We examine how families influence mental health service (MHS) utilization among African Americans by drawing on the concept of family ambivalence, which encompasses both family support and stress, and by placing utilization within the context of family histories of psychiatric disorder and treatment. Data are from the 2001–2003 National Survey of American Life, a nationally representative sample of African American adults (n = 3,149), including a clinical need subsample (n = 605) of respondents with a disorder. Negative family interactions have indirect positive effects on use of any MHS through need for care, whereas family social support lacks any effect. Although poor self-rated mental health (SRMH) is associated with greater utilization of any and specialty MHS given family histories of no disorder or treated disorder, utilization is low given a family history of untreated disorder, irrespective of SRMH. Screening for family histories of psychiatric disorder in primary care is recommended.
Abe-KimJenniferTakeuchiDavidHwangWei-Chin. 2002. “Predictors of Help Seeking for Emotional Distress Among Chinese Americans: Family Matters.” Journal of Consulting and Clinical Psychology70(5):1186–90.
2.
Albizu-GarciaCarmen E.AlegríaMargaritaFreemanDanielVeraMildred. 2001. “Gender and Health Services Use for a Mental Health Problem.” Social Science & Medicine53(7):865–78.
3.
AlegríaMargaritaCaninoGlorisaRiosRuthVeraMildredCalderonJoseRuschDanaOrtegaAlexander N.2002. “Inequalities in Use of Specialty Mental Health Services among Latinos, African Americans, and Non-Latino Whites.” Psychiatric Services53(12):1547–55.
4.
American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington, DC: Author.
5.
AugustKristin J.RookKaren S.NewsomJason T.2007. “The Joint Effects of Life Stress and Negative Social Exchanges on Emotional Distress.” Journal of Gerontology62B(5):S304–14.
6.
BreslauJoshuaAguilar-GaxiolaSergioKendlerKenneth S.SuMaxwellWilliamsDavidKesslerRonald C.2006. “Specifying Race-ethnic Differences in Risk for Psychiatric Disorder in a USA National Sample.” Psychological Medicine36(1):57–68.
7.
BreslauJoshuaKendlerKenneth S.SuMaxwellGaxiola-AguilarSergioKesslerRonald C.2005. “Lifetime Risk and Persistence of Psychiatric Disorders across Ethnic Groups in the United States.” Psychological Medicine35(3):317–27.
8.
ClausenJohn A.YarrowMarian Radke. 1955. “Mental Illness and the Family.” Journal of Social Issues11:3–5.
9.
DialaChamberlainMuntanerCarlesWalrathChristineNickersonKim J.LaVeistThomas A.LeafPhilip J.2000. “Racial Differences in Attitudes Towards Professional Mental Health Care and in the Use of Services.” American Journal of Orthopsychiatry70(4):455–64.
10.
HarrisKatherine M.EdlundMark J.LarsonSharon. 2005. “Racial and Ethnic Differences in the Mental Health Problems and Use of Mental Health Care.” Medical Care43(8):775–84.
11.
HeeringaSteven G.WagnerJamesTorresMyriamDuanNaihuaAdamsTerryBerglundPatricia. 2004. “Sample Designs and Sampling Methods for the Collaborative Psychiatric Epidemiology Studies (CPES).” International Journal of Methods in Psychiatric Research13(4):221–40.
12.
Hines-MartinVickiBrown-PiperAdaKimSanggilMaloneMary. 2003. “Enabling Factors of Mental Health Service Use among African Americans.” Archives of Psychiatric Nursing17(5):197–204.
13.
Hines-MartinVickiMaloneMaryKimSanggilBrown-PiperAda. 2003. “Barriers to Mental Health Care Access in an African American Population.” Issues in Mental Health Nursing24(3):237–56.
14.
KendlerKenneth S.1995. “Is Seeking Treatment for Depression Predicted by a History of Depression in Relatives? Implications for Family Studies of Affective Disorder.” Psychological Medicine25:807–14.
15.
KesslerRonald C.DemlerOlgaFrankRichard G.OlfsonMarkPincusHarold AlanWaltersEllen E.WangPhilipWellsKenneth B.ZaslavskyAlan M.2005. “Prevalence and Treatment of Mental Disorders, 1990–2003.” The New England Journal of Medicine352(24):2515–23.
16.
LincolnKaren D.TaylorRobert JosephChattersLinda M.2003. “Correlates of Emotional Support and Negative Interaction among Older Black Americans.” Journal of Gerontology58B(4):S225–33.
17.
LincolnKaren D.TaylorRobert JosephChattersLinda M.2012. “Correlates of Emotional Support and Negative Interaction among African Americans and Caribbean Blacks.” Journal of Family Issues:1–29.
18.
LindseyMichaelJoeSeanNebbittVon. 2010. “Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking among African American Boys.” Journal of Black Psychology36(4):458–82.
19.
MacKinnonDavid P.2008. Introduction to Statistical Mediation Analysis. New York: Taylor & Francis Group, LLC.
20.
MeadowsG.BurgessP.FosseyE.HarveyC.2000. “Perceived Need for Mental Health Care, Findings from the Australian National Survey of Mental Health and Well-being.” Psychological Medicine30(3):645-656.
21.
MechanicDavid. 2003. “Is the Prevalence of Mental Disorders a Good Measure of the Need for Services?”Health Affairs22:8–20.
22.
MoodCarina. 2010. “Logistic Regression: Why We Cannot Do What We Think We Can Do, and What We Can Do about It.” European Sociological Review26(1):67–82.
