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James S. Jackson, PhD, Harold W. Neighbors, PhD, Myriam Torres, MS, Lisa A. Martin, MA, David R. Williams, PhD and Raymond Baser, MS

James S. Jackson and Harold W. Neighbors are with the School of Public Health, Department of Health Behavior and Health Education, and the Institute for Social Research, University of Michigan, Ann Arbor. Myriam Torres and Raymond Baser are with the Institute for Social Research, University of Michigan, Ann Arbor. Lisa A. Martin is with the School of Public Health, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor. David R. Williams is with the School of Public Health, Department of Society, Human Development and Health, Harvard University, Cambridge, Mass.

Correspondence: Requests for reprints should be sent to Jennifer Lowe, Institute for Social Research, University of Michigan, Ann Arbor, MI 48106–1248 (e-mail: jdlowe{at}umich.edu.)

ABSTRACT

Objectives. We examined the use rates and correlates of formal psychiatric services among the US-born and immigrant Caribbean Black population.

Methods. We compared overall mental health service use in samples of Caribbean Blacks and African Americans and examined the within-sample ethnic variation among Caribbean Blacks, including for ethnic origin (Spanish Caribbean, Haiti, and English Caribbean), nativity status (those born in or outside the United States), number of years spent living in the United States, age at the time of immigration, and generational status.

Results. African Americans and Caribbean Blacks used formal mental health care services at relatively low rates. Among Caribbean Blacks, generational status and nativity showed the greatest effects on rates of reported use, satisfaction, and perceived helpfulness. Of those study participants who met the criteria for disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, about one third used formal mental health care services. The US-born subjects were more likely to receive care than were first-generation immigrants.

Conclusions. Our study underscores the importance of ethnicity, immigration, and migration-related factors, within racial categorization, as it pertains to the use of mental health services in the United States. Our findings suggest that timing of migration and generational status of Caribbean Black immigrants and ancestry groups contribute to important differences in rates and sources of use, relative satisfaction, and perception of helpfulness, with regard to formal mental health services.

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