Latinos’ Use of Mental Health-Related Services: Using a HealthCrit and LatCrit Lens to Examine the Role of Perceived Ethnic Discrimination as an Indicator of the Socio-Environmental Consequences of Living in a Racialized Society

The current political climate has erupted long standing undercurrents of racism and hatred in the U.S. with a particular focus on Latinos and immigrants. The ill effects of this climate have been well established. However, little research has examined how discrimination or neighborhood crime can contribute to Latinos’ need for and use of mental health services. Building upon existing research and drawing from the Public Health Critical Race praxis and Latino Critical Theory, this dissertation aims to ascertain the relationship between perceived ethnic discrimination, perceived neighborhood crime and Latinos’ use of mental health-related services; whether a diagnosable disorder mediates or moderates this relationship; and how these relationships differ by nativity and citizenship status. Data are drawn from the National Latino and Asian American Study (NLAAS). Multiple multivariate logistic regression models with mediation and moderation methods were used. This study finds perceived ethnic discrimination and perceived neighborhood crime have a statistically significant positive association with mental health-related service use and varied by Latinos’ nativity and citizenship status. From mediation analyses, this study supports a hypothesized causal mechanism which finds that having a disorder may partially explain the relationship between perceived ethnic discrimination and services use among U.S.-born Latinos only, and may fully explain the relationship between perceived neighborhood crime and service use among noncitizen Latinos only. From moderation analyses, this study supports the conditioning effect of having a disorder. Increases in perceived ethnic discrimination increased service use among U.S.-born Latinos without a disorder, but was a slight barrier to service use for similar Latinos with a disorder. Also, increases in perceived neighborhood crime increased service use for noncitizen Latinos with a disorder, but had no service effect for similar Latinos without a disorder.This study moves the field forward by establishing a relationship between perceived ethnic discrimination, perceived neighborhood crime and mental health-related services use among Latinos. Different aspects of racialization in the U.S. need to be critically identified and assessed to properly address the social and political determinants of poor mental health and service use among Latinos. The findings of this study have important implications for theory, practice and policy