A bitter bean: Mental health status and attitudes in chinatown

Abstract

This interview sample survey of adult residents of San Francisco's Chinatown was conducted in an effort to understand the phenomenon of underutilization of mental health services by Chinese Americans and the reasons underlying this phenomenon. Findings revealed that the use rate of mental health services was extremely low, with only 5% of respondents having sought mental health services, suggesting that this ethnic community has not yet seen the gains promised by the community mental health movement. At the same time, reported psychological disorders in the community were quite prevalent; a sizable number of respondents admitted to symptoms of emotional tension, depression, loneliness, and psychological‐physiological symptoms. Thus, need is high, but demand is small. Findings suggested that underutilization is not due to unwillingness to admit to symptoms nor to use of alternative cultural sources of help; rather, lack of knowledge of existing services seems to be a major contributor to low use rates. Other contributing factors include the belief among some respondents that mental disorders cannot be prevented, lack of awareness of how psychological problems can be treated, and a low priority attached to seeking professional help for depression. Compared to other low‐income Americans, Chinatown residents demonstrated more determination than resignation in handling personal problems. Moreover, approaches to handling problems were varied and often multiple in nature. The survey confirmed some existing notions about mental health among Asian Americans, while disconfirming other assumptions.

Mental Health Stigma, Self-Concealment, and Help-Seeking Attitudes among Asian American and European American College Students with No Help-Seeking Experience

“…One potential factor may be knowledge, or lack of knowledge, of available services: it is possible that help-seeking attitudes were influenced by whether or not students in the sample knew about the university's counseling services or other similar services, how to access such services, and whether those services were affordable. Although knowledge about services does not necessarily lead to actual help-seeking behavior, previous studies have shown that lack of knowledge is likely to prevent an individual from seeking services (Bram 1997;Loo et al 1989;Yorgason et al 2008). Therefore, counseling center outreach programs may be more effective if focused not just on reducing mental health stigma or overcoming greater selfconcealment, but also on providing basic information about what services are available and how to access them.…”

Help-Seeking Experiences and Attitudes among African American, Asian American, and European American College Students

“…In other cultural contexts, even when a person experiences severe psychological struggles, seeking mental health services is not even recognized as an option. Therefore, it seems crucial for service providers to acknowledge and work accordingly in light of the fact that, in some socio-cultural contexts, mental health service utilization is not an established cultural practice (Loo et al 1989) and that service underutilization is not simply due to negative images (e.g., stigma or shame) associated with mental illness or mental health services.…”

Stress, Coping, and Depression Among Elderly Korean Immigrants

“…Despite substantial prevalence rates, symptoms of depression often go unrecognized, undiagnosed, and untreated due to patient-and health-care-related barriers and problems in the organization and financing of mental health services for older adults, especially minority elders (Gottlieb, 1991). Studies (Loo, Tong, & True, 1989;Snowden & Cheung, 1990) also suggest that minority elders and immigrants tend to underutilize mental health services, even though the prevalence and types of reported psychological disorders were similar to those in the white population. Depressive symptoms do not tend to remit spontaneously in older adults (Allen & Blazer, 1991), and undiagnosed and untreated depression in late life usually cause tremendous distress for older adults, their families, and society.…”