Provider Perceptions of Structural and Individual Barriers Towards Mental Health Access Among Latinx Immigrants

Background and Purpose: The Latinx community is the largest and fastest-growing ethnic group in the U.S. and comprises over half (51%) of the immigrant population. Previous studies have shown that although Latinx immigrants have lower rates of depressive symptoms than the overall population, their access to mental health services is significantly lower than their White counterparts. Foreign-born and less acculturated Latinx are also more susceptible to mental health care disparities even after adjusting for health insurance, education, and socioeconomic factors compared to their U.S. born and more acculturated counterparts. In fact, a significant gap exists between the need and availability of mental health services among Latinx immigrants compared to their White counterparts. This mental health service utilization gap will continue to increase if left unaddressed. The inability to access and address the mental health needs among Latinx immigrant adults and children raises concerns from direct service providers who work closely with this population. The current study aims to examine direct service providers’ perspectives on Latinx immigrant barriers to mental health service access.

Methods: From August to December 2020, a sample of 21 providers from Massachusetts were interviewed remotely. The participants provided direct services to Latinx immigrants and had extensive experience working with Latinx immigrant families. Providers were in different fields ranging from education to psychology. All data were transcribed verbatim and analyzed using thematic analysis, guided by the principles of grounded theory and an inductive approach to qualitative research.

Results: The majority of providers were females with a median age of 33. Out of the twenty-one providers, fourteen identified as Latinx. Most providers (57%) had been practicing for 5 years or more. Data analysis revealed that structural and individual barriers impact Latinx immigrant adults and children mental health access. Specifically, providers mentioned the following structural barriers: 1) reinforced negative Latinx immigrants portrayals by providers and community members, 2) lack of resources and support for providers to do their work effectively, and 3) public mental health stigma limits help-seeking behavior. Providers also identified the following individual barriers: 1) economic reasons and social norms may promote lack of mental health access, 2) alcohol and drug consumption are sometimes used as mental health coping mechanisms, and 3) self-stigma limits mental health care access.

Conclusion and Implications: Findings highlight an in-depth analysis of provider’s perceptions on Latinx immigrant mental health access focusing on both individual and structural levels to provide a broader understanding of the impact of their mental health outcomes. As the Latinx population continues to grow, future research should continue to promote self-awareness among providers and increased cultural competency training to mitigate the reinforcement of negative portrayals in therapy. It is also recommended to review and adapt the ethical guidelines according to the population to provide resources and services that the population can access safely, comfortably, and effectively. Finally, it is essential to develop social policies that increase reach and provide basic needs to help reduce mental health care disparities among Latinx immigrants.