摘要：Objectives. We examined differences in the use of mental health services, conditional on the presence of psychiatric disorders, across groups of Mexico’s population with different US migration exposure and in successive generations of Mexican Americans in the United States. Methods. We merged surveys conducted in Mexico (Mexican National Comorbidity Survey, 2001–2002) and the United States (Collaborative Psychiatric Epidemiology Surveys, 2001–2003). We compared psychiatric disorders and mental health service use, assessed in both countries with the Composite International Diagnostic Interview, across migration groups. Results. The 12-month prevalence of any disorder was more than twice as high among third- and higher generation Mexican Americans (21%) than among Mexicans with no migrant in their family (8%). Among people with a disorder, the odds of receiving any mental health service were higher in the latter group relative to the former (odds ratio = 3.35; 95% confidence interval = 1.82, 6.17) but the age- and gender-adjusted prevalence of untreated disorder was also higher. Conclusions. Advancing understanding of the specific enabling and dispositional factors that result in increases in mental health care may contribute to reducing service use disparities across ethnic groups in the United States. Epidemiological studies have found that migration from Mexico to the United States is associated with a dramatic increase in psychiatric morbidity. Risk for a broad range of psychiatric disorders, which is relatively low in the Mexican general population, is higher among Mexican-born immigrants in the United States and higher still among US-born Mexican Americans. 1–5 Risk among US-born Mexican Americans is similar to that of the non-Hispanic White population. 6 Recent research suggests that the association between migration and mental health extends into Mexico, where return migrants and family members of migrants are at higher risk for substance use disorders than those with no migrant in their family. 3,7 Little is known about the influence of cultural and social changes associated with migration on the use of mental health services. As the mental health system is much more extensive 8 and use of mental health service is much more common 9 in the United States than in Mexico, we expect that Mexican Americans would use mental health services more frequently than their counterparts in Mexico. However, it is not known whether the increase in service use keeps pace with the increase in prevalence of psychiatric disorders. Moreover, in the United States, Hispanics in general and Mexican Americans in particular are less likely to receive mental health services than are non-Hispanic Whites, 10–12 and immigrants are less likely to use mental health services than the US born, particularly if they are undocumented. 13 We made use of a unique data set formed by merging surveys conducted in Mexico and the United States that used the same survey instrument. We used these data to examine differences in past-year mental health service use, conditional on the past-year prevalence of psychiatric disorder, associated with migration on both sides of the Mexico–US border.
