Advertisement

American Journal of Community Psychology

, Volume 22, Issue 1, pp 83–99 | Cite as

Effects of combining disparate groups in the analysis of ethnic differences: Variations among asian american mental health service consumers in level of community functioning

  • Edwina S. Uehara
  • David T. Takeuchi
  • Michael Smukler
Article

Abstract

The Asian American population comprises historically, socially, and culturally diverse ethnic groups. Given this diversity, investigators caution that combining disparate ethnic groups together may lead to erroneous conclusions. Whether by choice or necessity, however, mental health studies still typically consider Asian Americans as a single ethnic category rather than as separate ethnic groups. Few investigations have addressed the consequences of this practice. This paper examines the implications of conceptualizing Asian Americans as an ethnic category versus ethnic groups, in an investigation of the community functioning status of clients in publicly funded mental health programs in King County, Washington. When treated as a single ethnic category in a multivariate linear regression model, Asian Americans are found to have a lower level of functioning difficulty than their white counterparts. However, when treated as separate ethnic groups (e.g., Vietnamese, Japanese), only one of five Asian ethnic groups has a significantly lower level of difficulty. In a separate analysis of the Asian American subsample, groups are found to differ significantly from one another with respect to functional status. Several factors, including refugee status, account for this difference.

Key Words

analysis of ethnic differences ethnic category vs. ethnic groups Asian Americans functional status refugee status 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Chan, S. (1991).Asian Americans: An interpretive history. Boston: Twayne.Google Scholar
  2. Cheung, F. K., & Snowden, L. R. (1990). Community mental health and ethnic minority populations.Community Mental Health Journal, 26(3), 77–291.CrossRefGoogle Scholar
  3. Chi, I., Lubben, J. E., & Kitano, H. H. L. (1989). Differences in drinking behavior among three Asian-American groups.Journal of Studies on Alcohol, 50(1), 15–23.PubMedGoogle Scholar
  4. Chung, R. C. Y., & Okazaki, S. (1991). Counseling Americans of Southeast Asian Descent: The impact of the refugee experience. In E. E. Lee & B. L. Richardson (Eds.),Multicultural issues in counseling: New approaches to diversity (pp. 107–126). Alexandria, VA: American Association for Counseling and Development.Google Scholar
  5. Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989).Towards a culturally competent system of care. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center.Google Scholar
  6. Drake, R. E., & Wallace, M. A. (1992). Mental patients' attraction to the hospital: correlates of living preference.Community Mental Health Journal, 28, 5–12.PubMedCrossRefGoogle Scholar
  7. Ellis, R. H., Wilson, N., & Foster, M. (1984). Statewide treatment outcome assessment in Colorado: The Colorado client assessment record (CCAR).Community Mental Health Journal, 20, 72–89.PubMedCrossRefGoogle Scholar
  8. Fabrega, H. (1969). Social psychiatric aspects of acculturation and migration: A general statement.Comprehensive Psychiatry, 10, 314–392.PubMedCrossRefGoogle Scholar
  9. Gibb, J. T., & Huang, L. (eds.). (1991).Children of color: Psychological interventions with minority youth. San Francisco: Jossey-Bass.Google Scholar
  10. Gold, S. (1992).Refugee communities: a comparative field study. Newbury Park, CA: Sage.Google Scholar
  11. Havassy, B. E., & Hopkin, J. T. (1989). Factors predicting utilization of acute psychiatric inpatient services by frequently hospitalized patients.Hospital and Community Psychiatry, 40, 820–823.PubMedGoogle Scholar
