ABSTRACT
Understanding culture's impact on mental health and its treatment is extremely important, especially in light of recent reports highlighting the realities of health disparities and unequal treatment. This article provides a conceptual paradigm for understanding how culture influences six mental health domains, including (a) the prevalence of mental illness, (b) etiology of disease, (c) phenomenology of distress, (d) diagnostic and assessment issues, (e) coping styles and help-seeking pathways, and (f) treatment and intervention issues. Systematic interrelationships between each of these domains are highlighted and relevant literature is reviewed. Although no one model can adequately capture the complex facets of culture's influence on mental health, the Cultural Influences on Mental Health (CIMH) model serves as an important framework for understanding the complexities of these interrelationships. Implications for clinical research and practice are discussed.
Subject(s)
Cross-Cultural Comparison , Emigrants and Immigrants/psychology , Ethnicity/psychology , Mental Disorders/ethnology , Patient Acceptance of Health Care , Cross-Sectional Studies , Ethnicity/ethnology , Female , Health Services, Indigenous , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/psychology , Mental Disorders/therapy , Patient Care Team , Risk Factors , Sex Factors , Social Values , Somatoform Disorders/epidemiology , Somatoform Disorders/ethnology , Somatoform Disorders/psychology , Somatoform Disorders/therapyABSTRACT
OBJECTIVES: We examined rates of mental health-related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors. METHODS: Data were derived from the National Latino and Asian American Study (2002-2003). RESULTS: About 8.6% of the total sample (n=2095) sought any mental health-related services; 34.1% of individuals who had a probable diagnosis sought any services. Rates of mental health-related service use, subjective satisfaction, and perceived helpfulness varied by birthplace and by generation. US-born Asian Americans demonstrated higher rates of service use than did their immigrant counterparts. Third-generation or later individuals who had a probable diagnosis had high (62.6%) rates of service use in the previous 12 months. CONCLUSIONS: Asian Americans demonstrated lower rates of any type of mental health-related service use than did the general population, although there are important exceptions to this pattern according to nativity status and generation status. Our results underscore the importance of immigration-related factors in understanding service use among Asian Americans.
Subject(s)
Asian/psychology , Mental Disorders/ethnology , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Adolescent , Adult , Age Factors , Aged , Asian/statistics & numerical data , China/epidemiology , Emigration and Immigration , Female , Health Services Needs and Demand , Humans , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Philippines/ethnology , Residence Characteristics , United States/epidemiology , Vietnam/ethnologyABSTRACT
Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored.
