Despite advances in public understanding of mental health and the importance of mental health treatment there is still a significant proportion of individuals who need help but do not seek out treatment. Existing research identifies a range of reasons including both subjective reasons (e.g., believing treatment will not work) to objective reasons (e.g., cost). However, there is limited understanding of how the variety of reasons people give for foregoing treatment group together. This study uses k-modes clustering analysis with a subsample of participants from the Collaborative Psychiatric Epidemiology Surveys to determine if 1) there are identifiable subgroups of reasons for forgoing treatment for a mental health issue and 2) do these subgroups differ in terms of demographics and disorder-related variables. We identify four subgroups of reasons - one clearly comprised of subjective reasons, one clearly comprised of objective reasons, and two that are a mix. The demographic and disorder-related profiles of these clusters provide some additional insight into the interrelationship among reasons for not seeking help for a mental health issue. As such, this study can contribute to ongoing discussions about where to prioritize efforts to ensure that those in need are seeking treatment.
African Americans express stronger norms of familism compared to other racial and ethnic groups in the United States. Frequently overlooked is whether attitudes toward family and/or government support for older adults varies by lifecourse stage (young adult, middle age, and older adults) among African Americans as well as by type of support. Using data from the 2001-2003 National Survey of American Life Adult Reinterview (n=1696, aged 18-90), we conducted multinomial logistic regression analyses to examine whether attitudes toward family, equal family and government, or government responsibility for financial, household chores, and personal care support to older adults varies by the lifecourse stage of African Americans- young adults (18-39), midlife (40-64), and older adults (65 and older). Findings show that older adults had a lower likelihood than young adults of endorsing equal responsibility for financial support, whereas midlife adults had a higher likelihood than young adults of endorsing mainly government responsibility for financial support to older adults. Older adults were more likely than young adults to endorse mainly government responsibility for household chores and personal care support for older adults. Our study advances the existing literature on family support norms among African Americans by showing that lifecourse stage is an important factor in attitudes toward family-based responsibility for supporting older adults, potentially due to differences in resources and awareness of the need for government involvement in different types of support.
