Exploring positive deviance approach for promoting utilization of professional mental health services among Asian and Latino middle and older aged immigrant women

Background: The “Positive Deviance” approach is based on the premise that some individuals, families and communities can overcome constraints and reach positive health outcomes than their peers facing similar constraints. This study aims to apply the “positive deviance” concept to exploring key factors that enable immigrant women with mental disorders to utilize professional mental health services successfully (positive deviants) compared with non-positive deviants who also had mental disorders but failed seeking professional mental health services. Method: 162 Asian and Latino immigrant women with any diagnosed mental disorder (lifetime anxiety disorder, mood disorder, suicide ideation, or substance use) aged 50 and above from National Latino and Asian American Survey (NLAAS) were examined. Four categories of key factors including individual-related, Immigration history-related, neighborhood-related and psychosocial-related factors were examined. Descriptive, bivariate and multivariate analyses were conducted. Result: After controlling for demographic variables and the seriousness of mental disorders, the positive deviants have significantly better English ability (aOR=2.7, 95%CI: 1.67-4.35), more friend support (aOR=1.6, 95%CI: 1.04 -2.53) and more frequent to talk to others about their emotions problems (aOR=11.7, 95%CI: 1.59-85.25) than non-positive deviants. The health insurance plans among positive deviants are 0.16 times less likely to require referral to specialist compared with non-positive deviants. Conclusion: The positive deviance framework and key identified factors (English proficiency, friend support, communication attitudes, requirement of health insurance plan for seeking professional mental health services) should be addressed in the following community-based intervention program to improve the utilization of professional mental health services among old immigrant women.