Methods: This study is a cross-sectional survey using non-probability sampling. A total of 202 immigrants were recruited from a Qualtrics panel, an online research sample aggregator. The sample was largely female (59%), Asian American and Pacific Islanders (AAPI) immigrants (59%), followed by Latinx (23%) and Black (14%) immigrants, with an average age of 30 years old. Participants completed an online questionnaire including demographic and background questions (e.g., insurance, awareness of mental health services), General Help-Seeking Questionnaire (GHSQ), and Self-stigma of Mental Illness Scale. Confirmatory factor analysis (CFA) was used to examine the factor structure of the GHSQ. Multiple linear regression (MLR) was conducted to examine the association between mental illness stigma and different types of help-seeking intentions. CFA was conducted using Mplus 8.3 and MLR analyses were conducted using STATA 14.1.
Results: Results of the CFA confirmed four dimensions of help-seeking behavior for immigrants: a) informal sources (e.g., intimate partner, parent, friends); b) formal sources (e.g., mental health professional, medical doctor); c) semi-formal sources (e.g., phone helpline, online forum or other web-based resources); and d) traditional sources (e.g., religious leader, traditional healer). MLR models showed that immigrants with higher levels of mental illness stigma are more likely to seek help from traditional sources, and semi-formal sources. Mental illness stigma is not associated with intention to seek help from formal or informal sources. Lack of insurance and lack of awareness of service were associated with lower intention to seek formal help. Being married was associated with higher help-seeking intention from informal sources.
Conclusions and implications: To our knowledge, this study is the first to explore the dimensionality of GHSQ among immigrants in the U.S., deepening our understanding of variation in help-seeking behaviors among different racial/ethnic minority groups. The study also adds to gaps in the literature on the association between mental illness stigma and different dimensions of help-seeking. The results indicate the importance of considering informal, traditional sources alongside formal or semi-formal mental health services. For example, training could be provided to assist mental health professionals to 1) better understand the role of traditional help-seeking sources; and 2) develop more culturally relevant services for racial and ethnic minority immigrants. Additionally, mental health professionals may consider adopting semi-formal formats (such as online) to deliver services potentially reducing concerns about confidentiality and increasing accessibility to quality care for immigrants.