Does Social Support Contribute to Mental Health Service Use Among Immigrants?

Objective: Immigrants face unique challenges that reflect their exit circumstances, the migration process, and the context of reception in receiving countries.  Stressors stemming from immigration may exacerbate underlying mental health concerns or initiate new problems, placing immigrants at risk for decreased wellbeing. Despite an established need for mental health services, immigrants access mental health services at lower rates than nonimmigrants.  Usual coping mechanisms and support systems that may help deal with migration stressors are often disturbed by the process of leaving a home country and reestablishing roots elsewhere. Social relationships can help navigate barriers to mental health care and facilitate access to needed services. How and if these support systems are reestablished may have implications for immigrant mental health service use. This study examines the variety of social support experiences and whether different types of social support predict mental health service use among immigrants. Method: Drawing on data from the National Latino and Asian American Study (NLAAS) (n = 4639), we use latent class analysis (LCA) and multinomial logistic regression to explore unique patterns of social support from family, friends, and co-religionists and their effect on the help-seeking process. We tested 12-month and lifetime rates of service use from eight formal and informal mental health service provider types, controlling for need for services, insurance status, gender, age, time lived in the United States, and English proficiency.   Results: Results indicate six unique patterns of social support: High Support (26%), Family and Peer-Connected (24%), Family-Centered (23%), Low Support (11%), Friend-Centered (9%), and Religious (8%).  Social support profile was predictive of mental health service use from religious leaders, human service professionals, alternative practitioners, and any provider in a non-health care setting.  Social support profiles were not predictive of mental health service use from medical providers, mental health specialists, or any provider in a health care setting.  Immigrants with weak social support were less likely than nonimmigrants to use mental health services from any of these providers.  Immigrants with support from religious sources were more likely to seek mental health care from religious leaders or alternative practitioners. Conclusions: Practice implications include the need for social support-building efforts in new and established immigrant communities, for engaging support systems in mental health services education and outreach, and supporting collaborations between formal and informal service systems. Research efforts should focus on understanding the heterogeneity of immigrant experience with social support, documenting outcomes of formal and informal service sector collaborations, and exploring health and mental health outcomes for immigrants isolated from social support networks.