(see Poster Gallery) Resilience While Battling Inequities: Willingness to Use Mental Health Services Among Young Adults Living in Public Housing

Background and Purpose: Young adulthood is a vulnerable developmental stage when some first experience mental health challenges including depression, anxiety, psychosis, and substance use. Living in marginalized communities further exacerbates the risk of mental health challenges for young adults, and those who identify as immigrants often encounter additional stressors. Attending mental health services may mitigate these risks, however few studies have examined willingness to use mental health services among young adults living in marginalized communities. The purpose of this study was to examine factors associated with willingness to use mental health services among a sample of young adults, some of whom are immigrants, living in public housing.

Methods: Participatory methods were undertaken with a local agency embedded in the community (e.g., refinement of study aims, survey development). Participants were recruited from three public housing developments in a large city. Recruitment was multi-pronged and included random sampling, fliers placed in the neighborhood, and participant nominations. The cross-sectional, mixed methods survey took approximately two hours and included standardized scales on mental health (PHQ-8, Kroenke, Strine, Spitzer et al., 2008), intentions to seek counseling inventory (ISCI, Cash et al., 1975), acculturative stress (Social, Attitudinal, and Environmental Acculturative Stress Scale [SAFE], Mena, Padilla, & Maldonado, 1987), and a single-item measure of service use (“Have you ever received outpatient help from a community mental health center or other outpatient mental health clinic?”). Demographic measures included gender, age, and immigrant status. Descriptive and inferential statistics were managed in SPSS 28.0.

Results: A total of 121 young adults were recruited and agreed to take part in the study (Female = 62%, Mean age = 24.07, 10.7% born outside the U.S., 32.3% mother born outside the U.S., 38.8% father born outside the U.S). Results suggest that there was a statistically significant difference in willingness to use mental health services between third and second generation immigrants (F = 2.310, p = .031), with third generation immigrants reporting scores, on average, 5 points higher on willingness to seek services than second generation immigrants. Level of depression was trending towards significance, with those with higher levels of depression reporting higher scores on willingness to seek services than those with lower levels.

Conclusions and Implications: Results suggest that time spent in the US many be associated with willingness to use mental health treatment. Further exploration is warranted to examine immigrants’ hesitancies to seek professional services and whether they are seeking other types of mental health supports. These data were collected prior to the COVID-19 pandemic, and the advent of this international event had a substantial impact on the mental health of young adults and the provision of mental health services in the US. Mental health services are now frequently delivered virtually, and this major change is likely to persist into the future. Young adult willingness to engage in mental health services online should be thoroughly explored as compared to engagement in on-site services.