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The Association of Racial and Ethnic Social Networks with Mental Health Service Utilization Across Minority Groups in the USA

  • Sung W. ChoiEmail author
  • Christal Ramos
  • Kyungha Kim
  • Shahinshah Faisal Azim
Article

Abstract

Though they have comparable prevalence of mental illness, American racial and ethnic minorities are less likely to receive mental health services than white Americans. Minorities are often part of racial and ethnic social networks, which may affect mental health service utilization in two ways. While these networks can encourage service utilization by working as a channel of knowledge spillover and social support, they can also discourage utilization by stigmatizing mental illness. This study examined the association of racial and ethnic social networks with mental health service utilization and depression diagnosis in the USA. Using the 2012 Behavioral Risk Factor Surveillance System (BRFSS) data, a multilevel mixed-effect generalized linear model was adopted, controlling for predisposing, need, and enabling factors of mental health service utilization. The association of racial and ethnic social networks with mental health service utilization and depression diagnosis was significant and negative among African Americans. Despite having a comparable number of bad mental health days, the association was insignificant among Hispanic, Asian, and non-Hispanic white respondents. An African American living in a county where all residents were African American was less likely to utilize mental health services by 84.3–86.8% and less likely to be diagnosed with depression by 76.0–84.8% than an African American living in a county where no residents were African American. These results suggest racial and ethnic social networks can discourage mental health service utilization and should be engaged in efforts to improve mental health, particularly among African American communities in the USA.

Keywords

Mental health service utilization Depression diagnosis Social network Racial and ethnic minorities 

Notes

Compliance with Ethical Standards

Conflict of Interest

Sung W. Choi, Christal Ramos, Kyungha Kim, and Shahinshah Faisal Azim declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical Approval Retrospective Studies

Although retrospective studies are conducted on already available data or biological material (for which formal consent may not be needed or is difficult to obtain), ethical approval may be required dependent on the law and the national ethical guidelines of a country. Authors should check with their institution to make sure they are complying with the specific requirements of their country.

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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.School of Public AffairsThe Pennsylvania State University, HarrisburgMiddletownUSA
  2. 2.Health Policy CenterThe Urban InstituteWashingtonUSA
  3. 3.College of MedicineThe Pennsylvania State University, HersheyHersheyUSA

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