Barriers to Mental Health Service Utilization Among Undocumented Latino Immigrant Adults

Background and Purpose: A drastic shift in the socio-political climate revolving around immigration-related issues has garnered a new set of implications, one of them being mental healthcare accessibility. When evaluating aspects of the mental healthcare sector, it is crucial to examine minority populations. In particular, undocumented Latino immigrants are at a greater risk of developing mental health problems due to enormous challenges they face (e.g., stressors associated with their unsteady undocumented status, etc.), yet significantly underutilizing mental health services and resources. A combination of sociodemographic, economic, and political factors is believed to have immense impacts on this vulnerable population, preventing them from becoming aware of mental health resources and further inhibiting them from receiving adequate treatment. However, less is known about the barriers to mental healthcare experienced and perceived by this population. To address this gap, a systematic review was performed to summarize current literature describing barriers to mental healthcare utilization among undocumented Latino immigrant adults.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct an extensive review of existing studies regarding undocumented Latino immigrant adults’ under-utilization of mental healthcare services. Search of peer-reviewed articles was performed by inputting keywords relevant to the topic into an array of databases, such as ProQuest (Sociology), PubMed, APA PsychInfo, and EBSCOhost. A filter for articles published between 2013 and 2023 was used to capture the most recent literature available. The search yielded 413 unduplicated publications. After screening articles for relevance based on titles and abstracts, 85 articles were reviewed in full text.

Results: A total of 20 articles met inclusion criteria and were included in this review. The articles reviewed included a range of topics, including barriers to receiving mental healthcare, roles and perspectives of mental healthcare practitioners, as well as psychological stressors associated with pre-migration, in-transit, and post-migration factors. The included articles have identified significant barriers that impede mental health service utilization among undocumented Latino immigrants, such as lack of social capital, limited language proficiency, insurance coverage, discrimination, legal status, and cultural beliefs. The review further identified that mental healthcare practitioners held mixed perceptions on how current immigration policies may impact their undocumented clients and/or practices, and their perceived ability to effectively treat these patients. Moreover, articles reviewed also indicated that many undocumented immigrants reported experiencing previous trauma, in particular while living in their host country. These traumas may occur pre-migration (e.g., extortion, gang violence, kidnapping, poverty), in-transit, or post-migration (e.g., stressors associated with marginalization, discrimination, and acculturation). These stressors indeed amplified symptoms of psychological distress, depression, substance abuse, and anxiety among the undocumented Latino immigrant population, leading to heightened needs of mental health services.

Conclusions and Implications: Given the demographic shifts underway, it is vital that we expand research on the vulnerable undocumented immigrant populations to inform more inclusivity and culturally competent mental health services. Addressing the identified barriers and formulating evidence-based long-term solutions is necessary to better meet the mental health needs of this at-risk population.