Factors Associated with Mental Health Service Utilization Among Ethiopian Immigrants and Refugees
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ORIGINAL PAPER
Factors Associated with Mental Health Service Utilization Among Ethiopian Immigrants and Refugees Selam G. Ayele1 · Melva Thompson‑Robinson2 · Johanna Andrews2 · Carolee Dodge Francis3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study assesses factors associated with mental health service utilization by Ethiopian immigrants and refugees in the U.S. A cross-sectional survey, based on Anderson and Newman’s Framework of Health Services, which examines facilitators and barriers of service utilization, was implemented to gather data from 297 Ethiopian immigrants and refugees in the U.S. from February to March 2018. Descriptive statistics, chi-squared tests, and logistic regression were calculated. Approximately 13.3% of participants sought mental health services from healthcare professionals; while 17.3% utilized non-healthcare professionals for mental health problems. A mental health need (depressive symptoms) was identified. A model containing predictors of mental health service use was statistically significant, with gender, marital status, and employment (full-time or part-time) as the strongest predictors. The findings suggest a need for the development of culturally appropriate interventions and implementation of policies to minimize barriers to mental health services among this under-researched population. Keywords Mental health · Health care utilization · Immigrants · Depression
Introduction Although three-fourths of the foreign population from Africa migrated to the U.S. after 1990, Ethiopians, mainly students on scholarship seeking further education and technical training, began migrating to the U.S. in the 1920s [1, 2]. From a handful of Ethiopians in the 1920s, the number increased to the thousands by the 1970s [3, 4]. The second wave of Ethiopian immigrants was not until the 1980s, when Ethiopians were forced to leave their country as result of “The Red Terror,” a violent political campaign [2, 4]. The Ethiopian immigrant population in the U.S. has increased over the years. Between 2008 and 2012, Ethiopia ranked second as country of origin for African immigrants in the United States, with a population of 164,000 [1]. Furthermore, * Melva Thompson‑Robinson melva.thompson‑[email protected] 1
Honors College, University of Nevada Las Vegas, Las Vegas, NV, USA
2
Center for Health Disparities Research, University of Nevada Las Vegas, 4505 Maryland Pkwy, Box 453050, Las Vegas, NV 89154‑3050, USA
3
School of Human Ecology, University of Wisconsin, Madison, Madison, WI, USA
between 2010 and 2014, Ethiopia became one of the countries with the largest percentage increase in the number of immigrants living in the U.S. [5]. Despite the large number of Ethiopian immigrants living in the U.S., limited research has been conducted with this population. Immigrants and refugees are vulnerable to psychological illnesses due to the stressors they face unique to migration [6]. According to the stress process model, known as Migration Contingencies and Me
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