Does stigma keep poor young immigrant and U.S.-born Black and Latina women from seeking mental health care?
OBJECTIVE
This study examined the extent to which stigma-related concerns about mental health care account for the underuse of mental health services among low-income immigrant and U.S.-born black and Latina women.


METHODS
Participants included 15,383 low-income women screened for depression in county entitlement services who were asked about barriers to care, stigma-related concerns, and whether they wanted or were getting mental health care.


RESULTS
Among those who were depressed, compared with U.S.-born white women, each of the black groups were more likely to report stigma concerns (African immigrants, odds ratio [OR]=3.28, p=.004; Caribbean immigrants, OR=6.17, p=.005; U.S.-born blacks, OR=6.17, p=.06). Compared with U.S.-born white women, immigrant African women (OR=.18, p<.001), immigrant Caribbean women (OR=.11, p=.001), U.S.-born black women (OR=.31, p<.001), and U.S.-born Latinas (OR=.32, p=.03) were less likely to want treatment. Conversely, compared with U.S.-born white women, immigrant Latinas (OR=2.17, p=.02) were more likely to want treatment. There was a significant stigma-by-immigrant interaction predicting interest in treatment (p<.001). Stigma reduced the desire for mental health treatment for immigrant women with depression (OR=.35, p<.001) to a greater extent than it did for U.S.-born white women with depression (OR=.52, p=.24).


CONCLUSIONS
Stigma-related concerns are most common among immigrant women and may partly account for underutilization of mental health care services by disadvantaged women from ethnic minority groups.
Health Services Research Center and the Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, USA.
Erum
E
Nadeem
Jane M
JM
Lange
Dawn
D
Edge
Marie
M
Fongwa
Tom
T
Belin
Jeanne
J
Miranda
D000328:Adult; D001741:Black or African American; D002140:California; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D001523:Mental Disorders / Q000208:ethnology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D011203:Poverty; D013240:Stereotyping