Professional Service Use for a Serious Personal Problem: Comparing Older African Americans, Black Caribbeans, and Non-Hispanic Whites Using the National Survey of American Life

African Americans' and Black Caribbeans' Religious Coping for Psychiatric Disorders

This study investigates the use of religious coping among African Americans and Black Caribbeans with 12-month DSM-IV psychiatric disorders. Data from the National Survey of American Life is used to examine three indicators of religious coping: 1) using prayer and other spiritual practices for mental health problems, 2) the importance of prayer in stressful situations, and 3) looking to God for strength. Three out of four respondents who had a mental health problem reported using prayer as a source of coping. Agoraphobia and drug abuse disorder were associated with the importance of prayer during stress. Individuals with generalized anxiety disorder were more likely to report that prayer was important during stressful experiences and that they looked to God for strength. These findings contribute to the limited, but growing body of research on the ways that African Americans and Black Caribbeans cope with psychiatric disorders.

Help-seeking preferences among Chinese college students exposed to a natural disaster: a person-centered approach

BACKGROUND

Direct exposure to natural disasters is associated with increased mental disorders. Help-seeking behaviour among Chinese adults is low and the barriers and facilitators of help-seeking among Chinese adults exposed to natural disasters is understudied.

OBJECTIVE

Using a person-centred approach, this study describes help-seeking preferences and their correlates in a sample of Chinese college students after experiencing Typhoon Hato, the strongest storm to affect Macao, China in the past 50 years.

METHOD

The baseline sample was collected one month following exposure to the Typhoon (September 2017). Six months following the baseline study (April, 2018), a total of 815 students (females = 71.5%) completed follow-up and were included in the data analysis. Latent Class Analysis (LCA) and Multinomial Logistic Regression were used to analyse the data via Mplus 7.4 and Stata 15.0.

RESULTS

Three latent classes of help-seeking preferences were identified in this study, including: 'mental health professionals and close people' (MHPCP, 52%), non-seekers (31%), and 'multiple sources' (17%). The results of multinomial logistic regression showed that region of origin (mainland versus Macao, China), self-stigma, perceived helpfulness of professional mental health help, previous professional help-seeking behaviour, and perceived social support, were significantly associated with MHPCP help-seeking preferences.

CONCLUSION

A large proportion of students preferred to seek support from loved ones and professionals. However, over 30% of the sample preferred not seeking help for mental health concerns. Further research is needed to enhance mental health treatment seeking preferences among Chinese college students.

Who is seeking whom? A person-centred approach to help-seeking in adults with currently untreated mental health problems via latent class analysis

PURPOSE

Global surveys point to a gap in mental health service utilisation. However, contacting more than one source of professional help may influence the estimates of utilisation. Currently, few studies statistically differentiate between different sources of help based on patient characteristics.

METHODS

We assessed sociodemographic and psychosocial data in a convenience sample of 188 adults with mental health problems (M_age = 50.34 years; SD = 16.19; 71% female), who reported their help-seeking behaviour during the next 6 months. We analysed their behaviour via latent class analysis and compared baseline characteristics between classes.

RESULTS

We found four latent classes: "mental health professionals" (MHP; 9.0%), "multiple sources" (4.3%), "primary care" (35.6%), and "non-seekers" (51.1%). All classes had moderate to high probabilities of seeking help from friends or family. Primary care utilisers were more often in a cohabiting partnership; MHP utilisers were more experienced in mental health treatment and reported lower well-being and more depressive symptoms than non-seekers. By trend, non-seekers were younger, and both non-seekers and primary care utilisers reported fewer depressive and somatic symptoms than utilisers of multiple sources and MHP.

CONCLUSIONS

In our analysis, MHP utilisation was even lower (9.0%) than in previous studies. However, MHP utilisers appeared to suffer from more serious conditions than other latent classes. As informal sources such as family and friends were present in all latent classes, help-seeking behaviour seems to transcend traditional MHP-focused approaches. Further research is necessary to investigate tenability and trajectories of different latent classes of help-seeking in larger and representative samples with longer follow-ups.

Profiles of Depression Help Seeking Among Black Americans: A Latent Class Approach

Although Black Americans have lower prevalence of depression compared to non-Hispanic Whites (10% vs. 17%), they are nearly twice as likely to have worse outcomes. One contributor to poor depression outcomes involves the ways in which Black Americans seek help for depression. However, little is known about depression help-seeking behavior, and the use of multiple sources of help, among Black Americans. This study used latent class analysis to identify unique constellations of depression help seeking, from multiple sources, among African American and Black Caribbeans. Results indicated four profiles of depression help seeking including Informal/Primary Care Utilizers (41.4%), Formal Mental Health Utilizers (40.6%), All Support Utilizers (9.8%), and Mixed Source Utilizers (8.2%). The constellation of each profile and demographic differences in class assignment are discussed. Results have implications for tailored depression interventions for Black Americans including community-based psychoeducation and cultural competence training for mental health providers.

Differences between African Americans and Non-Hispanic Whites Utilization of Clergy for Counseling with Serious Personal Problems

There is a paradox in research on African Americans and non-Hispanic whites in the utilization of clergy. Research finds that African Americans have higher levels of religious service attendance and higher levels of contact with clergy. Research also finds that despite this, African Americans are less likely than non-Hispanic whites to seek out assistance from clergy for psychiatric disorders including depression and anxiety. The goal of this paper was to investigate race differences in the use of clergy for counseling for serious personal problems. It uses the National Survey of American Life. We find that non-Hispanic whites were more likely than African Americans to use clergy for a serious personal problem. The significant difference between African Americans and non-Hispanic whites appeared to be mediated by the fact that African Americans were more likely to have seen clergy in a religious setting and non-Hispanic whites were more likely to have seen clergy in other settings including hospitals.

The Role of Faith-Based Organizations in the Depression Care of African Americans and Hispanics in Los Angeles

OBJECTIVE

This study examined use of depression care provided by faith-based organizations (FBOs) by African Americans and Hispanics and factors associated with the receipt of such care, including mental illness severity and use of traditional mental health services.

METHODS

The study used baseline data from the Community Partners in Care study, a group-randomized trial comparing a community-partnered approach with a technical-assistance approach to improving depression care in underresourced communities in Los Angeles. A sample of 947 individuals (48% African American, 27% non-U.S.-born Hispanic, 15% U.S.-born Hispanic, and 10% non-Hispanic white) were surveyed about recent visits to a religious or spiritual place and receipt of FBO depression care. Descriptive analyses compared racial-ethnic, sociodemographic, and health service use variables for three groups: those who did not attend a religious place, those who attended a religious place and did not receive FBO depression services, and those who received FBO depression services. Multinomial logistic regression was used to identify predictors of receipt of FBO depression care.

RESULTS

A larger proportion of African Americans and non-U.S.-born Hispanics received FBO faith-based depression services compared with non-Hispanic whites and with U.S.-born Hispanics. Receipt of FBO depression services was associated with younger age, lifetime diagnosis of mania, use of primary care depression services, and receipt of a mental health service from a substance abuse agency.

CONCLUSIONS

FBO depression services were used in the community, especially by persons from racial-ethnic minority groups. Collaborative efforts between FBOs and traditional health services may increase access to depression services for African Americans and Latinos.