A longitudinal study of the use of mental health services by persons with serious mental illness: do Spanish-speaking Latinos differ from English-speaking Latinos and Caucasians?
OBJECTIVE
Reports of mental health care use by Latinos compared to Caucasians have been mixed. To the authors' knowledge, no large-scale studies have examined the effects of language on mental health service use for Latinos who prefer Spanish compared to Latinos who prefer English and to Caucasians. Language is the most frequently used proxy measure of acculturation. The authors used the administrative database of a mental health system to conduct a longitudinal examination of mental health service use among Spanish-speaking versus English-speaking Latinos and Caucasians with serious mental illness.


METHODS
There were 539 Spanish-speaking Latinos, 1,144 English-speaking Latinos, and 4,638 Caucasians initiating treatment for schizophrenia, bipolar disorder, or major depression during 2001-2004. Using multivariate regressions, the authors examined the differences among the groups in the type of service first used. The authors also examined the probability of use of each of four types of mental health services and the intensity of outpatient treatment.


RESULTS
Spanish-speaking Latinos differed from both English-speaking Latinos and Caucasians on most measures. Compared to patients in the other groups, the Spanish-speaking Latinos were less likely to enter care through emergency or jail services and more likely to enter care through outpatient services. There were no group differences in the proportion that stayed in treatment or used inpatient hospitalization.


CONCLUSIONS
This study suggests that for Latinos, preferred language may be more important than ethnicity in mental health service use. Future studies comparing mental health use may need to differentiate between Spanish- and English-speaking Latinos.
Department of Psychiatry, University of California, San Diego, San Diego, CA 92161, USA. dfolsom@ucsd.edu
David P
DP
Folsom
Todd
T
Gilmer
Concepcion
C
Barrio
David J
DJ
Moore
Jesus
J
Bucardo
Laurie A
LA
Lindamer
Piedad
P
Garcia
William
W
Hawthorne
Richard
R
Hough
Thomas
T
Patterson
Dilip V
DV
Jeste
D000069:Acculturation; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology / Q000208:ethnology; D015897:Comorbidity; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011330:Prisons / Q000458:organization & administration / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012720:Severity of Illness Index; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*