National Institute of Psychiatry, Mexico City, Mexico.
Am J Public Health. 2013 Sep;103(9):1610-8. doi: 10.2105/AJPH.2012.301169. Epub 2013 Jul 18.
We examined differences in the use of mental health services, conditional on the presence of psychiatric disorders, across groups of Mexico's population with different US migration exposure and in successive generations of Mexican Americans in the United States.
We merged surveys conducted in Mexico (Mexican National Comorbidity Survey, 2001-2002) and the United States (Collaborative Psychiatric Epidemiology Surveys, 2001-2003). We compared psychiatric disorders and mental health service use, assessed in both countries with the Composite International Diagnostic Interview, across migration groups.
The 12-month prevalence of any disorder was more than twice as high among third- and higher generation Mexican Americans (21%) than among Mexicans with no migrant in their family (8%). Among people with a disorder, the odds of receiving any mental health service were higher in the latter group relative to the former (odds ratio = 3.35; 95% confidence interval = 1.82, 6.17) but the age- and gender-adjusted prevalence of untreated disorder was also higher.
Advancing understanding of the specific enabling and dispositional factors that result in increases in mental health care may contribute to reducing service use disparities across ethnic groups in the United States.
我们研究了在存在精神障碍的情况下,不同移民美国经历的墨西哥人群体和墨西哥裔美国人的连续几代人之间,心理健康服务利用的差异。
我们合并了在墨西哥(2001-2002 年墨西哥国家共病调查)和美国(合作精神流行病学调查,2001-2003 年)进行的调查。我们使用复合国际诊断访谈在两个国家评估了移民群体的精神障碍和精神卫生服务利用情况。
与家庭中没有移民的墨西哥人(8%)相比,第三代及以上的墨西哥裔美国人(21%)的任何障碍 12 个月患病率高出一倍以上。在有障碍的人群中,与前者相比,后者接受任何精神卫生服务的可能性更高(比值比=3.35;95%置信区间=1.82,6.17),但未经治疗的障碍的年龄和性别调整患病率也更高。
深入了解导致精神卫生保健增加的具体有利和倾向因素,可能有助于减少美国不同族裔群体之间的服务利用差异。