Mental Health Access in the United States.: A Cross-Ethnic Comparative Study

The prevalence and impact of mental health challenges among racially and ethnically diverse populations have received growing attention in recent years. This study investigates the factors associated with mental health service utilization and unmet mental health care needs among minoritized adults in the United States. Drawing on data from the 2021-2022 National Health Interview Survey (NHIS), an annual survey of the U.S. civilian, noninstitutionalized population that understands public health conditions, this study included a sample of Asian, Black/African American, and Hispanic participants (N = 16,245). A secondary data analysis was conducted using a multinomial logistic regression framework to examine how predisposing, enabling, and need-based factors influence patterns of mental health service use, guided by Andersen's Behavioral Model of Health Services Use. Findings highlight persistent disparities, showing that Black and Hispanic individuals who reported living with disabilities were more likely to forgo mental health services due to cost. Additionally, Asian older adults were less likely to report receiving mental health services. Meanwhile, Asian young adults who had never been married and who experienced anxiety had the highest odds of delaying mental health care. Together, these findings underscore the importance of culturally responsive strategies to improve access and equity in mental health services for minoritized individuals with intersecting social identities, as well as the need to strengthen training for culturally competent providers with attention to cultural diversity, acculturation processes, language proficiency, and advocacy.