Date of Award
Summer 2008
Document Type
Dissertation - Restricted
Degree Name
Doctor of Philosophy (PhD)
Department
Psychology
First Advisor
Saunders, Stephen
Second Advisor
Guastello, Stephen
Third Advisor
Wierzbicki, Michael
Abstract
Substance abuse and dependence are common problems among the general population, but individuals with alcohol and substance use disorders (SUD), including Hispanics, generally underutilize mental health treatment. This study evaluated factors related to the underutilization of treatment services by Hispanics in the U.S. including demographics, resources, and illness variables. The study utilized the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) dataset. Analyses were conducted on 2,919 non-Hispanic white and Hispanic respondents who met criteria for a current SUD. These respondents were categorized according to whether they recognized a need for treatment. Those who did recognize the need for treatment were categorized according to whether or not they obtained treatment. Chi-square analyses revealed that non-Hispanic whites were less likely than Hispanics to recognize a need for treatment. Logistic regression analyses indicated that individuals with less than a high school education were more likely to recognize a need for treatment than those who completed high school. Furthermore, those who were widowed, divorced, or separated were more likely to recognize a need for treatment than those who were married or living together. Those with no insurance, or Medicare, Medicaid, or Veterans Administration (VA) coverage were more likely to recognize a need for treatment than those with private insurance, as were respondents who were unemployed. Illness severity also predicted recognizing the need for treatment: those with substance abuse were less likely than those with substance dependence, and those with no comorbid mental illness were less likely than those with a comorbid mental illness. Descriptive analyses revealed that non-Hispanic whites were significantly more likely to obtain treatment than Hispanics, as were respondents who were widowed, divorced, or separated. Logistic regression analyses indicated that respondents who met criteria for substance abuse were more likely to utilize treatment than those with substance dependence. This study isolated factors that impact treatment-seeking behavior among Hispanics, and might be useful in designing interventions to increase mental health service utilization for alcohol and substance use problems.