Structural Barriers, Not Stigma, Limit Access to Mental Health Services for Low-Income Latino Communities: Community Based Research

Background/Purpose: Much of the literature in mental health research on the adult Mexican population cites stigma as a leading barrier to access for services.  This study examines the desire for and barriers to accessing counseling programs by the low-income Latino community of the southwest side of Chicago.  

The proposed oral/poster presentation incorporates three community research projects conducted over three years. All three research projects largely focus on Little Village and Brighton Park, neighboring communities with similar demographics; low-income predominantly Mexican-immigrant communities with a large undocumented population.

First, the presentation reviews a 2014 community mental health needs assessment (MHNA) conducted in Little Village. Second, informed by the mental health needs assessment, a community health survey was expanded to assess mental health needs in the neighboring community of Brighton Park (BP). Three survey questions were included to assess mental health needs, desire to access services, and perceived barriers. Third, organizational data was collected from a community-based mental health provider serving both communities. This provider specifically targets undocumented and uninsured Spanish-speaking adult offering free culturally-responsive mental health services purposefully designed to address structural barriers.

Methods:

1. The MHNA incorporated a combination of statistical modeling, interviews with service providers, and focus groups with community residents.  

2. Data was collected as part of a community health survey conducted by a BP community-based organization in 2014 (n=434) and 2015 (n=295).  Surveys were administered to a community-dwelling sample of adults.

3. A review of the program data between 2012-2015 with a focus on staffing capacity, referrals and waiting-list information.

Results:

1. MHNA: The findings of the study indicate that only 29.5% of residents within South Lawndale are accessing the needed mental health service.  The report went on to identify possible barriers that can be categorized as both individual and structural barriers.  

2. BP Mental Health Survey: Findings indicate a desire to seek counseling services with 58% in 2014 and 56% in 2015 reporting positively. In both years depressive symptoms were the highest reported reason. When it came to selecting from a list of ten barriers to accessing services cost (55% 2014, 33% 2015) and lack of health insurance (39% 2014, 22% 2015) were the two highest reported barriers while “not thinking it would help” (9% 2014, 6% 2015) and stigma (7% 2014, 5% 2015) were the lowest rated.

3. SAH:CWP Organizational Data: Findings indicate that even though staffing increased substantially for the mental health program over that period (from 1 FTE to 4 FTE) the number of referrals to the program for services doubled leading to a constant 3-6 month wait for services.

Conclusions/Implications:  Contrary to popular belief our findings indicate that stigma may not be a large factor as a barriers to mental health access.  A demand for mental health services may be largely unserved by the need for free or low-cost services to the uninsured or underinsured.  These findings are corroborated by the organizational data analysis that indicated that when structural barriers for the Latino-immigrant community are addressed demand for services is high.