Culture and community: Latinos and mental health service use

Although the prevalence of mental illness in Latinos is similar to that of other groups, Latinos are less likely than non-Latino whites to access mental health services, and when they do, the quality of care is poor. The Behavioral Health Department in San Bernardino County, California (the largest county in the US) convened a community-based coalition to evaluate barriers to mental health services for three ethnic minorities. This presentation reports on the methods and findings specific to Latinos, who although represent 47 percent of the county's population only accounted for 28 percent of mental health service users.

Using a mixed-method design and based on principles of community-based participatory research, the team conducted six focus groups (n= 80) and administered 150 surveys to voluntary first-time users of mental health services as well as to non-users, to examine attitudes, practices, beliefs and experiences, regarding mental health among Latinos.

Focus group dialogue was analyzed using grounded theory for recurrent themes. This presentation reports on unique barriers to mental health services for Latinos, including language barriers, lack of cultural competent care (patient-provider cultural dissonance), costs and lack of insurance, fear of deportation, and the ‘no estoy loco' (I'm not crazy) attitude. Additionally, the presentation reports on the logistic regression analysis of the interaction between cultural beliefs about mental health, acculturation, social capital, and family social support, and their effects on use of mental health services. Recommendations to increase access and use of services will be presented based on a socio-ecological framework.