks. Intervention programs must identify strategies to incorporate cultural values in their research and evaluation of intervention efficacy. Culturally innovative approaches hold the promise of substantially reducing HIV risk behaviors among Hispanic drug injectors, and may hold promise for other populations affected by HIV/AIDS as well.

Mexican Americans face a significant health disparity related to the development of Mild Cognitive Impairment (MCI) when compared to other ethnic groups. Recent work has documented the utility of utilizing blood-based biomarkers in the detection of amnestic MCI among this population. Efforts to enhance the utility of biomarkers in detecting disease through the inclusion of select neuropsychological measures, an approach termed Molecular Neuropsychology, has shown promise. The present study sought to utilize the molecular neuropsychology approach and examine biobanked serum samples as well as neuropsychological assessments from the Health and Aging Brain among Latino Elders (HABLE) study. Random Forest analyses were conducted to determine the proteomic profile of MCI. Then separate linear regression analyses were conducted to determine the variance accounted for by the biomarkers within the select neuropsychological measures. Trail Making Test Part B was identified as having the least amount of variance and was combined with top five biomarkers within the MCI proteomic profile to create a biomarker-cognitive profile for detecting disease presence. This same method was applied to the amnestic and non-amnestic forms of MCI. The overall biomarker-cognitive profile was shown to be 90% accurate in the detection of MCI, with no significant increase when demographic variables were included into the model. Among amnestic MCI cases, the detection accuracy of the biomarker-cognitive profile was 92% and increased to 94% upon inclusion of demographic variables.

The present study proposed to investigate the effects of level of acculturation and of language of the therapy interview on self-disclosure by Mexican-American women. It was predicted that self-disclosure would be affected by both level of acculturation and by the language of the initial therapy interview. The principal implication of this finding is that for the first-generation Mexican-American woman, that is, a woman who has not acculturated to the mainstream society, the language in which therapy is conducted constitutes a significant factor in predicting whether she is likely to self disclose and thereby benefit from the therapy. The findings of this study suggest that less acculturated Mexican-American women would be more likely to utilize mental health services if they are available in Spanish.