Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA 02143, USA.
Med Care. 2010 Dec;48(12):1097-104. doi: 10.1097/MLR.0b013e3181f80749.
The impact of language proficiency as a potential contributor to ethnic disparities in mental health care has received less attention than other factors. Data from the National Latino and Asian American Study were examined to assess the impact of limited English proficiency (LEP) on access to and quality of mental health care for community-dwelling Latino and Asian Americans with mental disorders.
English-proficient (EP) and LEP individuals with mental disorders were compared on lifetime use of healthcare services for a mental disorder, duration of untreated disorders, receipt of minimally adequate care, and barriers to treatment (eg, lack of identification of need for treatment, language barriers, and embarrassment or discomfort related to treatment).
Compared with EP individuals, LEP individuals with mental disorders were significantly less likely to identify a need for mental health services, experience longer duration of untreated disorders, and use fewer healthcare services for mental disorders, particularly specialty mental health care. Receipt of minimally adequate care did not differ significantly by language proficiency. Embarrassment and discomfort were not more common among LEP individuals. Perceived need for treatment predicted lifetime mental healthcare use, whereas embarrassment and discomfort did not.
Among Latino and Asian Americans with mental disorders, LEP contributes to disparities in access to care and longer duration of untreated disorders. Potential disparities in quality of care were difficult to detect in the context of low overall rates of mental healthcare use and quality of care among both LEP and EP individuals.
语言能力作为导致心理健康护理中族裔差异的一个潜在因素，其受到的关注不如其他因素多。本研究利用来自全国拉丁裔和亚裔美国人研究的数据，评估了英语水平有限（LEP）对社区居住的有精神障碍的拉丁裔和亚裔美国人获得和接受精神卫生保健的质量的影响。
将有精神障碍的英语熟练（EP）和 LEP 个体进行比较，比较内容包括：一生中使用精神障碍保健服务的情况、未治疗障碍的持续时间、获得基本充分的护理情况，以及治疗障碍（例如，缺乏治疗需求识别、语言障碍、以及与治疗相关的尴尬或不适）。
与 EP 个体相比，有精神障碍的 LEP 个体明显不太可能识别出对精神卫生服务的需求，未治疗障碍的持续时间更长，用于精神障碍的保健服务更少，特别是专科精神卫生保健。语言能力与获得基本充分的护理情况没有显著差异。尴尬和不适在 LEP 个体中并不更为常见。治疗需求的认知预测了一生中的精神保健使用，而尴尬和不适则没有。
在有精神障碍的拉丁裔和亚裔美国人中，LEP 导致获得护理的机会减少和未治疗障碍的持续时间延长。在 LEP 和 EP 个体的整体精神保健使用率和保健质量都较低的情况下，很难发现护理质量方面存在潜在的差异。
