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Ethnic Identity and Mechanisms of Mental Health Service Engagement Among Young Adults with Serious Mental Illnesses

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Purpose

Young adults from minoritized racial and ethnic groups have lower rates of engagement in treatment for serious mental illnesses (SMI). Previous research suggests a relationship between ethnic identity development and engagement in mental health services, but it remains unclear how a sense of belonging and attachment to one’s racial and ethnic group influences participation in treatment among young adults with SMI.

Methods

Bivariate analyses and structural equation modeling (SEM) were used to examine whether ethnic identity was associated with treatment engagement (attendance and investment in treatment) and how ethnic identity might influence engagement through theoretical proximal mediators. Eighty-three young adults with SMI (95% from minoritized racial and ethnic groups) were recruited from four outpatient psychiatric rehabilitation programs and assessed at least 3 months after initiating services.

Results

Stronger ethnic identity was associated with greater investment in treatment but not with treatment attendance. The SEM analysis indicated that stronger ethnic identity may improve investment in treatment by enhancing hope (0.53, p < .05) and beliefs that mental health providers are credible (0.32, p < .05), and by increasing self-efficacy (−0.09, p < .05). Proximal mediators of engagement were associated with investment in treatment (hope and credibility, p < .05, and self-efficacy p = 0.055).

Conclusions

Findings provide preliminary evidence of an empirical and theoretical relationship between ethnic identity development and engagement in treatment among young adults with SMI. Assessment and strengthening of a young person’s ethnic identity may be a promising approach for improving their engagement in services and reducing inequities in their care.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request, in accordance with our data sharing plan.

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Funding

This project was supported by a grant from the National Institute of Mental Health (grant number R34 MH111861-02S1, PI: Kiara Moore). The funding source did not play a role in conceptualizing or writing the manuscript.

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Authors and Affiliations

  1. New York University, Silver School of Social Work, 1 Washington Square North, New York, NY, 10003, USA

    Kiara L. Moore, Michelle R. Munson & James Jaccard

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  1. Kiara L. Moore
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  2. Michelle R. Munson
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  3. James Jaccard
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Kiara Moore and Michelle R. Munson. Data analyses were performed by all authors. The first draft of the manuscript was written by Kiara Moore, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kiara L. Moore.

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Ethics Approval

The study was approved by New York University’s Committee on Activities Involving Human Subjects (reference number IRB-FY2017-1002).

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Informed consent was obtained from all individual participants included in the study.

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The manuscript does not contain any individual person’s data in any form.

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The authors declare no competing interests.

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Moore, K.L., Munson, M.R. & Jaccard, J. Ethnic Identity and Mechanisms of Mental Health Service Engagement Among Young Adults with Serious Mental Illnesses. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01842-9

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  • DOI: https://doi.org/10.1007/s40615-023-01842-9

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