title: Sociocultural influences on mental health service use by Latino older adults for emotional distress: exploring the mediating and moderating role of informal social support.
abstract: This study investigated the determinants of mental health services for emotional distress by low-income older Latinos living in Los Angeles County (United States). The functional effects of informal support on service use were tested while accounting for dimensions of support and sociocultural factors. Using data from a cross-sectional survey of older Latinos (n = 235), we preformed a secondary data analysis using path analysis with Poisson regression to assess mediation and moderation models by type of perceived support, emotional and instrumental. Data was originally collected between 1998 and 2005. Results indicated that no mediation effects were present however significant moderation effects emerged. Respondents with low levels of linguistic acculturation and informal support used fewer services. Variations by type of informal support emerged, with emotional support presenting the best model fit compared to instrumental support in the moderation model analysis. The direct effects of linguistic acculturation and age remained significant after controlling for need. Findings reveal limited informal support is a risk factor for the underutilization of mental health services by older Latinos with low levels of linguistic acculturation as they age. Integrating support resources that assist in navigating service systems and address language barriers can enhance service use by older Latino adults. Implications for service delivery and program development are discussed.
authors.affiliation: University of Houston, Graduate College of Social Work, 110HA Social Work Building, Houston, TX 77204-4013, United States. mhansen5@uh.edu
authors.forename: Marissa C
authors.initials: MC
authors.lastname: Hansen
authors.forename: María P
authors.initials: MP
authors.lastname: Aranda
mesh_terms: D000069:Acculturation; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003469:Culture; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D016012:Poisson Distribution; D011203:Poverty; D012931:Social Environment; D012944:Social Support; D013315:Stress, Psychological / Q000628:therapy*