Examining Latinx Use of Informal Vs. Formal Systems of Help-Seeking for Behavioral Health Concerns

Background: Research has consistently demonstrated that Latinx individuals utilize formal health care systems at significantly lower rates than their White peers, particularly when experiencing mental health symptoms or substance related concerns. This study examined a primarily immigrant and Spanish speaking sample of Latinx adults’ preference for engagement with formal vs. informal networks of care in relation to behavioral health concerns.

Methods: Data collection was done as part of a larger study investigating Latinx perceptions of mental health symptomology and help seeking preferences. A community convenience sample of Latinx individuals over the age of 18 (n = 487) were enrolled. In person recruitment took place at community-based agencies serving the Latinx community. Data were collected using a cross-sectional survey design. Participants were given a measure that could be completed in English (11.9%) or Spanish (88.1%) containing two different vignettes describing a person experiencing behavioral health symptoms. Participants were asked to recommend where the person should first seek help for that problem, and if that source was not perceived as “helpful” who they would recommend as second and third sources of help. Responses were then coded as “formal” (such as health care providers) or “informal” (friends, family, church etc.).

Results: 68% of the participants were female and the mean age of respondents was 43.14 years (sd = 16.27). 84.2% were born outside of the United States. 37.8% reported having less than a high school education. When asked where the person should seek help first, 48.3% indicated the person should seek formal help first and 51.7% indicated the person should seek informal help. Chi Square analyses indicate that people under 40 (X² = 13.90, df = 1, p = .00, N = 852) and those with less than high school education, (X² = 16.16 df = 1, p = .00, N = 853) were less likely to first recommend formal help. Help-seeking sources most frequently recommended were family (30.8 %), doctor (21.5 %) or mental health professional (16.5 %). The pattern of help-seeking that was most prevalent (20.9%) was recommending formal help first, followed by recommending for informal help second and third. 17.8% indicating they would recommend all informal sources of help.

Implications: Findings indicate that although family is often the first point of help-seeking for those experiencing behavioral health issues, formal networks of care are also frequently the first place that Latinx individuals seek help for behavioral health concerns. One way to increase use of formal services is to assist in building knowledge and health literacy in the overall community so that when one goes to a family member for help, he/she can recommend appropriate health care services that may be seen as “helpful” to others. These data also suggest that when formal services are not seen as “helpful” then Latinx individuals will continue to seek help, but only from informal sources. Accordingly, health care systems must continue to develop culturally acceptable/culturally grounded services in order to be perceived as “helpful” and keep people engaged in formal systems of care.