Access to mental health treatment by English language proficiency and race/ethnicity.
BACKGROUND
Limited English proficiency (LEP) may contribute to mental health care disparities, yet empirical data are limited.


OBJECTIVE
To quantify the language barriers to mental health care by race/ethnicity using a direct measure of LEP is the objective of the study.


METHODS
Cross-sectional analysis of the 2001 California Health Interview Survey is the study's design.


METHODS
Adults aged 18 to 64 who provided language data (n = 41,984) were the participants of the study.


METHODS
Participants were categorized into three groups by self-reported English proficiency and language spoken at home: (1) English-speaking only, (2) Bilingual, and (3) Non-English speaking. Mental health treatment was measured by self-reported use of mental health services by those reporting a mental health need.


RESULTS
Non-English speaking individuals had lower odds of receiving needed services (OR: 0.28; 95% CI: 0.17-0.48) than those who only spoke English, when other factors were controlled. The relationship was even more dramatic within racial/ethnic groups: non-English speaking Asian/PIs (OR = 0.15; 95% CI: 0.30-0.81) and non-English speaking Latinos (OR: 0.19; 95% CI: 0.09-0.39) had significantly lower odds of receiving services compared to Asian/PIs and Latinos who spoke only English.


CONCLUSIONS
LEP is associated with lower use of mental health care. Since LEP is concentrated among Asian/PIs and Latinos, it appears to contribute to racial/ethnic disparities in mental health care. Heightened attention to LEP is warranted in both mental health practice and policy.
Sentell
Tetine
T
Department of Psychiatry, University of California, San Francisco, 2727 Mariposa Street, Suite 100, San Francisco, CA 94110, USA. tetines@yahoo.com
Shumway
Martha
M
Snowden
Lonnie
L
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D002140:California; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007802:Language; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D020380:Needs Assessment; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data