The underutilization of mental health services in an ethnically and racially diverse, predominantly low -income population: An investigation of worldview

Research has demonstrated that ethnic and racial minorities and those of low socioeconomic status underutilize professional mental health services (Bullock & Lott, 2002; Neighbors, 1984; Shore, 1992; Snowden & Cheung, 1990). Despite this underutilization of services, ethnic/racial minorities and those of low socioeconomic status experience mental illness prevalence rates at least as high as the general population (Sue, Zane, & Young, 1994; Vega & Rumbaut, 1991). To date, the literature regarding mental health service utilization has focused upon demographics and other variables that may predict mental health service utilization (Sue & Sue, 1999). This study sought to move beyond demographics and investigate within group variability by examining the role of worldview in attitudes towards seeking professional psychological help in a predominantly low income, ethnically and racially diverse community population. After the background for the study was provided, the literature regarding the history of the underutilization of mental health services by racial/ethnic minorities and mental health and help-seeking among racial/ethnic minority groups and those of low socioeconomic status were reviewed. Within this review of the literature, the concepts of worldview, cultural differences in the perceptions of the etiology and treatment of mental health problems, and the role of attitudes in the mediation of behaviors were addressed. A sequential explanatory mixed-methodology was employed. In the initial quantitative phase, a series of descriptive statistics, a canonical discriminant function, and a regression analysis were conducted. Overall, results provided support that Caucasians were more likely to have positive attitudes toward seeking psychological help than non Caucasians in this racially/ethnically diverse, predominantly low income population. In addition, analyses revealed that worldview orientations significantly related to attitudes towards seeking psychological services. Finally, qualitative case study interviews were conducted with individuals from each primary worldview orientation to develop a deeper understanding of definitions of mental health and healing