Clinical Social Work Journal

, Volume 40, Issue 2, pp 134–143

The Evolution of Community Mental Health Services in Asian American Communities

  • Duy Nguyen
  • Tazuko Shibusawa
  • Mouchuan Teddy Chen
Original Paper


This paper explores the history of Asian immigration to the United States, and its intersections with the mental health system. As mental health care have evolved since the 1960s from institutions to the community, public mental health services for Asian Americans have become increasingly culturally relevant. Major policy shifts, trends in immigration, and mental health practice will be presented with a focus on the Bridge Program at the Charles B. Wang Community Health Center. Integrative practice and research models that extend evidence-based knowledge to Asian American communities and practice implications are discussed.


Asian Americans Community mental health services Cultural competence Evidence based 


  1. Abe-Kim, J., Takeuchi, D. T., Hong, S., Zane, N., Sue, S., Spencer, M. S., et al. (2007). Use of mental health-related services among immigrant and US-born Asian Americans: Results from the National Latino and Asian American study. American Journal of Public Health, 97(1), 91.PubMedCrossRefGoogle Scholar
  2. Abe-Kim, J., Takeuchi, D., & Hwang, W. C. (2002). Predictors of help seeking for emotional distress among Chinese Americans: Family matters. Journal of Consulting and Clinical Psychology, 70(5), 1186–1190.PubMedCrossRefGoogle Scholar
  3. Alegría, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health, 97(1), 68.PubMedCrossRefGoogle Scholar
  4. Alegria, M., Perez, D. J., & Williams, S. (2003). The role of public policies in reducing mental health status disparities for people of color. Health Affairs, 22(5), 51–64.PubMedCrossRefGoogle Scholar
  5. Beiser, M. (1988). Influences of time, ethnicity, and attachment on depression in Southeast Asian refugees. American Journal of Psychiatry, 145(1), 46–51.PubMedGoogle Scholar
  6. Brown, C., Abe-Kim, J. S., & Barrio, C. (2003). Depression in ethnically diverse women: Implications for treatment in primary care settings. Professional Psychology: Research and Practice, 34(1), 10–19.CrossRefGoogle Scholar
  7. Centers for Disease Control. (2004). Leading causes of death by age group, Asian or Pacific Islander FemalesUnited States, 2004. Retrieved January 5, 2007 from
  8. Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.PubMedCrossRefGoogle Scholar
  9. Chen, J.-P., Chen, H., & Chung, H. (2002). Depressive disorders in Asian American adults. Western Journal of Medicine, 176(4), 239–244.PubMedGoogle Scholar
  10. Chen, T. M., Huang, F. Y., Chang, C., & Chung, H. (2006). Using the PHQ-9 for depression screening and treatment monitoring for Chinese Americans in primary care. Psychiatric Services, 57(7), 976.PubMedCrossRefGoogle Scholar
  11. Chen, S., Sullivan, N. Y., Lu, Y. E., & Shibusawa, T. (2003). Asian Americans and mental health services: A study of utilization patterns in the 1990 s. Journal of Ethnic & Cultural Diversity in Social Work, 12(2), 19–42.CrossRefGoogle Scholar
  12. Chow, J. C., Jaffee, K., & Snowden, L. R. (2003). Racial/ethnic disparities in the use of mental health services in poverty areas. American Journal of Public Health, 93(5), 792–797.PubMedCrossRefGoogle Scholar
  13. Chung, H. (2002). The challenges of providing behavioral treatment to Asian Americans. Western Journal of Medicine, 176(4), 222–223.PubMedGoogle Scholar
  14. Chung, I. W. (2008). Affective lexicons and indigenous responses: Social work practice with Chinese immigrant elders. China Journal of Social Work, 1(3), 237–247.CrossRefGoogle Scholar
