English language proficiency and mental health service use among Latino and Asian Americans with mental disorders.
OBJECTIVE
The impact of language proficiency as a potential contributor to ethnic disparities in mental health care has received less attention than other factors. Data from the National Latino and Asian American Study were examined to assess the impact of limited English proficiency (LEP) on access to and quality of mental health care for community-dwelling Latino and Asian Americans with mental disorders.


METHODS
English-proficient (EP) and LEP individuals with mental disorders were compared on lifetime use of healthcare services for a mental disorder, duration of untreated disorders, receipt of minimally adequate care, and barriers to treatment (eg, lack of identification of need for treatment, language barriers, and embarrassment or discomfort related to treatment).


RESULTS
Compared with EP individuals, LEP individuals with mental disorders were significantly less likely to identify a need for mental health services, experience longer duration of untreated disorders, and use fewer healthcare services for mental disorders, particularly specialty mental health care. Receipt of minimally adequate care did not differ significantly by language proficiency. Embarrassment and discomfort were not more common among LEP individuals. Perceived need for treatment predicted lifetime mental healthcare use, whereas embarrassment and discomfort did not.


CONCLUSIONS
Among Latino and Asian Americans with mental disorders, LEP contributes to disparities in access to care and longer duration of untreated disorders. Potential disparities in quality of care were difficult to detect in the context of low overall rates of mental healthcare use and quality of care among both LEP and EP individuals.
Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA 02143, USA. abauer@challiance.org
Amy M
AM
Bauer
Chih-Nan
CN
Chen
Margarita
M
Alegría
D000328:Adult; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D001294:Attitude to Health; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D012931:Social Environment; D014481:United States / Q000453:epidemiology; D055815:Young Adult