This study uses data from a household survey (Mexican American Prevalence and Services Study; MAPSS) of 3,000 respondents in Fresno County, California, to 1) contrast use across multiple sectors of care among immigrant and U.S. born Mexican Americans with recent psychiatric disorders, 2) contrast multiple provider utilization patterns, and 3) identify specific factors associated with the use of mental health specialty and general medical sectors. Immigrants and U.S. born disproportionately used the general medical sector for treating mental health problems. The U.S. born were more likely to use family physicians and counselors than were immigrants, and neither relied heavily upon informal network providers to treat psychiatric disorders. A comparison of patterns showed that most people with a recent disorder used a combination of providers. The logistic regression analyses showed that knowing where to find a provider increased the likelihood of specialty mental health use by an odds ratio (O.R.) of 4.68. Private insurance increased use of mental health providers, O.R. = 3.76. Public insurance availability did not increase mental health provider use, suggesting that other factors were linked to use of mental health specialty care. Public insurance did increase medical sector care for psychiatric problems, O.R. = 2.57. Poor self-rated mental health status was primarily associated with use of physicians by U.S. born (O.R. = 5.39). Severe mental health impairment increased use of both general medical (O.R. = 5.54) and specialty mental health (O.R. = 5.1) providers. These results point out that eligibility for public insurance is a necessary but not sufficient status to increase mental health sector care among immigrants, and education and more effective referral from other sectors are needed to encourage use of these services.
