Lannert, B. K. (2010). Predictors of help-seeking in a national sample of Asian American: The effects of demographics, language, disorder, distress, and ethnicity
Summary of Topic
The topic of this thesis focuses on mental health issues which affect many people from all over the world. However, some people may seek out help for their mental health problems and some do not. The cause of this may be related to various factors such as age, gender, mental disorder status, language barriers, distress, or even discrimination. However, other causes may be different cultural beliefs and norms for people of different races that have their own unique views and behaviors toward seeking out help for their mental issues through the use of professional mental health services. Mental health behaviors among a race may be associated with the perceptions, attitudes, values as well as the beliefs of those affected. This is also subjective to individual experiences for those who deal with mental health problems, which is specific to underutilization of mental health services and disparities in care.
This thesis deals with mental health disparities as it pertains to help-seeking and underutilization of mental health services as a barrier to care for minority populations, particularly the population of Asian Americans/Pacific Islanders (AAPIs).
Statement of the Problem
This work also examines study findings that show AAPIs suffer from mental health problems as much as non-Hispanic Whites, but are not as likely to seek out and utilize mental health services, and there is a significant disparity in this area.
Review of the Literature
This thesis, as stated, highlights disparities in the mental health services utilization among Asian Americans/Pacific Islanders, as compared to non-Hispanic Whites. The research proposes this remains a barrier to positive and equal mental healthcare outcomes for ethnic minority populations, in general, but for the AAPIs in particular. This is found in research study evidence that shows the AAPI population to consistently and notoriously underutilize available mental health services as a way of help-seeking for their mental health conditions.
The research explains the signficance of the under-representation of racial-ethnic minority patient populations for mental health services utilization, as reported by the U.S. Department of Health and Human Services. This is true even though this group of people have comparable numbers of individuals who suffer from mental health problems as do those in the general population. The author points out the importance of understanding the reasons why this segment of the population is underserved in the area of mental healthcare, particularly as it pertains to specific factors such as their traits and life experiences and circumstances. This is the way to understanding their real and perceived barriers to help-seeking for professional mental health assessment and treatment. Understanding the barriers is also a way to eliminate them and improve access to quality healthcare and remedy service inequalities so that healthcare disparities are reduced or eliminated. This is particularly true of Asian Americans, as the focus group of this thesis.
The theory in this research focuses on assessing the predictive value of variables on help-seeking behaviors, by range. The author gives a comprehensive background about Asian Americans as it pertains to mental healthcare utilization, treatment and care, as compared to other ethnic minorities, Asian groups, and non-Hispanic Whites. The thesis also covers influencing factors such as socio-economic status, culture, education, mental health status, distress level, discrimination, and English-language proficiency barriers on help-seeking behaviors toward mental health services. These are the predictor variables assessed in the study.
Based on the predictor variables, the research aimed at predicting help-seeking behaviors of the study group as assessed by 1) use of any health service, 2) use of formal health services, 3) use of informal health services, and 4) use of speciality mental health services.
Research Method Used
The research was carried out by household surveys of Asian Americans, and participants were obtained from the 2002-2003 Asian American subset in the National Latino and Asian American Survey (NLAAS), according to the thesis. Data was collected on mental illness prevelance, impairment and treatment patterns of certain mental health disorders, and this was gathered from representative samples of the U.S. general adult population. Other demographic data, as discussed in this review, was collected as well.
The research sample consisted of 4,649 adults, broken down as follows: 2,095 Asian American and 2,554 Latino Americans. Three Asian-American groups served as the targets for the study and these were Chinese, Filipino, and Vietnamese. A separate Asian category included other Asian American groups. For the purposes of the study, the survey was presented in four Asian languages. Data collected included citizenship, migration status, residency, and ethnicity. Other data collected included housing unit information, socio-economic status, ethnicity, mental disorder status, discrimination experiences, perceived stress level, and mental health services usage. The surveys were administered using computer-assisted software via laptops, and some interviews were conducted by telephone.
Data Analysis, Results and Findings
Statistical analysis of the research included descriptives and correlations. The data was constructed from a 12-month prevalence of service use as computed for either of the four mental services types: any, formal, informal, and specialty. The 12-month prevalance descriptive included ratings for “mood/anxiety disorders, substance use and abuse disorders, intermittent explosive disorders, and eating disorders” (p. 25). Predictions of outcomes were then examined according to ethnicity. The correlations were used to assess relationships between variables, predictors and outcomes. Variables included “age, distress, discrimination, and acculturative stress” (p. 25), and these showed violations as it relates to perceived normalcy.
Results revealed from descriptive statistics included predictor variables for the entire sample of Asian Americans (2,095 individuals). The participant age range was 18 to 95 years. Results showed 11.7% of the sample reported positive mood/anxiety disorders within the last year, 1.3% of the sample had substance use disorders, 2.4% of the sample reported intermittent explosive disorder, and 1.6% of the sample had eating disorders. There was a low rating for past discrimination, acculturative stress and general distress. Only 6.3% of the sample reported they used a mental service in the past year for mood, nervousness or substance abuse, 86.3% of the sample used formal mental health services and 35.9% of them used informal services. Other results included increased age was related to lower education levels, lower rates of discrimination was related to lower substance abuse but higher stress levels and eating and mood disorderss, and higher education levels were related to increased English proficiency.
As reported in this thesis, the study highlights a need for further research as it pertains to help-seeking behavior among Asian Americans, especially as it relates to distress. This is particularly evident in patterns of mental health services utilization according to various forms of distress among ethnic subgroups. The study reports that past discrimination and English language insufficiency may present as significant barriers to help-seeking for mental health services among this group. The research concludes that under utilization of mental health services is more closely related to Asian subgroups instead of “a single, monolithic Asian American group” (p. 49). It is noted, interestingly enough, that the study found little need for implementing mental health services that were geared toward ethnic cultures or linguistics, but the need for service distinction was at the level of the ethnic subgroups. It is also noted that the research drew from previous research related to help-seeking behaviors for mental health services among Asian Americans and this is something that can be used for future research to draw upon. This thesis aimed at explaining the reasons for mental health disparities as it relates to help-seeking behaviors and underutilization of mental health services as a barrier to care for minority populations, particularly the population of Asian Americans/Pacific Islanders, and it reached its goal.
Opinion and Critique
Another influence on whether or not certain ethnic groups, such as the Asian Americans, make use of mental health services may be reactions they receive from their families, friends and the general population. In addition, how these people in their lives feel, in general, toward people who suffer from mental conditions may cause a potential mental health patient to stumble as it relates to help-seeking behaviors. What may make the difference in non-utilization of mental health services for certain individuals may be from what they perceive as the collective attitudes of other people. This type of thinking may very well discourage someone having mental health issues from seeking out profressional care for their condition. This may be particularly true with people from different cultures who may perceive mental illness as something to be ashamed of due to their cultural beliefs. Help-seeking behaviors from those who need professional mental health services can easily be influenced by society and this could serve as barriers to care because it may make someone too uncomfortable to get help. This would be a shame if someone was hindered from getting the help they needed because of the judgment of someone else. This is why awareness and education about this topic is so important.
This is an interesting topic, as it is likely that almost everyone knows of someone who has struggled with some type of mental health issue. However, this research brings to light information about the topic that many people may have not realized or taken for granted. Disparities among different demographic groups is a real issue in America and reading this thesis has shed some light on the plight of those who are mentally ill, in general, and of those in this ethnic group, specifically. The thesis is informative and very well-researched and well-written and very easy to understand.