  15. Chung, I. W. (2010). Changes in the socio-cultural reality of Chinese immigrants: Challenges and opportunities in help-seeking behavior. International Journal of Social Psychiatry, 56(4), 436–447.PubMedCrossRefGoogle Scholar
  16. Chung, H., Teresi, J., Guarnaccia, P., Meyers, B. S., Holmes, D., Bobrowitz, T., et al. (2003). Depressive symptoms and psychiatric distress in low income Asian and Latino primary care patients: Prevalence and recognition. Community Mental Health Journal, 39(1), 33–46.PubMedCrossRefGoogle Scholar
  17. Freeman, J. M. (1995). Changing identities: Vietnamese Americans 1975–1995. Boston: Allyn and Bacon.Google Scholar
  18. Gambrill, E. (2003). Evidence-based practice: Implications for knowledge development and use in social work. In A. Rosen & E. K. Proctor (Eds.), Developing practice guidelines for social work intervention: Issues, methods, and research agenda. New York: Columbia University Press.Google Scholar
  19. Gamst, G., Aguilar-Kitibutr, A., Herdina, A., Hibbs, S., Krishtal, E., Lee, R., et al. (2003). Effects of racial match on Asian American mental health consumer satisfaction. Mental Health Services Research, 5(4), 197–208.PubMedCrossRefGoogle Scholar
  20. Gamst, G., Dana, R. H., Der-Krabetian, A., & Kramer, T. (2001). Asian American mental health clients: Effects of ethnic match and age on global assessment and visitation. Journal of Mental Health Counseling, 23(1), 57–71.Google Scholar
  21. Grob, G. N. (1991). From asylum to community: Mental health policy in modern America. Princeton, NJ: Princeton University Press.Google Scholar
  22. Hankey, A. (2006). CAM and the phenomenology of pain. Evidence-Based Complementary and Alternative Medicine, 3(1), 139–141.PubMedCrossRefGoogle Scholar
  23. Harada, N. D., & Kim, L. S. (1995). Use of mental health services by older Asian and Pacific Islander Americans. In D. Padgett (Ed.), Handbook on ethnicity, aging, and mental health (pp. 185–202). Westport, CT: Greenwood Press.Google Scholar
  24. Hu, T. W., Snowden, L. R., Jerrel, J. M., & Nguyen, T. D. (1991). Ethnic populations in public mental health: Services choice and level of use. American Journal of Public Health, 81(11), 1429–1434.PubMedCrossRefGoogle Scholar
  25. Hu, T. W., Snowden, L. R., Jerrell, J. M., & Kang, S. H. (1993). Public mental health services to Asian American ethnic groups in two California counties. Asian American and Pacific Islander Journal of Health, 1(1), 79–90.Google Scholar
  26. Jenkins, C. N. H., Le, T., McPhee, S. J., Stewart, S., & Ha, N. T. (1996). Health care access and preventive care among Vietnamese immigrants: Do traditional beliefs and practices pose barriers? Social Science and Medicine, 43(7), 1049–1056.PubMedCrossRefGoogle Scholar
  27. Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., et al. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine, 352(24), 2515.PubMedCrossRefGoogle Scholar
  28. Kinzie, J. D., Tran, K. A., Breckenridge, A., & Bloom, J. D. (1980). An Indochinese refugee psychiatric clinic: Culturally accepted treatment approaches. American Journal of Psychiatry, 137(11), 1429–1432.PubMedGoogle Scholar
  29. Kitano, H. H., & Nakaoka, S. (2001). Asian Americans in the twentieth century. Journal of Human Behavior in the Social Environment, 3(3/4), 7–17.Google Scholar
  30. Kramer, E. J., Kwong, K., Lee, E., & Chung, H. (2002). Cultural factors influencing the mental health of Asian Americans. Western Journal of Medicine, 176(4), 227–231.PubMedGoogle Scholar
  31. Kroll, J., Habenicht, M., Mackenzie, T., Yang, M., Chan, S., Vang, T., et al. (1989). Depression and posttraumatic stress disorder in Southeast Asian refugees. American Journal of Psychiatry, 146(12), 1592–1597.PubMedGoogle Scholar
