Mental Health Help-Seeking Experiences of Hispanic Women in the United States: Results from a Qualitative Interpretive Meta-Synthesis

Background:Research has consistently demonstrated disparities in access to and quality of mental health treatment for Hispanics in the United States. While researchers have identified a need for further examination on how gender influences the attitudes and use of mental health services among the Hispanic population, little research has been conducted to fill this gap. To eliminate the mental health treatment disparity experienced by Hispanic women, a more in-depth understanding of the factors related to mental health service use for this population is needed. Thus, the purpose of this study was to examine the experiences and perceptions of mental health help-seeking of Hispanic women in the United States using a qualitative interpretive meta-synthesis (QIMS).

Method:A QIMS was chosen as the method for this study because of its ability to use multiple qualitative studies to form a more in-depth and holistic understanding of a phenomenon while maintaining the integrity of the original studies. An exhaustive literature search yielded 121 potentially relevant studies. Of these, a total of five studies were used for the QIMS that included experiences and perceptions of 60 adult Hispanic women (immigrant and US born) from various parts of the United States. The first step in the analysis was the identification of the original themes from each study. Next, the first author completed the initial analysis of participant quotes within each original study using an open-coding process in Atlas.ti 7. The first author, second author, and expert colleague met multiple times over the course of six weeks to reach an agreed-upon translation of the initial codes into new, overarching themes. 

Results:Results of the analysis generated one over-arching theme: determinants of mental health help-seeking. Organization of the determinants was guided by Andersen and Newman’s (1973) framework for viewing health services utilization, and generated the following subthemes: societal determinants, health services system, and individual determinants. Societal determinants in the form of cultural values included the role of women, family respect, and religious beliefs. Women also discussed the role of health services systems, including organizational structure, available resources, and previous experiences. The individual determinants of help-seeking emphasized the role of individual beliefs and perceptions of mental health issues and help-seeking and the importance of enabling factors such as time, money, and social support. Some of the women also discussed concerns with seeking professional help and fears of medication, while others were motivated to seek help due to severity of their symptoms and perceived burden on others.

Conclusions: Results of this study indicate that mental health help-seeking behaviors and perceptions of Hispanic women are influenced by a complex set of factors at both the individual and societal level. Therefore, interventions aiming to alleviate the suffering experienced by these women must be implemented at the individual, community, and healthcare system level. Furthermore, continued emphasis on experiential research giving voice to Hispanic women can provide a greater understanding of the barriers and facilitators to receiving mental health care, contributing to the elimination of the mental health disparities experienced by these women.