| Many studies on mental health service use have found that racial and ethnic minorities and older adults underutilize mental health services when faced with a mental disorder. However, most studies have failed to acknowledge the multifaceted role that informal support can play in the help-seeking process. Using data from the National Survey of American Life (NSAL), a nationally representative sample of African Americans, Caribbean Blacks, and non-Hispanic Whites in the continental United States, this dissertation examines the use of both professional services and informal support among adults with a lifetime mood or anxiety disorder. In particular, it addresses the following questions: (1) To what extent do adults with a mood or anxiety disorder use professional services only, informal support only, both professional services and informal support, or not receive any help at all and how do these patterns of help-seeking vary by race (comparing Black Americans and non-Hispanic Whites) and across age cohorts? (2) How do these patterns of help-seeking vary among Black Americans (comparing African Americans and Caribbean Blacks)? (3) To what extent do adults aged 55 and older use professional services and informal support as complements to or substitutes for one another and what factors predict the use of professional services among older adults? The results suggest that adults with a lifetime mood or anxiety disorder tend to use professional services and informal support as complements to rather than substitutes for one another. African Americans and Caribbean Blacks are less likely than Whites to receive help from either source; however, differences between African Americans and Whites appear to be driven by differences in socioeconomic status. There appears to be no difference in help-seeking between African Americans and Caribbean Blacks. Older adults tend to use both professional services and informal support while younger adults are more likely to rely exclusively on informal support. The findings provide important insights into the help-seeking process. Implications for practice, policy, and future research are discussed. |