23.
NeighborsHarold W.CaldwellCleopatraWilliamsDavid R.NesseRandolphTaylorRobert JosephBullardKai McKeeverTorresMyriamJacksonJames S.2007. “Race, Ethnicity, and the Use of Services for Mental Disorders: Results from the National Survey of American Life.” Archives of General Psychiatry64(4):485–94.
24.
NeighborsHarold W.WoodwardAmanda TolerBullardKai McKeeverFordBriggett C.TaylorRobert JosephJacksonJames S.2008. “Mental Health Service Use among Older African Americans: The National Survey of American Life.” The American Journal of Geriatric Psychiatry16(12):948–56.
25.
PescosolidoBernice A.1992. “Beyond Rational Choice: The Social Dynamics of How People Seek Help.” AJS97:1096–138.
26.
PescosolidoBernice A.BoyerCarol A.2010. “Understanding the Context and Dynamic Social Processes of Mental Health Treatment.” Pp. 420–38 in A Handbook for the Study of Mental Health, edited by ScheidT. L.BrownT. N.Cambridge: Cambridge University Press.
27.
PescosolidoBernice A.GardnerCarol BrooksLubellKeri M.1998. “How People Get into Mental Health Services: Stories of Choice, Coercion and 'Muddling Throught' from 'First Timers.'”Social Science & Medicine46(2):275–86.
28.
ProctorBernadette D.DalakerJoseph. 2002. Poverty in the United States: 2001. Washington, DC: U.S. Census Bureau.
29.
ProkofyevaElenaMartinsSilvia S.YounèsNadiaSurkanPamela J.MelchiorMaria. 2013. “The Role of Family History in Mental Health Service Utilization for Major Depression.” Journal of Affective Disorders151:461–66.
30.
RookKaren S.1998. “Investigating the Positive and Negative Sides of Personal Relationships: Through a Lens Darkly?” Pp. 369–93 in The Dark Side of Close Relationships, edited by SpitzbergB. H.CupachW. R.Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
31.
SchorEdwardStarfieldBarbaraStidleyChristineHankinJanet. 1987. “Family Health: Utilization and Effects of Family Membership.” Medical Care25(7):616–26.
32.
SherbourneCathy Donald. 1988. “The Role of Social Support and Life Stress Events in Use of Mental Health Services.” Social Science & Medicine27:1393–1400.
33.
SnowdenLonnie R.2001. “Barriers to Effective Mental Health Services for African Americans.” Mental Health Services Research3(4):181–87.
34.
SnowdenLonnie R.PingitoreDavid. 2002. “Frequency and Scope of Mental Health Service Delivery to African Americans in Primary Care.” Mental Health Services Research4(3):123–30.
SussmanLinda K.RobinsLee N.EarlsFelton. 1987. “Treatment-seeking for Depression by Black and White Americans.” Social Science & Medicine24(3):187–96.
37.
TaylorRobert JosephChattersLinda M.1991. “Extended Family Networks of Older Black Adults.” Journal of Gerontology46(4):S210-217.
38.
ThoitsPeggy A.1985. “Self-labeling Processes in Mental Illness: The Role of Emotional Deviance.” AJS91:221–49.
39.
ThoitsPeggy A.2011a. “Mechanisms Linking Social Ties and Support to Physical and Mental Health.” Journal of Health and Social Behavior52(2):145–61.
40.
ThoitsPeggy A.2011b. “Perceived Social Support and the Voluntary, Mixed, or Pressured Use of Mental Health Services.” Society and Mental Health1(1):4–19.
41.
ThomasWilliam IsaacThomasDorothy Swaine. 1928. The Child in America: Behavior Problems and Programs. New York: Knopf.
42.
VogelDavid L.WadeNathaniel G.WesterStephen R.LarsonLisaHacklerAshley H.2007. “Seeking Help from a Mental Health Professional: The Influence of One’s Social Network.” Journal of Clinical Psychology63(3):233–45.
43.
WangPhilip S.LaneMichaelOlfsonMarkPincusHarold A.WellsKenneth B.KesslerRonald C.2005. “Twelve-month Use of Mental Health Services: Results from the National Comorbidity Survey Replication.” Archives of General Psychiatry62(6):629–40.
44.
WheatonBlairYoungMarisaMontazerShirinStuart-LahmanKatie. 2013. “Social Stress in the Twenty-First Century.” In Handbook of the Sociology of Mental Health, edited by AneshenselC. S.PhelanJ. C.BiermanA.New York: Springer.
45.
WilliamsDavid R.GonzalezHector M.NeighborsHaroldNesseRandolphAbelsonJamie M.SweetmanJulieJacksonJames S.2007. “Prevalence and Distribution of Major Depressive Disorder in African American, Caribbean Blacks, and Non-Hispanic Whites: Resutls from the National Survey of American Life.” Archives of General Psychiatry64(3):305–15.
46.
WoodwardAmanda TolerTaylorRobert JosephBullardKai McKeeverNeighborsHarold W.ChattersLinda M.JacksonJames S.2008. “Use of Professional and Informal Support by African Americans and Caribbean Blacks with Mental Disorders.” Psychiatric Services59(11):1292–98.
47.
YokopenicPatricia A.ClarkVirginia A.AneshenselCarol S.1983. “Depression, Problem Recognition, and Professional Consultation.” The Journal of Nervous and Mental Disease171(1):15–23.
