Discrimination and Help-Seeking: Use of Professional Services and Informal Support Among African Americans, Black Caribbeans, and Non-Hispanic Whites with a Mental Disorder

Abstract

This study used data from the National Survey of American Life to investigate the use of professional services and informal support among African Americans, black Caribbeans, and non-Hispanic whites. Multinomial logistic regression was used to examine the association of race and perceived discrimination with the use of professional services only, informal support only, both professional services and informal support, or no help at all. Fifty-one percent of the sample used both professional services and informal support, 16% relied on professional services only, 20% used informal support only, and 13% did not seek help. Before controlling for other factors, African Americans and black Caribbeans were significantly less likely to receive either professional or informal help compared with whites. When everyday racial discrimination was included, racial differences in not seeking help were no longer significant. Household income also influenced the relationship between race and help-seeking. Other factors significantly associated with help-seeking include age, gender, education, employment status, insurance coverage, type and severity of disorder, and subjective closeness to family and friends. The association of these factors and implication of the findings for future research and mental health service delivery will be discussed.

African American Women Living with Mental Disorders: Factors Associated with Help Seeking from Professional Services and Informal Supports

“…This is consistent across age groups, racial groups, and type and severity of mental disorder (Addis & Mahalik, 2003;Neighbors & Howard, 1987). Although income and health insurance status are clearly important in the ability to seek professional help, women are still more likely to seek professional help than men even when controlling for these variables (Neighbors & Howard, 1987;Rhodes et al, 2002;Woodward et al, 2008).…”

“…In fact, it is common for people to use professional services and informal supports concurrently (Horwitz & Uttaro, 1998;Lam & Rosenheck, 1999;Pescosolido et al, 1998;Snowden, 2001;Woodward et al, 2008). The use of informal supports such as family, friends, and community members appears to be widespread.…”

“…The literature suggests that race and gender intersect to affect African American women's experiences of living with mental disorders, as within African American culture gender differences are apparent. For instance, African American women more consistently turn to professional and informal sources of support than men and tend to seek support from social networks more readily (Neighbors & Jackson, 1984;Woodward et al, 2008). Studies of exclusively African American families also demonstrate that women's active involvement in their families and social networks provide a relatively greater likelihood of receiving informal support compared with men (Antonucci et al, 2001;Chatters et al, 2002;Keith et al, 2000).…”

Emotional support, negative interaction and DSM IV lifetime disorders among older African Americans: findings from the national survey of American life (NSAL)

“…Extended family networks and relationships are important resources for a variety of concerns including assistance when ill or disabled (Dilworth-Anderson et al, 1999), providing a place to live when confronting homelessness (Taylor et al, 2003) and assistance in coping with psychiatric problems (Woodward et al, 2008). For example, a recent study found that social support from family and friends was associated with fewer depressive symptoms among African Americans (Lincoln et al, 2005).…”

Everyday Racial Discrimination, Everyday Non-Racial Discrimination, and Physical Health Among African-Americans

“…Experiences of racial discrimination have been associated with delays in seeking medical help and reduced compliance with treatment regimens (Casagrande, Gary, LaVeist, Gaskin, & Cooper, 2007). Some evidence supports the association of discrimination experiences with decreased use of informal support as well (Spencer & Chen, 2004; Spencer, Chen, Gee, Fabian, & Takeuchi, 2010) while other research suggests a more complicated relationship when both informal and professional support are considered (Woodward, Chatters, Taylor, Neighbors, & Jackson, 2010; Woodward, 2011). …”