  32. Kung, W. W. (2003). Chinese Americans’ help seeking for emotional distress. Social Service Review, 77(1), 110–134.CrossRefGoogle Scholar
  33. Kushida, A. H., Montenegro, M., Chikahisa, P., & Morales, R. F. (1976). A training program for Asian and Pacific Islander Americans. Social Casework, 57(3), 185–194.Google Scholar
  34. Leong, F. T. L. (1994). Asian Americans’ differential patterns of utilization of inpatient and outpatient public mental health services in Hawaii. Journal of Community Psychology, 22(2), 82–96.CrossRefGoogle Scholar
  35. Leung, J. P. (1998). Emotions and mental health in Chinese people. Journal of Child and Family Studies, 7, 115–128.CrossRefGoogle Scholar
  36. Lin, K. M., & Cheung, F. K. (1999). Mental health issues for Asian Americans. Psychiatric Services, 50(6), 774–779.PubMedGoogle Scholar
  37. Mathews, C. A., Glidden, D., Murray, S., Forster, P., & Hargreaves, W. A. (2002). The effect on treatment outcomes of assigning patients to ethnically focused inpatient psychiatric units. Psychiatric Services, 53(7), 830–835.PubMedCrossRefGoogle Scholar
  38. Miranda, J., Nakamura, R., & Bernal, G. (2003). Including ethnic minorities in mental health intervention research: A practical approach to a long-standing problem. Culture, Medicine and Psychiatry, 27, 467–486.PubMedCrossRefGoogle Scholar
  39. Mui, A. C. (1996). Depression among elderly Chinese immigrants: An exploratory study. Social Work, 41, 633–645.PubMedGoogle Scholar
  40. Mui, A. C., & Shibusawa, T. (2008). Asian American elders in the twenty-first century: Key indicators of well-being. New York: Columbia University Press.Google Scholar
  41. Ngo, D., Tran, T. V., Gibbons, J. L., & Oliver, J. M. (2001). Acculturation, premigration traumatic experiences, and depression among Vietnamese Americans. Journal of Human Behavior in the Social Environment, 3, 225–242.CrossRefGoogle Scholar
  42. Office of Minority Health. (2007). Health status of Asian American and Pacific Islander women. Retrieved September 8, 2010 from
  43. Pang, K. Y. (1995). A cross-cultural understanding of depression among Korean immigrants: Prevalence, symptoms, and diagnosis. Clinical Gerontologist, 15(4), 3–20.CrossRefGoogle Scholar
  44. Phan, T. (2000). Investigating the use of services for Vietnamese with mental illness. Journal of Community Health, 25(5), 411–425.PubMedCrossRefGoogle Scholar
  45. Ranguram, R., Weiss, M. G., Channabasavann, S. M., & Devins, G. M. (1996). Stigma, depression, and somatization in South India. American Journal of Psychiatry, 153, 1043–1049.Google Scholar
  46. Shibusawa, T., & Chung, I. (2009a). Health of Asian American elderly. In M. Rey, C. Trin-Shevrin, & N. Islam (Eds.), Asian American communities and health: Context, research, policy and action (pp. 199–225). New York: Jossey Bass.Google Scholar
  47. Shibusawa, T., & Chung, I. (2009b). Wrapping and unwrapping emotions: Clinical practice with East Asian immigrant elders. Clinical Social Work Journal, 37(4), 312–319.CrossRefGoogle Scholar
  48. Shibusawa, T., & Mui, A. C. (2001). Stress, coping, and depression among Japanese American elders. Journal of Gerontological Social Work, 36(1–2), 63–81.Google Scholar
  49. Snowden, L. R., & Cheung, F. K. (1990). Use of inpatient mental health services by members of ethnic minority groups. American Psychologist, 45(3), 347–355.PubMedCrossRefGoogle Scholar
  50. Spencer, M. S., & Chen, J. (2004). Effect of discrimination on mental health service utilization among Chinese Americans. American Journal of Public Health, 94(5), 809–814.PubMedCrossRefGoogle Scholar