  12. Hazel, K. L., Herman, S. E., & Mowbray, C. R. (1991). Characteristics of, seriously mentally ill adults in a public mental health system.Hospital and Community Psychiatry, 42, 518–525.PubMedGoogle Scholar
  13. Huang, L. (1991). Southeast Asian refugee children and adolescents. In J. T. Gibbs & L. Huang (Eds.),Children of color: Psychological interventions with minority youth (pp. 278–321). San Francisco: Jossey-bass.Google Scholar
  14. Hurh, W. M., & Kim, K. C. (1988).Uprooting and adjustment: A sociological study of Korean immigrants' mental health. Macomb, IL: Department of Sociology and Anthropology, Western Illinois University.Google Scholar
  15. Jackson, J. (Ed.). (1991).Life in black America. Newbury Park, CA: Sage.Google Scholar
  16. Kessler, R., Price, R., & Wortman, C. (1985). Social factors in psychopathology: Stress, social support, and coping processes.Annual Review of Psychology, 36, 531–572.PubMedCrossRefGoogle Scholar
  17. Kim, S., McLeod, J., & Shantzis, C. (1992). Cultural competence for evaluators working with Asia-American communities: Some practical considerations. In M. Orlandi (Ed.),Cultural competence for evaluators: A guide for alcohol and other drug abuse prevention practitioners working with ethnic/racial communities. Washington, DC: U.S. Department of Health and Human Services, ADAMHA.Google Scholar
  18. Kitano, H. H. L., Hatanaka, H., Yeung, W. T., & Sue, S. (1985). Japanese-American drinking patterns. In L. A. Bennett and G. M. Ames (Eds.),Three American experience with alcohol. New York: Plenum Press.Google Scholar
  19. Kuo, W. (1976). Theories of migration and mental health: An empirical testing on Chinese Americans.Social Science and Medicine, 10, 297–306.CrossRefGoogle Scholar
  20. Kuo, W. (1984). Prevalence of depression among Asian Americans.Journals of Nervous and Mental Disorders, 172, 449–457.CrossRefGoogle Scholar
  21. Longres, J. (1991). Toward a status model of ethnic sensitive practice.Journal of Multicultural Social Work, 1(1), 41–55.CrossRefGoogle Scholar
  22. McLaughlin, D. G., Raymond, J. S., Murakami, S. R., & Goebert, D. (1987). Drug use among Asian Americans in Hawaii.Journal of Psychoactive Drugs, 19(1), 85–94.PubMedGoogle Scholar
  23. Michigan Department of Mental Health. (1988).Clients with serious mental illness: Characteristics and typology. Lansing, MI: Department of Mental Health.Google Scholar
  24. National Institute of Mental Health. (1991).Caring for people with severe mental disorders: A national plan of research to improve services (DHHS Publication No. ADM 91-1762). Washington, DC: U.S. Government Printing Office.Google Scholar
  25. Newman, F., Griffin, B. P., Black, R. W., & Page, S. E. (1989). Linking level of care to level of need: Assessing the need for mental health care for nursing home residents.American Psychologist, 44, 1315–1324.PubMedCrossRefGoogle Scholar
  26. O'Hare, W., & Felt, J. (1991).Asian Americans: America's fastest growing minority group. Washington, DC: Population Reference Bureau.Google Scholar
  27. Pandiani, J. A., Gordon, L. R., Wilson, S. F., & Carling, P. J. (1983).Statistical properties of the Vermont alternate care assessment: A technical report to the Vermont Department of Mental Health. Burlington: Department of Mental Health.Google Scholar
  28. Polissar, L., & Diehr, P. (1982). Regression analysis in health services research: The use of dummy variables.Medical Care, 20, 959–966.PubMedCrossRefGoogle Scholar
  29. Portes, A. (1984). The rise of ethnicity: Determinants of ethnic perceptions among Cuban exiles in Miami.American Sociological Review, 49, 383–397.PubMedCrossRefGoogle Scholar
  30. Rappaport, J. (1977).Community psychology: Values, research, and action, New York: Holt, Rinehart and Winston.Google Scholar
  31. Schmidt, L. (1992). A profile of problem drinkers in public mental health services.Hospital and Community Psychiatry, 43, 245–250.PubMedGoogle Scholar
