Mental Health Service Use Types Among Asian Americans with a Psychiatric Disorder: Considerations of Culture and Need


Despite levels of need that are comparable with other groups, relatively few Asian Americans receive mental health care. While studies have described the tendency for Asian Americans to delay care until mental health symptoms are severe, relatively little research has examined how the severity of symptoms impact mental health service use. This study uses publicly available data from the National Latino and Asian American Study (NLAAS) and focuses solely on Asian American respondents with a psychiatric disorder (n = 230). Unexpectedly, few Asian Americans with a psychiatric disorder received care in a medical setting. The perception of mental health needs increased the likelihood of using mental health specialist care. Social and systemic barriers together hinder mental health service use. Implications for addressing Asian American mental health service use within a changing health care environment are discussed.

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  1. 1.

    Takeuchi DT, Zane N, Hong S, et al. Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health. 2007;97(1):84-90.

    PubMed  Article  PubMed Central  Google Scholar 

  2. 2.

    Abe-Kim J, Takeuchi DT, Hong S, et al. 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. 2007;97(1):91-98.

    PubMed  Article  PubMed Central  Google Scholar 

  3. 3.

    US Department of Health and Human Services. Mental health: Culture, race, and ethnicity - A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.

  4. 4.

    Nguyen, D. The effects of sociocultural factors on older Asian Americans’ access to care. Journal of Gerontological Social Work, 2012: 55(1), 55-71

    PubMed  Article  Google Scholar 

  5. 5.

    Nguyen D, Lee R. Asian immigrants’ mental health service use: An application of the life course perspective. Asian American Journal of Psychology, 2012:3(1), 53.

    Article  Google Scholar 

  6. 6.

    Jang M, Lee E, Woo, K. Income, language, and citizenship status: Factors affecting the health care access and utilization of Chinese Americans. Health and Social Work. 1998;23(2).

  7. 7.

    Loo C, Tong B, True R. A bitter bean: Mental health status and attitudes in Chinatown. Journal of Community Psychology. 1989;17(4):283-296.

    Article  Google Scholar 

  8. 8.

    New Freedom Commission on Mental Health. Achieving the promise: Transforming mental health care in America. Final report. Rockville, MD: DDHS Pub; 2003.

  9. 9.

    Kung WW. Chinese Americans' help seeking for emotional distress. Social Service Review. 2003;77(1),110-134.

    Article  Google Scholar 

  10. 10.

    Nguyen D, Shibusawa TS, Chen TC. Culturally competent mental health care for Asian Americans. Clinical Social Work Journal. 2011. doi: 10.1007/s10615-011-0356-z.

    Google Scholar 

  11. 11.

    Pescosolido BA, Boyer CA. How do people come to use mental health services? Current knowledge and changing perspectives. In: Horowitz AV, Scheid TL, eds. A handbook for the study of mental health: Social contexts, theories, and systems. New York: Cambridge University Press. 1999:392-411.

    Google Scholar 

  12. 12.

    Chen H, Kramer EJ, Chen T, et al. Engaging Asian Americans for mental health research: Challenges and solutions. Journal of Immigrant Health, 2005:7(2), 109-116.

    PubMed  Article  Google Scholar 

  13. 13.

    Nguyen D, Shibusawa T, Chen MT. The evolution of community mental health services in Asian American communities. Clinical Social Work Journal, 2012:40(2), 134-143.

    Article  Google Scholar 

  14. 14.

    Yeung A, Chang D, Gresham RL, et al. Illness beliefs of depressed Chinese American patients in primary care. The Journal of Nervous and Mental Disease. 2004;192(4):324-327

    PubMed  Article  Google Scholar 

  15. 15.

    Pescosolido BA, Wright ER, Alegria M, et al. Social networks and patterns of use among the poor with mental health problems in Puerto Rico. Medical Care 1998; 36(7):1057.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Alegría M, Pescosolido BA, Williams S, et al. Culture, race/ethnicity and disparities: Fleshing out the socio-cultural framework for health services disparities. In: Pescosolido BA, Martin, JK, McLeod JD, et al., eds. Handbook of the Sociology of Health, Illness, and Healing A Blueprint for the 21st Century. New York: Springer. 2011:363-382.

    Google Scholar 

  17. 17.