  51. Sue, S. (1977). Community mental health services to minority groups: Some optimism, some pessimism. American Psychologist, 59, 616–624.CrossRefGoogle Scholar
  52. Sue, S. (1999). Science, ethnicity, and bias: Where have we gone wrong? American Psychologist, 54(12), 1070–1077.PubMedCrossRefGoogle Scholar
  53. Sue, S. (2003). In defense of cultural competency in psychotherapy and treatment. American Psychologist, 58(11), 964–970.PubMedCrossRefGoogle Scholar
  54. Sue, S., Fujino, D. C., Hu, L. T., Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59(4), 533–540.PubMedCrossRefGoogle Scholar
  55. Takaki, R. (1993). A different mirror: A history of multicultural America. Boston: Little Brown and Co.Google Scholar
  56. Takeuchi, D. T., Sue, S., & Yeh, M. (1995). Return rates and outcomes from ethnicity-specific mental health programs in Los Angeles. American Journal of Public Health, 85(5), 638–643.PubMedCrossRefGoogle Scholar
  57. Takeuchi, D. T., Zane, N., Hong, S., Chae, D. H., Gong, F., Gee, G. C., et al. (2007). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health, 97(1), 84–90.PubMedCrossRefGoogle Scholar
  58. Thielke, S., Vannoy, S. D., & Unutzer, J. (2007). Integrating mental health and primary care. Primary Care: Clinics in Office Practice, 34, 571–592.PubMedCrossRefGoogle Scholar
  59. Tseng, W. (2009). Social, demographic, and cultural characteristics of Asian Americans. In C. Trinh-Shevrin, N. S. Islam, & M. J. Rey (Eds.), Asian American communities and health: Context, research, policy and action (pp. 23–49). San Francisco, CA: Jossey-Bass.Google Scholar
  60. US Census Bureau. (2002). The Asian Population: 2000. Retrieved September 19, 2003, from
  61. Williams, D. R., Haile, R., Gonzalez, H. M., Neighbors, H., Baser, R., & Jackson, J. S. (2007). The mental health of black Caribbean immigrants: Results from the National Survey of American Life. American Journal of Public Health, 97(1), 52.PubMedCrossRefGoogle Scholar
  62. Yee, B. W. K. (1997). The social and cultural context of adaptive aging among Southeast Asian elders. In J. Sokolovsky (Ed.), The cultural context of aging (pp. 293–303). Westport, CT: Greenwood Press.Google Scholar
  63. Ying, Y., & Hu, L. (1994). Public outpatient mental health services: Use and outcome among Asian Americans. American Journal of Orthopsychiatry, 64(3), 448–455.PubMedCrossRefGoogle Scholar
  64. Zane, N., Enomoto, K., & Chun, C. A. (1994). Treatment outcomes of Asian- and White- American clients in outpatient therapy. Journal of Community Psychology, 22, 177–191.CrossRefGoogle Scholar
  65. Zane, N., & Hatanaka, H. (1994). Ethnic-specific mental health services: Evaluation of the parallel approach for Asian–American clients. Journal of Community Psychology, 22, 68–81.CrossRefGoogle Scholar
  66. Zane, N., & Sue, S. (1991). Culturally responsive mental health services for Asian Americans: Treatment and training issues. In H. Myers, P. Wohlford, & P. Guzman (Eds.), Ethnic minority perspectives on clinical training and services in psychology (pp. 49–58). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  67. Zhou, M., & Gatewood, J. V. (2000). Contemporary Asian America: A multidisciplinary reader. New York: New York University Press.Google Scholar
  68. Ziguras, S., Klimidis, S., Lewis, J., & Stuart, G. (2003). Ethnic matching of clients and clinicians and use of mental health services by ethnic minority clients. Psychiatric Services, 54(4), 535–541.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Duy Nguyen
    • 1
  • Tazuko Shibusawa
    • 1
  • Mouchuan Teddy Chen
    • 2
  1. 1.Silver School of Social WorkNew York UniversityNew YorkUSA
  2. 2.Mental Health Bridge ProgramCharles B. Wang Community Health CenterNew YorkUSA

Personalised recommendations