Census predictions indicate that by 2020 Latinos/as will constitute 15% of the U.S. population (U.S. Census Bureau, 2000). As of the 2000 Census, Latinos/as represented approximately 12.5% of the U.S. population, moving them ahead of African Americans as the largest ethnic minority population in the United States (Grieco & Cassidy, 2001). Furthermore, Latinos/as make up even larger portions of the population in some states. For example, in California, as of 2000, Latinos/as (primarily Mexican Americans) composed 32.2% of the population (U.S. Census Bureau, 2000). Although Latinos/as encompass various ethnic backgrounds, approximately 64% of the Latinos/as in the United States are of Mexican origin (Falicov, 1998), with the highest concentration in the southwestern United States (Gloria & Segura-Herrera, 2004; Santiago-Rivera, Arredondo, & Gallardo-Cooper, 2002). These figures may actually underestimate the number of Mexican Americans, given that undocumented immigrants often do not show up in U.S. Census Bureau data (Rogler, Malgady, & Rodriguez, 1989).
* Underuse of Counseling Services
Psychologists are aware that such an increase in the Mexican American population, by way of immigration and high birth rate, will produce a greater need for mental health services for this group. In addition to population increase, other factors experienced by Mexican Americans may also influence the need for more services. It is well documented that the Latino/a population experiences psychological stress from immigration (Falicov, 1998), poverty (Comas-Diaz, 1990; Gloria & Segura-Herrera, 2004), and acculturation (Abreu & Sasaki, 2004; Berry & Annis, 1974; Menas, Padilla, & Maldonado, 1987; Padilla, Alvarez, & Lindholm, 1986; Padilla, Wagatsuma, & Lindholm, 1985). The cumulative psychological distress from the various sources can be overwhelming, increasing the risk for mental health problems.
Considering the psychological distress that results from immigration, poverty, and acculturation, it is not surprising that psychiatric epidemiology studies indicate that Latinos/as experience more mental health problems than does any other ethnic population (Rogler et al., 1989; Williams & Harris-Reid, 1999). Moreover, such risk factors experienced by Mexican Americans may produce a greater need for mental health services to alleviate psychological distress and reduce mental illness for Mexican Americans. Nevertheless, despite the apparent need for services, there is evidence to suggest that Mexican Americans underuse mental health services (Abreu & Sasaki, 2004; Atkinson, Jennings, & Liongson, 1990; Castro, Coe, Gutierres, & Saenz, 1996; Keefe & Casas, 1978; Leong, Wagner, & Tata, 1995; Matin, Marin, Padilla, & De La Rocha, 1983; Reeves, 1986; Rogler et al., 1989; Zane, Hatanaka, Park, & Akutsu, 1994). Of those who do use mental health services, many do not return after the initial visit (Cheung & Snowden, 1990).
In their review of mental health practices among ethnic minorities, Leong et al. (1995) identified three explanations for underuse of mental health services. One hypothesis is that Mexican Americans have a lower incidence of mental illness. Epidemiological data cited by Rogler et al. (1989), however, contradict this hypothesis. The second factor identified in the literature as influencing help-seeking behaviors is institutional barriers. Structural incongruities that result in barriers include (a) lack of Spanish-speaking counselors, (b) inadequate financial resources, (c) location of mental health clinics outside of Latino/a communities, (d) culturally irrelevant therapeutic approaches, and (e) lack of ethnically similar counselors. These factors not only impede persistence in counseling but also may inhibit initial help-seeking intentions.
The third explanation identified by Leong et al. (1995), and the focus of the current study, is cultural barrier theory. …