  32. Schneider, C., & Struening, E. L. (1983). SLOF: A behavioral rating scale for assessing the mentally ill.Social Work Research and Abstracts, Vol: 9–21.Google Scholar
  33. Sue, D., & Sue, S. (1987). Cultural factors in the clinical assessment of Asian Americans.Journal of Consulting and Clinical Psychology, 55, 479–487.PubMedCrossRefGoogle Scholar
  34. Sue, S., Fujino, D., Hu, L., Takeuchi, D., & Zane, N. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis.Journal of Consulting and Clinical Psychology, 59, 533–540.PubMedCrossRefGoogle Scholar
  35. Sue, S., & McKinney, H. (1975). Asian Americans in the community mental health care system.American Journal of Orthopsychiatry, 45, 111–118.PubMedCrossRefGoogle Scholar
  36. Sue, S., & Morishima, J. (1982).The mental health of Asian Americans. San Francisco: Jossey-Bass.Google Scholar
  37. Suinn, R., Rickard-Figueroa, K., Lew, S., & Vigil, P. (1987). The Suinn-Lew Asian self-identity acculturation scale: an initial report.Educational and Psychological Measurements, 47, 401–407.Google Scholar
  38. Sutherland, J. E., Avant, R. F., Franz, W. B., Monzon, C. M., & Stark, N. M. (1983). Indo-Chinese refugee health assessment and treatment.Journal of Family Practice, 16, 61–67.PubMedGoogle Scholar
  39. Takaki, R. (1989).Strangers from a different shore. Boston: Little, Brown.Google Scholar
  40. Takaki, R. (1992).A different mirror; A history of multicultural America. Boston: Little, Brown.Google Scholar
  41. Uehara, E., Smukler, M., & Bates, R. (1992).Reliability, validity and appropriateness of the Problem Severity Summary Scales: Preliminary report. Seattle, WA: Community Psychiatric Clinic.Google Scholar
  42. Uehara, E., Smukler, M., & Newman, F. (in press). Linking resource use to consumer level of need in a local mental health system: Field test of the “LONCA” method.Journal of Consulting and Clinical Psychology.Google Scholar
  43. U.S. Bureau of the Census. (1988).We, the Asian and Pacific Islander Americans. Washington, DC: U.S. Government Printing Office.Google Scholar
  44. U.S. Bureau of the Census. (1991).1990 Census Profile No. 2: Race and Hispanic origin. Washington, DC: U.S. Government Printing Office.Google Scholar
  45. Vega, W., & Rumbaut, R. (1991). Ethnic minorities and mental health.Annual Review of Sociology, 17, 351–383.CrossRefGoogle Scholar
  46. Waters, M. (1990).Ethnic options: Choosing identities in America. Berkeley: University of California Press.Google Scholar
  47. Willer, B., & Guastaferro, J. R. (1989). Community living assessment for persons with severe and persistent mental illness.Community Mental Health Journal, 17, 267–276.Google Scholar
  48. Westermeyer, J., Vang, T. F., & Neider, J. (1983). A comparison of refugees using and not using a psychiatric service: An analysis of DSM-III criteria and self-rating scales in cross-cultural context.Journal of Operational Psychology, 14, 36–41.CrossRefGoogle Scholar
  49. Ying, Y. W. (1988). Depressive symptomatology among Chinese Americans as measured by the CES-D.Journal of Clinical Psychology, 44, 739–746PubMedGoogle Scholar
  50. Yoshioka, R. B., Tashima, N., Chew, M., & Murase, K. (1981).Mental health services for Pacific/Asian Americans. San Francisco: Pacific Asian Mental Health Research Project.Google Scholar
  51. Zane, N., Sue, S., Castro, F., & George W. (1982). Service system models for ethnic minority groups. In L. Snowden (Ed.),Services to the underserved (pp. 229–258). Los Angeles: Sage.Google Scholar
  52. Zane, N., Takeuchi, D., & Young, K. (Eds.). (1993).Confronting critical health issues of Asian and Pacific Islander Americans. Newbury Park, CA: Sage.Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Edwina S. Uehara
    • 1
  • David T. Takeuchi
    • 2
  • Michael Smukler
    • 3
  1. 1.University of WashingtonWashingtonUSA
  2. 2.University of California-Los AngelesUSA
  3. 3.Community Psychiatric ClinicWashington

Personalised recommendations