Barrier to access and utilization of Healthcare to African American population with mental

health

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Part 2: literature review draft

Jon-Ubabuco and Dimmitt Champion (2019) conducted a study that focused on the

health-seeking behavior as well as the perceived mental healthcare barriers of Black American

caregivers of youth with mental health issues. The study indicates that black American youths

with mental health disorders have a high likelihood of experiencing higher depressive moods

rates while having a low likelihood of using mental health resources. Therefore, the caregivers of

these adolescents with mental health issues experience socio-ecological barriers when looking

for mental healthcare for the youths. The study used a qualitative research design with the data

collection instrument being semi-structured interviews. The study found out that stigmatization

and financial barriers are some of the perceived mental health barriers of caregivers of African

American teenagers with mental health issues. The study recommends that the ability of

healthcare providers engaging with caregivers, teenagers, as well as support systems enhances

the likelihood for affirmative experiences along with continuation of treatment. This study is of

high quality since it provides the perceived barriers that caregivers get in caring for teenagers

with mental health issues. One of the strengths of this study is that it uses caregivers that have

access to mental health services hence being capable of providing valid responses. Additionally,

the study uses semi-structured interviews which guide caregivers in responding to the questions.

The weaknesses of the study are that it uses a small sample size which means that the findings

cannot be generalized to the entire population. As well, the study does not incorporate caregivers

who do not have access to mental health services.

Connell et al. (2019) conducted a study examining the barriers to healthcare seeking

among Black American adults. The study compares as well as contrasts perceptions of healthcare

providers, volunteer community health advisors, and lay community members in regard to
interpersonal and structural barriers to healthcare seeking as well as provision among Blacks

experiencing health disparities in rural areas of Mississippi. The clinical practice issue under

investigation is healthcare seeking and provision of Blacks in Mississippi. The study used a

constant comparative method with the data collection instrument being focus groups. There were

a total of 64 participants which comprised of 40 females and 24 males. The study found out those

interpersonal barriers of gender socialization of Black males as well as prevention being a low

priority. The structural barriers were rurality, lack of health insurance, and poverty. The qualities

of the study are that the study uses a range of participants to collect the data from experts to lay

community members. Hence, one of the strength of the study is that it has a wide range of

participants who form three focus groups. Strength of the study is that it uses a large sample size

which means that the study can be generalized to the target population. The weaknesses of the

study are that the study focuses on two categories of barriers which are interpersonal and

structural barriers. Additionally, the study does not focus on the mental health service seeking

and provision.

Barriers were broadly categorized as structural and interpersonal with all groups noting structural

barriers including poverty, lack of health insurance, and rurality.

Lu et al. (2021) study focused on the facilitators and barriers of mental health service

utilization among ethnic/racial minority teenagers. The study acknowledges that mental health

disorders are a severe public health concerns in the United States with Whites adolescents having

a high likelihood of being affected by mental health disorders and having a low likelihood to

utilize mental health services. The study uses a systematic review of seven databases related to

facilitators and barriers of mental health service utilization among ethnic/racial minority

teenagers. The clinical practice issue of this study is barriers and facilitators of mental health
services use. The study reviewed 32 quantitative studies and (12) 37.5% of those studies

involved African Americans. The findings of the study indicated that some of the facilitators and

barriers of utilization of mental health services include psychological, behavioral, clinical, and

biological characteristic of minority adolescents. This study is of quality since it incorporates all

racial/ethnic minority youths. Therefore, one of the strengths of the study is using diverse

racial/ethnical minority youths. Also, the study uses a broad range of literature from seven

databases. The weaknesses of the study are that the findings of the study are that the study had

limited number of studies which means that it was hard to conduct more detailed analyses. The

study also used study from the seven databases which means journals published in other

databases not indexed were not included in the study.

Green et al. (2020) study examined the barriers to the use of mental health services as

well as predictors of treatment dropout in regard to ethnic/racial disparity in a population-based

research. The researchers acknowledge that a large number of adults with mental health disorders

in the United States do not receive treatment with the most affected being Asians, Latinos, and

Blacks as compared to Whites. The clinical practice issue being investigated is barriers of mental

health treatment and dropout of treatment among various racial/ethnic adults. This study is of

high quality since it incorporates different ethnic or racial groups and compares them. The study

uses a quantitative methodology and collected data/information from Collaborative Psychiatric

Epidemiology Studies. The study comprised of 1,417 participants. The findings of the study

indicate that Latinos had fewest attitudinal barriers and Latinos and Asians had lower perceived

need of mental health treatment as compared to African Americans and Whites. The strengths of

study are that the study compares different racial or ethnic adults in relation to mental health

treatment. Also the study uses a large sample size which means that the findings can be
generalized. The weaknesses of the study are that the findings are based on retrospective

research done in the last 12 months prior to the publication of the study hence leading to recall

bias and that respondents were provided with a list of barriers which were established on

previous research.

