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.
Nadeem
Erum
E
Health Services Research Center and the Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, USA.
Lange
Jane M
JM
Edge
Dawn
D
Fongwa
Marie
M
Belin
Tom
T
Miranda
Jeanne
J
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