Social Support and Mental Health Service Utilization among Immigrants in the United States
Derr, Amelia Seraphia
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Immigrants face unique challenges that reflect their exit circumstances, the migration process, and the context of reception in the United States. Stressors stemming from immigration may exacerbate underlying health or mental health concerns or initiate new problems, placing immigrants at risk for decreased wellbeing. Usual coping mechanisms and support systems that may help deal with migration stressors are often disturbed by the process of leaving a home country and reestablishing roots elsewhere. How and if these support systems are reestablished may have implications for immigrant health and mental health outcomes. Previous research indicates that, despite an established need, immigrants access mental health services at lower rates than nonimmigrants. Social relationships can help navigate barriers to mental health care and facilitate access to needed services. This dissertation examines these issues by asking three questions: 1. What is the current empirical knowledge about immigrant mental health service use in the United States? 2. Do immigrants have unique patterns of social support and are they different than those of nonimmigrants? 3. Do specific types of social support influence rate and type of mental health service use among immigrants? Chapter 1 provides a systematic literature review of the current empirical knowledge on mental health service utilization among immigrants. Findings suggest that immigrants have disproportionately low rates of mental health service use compared to nonimmigrants and face many barriers to accessing services. Informal networks such as family, friends, and religious leaders are particularly important sources of support for immigrants and may be promising sites for collaborative efforts with more formal mental health service systems. Chapter 2 explores the heterogeneity of immigrant experiences of social support using data from the National Latino and Asian American Study (NLAAS). Results show that being an immigrant is predictive of having low levels of support from family, friends, and religious sources. Finally, Chapter 3 builds on the findings from Chapter 2 by examining whether different types of social support predict mental health service use among immigrants. Results show that social support profile was predictive of mental health service use from religious leaders, human service professionals, alternative practitioners, and any provider in a non-health care setting. Immigrants with weak social support were less likely than nonimmigrants to use mental health services from any of these providers. Immigrants with support from religious sources were more likely to seek mental health care from religious leaders or alternative practitioners. Taken together, findings from these three chapters point to the need for interventive efforts to strengthen social support networks for immigrants and collaboratory efforts between formal and informal mental health service systems. Implications for social work practice with immigrants and refugees and future research are discussed.