Degree Date
6-2025
Document Type
Dissertation - Public Access
Degree Name
Ph.D. Doctor of Philosophy
Academic Discipline
Counselor Education and Supervision
First Advisor
Laura Schmuldt
Second Advisor
Ruth Quiroa
Abstract
This study examined barriers to mental health service utilization among Latinx populations using data from the 2022 National Survey on Drug Use and Health (NSDUH). Through the theoretical frameworks of Minority Stress Theory and Toxic Stress Theory, the study investigated the relationships between age, language proficiency, socioeconomic status, and mental health service access among different Latinx subgroups. Statistical analyses included chi-square tests, multiple regression, and mediation analyses on a sample of Latinx adults (N = 9,852). Results indicated associations between age and English proficiency (χ² = 145.23, p < .001, Cramer's V = 0.38), with 45% of adults aged 50 and older reporting limited English proficiency. Socioeconomic analysis revealed that 32% of older Latinx adults reported family incomes below $20,000, with insurance status partially mediating the relationship between income and service utilization (indirect effect = 0.15, 95% CI [0.08, 0.23]). differences in utilization rates emerged among Latinx subgroups (F(6, 1243) = 8.76, p < .001, η² = 0.12), with Mexican-origin individuals showing higher utilization (10%) compared to Puerto Rican individuals (2-3%). Age and socioeconomic status demonstrated interaction effects (β = 0.18, p < .01), while language proficiency moderated the relationship between age and service utilization (β = 0.24, p < .001). These findings suggest that barriers to mental health service utilization among Latinx populations are complex and interconnected, requiring multilevel interventions that address linguistic, cultural, and socioeconomic factors simultaneously. Implications for healthcare policy and service delivery are discussed, emphasizing the need for culturally responsive and linguistically appropriate mental health services.
Recommended Citation
Thorson, Melissa, "Intersecting Inequities: Latinx Access To Mental Health Services" (2025). Dissertations. 905.
https://digitalcommons.nl.edu/diss/905
Comments
Chapter 1: Introduction............................................................................................................... 1
........... Historical Overview of Latinx Mental Health Access.................................................... 1
Historical Analysis of Latinx Mental Health Access: Migration Trends and Service Engagement 3
........... Rationale for the Study................................................................................................... 7 Demographic Variables and Mental Health Services ..................................................... 9 Cultural Influences on Service Utilization ..................................................................... 11 Socioeconomic Determinants in Access......................................................................... 14
Chapter 2: Literature Review...................................................................................................... 17
...........
........... Overview of Existing Research on Latinx Mental Health Access ................................. 17 Demographic Variations in Latinx Populations.............................................................. 19 Cultural Barriers to Mental Health Services.................................................................... 22 Socioeconomic Challenges in Service Utilization.......................................................... 25 Comparative Analysis of Hispanic Country of Origins................................................... 28 Identification of Research Gaps...................................................................................... 31
Chapter 3: Method....................................................................................................................... 35
Restating Purpose and Scope........................................................................................... 35
Research Questions and Hypotheses............................................................................... 37 Participants and Sample-Size Justification...................................................................... 43
Instruments and Measures............................................................................................... 44
Sampling and Data Collection......................................................................................... 46
Methods and Hypothesis Testing..................................................................................... 48
Chapter 4: Data Analysis............................................................................................................. 52
Overview of Quantitative Methods................................................................................. 52
Sample Selection and Description................................................................................... 54
Statistical Analysis Techniques....................................................................................... 55. Ethical Concerns...................................................................................................................................... 56
Outcomes......................................................................................................................... 57
Hypotheses Analysis........................................................................................................ 62
Chapter 5: Discussion and Conclusions 65
Key Findings............................................................................................................................... 65
Conclusions.................................................................................................................................. 69
References................................................................................................................................... 72