Methods: We did an inductive content analysis of a single question from a cross-sectional survey on mental health services use and barriers of Latinx adults, March-May 2023, collected using a modified random walk approach with a two-cluster sampling frame. Participants were asked: “If you could make one change to improve mental health service use, what is the one recommendation you would make?” Two bilingual research assistants coded responses. Inter-rater reliability was calculated using Cohen’s kappa. We used 95% CIs and considered a p-value < 0.05 as significant.

Results: Of 1004 participants, 90 had no recommendation, and 26 responses were incomplete. The remaining 888 recommendations were analyzed. Cohen’s kappa after 400 responses was 0.69 and at the study’s completion was 0.77, indicating substantial agreement. The top 5 most common recommendations included: improving the quality of mental health service delivery (13.5%), increasing the accessibility of mental health services (12.7%), informing and educating the community (10.8%), developing new/expanding existing mental health resources (10.1%), and increasing community outreach efforts (9.2%). On average, participants shared 1-2 recommendations for improving mental health services in their community. Foreign-born respondents were more likely to suggest an increase in language services (OR=4.4, 95% CI: 2.5-8.6) and additional information and education (OR=1.8, 95% CI: 1.1-2.4). However, they were less likely to propose an increase in mental health service accessibility (OR=0.5, 95% CI: 0.4-0.7) or a reduction in mental health service costs (OR=0.5, 95% CI: 0.3-0.7).

Conclusion: These findings highlight potential areas of focus for mental health help-seeking within the Latinx community. Specifically, foreign-born Latinx adults suggest that additional information and language resources to their community would enhance their ability to utilize mental health services effectively.