Nonetheless, the rapidly increasing Amish population, the decline in geographical isolation, and the increasing connectivity of society have resulted in increasing numbers of Amish entering English society for work, business, and services ( Kraybill, 1994). The Amish have historically chosen to remain insulated from the greater American society, referred to as English. One particularly underrepresented group, the Old Order Amish (henceforth shortened to “Amish”), have underutilized mental health services for a variety of reasons including stigma, distrust, and historical injustices perpetrated by the non-Amish society at large ( Kraybill, 1993 Nolt, 2011). Many different cultural and ethnic minority groups, however, have consistently underutilized mental health services ( Brinson & Kottler, 1995 Dobalian & Rivers, 2008). Recent estimates suggest that the number of people seeking mental health treatment has increased significantly in the past 20 years ( Kessler et al., 2005 Mojtabai, 2005 Lipson, Lattie, & Eisenberg, 2019).
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