Ethnicity and the Utilization of Mental Health Services: Stoicism versus Hypochondria

Dennis N. Quintana (Ph.D., 1990)

Thesis directed by Professor Peter G. Ossorio

Various explanations are offered in the literature for the fact that Mexican-Americans (M-As) are reluctant to utilize mental health services. Research in this area has focused on efforts to determine what sorts of cultural differences exist which might explain this pattern of underutilization. Typically, these efforts have examined M-A and Anglo-American (A-A) views of emotional disturbance and the appropriateness of various forms of intervention for dealing with personal problems. With few exceptions, little has been found in these empirical efforts which can serve to explain the phenomenon in any sort of definitive way.

The present study is based on a conceptual formulation which suggests that cultural displacement, along with other cultural and historical considerations, can serve as a useful model for understanding M-A reluctance to engage in the social practices of A-A institutions. Accordingly, four hypotheses were developed which address themselves to differences between M-As and A-As in their use of formal mental health services. These hypotheses were tested through the use of a questionnaire designed to assess views regarding source of discomfort, relative severity on sources of discomfort, the benefits of various forms of intervention, and the wisdom of waiting to seek mental health assistance for emotional disturbance. 37 M-A and 37 A-A walk-in clients at a community mental health center in Northern New Mexico were surveyed in order to determine if there were cultural differences in perceptions of these matters.

The findings indicate that there were clear differences between the groups. M-As, unlike A-As, perceive treatment as needing to be relatively straightforward and "medical" in nature. They see less value in pursuing psychological forms of intervention and they appear to tolerate much higher levels of distress, than do A-As, prior to seeking out these services. These findings indicate that mental health practitioners may need to modify treatment approaches in order to better meet the needs of Mexican-American clients.