# Accessing mental health care: A population-level exploration of the impact of immigration duration in the United States 2019–2023

## TL;DR

Recent immigrants in the U.S. are less likely to access mental health care compared to those who have lived in the country longer, highlighting a need for policy changes to address this disparity.

## Contribution

This study provides population-level evidence on how immigration duration affects mental health service use among immigrants in the U.S.

## Key findings

- Recent immigrants (<5 years) had 46% lower odds of receiving mental health care compared to those in the U.S. for ≥5 years.
- No significant variations in the relationship were found across citizenship status, symptom severity, or during the COVID-19 period.
- The findings suggest a need for targeted interventions to improve mental health service access for recent immigrants.

## Abstract

Immigrant populations in the United States are known to experience worsening mental health as time since immigration increases, with consistently lower rates of mental health service engagement compared to their domestic-born counterparts. However, there is little evidence investigating how time since immigration affects mental health service use. Using 2019–2023 National Health Interview Survey data, this population-based study examines how time since immigration influences use of mental health services among immigrants reporting monthly or more depression or anxiety symptoms among civilian, non-institutionalized adults in the United States. Of the 6,201 participants (representing 11.9 million adults annually), 21.2% reported accessing medication or counselling. Multivariable logistic regression analyses found that recent immigrants (<5 years) had 46% lower odds of receiving care compared to those residing in the United States for ≥5 years (95% CI: 0.38, 0.78). Sensitivity analyses lent robustness to study findings. Effect modification analyses revealed no significant variations in the relationship between time since immigration and mental health service use across citizenship status, symptom severity, and COVID-19 periods. Findings highlight the need for targeted interventions and policy reforms to address disparities in mental health service use among immigrants, promoting equitable access and improving well-being for recent immigrants.