    Nguyen D, Lee R. Nativity and level of need: Toward an integrative view of Asian American mental health service use. Journal of Immigrant Health, 2013. doi: 10.1007/s10903-013-9812-x

  18. 18.

    Wang PS, Lane M, Olfson M, et al. Twelve-month use of mental health services in the United States results from the national comorbidity survey replication. Archives of General Psychiatry. 2005;62(6), 629-640.

    PubMed  Article  Google Scholar 

  19. 19.

    Alegria M, Takeuchi D, Canino G, et al. Considering context, place and culture: The National Latino and Asian American study. International Journal of Methods in Psychiatric Research, 2004: 13(4), 208-220.

    PubMed  Article  PubMed Central  Google Scholar 

  20. 20.

    Kessler RC, Üstün TB. The world mental health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). International Journal of Methods in Psychiatric Research. 2004;13(2):93-121.

    PubMed  Article  Google Scholar 

  21. 21.

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association. 1994.

  22. 22.

    Kessler RC, Demler O, Frank RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine. 2005;352(24):2515.

    PubMed  Article  CAS  PubMed Central  Google Scholar 

  23. 23.

    Sheehan DV. The Anxiety disease. New York: Scribner. 1983

    Google Scholar 

  24. 24.

    Rush JA, First MB, Blacker D. Handbook of Psychiatric Measures,Washington, DC: American Psychiatric Association. 2000.

  25. 25.

    Leong FTL, Lau ASL. Barriers to providing effective mental health services to Asian Americans. Mental Health Services Research. 2001:3(4):201-214.

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Snowden LR, Cheung FK. Use of inpatient mental health services by members of ethnic minority groups. The American Psychologist. 1990;45(3):347-355.

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Okazaki S. Treatment delay among Asian American patients with severe mental illness. American Journal of Orthopsychiatry. 2000;70(1):58-64.

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Kinzie JD, Tran KA, Breckenridge A, et al. An Indochinese refugee psychiatric clinic: Culturally accepted treatment approaches. American Journal of Psychiatry. 1980;137(11):1429-1432.

    PubMed  CAS  Google Scholar 

  29. 29.

    Buchwald D, Manson SM, Brenneman DL, et al. Screening for depression among newly arrived Vietnamese refugees in primary care settings. Western Journal of Medicine. 1995;163(4):341.

    PubMed  CAS  PubMed Central  Google Scholar 

  30. 30.

    Lin KM, Cheung F. Mental health issues for Asian Americans. Psychiatric Services. 1999;50(6):774-780.

    PubMed  CAS  Google Scholar 

  31. 31.

    Nguyen D. Acculturation and perceived mental health need among older Asian immigrants. Journal of Behavioral Health Sciences & Research. 2011;38(4):526-533.

    Article  Google Scholar 

  32. 32.

    Huang K, Carrasquillo O. The role of citizenship, employment, and socioeconomic characteristics in health insurance coverage among Asian subgroups in the United States. Medical Care. 2008;46:1093-1098.

    PubMed  Article  Google Scholar 

  33. 33.

    Chen HJ. Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services. Issues in Mental Health Nursing. 2005;26(10):1061-1079.

    PubMed  Article  Google Scholar 

  34. 34.

    Chen H, Kramer EJ, Chen T, et al. Engaging Asian Americans for mental health research: Challenges and solutions. Journal of Immigrant Health. 2005;7(2):109-116.

    PubMed  Article  Google Scholar 

  35. 35.

    Quijano LM, Stanley MA, Petersen NJ, et al. Healthy IDEAS: A depression intervention delivered by community-based case managers serving older adults. Journal of Applied Gerontology. 2007;26(2):139-156.

    Article  Google Scholar 

  36. 36.

    Kilo CM, Wasson JH. Practice redesign and the patient-centered medical home: History promises, and challenges Health Aff. (Millwood) 2010;29(5):773-778.

    Google Scholar 

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No conflict of interest exists in the current study.

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Correspondence to Duy Nguyen PhD.

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Nguyen, D., Bornheimer, L.A. Mental Health Service Use Types Among Asian Americans with a Psychiatric Disorder: Considerations of Culture and Need. J Behav Health Serv Res 41, 520–528 (2014).

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  • Mental Health
  • Mental Health Service
  • Mental Health Care
  • General Medical Service
  • Sheehan Disability Scale