Cyr et al. (2019) study, on the other hand focuses on investigating the access to specialty

healthcare in urban populations as compared to rural United States population. Specifically, the

study focuses on the barriers and facilitators of specialty care in rural versus urban U.S

populations. The clinical practice issue under investigation is the access to specialty healthcare.

The study systematically reviews literature in five databases which include ProQuest, PsycInfo,

PubMed, Medline, and CINAHL and these studies were published between 2013 and 2018. A

total of 67 articles were reviewed. The findings of the study indicated numerous access barriers

and facilitators despite the demographic and geographic differences. Some of these barriers and

facilitators are stigma, accommodation and availability, ability to perceive, appropriateness,

insurance and government policy, and health operations and organization. The strengths of the

study are that the systematic review incorporates both quantitative and qualitative studies which

mean that the study provides a more detailed analysis. Additionally, the findings can provide

quantitative data. The weaknesses of the study are that the systematic review was limited to five

databases and that only peer-reviewed journals were used which indicate that the study did not

incorporate literature from other journals.

Fante-Coleman and Jackson-Best (2020) study focused on the facilitators and barriers of

Black youths in accessing mental healthcare in Canada. This is due to the fact that Black youth

and children in Canada unevenly face challenges in accessing mental healthcare. The clinical

practice issue being investigated is the barriers and facilitators of mental healthcare. This study is
of high quality since it uses a systematic review of previous research. The study systematically,

reviews six databases which are EBSCOhost, PubMed, PsycINFO, CINAHL, Applied Social

Sciences Index and Abstracts, and Social Science Citation Index. The reviewed articles were

published between 2005 and 2019. This study is of high quality since it uses both peer-reviewed

literature and gray literature. Approximately 33 articles were reviewed. The strengths of the

study are that it involves both peer-reviewed literature and gray literature. Additionally, the study

quantifies the data. The weaknesses of the study are that it uses a limited number of databases

and there is lack of relevant research since the studies focus on the developmental aspects of

Black youths.

Martinez et al. (2020) study examined the barriers and facilitators of seeking help for

mental health issues among Filipinos. The study indicates that approximately six million

Filipinos live with anxiety or depression hence being among the countries with the highest rate

of mental health issues in the Western Pacific Region. The clinical practice issue under

investigation in the Martinez et al. study is mental health issues. The study systematically

reviews 15 studies that have been carried out in seven nations on Filipino seeking help. The

findings of the study indicated that Filipinos prefer to seek help from close friends and family.

Some of the barriers that deter Filipinos from seeking help include services’ inaccessibility and

financial barriers, while overseas Filipinos are constrained by language difficulty, lack of health

insurance, and immigration status. The strengths of the study is that reviews articles from seven

countries and that the study focuses on local Filipinos and overseas Filipinos. The weaknesses of

the study are that it reviews limited studies which mean that the analysis is not more detailed.

Additionally, the study failed to indicate the actual support or type of assistance that Filipinos

required.
 References

Connell, C. L., Wang, S. C., Crook, L., & Yadrick, K. (2019). Barriers to healthcare seeking and

provision among African American adults in the rural Mississippi Delta region:

community and provider perspectives. Journal of community health, 44, 636-645.

https://doi.org/10.1007/s10900-019-00620-1

Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to specialty

healthcare in urban versus rural US populations: a systematic literature review. BMC

health services research, 19(1), 1-17. https://doi.org/10.1186/s12913-019-4815-5

Fante-Coleman, T., & Jackson-Best, F. (2020). Barriers and facilitators to accessing mental

healthcare in Canada for Black youth: A scoping review. Adolescent Research

Review, 5(2), 115-136. https://doi.org/10.1007/s40894-020-00133-2

Green, J. G., McLaughlin, K. A., Fillbrunn, M., Fukuda, M., Jackson, J. S., Kessler, R. C., ... &

Alegría, M. (2020). Barriers to mental health service use and predictors of treatment drop

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https://doi.org/10.1007/s10488-020-01021-6

Jon-Ubabuco, N., & Dimmitt Champion, J. (2019). Perceived mental healthcare barriers and

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health disorders. Issues in mental health nursing, 40(7), 585-592.

https://doi.org/10.1080/01612840.2018.1547803

Lu, W., Todhunter-Reid, A., Mitsdarffer, M. L., Muñoz-Laboy, M., Yoon, A. S., & Xu, L.

(2021). Barriers and facilitators for mental health service use among racial/ethnic
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641605. https://doi.org/10.3389/fpubh.2021.641605

Martinez, A. B., Co, M., Lau, J., & Brown, J. S. (2020). Filipino help-seeking for mental health

problems and associated barriers and facilitators: A systematic review. Social Psychiatry

and Psychiatric Epidemiology, 55, 1397-1413.